The quality of Syrian healthcare services during COVID-19: A HEALTHQUAL approach

Allahham, Lilas; Mouselli, Sulaiman; Jakovljević, Mihajlo

doi:10.3389/fpubh.2022.970922

Cited by 10 publications

(12 citation statements)

References 46 publications

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“…This justi able approach in prioritizing only the most severe cases for admission cancelled or signi cantly delayed the possibility of hospitalizing less critical cases 21 . Private care was also out of the reach of the vast majority of the patients due to the collapsed economy 13,34 . Similar scenarios were reported in countries with similar dramatic deterioration of the socioeconomic situation, such as the neighbor Lebanon 10 .…”

Section: Discussionmentioning

confidence: 99%

Could home management of COVID-19 cases alleviate strain on the fragile healthcare system in Damascus, Syria: a prospective cohort study

Alsalkini,

Hanafi,

Alkhaledi

et al. 2023

Preprint

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The global impact of COVID-19 was devastating, particularly in low-income countries. Conflict zones like Syria, already plagued by political and socioeconomic instability, faced additional hardships, resulting in a fast collapse of the healthcare system. The overwhelmed system necessitated the implementation of home-based management as a practical solution to alleviate strain on hospitals. This study documents the efforts of a volunteer team during the initial COVID-19 wave in Damascus, Syria (August-September 2020) in implementing management through home visits and evaluates its outcomes in terms of recovery, hospitalization, and mortality. Out of the managed 770 moderate and severe cases, approximately 80% reported full or partial recovery from COVID-19, with only 6.6% experiencing persistently low peripheral blood oxygen levels at follow-up. Nonetheless, 28.6% of patients necessitated hospitalization, 14.5% were admitted to intensive care units, and 15.3% died. Age, masculinity, and cardiac comorbidities were associated with a higher need for oxygen support and led to higher hospitalization and mortality rates. This approach effectively steered most patients toward recovery and facilitated the timely identification and management of critical cases until their transition to hospital care when capacities allowed, proving to be a pivotal asset to the healthcare system in the face of such challenging circumstances.

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Section: Discussionmentioning

confidence: 99%

Could home management of COVID-19 cases alleviate strain on the fragile healthcare system in Damascus, Syria: a prospective cohort study

Alsalkini,

Hanafi,

Alkhaledi

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…fragmented, health systems have limited capacity, and insecurity and violence threaten response efforts. In Syria, COVID-19 research is relatively limited, especially related to the experiences and practices of ordinary Syrians that can play a significant role in mitigating transmission in areas with minimal governance or local authority support [20][21][22][23]. The COVID-19 pandemic has exacerbated ongoing socioeconomic challenges [14,24].…”

Section: Plos Onementioning

confidence: 99%

“They cannot afford to feed their children and the advice is to stay home. How‥?”: A qualitative study of community experiences of COVID-19 response efforts across Syria

et al. 2022

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Introduction COVID-19 highlighted the importance of meaningful engagement between communities and health authorities. This is particularly challenging in conflict-affected countries such as Syria, where social protection and food security needs can hinder adherence to non-pharmaceutical interventions (NPIs) and vaccine uptake. This study explored community perspectives of COVID-19 and health authority responses across the three main areas of control in Syria, i.e. Syrian government-controlled areas (GCA), autonomous administration-controlled areas (AACA), and opposition-controlled areas (OCA). Methods We conducted a qualitative study, interviewing 22 purposively-sampled Syrians accessing health services in AACA, GCA, or OCA in 2021 to provide approximately equal representation by governance area and gender. We analysed data thematically using deductive and inductive coding. Findings Interviewees in all areas described how their fears of COVID-19 and willingness to adhere to NPIs decreased as their local COVID-19 epidemics progressed and NPIs disrupted access to household essentials such as work and food. Community-level responses were minimal and ad hoc, so most people focused on personal or household protective efforts and many mentioned relying on their faith for comfort. Misinformation and vaccine hesitancy were common in all areas, linked to lack of transparency from and mistrust of local health authorities and information sources. Conclusions The COVID-19 pandemic has increased health actors’ need to engage with communities to control disease spread, yet most NPIs implemented in Syria were inappropriate and adherence decreased as the pandemic progressed. This was exemplified by lockdowns and requirements to self-isolate, despite precarious reliance on daily wages, no subsidies for lost income, individual self-reliance, and mistrust/weak communication between communities and health authorities. We found minimal community engagement efforts, consisting entirely of informing with no efforts to consult, involve, collaborate, or empower. This contributed to failures of health actors to contextualise interventions in ways that respected community understandings and needs.

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“…However, public hospitals began to decline throughout the war due to destruction, emigration of HCWs, bad working conditions, and significant financial constraints. [8] HCWs have experienced various psychological issues throughout this pandemic, including depression, mental distress, anxiety, and poor sleep quality. Moreover, during the COVID-19 pandemic, increased levels of obsessive-compulsive disorder symptoms were seen among HCWs.…”

Section: Introductionmentioning

confidence: 99%

Health-care provider burnout in Syria during COVID-19 pandemic’s Omicron wave

et al. 2022

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Health-care workers (HCWs) have dealt with various psychological problems during the COVID-19 epidemic, including sadness, mental discomfort, anxiety, and poor sleep. Burnout is a state of prolonged work-related psychological, emotional, and physical stress brought on by emotional weariness, depersonalization, and decreased professional success. This study aimed to determine how many HCWs burned out during the Omicron wave of the COVID-19 pandemic and determine what factors put them at risk for this psychological effect. This cross-sectional research was performed in Syria during the current Omicron wave of the COVID-19 pandemic to evaluate the burnout experienced by Syrian physicians who treat COVID-19 patients. The inclusion criteria were all Syrian HCWs who treated COVID-19 patients during the current Omicron wave of COVID-19. The data was collected between April 3 and March 20, 2022. We investigated whether the questionnaire used was valid and understandable to the participants. A total of 729 health-care providers were inquired in our study; however, 30 participants were disqualified because their answers were not fully completed. The overall age of the participants was 31 ± 9, and the ratio of males to females was almost equal. The majority (47.5%) of the sample study’s participants are residents, and 72.8% who cared for COVID-19 patients. The prevalence of high levels of burnout in the sample study was 41.6%. Compared to men (22.3%), women were much more likely (27.9%) to report experiencing a high degree of emotional exhaustion; also, the participants who cared for COVID-19 patients were much more likely (30.1%) to report experiencing a high degree of emotional exhaustion compared to others, which individuals who cared for COVID19 patients were 1.76 times more likely than participants who did not care for COVID19 patients to experience severe burnout (odds ratio: 1.766, 95% confidence interval:1.2–2.4, P value < .001). Our research found severe burnout among Syrian health-care providers during the omicron wave of COVID-19, with clinicians caring for COVID-19 patients being considerably more likely to express high burnout than others.

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The quality of Syrian healthcare services during COVID-19: A HEALTHQUAL approach

Cited by 10 publications

References 46 publications

Could home management of COVID-19 cases alleviate strain on the fragile healthcare system in Damascus, Syria: a prospective cohort study

Could home management of COVID-19 cases alleviate strain on the fragile healthcare system in Damascus, Syria: a prospective cohort study

“They cannot afford to feed their children and the advice is to stay home. How‥?”: A qualitative study of community experiences of COVID-19 response efforts across Syria

Health-care provider burnout in Syria during COVID-19 pandemic’s Omicron wave

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