Health access and utilization survey: Access to Health Services in Jordan among Syrian Refugees - Baseline Survey December 2016

Executive summary

Approximately 80% of the more than 727,000 refugees in Jordan live in major urban centres. More and more, UNHCR and partners recognize the link between robust support of non-camp refugees and local host communities, and the preservation of existing protection space. Compared to camp refugees, reliable data on the health service needs of non-camp refugees is more difficult to collect on a routine basis. In an effort to develop a cost-effective and efficient mechanism for regularly monitoring the health access and utilization of non-camp refugees, UNHCR in collaboration with Nielsen have carried out a household telephone survey. The main objectives of the survey were to evaluate access to and utilization of key health services and challenges faced by registered noncamp refugees.

The health access & utilization survey is a tool used by UNHCR on annual basis to monitor non-camp refugees’ access and utilization behaviors over time and it assess each of the following attributes:

Sample structure

• Syrian refugees living in non-camp settings are predominantly concentrated in Amman (37%) followed by Irbid (24%) in 2016

• Among the 400 interviewed Syrian households, 2334 members were reported living within these households given an average of 6 members per household.

• An average of 2 children were reported living among the 400 interviewed Syrian households

Health services access & awareness

• Although 97% of the respondents are MOI security cardholders, only 70% of them were actually aware of the subsidized access to governmental facilities provided by the card.

• Majority of the respondents (93%) issued the security card in their residing governorate, yet few of them (7%) reported otherwise.

Childhood vaccination

• 9 in 10 of the households who had children less than 5 years old were aware and had access to children vaccination care, yet there is room for minor improvements

• From the households who had children less than 5 years old, 9 in 10 of them had their children vaccinated for both MMR & Polio where governmental facilities were the main source of vaccination.

Antenatal care

• From those who needed antenatal care (40%), 2 in 10 of them didn’t receive the needed care.

• Governmental & private hospitals were the main places of delivery scoring 43% and 41% respectively.

• 4 in 10 of the deliveries were free of charge as a result that 41% of them were delivered in a governmental facility.

Chronic diseases

• Hypertension is predominantly the most reported disease followed by Diabetes among household members who had a chronic disease

• 34% and 37% were unable to access medicine and health services respectively. Inability to afford user fees was the most reported reason for not accessing medicine and health services scoring 75% and 74% respectively.

Disability & impairment

• Half of the impaired/disabled households reported natural reason as cause of disability while 2 in 10 reported that violence/war was the cause of their disability

• Rehabilitation (44%) followed by Surgical (31%) treatments were the main types of treatment received by the disabled/impaired household members.

• Inability to afford user fees (50%) is predominantly the main barrier to proper care followed by the respondent’s personal sentiment that the treatment is unnecessary (21%)

Monthly health access assessment

• 3 in 10 household members sought health care during the last month of the interview

• Governmental & private hospitals were the first sought facility scoring 28% and 25% respectively

• 81% of the interviewed households spent an average of 105.3 JDs on health care during the last month of the interview although their combined monthly income is 233.0 JDs