Introduction: According to Lebanese official data, Lebanon hosts over 1.5 million displaced Syrians (DS). Research shows that migrants encounter barriers when accessing healthcare. The social determinants of health (SDOH) related to migration are an additional challenge for DS in Lebanon, though bias plays a significant factor in exacerbating health inequalities. This study aims to identify DS perception of healthcare biases in the Lebanese healthcare system, and its consequences on DS' accessing and receiving quality healthcare in Lebanon. Methods: A qualitative analysis using in-depth, semi-structured interviews was utilized. 28 semi-structured interviews were conducted with doctors (n = 12) and nurses (n = 16) in 2021. Six group interviews were conducted with DS (n = 22) in Lebanese healthcare facilities. The recruitment of participants relied on reasoned and targeted sampling. Thematic analysis was performed to identify common themes in participants' experiences with DS accessing Lebanese healthcare. Results: The findings indicated that there were barriers to accessing healthcare related to the SDOH, such as transportation and financial resources. The results also suggested that DS perceived health biases, including discriminatory behavior from Lebanese healthcare providers, stereotypes and racism leading to health inequalities. Conclusion: Based on the perceptions and experiences reported by participants, the underlying causes of biases are due to the fragility of the Lebanese healthcare system when facing a humanitarian crisis as well as a collapsing infrastructure torn by past wars and the current socio-political and financial crises in the country. Global initiatives are required to provide the necessary resources needed for offering equitable health services. Such initiatives involve addressing biases, health inequities, discrimination, and the lack of a Lebanese infrastructure system for the provision of healthcare. Addressing health inequalities remains a major health objective in achieving health equity on the micro level (cultural awareness and competencies) and macro level (equitable distribution of resources, implementation of a universal health coverage) in order to guarantee quality healthcare services to DS.
Delivery of Health Care , Health Personnel , Humans , Lebanon , Health Inequities
The study aims to examine cultural differences and discrimination as difficulties encountered by DS when using the Lebanese healthcare system, and to evaluate the equity of DS access to health services in Lebanon. This is a qualitative study using in-depth semi-structured interviews with DS and Lebanese healthcare professionals. The participants were selected by visiting two hospitals, one public Primary Healthcare Center, and three PHCs managed by Non-Governmental Organizations. The recruitment of participants was based on reasoned and targeted sampling. Thematic analysis was performed to identify common themes in participants' experiences of DS in accessing Lebanese healthcare. Twenty interviews took place with directors of health facilities (n = 5), health professionals (n = 9), and DS (n = 6) in six different Lebanese healthcare institutions. The results showed barriers of access to care related to transportation and financial issues. Healthcare services provided to the DS appear to be of poor quality due to inequitable access to the health system, attributable to the discriminatory behavior of healthcare providers. Among the several factors contributing to the presence of discrimination in the Lebanese healthcare system, the persisting fragility of the healthcare system-facing a humanitarian crisis-emerged as the major driver of such unequal treatment. The number of DS in Lebanon is roughly equal to a quarter of its citizens; there is an urging need to restore the Lebanese health system to ensure the equitable provision of health services for DS and appropriate working conditions for health professionals.
INTRODUCTION: In the context of public health, seeking or not seeking dental care is a poorly documented topic. However, its control is essential for the establishment of effective prevention. PURPOSE OF RESEARCH: The main objective of our study is to explore the perceptions, attitudes, social representations and factors determining the behavior of the Lebanese population seeking oral care in two governorates, Beirut and Mount Lebanon.The method follows the descriptive qualitative approach. Semi-directed exploratory interviews were conducted with 20 beneficiaries and 7 dentists. The data was analyzed thematically in several stages according to the Kreuter and Green model. RESULTS: The results of our study showed that several factors hamper the beneficiaries’ use of dental care. The lack of knowledge about the association between dental health and general health, the negative perceptions of citizens towards prevention and dentistry as well as financial incapacity remain primordial factors obstructing the seeking of dental care. On the other hand, health education, changing perceptions as well as cost coverage or reimbursement would be factors that could promote the use of dental care. CONCLUSION: Not seeking dental care remains a worrying problem in a developing country like Lebanon. The impact is considerable on oral health and on general health with all its consequences on an already fragile health system.
Health Knowledge, Attitudes, Practice , Perception , Humans , Qualitative Research , Lebanon , Dental Care
