10 years of the Syrian war had a devastating effect on all aspects of the Syrian lives, millions of refugees and displaces people, enormous destruction in the infrastructure, and the worst economic crisis Syria has ever faced. This literature review aims to review all the literature written on health in Syria during the ten years of war and to summarize – within one study – all aspects of health for the Syrian population. This review focused on the direct and indirect consequences of the Syrian war over public health, reviewing, summarizing, and categorizing all the available articles and data, which makes it up-to-date research that can be of great importance for any plan to rebuild the health system in Syria.
Syria's healthcare facilities and workers have been directly affected by the conflict and violence. According to the non-governmental organization "Physicians for Human Rights (PHR)", 382 attacks on medical facilities occurred between March 2011 and June 2016, killing 757 medical personnel. These attacks have destroyed the public health system, resulting in serious population health consequences such as an increase in infectious and non-communicable disease risks, serious maternal and child health challenges, conflict-related trauma, and mental health issues, as well as the exodus of Syrian healthcare workers who are seeking to flee the conflict.
Due to the conflict, aid workers and medical suppliers have found it difficult to reach civilians, particularly IDPs in informal camps scattered across the country or in besieged areas such as Aleppo. Moreover, there have been many attacks on the health facilities operating in Syria from different sides, which further complicated the healthcare access for the population inside Syria. Syria's health system provided high-quality care prior to the war, however, according to the OCHA, only 64% of hospitals and 52% of primary health-care centers in the country were operational by the end of 2019, at a very low functioning percentage comparing to there function before the war, and the drugs industry have collapsed.
Table of Contents
Introduction
Aim of the research
Objectives
Research questions
Methods
Search strategy
Results of the search
Thematic analysis
Syrian health system before the war
Current health status for the population inside Syria
1- Under opposition control
2- Under governmental control
Health status for the Syrian refugees
1- Refugees in Turkey
2- Refugees in Lebanon
3- Refugees in Jordan
4- Refugees in Europe
5- Refugees in other countries
Public health indicators of the Syrian population
1- Mental health
2- Maternal and children health
3- Oral health
4- Non-communicable diseases
5- Infectious and communicable diseases
6- Occupational health and healthcare providers situation
7- Health system in Syria during COVID-19 pandemic
The future of the health system in Syria
Conclusion
Acknowledgments
References
Research Objectives and Key Themes
This study aims to synthesize existing literature on the health status of the Syrian population—both internally displaced and refugees—to provide a comprehensive overview of the public health consequences of the decade-long war and identify potential strategies for systemic reconstruction.
- Impact of the Syrian war on health infrastructure and service delivery
- Mental health, maternal/child health, and communicable/non-communicable disease prevalence
- Healthcare challenges and disparities for refugees in host countries (Turkey, Lebanon, Jordan, Europe)
- Strategic recommendations for rebuilding the Syrian health system, including informatics and human resource management
Excerpt from the Book
Syrian health system before the war
Just before the war, the health service in Syria consisted primarily of a public system run by the government that provided primary care, with the private sector located in the big cities providing the majority of developed health services and advanced care, and over the last three decades, improvement has been made for the health system capacity which rapidly improved the national health indicators such as a falling infant mortality rate and an increased child immunization rate. Furthermore, the drug industry grew gradually, and Syria was able to produce 90% of its medication needs locally. In 2008, Syrians spent 60% of their health budget on out-of-pocket payments to private providers and co-payments to public hospitals. In recent years, attempts to liberalize the health-care system and give the private sector more autonomy have resulted in a widening of access to care and increased the financial burden on those least able to pay [15, 16].
Nonetheless, the start of the civil war resulted in a complete breakdown of the health infrastructure, with widespread destruction of facilities, a shortage of health care personnel and medicines, and a lack of safe routes and transportation, which raises the question about the current status and capacity of the Syrian health system after years of war [16].
Chapter Summaries
Introduction: Outlines the humanitarian crisis in Syria since 2011, detailing the destruction of the health system and the vulnerability of internally displaced populations.
Aim of the research: Defines the review's goal to synthesize literature on the Syrian population's health status and provide a basis for future health system rebuilding.
Objectives: Lists primary goals, including summarizing health status, describing public health consequences, and suggesting reconstruction strategies.
Research questions: Formulates the core inquiries regarding current health status, access to services, and the impact of the crisis on health indicators.
Methods: Describes the systematic literature review process covering articles from 2012 to 2021 across five major databases.
Results of the search: Details the screening process that led to the inclusion of 207 relevant research articles categorized by health topics.
Thematic analysis: Provides an in-depth review of health systems before the war, inside Syria, and among refugees in host nations.
The future of the health system in Syria: Proposes five critical steps for rebuilding, emphasizing infrastructure, human resources, research, and informatics.
Conclusion: Summarizes the devastating impact of the war on health and underscores the urgent need for international collaboration to restore healthcare access.
Acknowledgments: Dedicates the research to the healthcare workers who lost their lives while serving in the conflict.
References: Lists the academic sources used to substantiate the literature review.
Keywords
Syrian War, Public Health, Health Infrastructure, Syrian Refugees, Humanitarian Crisis, Mental Health, Infectious Diseases, Non-communicable Diseases, Healthcare Workers, Health System Rebuilding, COVID-19, Maternal Health, Child Health, Health Informatics, Conflict-affected Populations
Frequently Asked Questions
What is the primary focus of this literature review?
The paper examines the public health status of the Syrian population—both inside Syria and as refugees in host countries—following ten years of war.
What are the main thematic areas covered in the research?
The review covers mental health, maternal and child health, oral health, infectious and non-communicable diseases, and the specific challenges faced by healthcare workers during the conflict.
What is the ultimate goal of the research?
The goal is to summarize existing data to provide a clear overview of the current health landscape and propose actionable steps for rebuilding Syria’s damaged health system.
Which scientific methodology was employed?
The author conducted a systematic literature review using the modified Arksey and O'Malley framework, screening five major databases to identify 207 relevant peer-reviewed articles.
What does the main body of the work address?
It analyzes the health status of populations inside Syria (under opposition vs. governmental control), the health situation for refugees in various host countries, and public health indicators.
Which keywords characterize this work?
Key topics include the Syrian War, health infrastructure, humanitarian crisis, Syrian refugees, mental health, and health system reconstruction strategies.
How did the war impact the health status of children in Syria?
The report highlights significant issues including high rates of malnutrition, insufficient vaccination coverage, and a high prevalence of upper respiratory tract infections and dental caries.
What are the identified barriers for Syrian refugees in host countries?
Refugees face financial hardship, language barriers, limited access to specialized care, and administrative obstacles in navigating new health systems, particularly in nations like Lebanon and Turkey.
What specific strategies are proposed for the future of the Syrian health system?
The author suggests five major steps: repairing health infrastructure, increasing system capacity, improving human resources, supporting medical research, and developing a unified health informatics database.
How has the COVID-19 pandemic affected the Syrian health situation?
The pandemic further strained an already collapsed system, increasing the workload on remaining health workers, causing high levels of stress, and exacerbating the existing lack of surveillance and medical supplies.
- Citar trabajo
- Bahaa Aldin Alhaffar (Autor), 2021, Health assessment for the Syrian population after the war. Overview of the current health status, health problems, and the future of the health system in Syria, Múnich, GRIN Verlag, https://www.grin.com/document/1176750
