- KEY FINDINGS
Summary of Priorities
Based on the data review and inputs from the Sector Working Group we can provide the following preliminary conclusions:
The overall impression gained from the available evidence and focus group discussions is that the sector will face multiple challenges and increasing demands on resources over the next year. Health and healthcare services influence and are influenced by nearly all other sectors, making it a fundamental driver and outcome of the humanitarian response. Health equity must be embedded in the response and a ―health in all sectors‖ strategy must be adopted if population health is to be protected and promoted. The basic health needs and access to services of the refugee population and vulnerable groups are largely being met by the response, with support from the Government of Lebanon (GoL). It is apparent that there are gradual moves within the sector to focus on medium- to long-term programmes and shift to development strategies. This involves strengthening healthcare services and systems, focusing on public and primary health interventions and policies. This will assist refugees in the short term, but will provide cost-effective, long-term and sustainable health improvements for host communities.
Ideally the health response and provision of healthcare services should adopt an equitable, nationwide approach. However, given the increasing response challenges it is currently necessary to focus on those areas which are underserved, most in need and prone to disease outbreaks namely – Akkar, Bekaa and Tripoli. Within these governorates, areas lacking water, sanitation and hygiene (WASH) infrastructure should be prioritised.
Given the predominantly privatised nature of the Lebanese health care system, the response should prioritise and target those who lack insurance and other local payment support mechanisms. Within this a number of groups such as those with chronic conditions, older people, children, pregnant women and local communities vulnerable or exposed to disease outbreaks should be targeted. Given the looming threat of polio and other vaccine-preventable diseases, the blanket immunisation of all children regardless of their nationality or economic status must be employed and sustained over the next year. This will be an extremely cost-effective measure for Lebanon and the region.
Both focus group respondents and the data reviewed confirm that the response requires more accurate and timely data on which to base decisions. In addition, difficulties gathering and thus analysing data has hindered effective identification, targeting and forecasting of needs. Outcome evaluations of health interventions and programmes of the humanitarian community are required to know what works, why and for whom, as well as to improve cost-effectiveness of donor aid.
Three key issues were highlighted that may affect the future development and operation of the sector. Firstly, the likely budget constraints for health will enact a shift toward more targeted assistance. Secondly, a sudden refugee influx as a result of the situation in Syria will further strain government-run public health services and may exceed the capacities of the response. Thirdly, the onset of summer will increase the potential for disease outbreaks and need for access to medical care among refugees in informal settlements where WASH and nutrition conditions are deteriorating. A key preventive intervention that will have immediate effects is the further investment in improving WASH conditions for those living in informal settlements.