Attachments
Background
The Government of Lebanon estimates that the country currently hosts 1.5 million Syrians who have fled the conflict in Syria, including 844,056 registered as refugees. These populations live across all governorates in Lebanon in urban centers and informal settlements. UNHCR is providing assistance and support to refugees through a variety of programs covering basic assistance, protection, shelter, WASH, education and health. The public health unit of UNHCR plays a role both in provision of health care services and institutional support through implementing partners and in coordination of the response together with the Lebanese Ministry of Public Health (MOPH), the World Health Organization (WHO) and the InterAgency coordination unit at UNHCR. The UNHCR public health programme aims to ensure equitable refugee access to comprehensive health services within Lebanon including primary health- and hospital care. Primary health care (PHC) is the core of all health interventions and in total, there are 158 primary health care facilities1 countrywide in which subsidized care is available for refugees. UNHCR supports through international and national partners some of these facilities that either are situated in areas which have sizeable refugee populations or providing services that are generally lacking in the Lebanese system (e.g. Mental Health care services). Hospital care is an essential component of access to comprehensive health services for refugees. UNHCR supports deliveries and life-saving emergency care by paying a part of hospital fees depending on the cost of the admission. To facilitate the administration of hospital care support, UNHCR contracts a Third-Party Administrator (TPA) and since January 2017 this is NEXtCARE. The programme is based on cost-sharing in which the patient share on average constitutes one third of the total cost of the admission. The scheme is designed so that beneficiaries pay a higher proportion of lowcost admissions (between 50-25%) and a lower proportion of high-cost admissions (around 5%).
It is challenging to collect reliable routine data on the health service needs of urban/non-camp refugees when compared to those residing in traditional camps. For this reason, Household Access and Utilization Surveys (HAUS) allow UNHCR to monitor trends in how refugees access and utilize health services over time. Since 2014, UNHCR Lebanon has conducted annual HAUS per telephone (the proportion of registered Syrian refugee households with telephone numbers in Lebanon is 98%) which has provided important information on the challenges faced by refugees in accessing health care services. The survey results guide program delivery by providing timely and regular information in a cost-efficient manner on key variables relating to access and utilization.