Health and Health Seeking in Mosul During ISIS Control and Liberation: Results From a 40-Cluster Household Survey

Lafta, Riyadh; Cetorelli, Valeria; Burnham, Gilbert

doi:10.1017/dmp.2019.11

Cited by 10 publications

(5 citation statements)

References 16 publications

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“…A plethora of further analyses showed that refugee children are at particular risk for diseases such as depression, infections, or poorly managed chronic diseases [4,5,6,7]. We and others previously identified children arriving in Europe during the current crisis to be particularly vulnerable to physical trauma and infectious diseases during their flight [8,9,10,11,12,13]. Besides psychological and physical trauma during displacement, malnutrition, poor hygiene, and overcrowded living conditions further add to the particular risk of refugee children for increased morbidity [1,14].…”

Section: Introductionmentioning

confidence: 99%

Pediatric Healthcare Utilization in a Large Cohort of Refugee Children Entering Western Europe During the Migrant Crisis

Happle

Dopfer

Ernst

et al. 2019

IJERPH

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Background: Currently, half of the population displaced worldwide is children and adolescents. Little is known on healthcare demand in underage migrants. Materials and Methods: We analyzed healthcare utilization in n = 1.411 children and adolescents living in a large German refugee reception in 2015-2016. Results: The mean age of all included refugees was 9 years (60.8% male). The majority came from the eastern Mediterranean region. During a mean camp inhabitance of 34 days, 57.6% needed primary healthcare, with a significant inverse correlation of healthcare seeking frequency with age and duration of camp inhabitance. Infants and unaccompanied minors displayed particular high demands for medical help. Discussion: Our analysis showed that pediatric primary healthcare in pediatric and adolescent refugees are most sought during the first period upon arrival with particular demand in infants, toddlers, and unaccompanied minors. Based on this data, future care taking strategies should be adapted accordingly.

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Section: Introductionmentioning

confidence: 99%

Pediatric Healthcare Utilization in a Large Cohort of Refugee Children Entering Western Europe During the Migrant Crisis

Happle

Dopfer

Ernst

et al. 2019

IJERPH

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“…Supply chains were interrupted. Some people hesitated to attend the remaining functional PHCCs as they doubted the medicines they might need would be present, or feared encounters with Al Hesba , the religious police [ 19 ]. Where services were able to adapt, there was usually a strong cohesion between communities and health facilities and committed health staff.…”

Section: Discussionmentioning

confidence: 99%

Resilience of health systems in conflict affected governorates of Iraq, 2014–2018

Ibrahim¹,

Al-Dahir

Mulla³

et al. 2021

Confl Health

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Objectives The objective of this study was to assess the resilience of health systems in four governorates affected by conflict from 2014 to 2018, and to convey recommendations. Methods Health managers from Al Anbar, Ninawa, Salah al-Din, and Kirkuk governorates discussed resilience factors of Primary Health Care services affected by the 2014–2017 ISIS insurgency in focus groups, and general discussions. Additional information was gathered from key informants and a UNICEF health facility survey. Three specific aspects were examined: (1) meeting health needs in the immediate crisis response, (2) adaptation of services, (3) restructuring and recovery measures. Data from a MoH/UNICEF national health facility survey in 2017 were analyzed for functionality. Results There were many common themes across the four governorates, with local variations. (1) Absorption The shock to the public sector health services by the ISIS invasion caught health services in the four governorates unprepared, with limited abilities to continue to provide services. Private pharmacies and private clinics in some places withstood the initial shock better than the public sector. (2) Adaptation After the initial shock, many health facilities adapted by focusing on urgent needs for injury and communicable disease care. In most locations, maternal, neonatal, and child health (MNCH) preventive and promotive PHC services stopped. Ill persons would sometimes consult health workers in their houses at night for security reasons. (3) Restructuring or transformative activities In most areas, health services recovery was continuing in 2020. Some heavily damaged facilities are still functioning, but below pre-crisis level. Rebuilding lost community trust in the public sector is proving difficult. Conclusion Health services generally had little preparation for and limited resilience to the ISIS influx. Governorates are still restructuring services after the liberation from ISIS in 2017. Disaster planning was identified by all participants as a missing component, as everyone anticipated future similar emergencies.

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“…Some people hesitated to attend the remaining functional PHCCs as they doubted medicines they might need would be present, or feared encounters with Al Hesba the religious police. [18] Where services were able to adapt, there was usually a strong cohesion between communities and health facilities and committed health staff. Some patient consultations took place in the evenings at the homes of health workers, where people felt safer.…”

Section: Discussionmentioning

confidence: 99%

Resilience of Health Systems in Conflict Affected Governorates of Iraq, 2014-2018

Ibrahim¹,

Al-Dahir

Al-Mulla

et al. 2021

Preprint

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ObjectivesThe objective of this study was to assess the resilience of health services in four governorates affected by conflict from 2014-2018, and to convey recommendations.MethodsHealth managers from Al Anbar, Ninawa, Salah-al-din, and Kirkuk governorates assessed resilience factors of Primary Health Care services affected by the 2014-2017 ISIS insurgency. Additional information was gathered from key informants and a health facility Unicef survey. Three specific aspects were examined: 1) meeting health needs in the immediate crisis response, 2) adaptation of services, 3) restructuring and recovery measures. Data from and MoH/UNICEF national health facility survey were 2017-2019 analyzed for functionality.FindingsThere were many common themes across the four governorates, with local variations.1. Absorption. The shock to the public sector health services by the invasion by ISIS caught the in the four governorates unprepared, with limited abilities to continue to provide services. Pharmacies and private clinics sometimes withstood the initial shock better. 2. Adaptation. After the initial shock, many health facilities adapted by focused on urgent needs for injury and communicable disease care. In most locations, maternal, neonatal, and child health (MNCH) preventive and promotive services stopped. Ill persons would sometimes consult health workers in their houses at night for security reasons. 3. Restructuring or transformative activities. In most areas, health services restructuring was continuing in 2020. Some heavily damaged facilities are still functioning below pre-crisis level, with reduced service availability. Rebuilding lost community trust in the public sector is proving difficult, though in some communities, trust remained strong.ConclusionHealth services generally had little preparation and limited resilience to the ISIS influx. Governorates are, in places, still restructuring services after the liberation from ISIS in 2017. Disaster planning was identified by all participants as a missing component, as managers anticipated future emergencies.

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Health and Health Seeking in Mosul During ISIS Control and Liberation: Results From a 40-Cluster Household Survey

Cited by 10 publications

References 16 publications

Pediatric Healthcare Utilization in a Large Cohort of Refugee Children Entering Western Europe During the Migrant Crisis

Pediatric Healthcare Utilization in a Large Cohort of Refugee Children Entering Western Europe During the Migrant Crisis

Resilience of health systems in conflict affected governorates of Iraq, 2014–2018

Resilience of Health Systems in Conflict Affected Governorates of Iraq, 2014-2018

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