Health system resilience: Lebanon and the Syrian refugee crisis

Walid Ammar, Ola Kdouh, Rawan Hammoud, Randa Hamadeh, Hilda Harb, Zeina Ammar, Rifat Atun, David Christiani, Pierre A. Zalloua

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127 Scopus citations

Abstract

Background Between 2011 and 2013, the Lebanese population increased by 30% due to the influx of Syrian refugees. While a sudden increase of such magnitude represents a shock to the health system, threatening the continuity of service delivery and destabilizing governance, it also offers a unique opportunity to study resilience of a health system amidst ongoing crisis. Methods We conceptualized resilience as the capacity of a health system to absorb internal or external shocks (for example prevent or contain disease outbreaks and maintain functional health institutions) while sustaining achievements. We explored factors contributing to the resilience of the Lebanese health system, including networking with stakeholders, diversification of the health system, adequate infrastructure and health human resources, a comprehensive communicable disease response and the integration of the refugees within the health system. Results In studying the case of Lebanon we used input-process-output- outcome approach to assess the resilience of the Lebanese health system. This approach provided us with a holistic view of the health system, as it captured not only the sustained and improved outcomes, but also the inputs and processes leading to them. Conclusion Our study indicates that the Lebanese health system was resilient as its institutions sustained their performance during the crisis and even improved.

Original languageBritish English
Article number020704
JournalJournal of Global Health
Volume6
Issue number2
DOIs
StatePublished - 2016

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