In a new research paper aiming to better understand the resilience of health capacities in crisis situations, experts from the Faculty of Health Sciences (FHS) at the American University of Beirut – Faculty of Health Sciences, Graduate Public Health Program (AUB), the Institute for Global Health and Development at Queen Margaret University (QMU), and the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) conducted jointly a research studying the resilience of health systems in countries hosting Palestinian refugees fleeing the Syrian conflict.
The research focused on three main themes:
Under this theme, researchers explored key issues such as organizational mission and the service delivery, the effectiveness of the logistical responsiveness in mitigating the impact of the crisis, funds mobilization, and health systems reforms.
The paper also addressed the impact of the crisis on UNRWA resources, the limitations of the policies in place regarding access to healthcare, and the actions taken in this regard to sustain medicine supply and enhance service delivery capacity.
As the conflict in the region showed no sign of abating and as displaced Palestinian refugees coming from Syria started to settle in host countries, UNRWA systems had become the principal custodians. In order to deal with this new situation, UNRWA introduced new systems to improve registration processes, while it bolstered advocacy efforts to establish effective partnerships with various stakeholders throughout the region.
The results found that the UNRWA systems in Lebanon and Jordan were broadly resilient, deploying diverse strategies to address health challenges and friction between host and refugee populations.
Researchers completed 62 semi-structured interviews (30 in Lebanon in November–December 2016, and 32 in Jordan in January 2017) with professionals at primary care, area, and country management levels. Participants reflected on changes in population health status and health service delivery during the Syrian crisis, notably with respect to the influx of refugees from Syria. Interviews were analyzed through inductive thematic analysis and used to critically interrogate health systems resilience against a pro-capacities framework.
Resilience is increasingly recognized as a key process mitigating the impact of shocks and stressors on functioning. The literature on individual and community resilience is being extended to address characteristics of resilient service delivery systems in contexts of adversity. The validity and utility of a capacity-oriented resilience framework (including absorption, adaptation and transformation) is examined in this paper with respect to the functioning of UNRWA health systems in Lebanon and Jordan in the context of the Syrian crisis.
While the study adds to the limited literature on health system and organizational resilience and indicates that capacity-oriented framings of resilience are valuable in extracting generalizable lessons for health systems facing adversity.