Conflict-Related Population Health Research in Syria, 2011-2019: An Assessment of Information Gaps, Research Needs and Challenges, for The Lancet - AUB Commission on Syria

Abstract

Backgorund. While there has been a growth of research on health and the Syrian conflict, most such research covers Syrian refugees. There is limited information about the scope and focus of research on health and population inside Syria. While there are several systemtic and scoping literarure reviews of health of Syrian refugees, there has not been a sccoping review of research literature on health issues inside Syria. Methods. As part of a broader scoping review covering January 2011 to December 2019, we examined English-language conflict-related research papers that studied health issues inside Syria and focused on Syrians or those permanently resident in Syria. We classified research articles based on the major thematic areas studied. We abstracted bibliometric information, study characteristics, funding statements and reported key limitations and challenges of conducting research. To gain additional insights or data, we examined separately publications reporting field and operational activities as well as personal reflections and narrative accounts of first-hand experiences inside Syria. Results. Of 2,088 papers identified in the scoping review, 708 (34%) exclusively focus on health issues of Syrians inside Syria, of which 350 (49%) are conflict-related with. Of conflict-related publications, 89 (25%) are research papers. Annual volume of research increased over time, from one publication in 2013 to 27 publications in each of 2018 and 2019. Damascus is the most frequently studied governorate (n=33), followed by Aleppo (n=25). Papers used a wide range of research methodologies, primarily quantitative (n=68). The country of institutional affiliation(s) of first and last authors are Syria (n=30, 20 respectively), the United States (n=25, 19 respectively) or the United Kingdom (n=12, 10 respectively). Themes most covered were health status, health system and humanitarian assistance, response or needs (n=38, 32, 26 respectively). Thirty one publications presented field and operational activities and eight publications were reflections or first-hand personal accounts of experiences inside Syria. Authors encountered contextual, methodological and administrative challenges in doing research on health inside Syria. Conclusions. Although it is commonly stated that Syria is among the most documented of recent wars, our analysis shows that a relatively limited number of research studies focused on health or populations inside Syria have been published over the nine years of the conflict. Beyond the need to increase the volume of research, it is important to address the knowledge gaps identified in this review.

Medical Research Conduct and Publication During Higher Education in Syria: Attitudes, Barriers, Practices, and Possible Solutions

“…Research contribution by postgraduates of the different Syrian universities was similar in the current study, which was a remarkable improvement from the article published in 2011 which had reported that more than half of the Syrian publications had originated from Damascus University (10). This nding was supported as well by a recent review of the published articles from the different Syrian cities (17).…”

“…Starting in 2011, Syria has also had a decade-long war that severely crippled its healthcare system. This created an unfortunate, yet an important opportunity and need, for research in healthcare (17). Many facets now require further study and analysis, including the effects of lack of medicines and healthcare services accessibility, the spread of endemic diseases, and the war-related injuries.…”

Medical education in Syria at a time of crisis: Analysis of the results of the knowledge‐based National Medical Examination

“…11 The impact of this crisis on medical education in Syria has not been studied satisfactorily as most existing reports were merely descriptive studies of certain aspects of the calamity. 3,12,13 Therefore, there is a need for a quantitative and comparative analyses of the academic performance of medical students across different universities and time periods in Syria. Such analyses may provide valuable insights into the challenges and opportunities for improving medical education in Syria and other countries facing similar crises.…”

“…The health workforce capacity has been unevenly distributed across different specialties and areas of need, because of factors such as the destruction of the health care infrastructure, the overload of the system, the scarcity of job opportunities, the financial hardships, and the loss of many educators, doctors, and health care workers 11 . The impact of this crisis on medical education in Syria has not been studied satisfactorily as most existing reports were merely descriptive studies of certain aspects of the calamity 3,12,13 . Therefore, there is a need for a quantitative and comparative analyses of the academic performance of medical students across different universities and time periods in Syria.…”