Doocy Shannon, Lyles Emily, Akhu-Zaheya Laila, Burton Ann, Weiss William
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Jordan University of Science and Technology, School of Nursing, Irbid, Jordan.
Int J Health Plann Manage. 2016 Jan-Mar;31(1):97-112. doi: 10.1002/hpm.2336. Epub 2016 Jan 22.
With over one million Syrian refugee children in the region, we undertook this study to characterize care-seeking behaviors and health service utilization for child refugees with the aim of informing humanitarian programming for non-camp settings in Jordan.
A survey of Syrian refugees living outside of camps in Jordan was conducted using a 125 × 12 cluster design with probability proportional to size sampling to obtain a representative sample. The questionnaire focused on access to health services, including a module on care seeking for children.
Care seeking was high with 90.9% of households with a child less than 18 years seeking medical care the last time it was needed. Households most often sought care for children in the public sector (54.6%), followed by private (36.5%) and charity sectors (8.9%). Among child care seekers, 88.6% were prescribed medication during the most recent visit, 90.6% of which obtained the medication. Overall, 49.4% of households reported out-of-pocket expenditures for either the consultation or prescribed medications at the most recent visit (mean $US21.1 and median $US0).
Syrian refugees had good access to care for their sick children at the time of the survey; however, this has likely deteriorated since the survey because of the withdrawal of free access for refugees. The number of refugees in Jordan and relative accessibility of care has resulted in a large burden on the health system; the Jordanian government will require additional support if current levels of health access are to be maintained for Syrian refugees.
该地区有超过100万叙利亚难民儿童,我们开展了这项研究,以描述儿童难民的就医行为和卫生服务利用情况,旨在为约旦非难民营环境下的人道主义项目提供参考。
采用125×12的整群设计,按规模大小概率抽样,对居住在约旦难民营外的叙利亚难民进行了一项调查,以获得具有代表性的样本。调查问卷重点关注卫生服务的可及性,包括一个关于儿童就医的模块。
就医率较高,在最近一次需要医疗服务时,90.9%有18岁以下儿童的家庭寻求了医疗护理。家庭最常为儿童在公共部门寻求护理(54.6%),其次是私营部门(36.5%)和慈善部门(8.9%)。在寻求儿童护理的人群中,88.6%在最近一次就诊时被开了药,其中90.6%拿到了药。总体而言,49.4%的家庭报告在最近一次就诊时为咨询或处方药支付了自付费用(平均21.1美元,中位数0美元)。
在调查时,叙利亚难民能较好地为患病儿童获得医疗护理;然而,自调查以来,由于难民免费医疗服务的取消,情况可能已经恶化。约旦的难民数量以及相对可及的医疗服务给卫生系统带来了巨大负担;如果要维持目前叙利亚难民的医疗可及水平,约旦政府将需要额外的支持。