Discussion of “Health service utilization and access to medicines among Syrian refugee and host community children in Lebanon” by Lyles et al.

Abstract

Background: With over 500,000 Syrian refugee children in Lebanon, we undertook this study to assess unmet child health needs and health service utilization among Syrian refugees and affected host communities in Lebanon with the aim of informing humanitarian programming. Methods: A cross-sectional survey of Syrian refugees and host communities in Lebanon was conducted using a two-stage cluster survey design with probability proportional to size sampling. The questionnaire focused on access to health services, including a module on care seeking for children. Results: The care seeking rate was 74.2 % among refugee and 89.0 % among host community households with a child less than 18 years seeking medical care the last time it was needed. Refugee households most often sought care in primary health care centers (52.7 %), followed by pharmacies (22.2 %) and private clinics (17.8 %), whereas host community households most often sought care in private clinics (47.6 %) and primary health care centers (23.2 %). Among child care seekers, 95.2 % of refugee and 94.6 % of host community children were prescribed medication during the most recent visit, of which 92.7 and 97.3 %, respectively, obtained the medication. Overall, 66.0 % of refugee and 75.9 % of host community households reported out-of-pocket expenditures for either the consultation or prescribed medications at the most recent visit (refugee mean US$30.4; host community mean US$56.0). Conclusions: Care seeking was significantly lower among refugees than the host community. Out-of-pocket payments were considerable for both groups, the majority of which were for medication, and cost was the primary barrier to both care seeking and attaining medications.