Jamaluddine Zeina, Irani Alexandra, Salti Nisreen, Abdulrahim Sawsan, Chaaban Jad, El-Asmar Khalil, Ghattas Hala
Center for Research on Population and Health, American University of Beirut, Beirut, Lebanon.
Applied Economics and Development Research Group, American University of Beirut, Beirut, Lebanon.
Lancet. 2021 Jul;398 Suppl 1:S32. doi: 10.1016/S0140-6736(21)01518-X.
Palestinian refugees in Lebanon (PRL) and Palestinian refugees from Syria (PRS) living in Lebanon have high poverty rates. As the social, economic, and physical environment in which a child develops is a strong determinant of health and wellbeing, a comprehensive approach that recognises the influence of multidimensional deprivation on child wellbeing is needed. This study investigates overlaps (co-occurrences) in deprivation indicators experienced by Palestinian children compared to those experienced by other vulnerable children living alongside them in Lebanon; children who are Syrian refugees (SYR) and children who are Lebanese nationals (LBN).
This analysis adopted a life-cycle approach using data from the UNICEF 2016 Lebanon Household Survey, and included data on children aged 2-17 years (PRL, n=7106; PRS, n=2768; LBN, n=10555; SYR n=5891). We report on indicators relating to early childhood (24-59 months) and school age (6-17 years), including child survival (nutrition, health, water, sanitation, and overcrowding), child development (education), and child protection (labour, exposure to violence, and early marriage), as well as the co-occurrence of these deprivation indicators. Socio-demographic and geographical correlates of child deprivation were explored using univariate and multivariable logistic regression analysis, a using sampling weights and clustering for children in the same households. Analyses were conducted using Stata 15.
Among children aged 24-59 months, 28·9% (347 of 1202) of PRL and 46·2% (260 of 563) of PRS children were deprived in at least two dimensions, compared with 13·2% (67 of 508) of LBN and 68·5% (915 of 1335) of SYR children. Co-occurring deprivations were highest across the protection and overcrowding dimensions in Palestinian refugee children aged 6-17 years (PRL, 14·2% [769 of 5421]; PRS, 26·7% [531 of 1985]). Across all ages, PRS children were more likely to be deprived in two dimensions than PRL children. However, indicators of health and education deprivation were lower in PRL and PRS children than in SYR children. Geographical disparities in deprivation existed within all four populations, with the highest disparity among those living in North Lebanon and the Bekaa. Higher maternal education (completed intermediate education) was consistently associated with lower odds of having at least two concurrent deprivations among children aged 6-17 years (LBN odds ratio [OR] 0·1, 95% CI 0·1-0·2, p<0·0001; PRL OR 0·3, 95% CI 0·3-0·5, p<0·0001; PRS OR 0·5, 95% CI 0·3-0·7, p=0·0002; SYR OR 0·4, 95% CI 0·2-0·7, p=0·0004).
The most common overlaps in deprivation indicators were in housing (overcrowding) and protection (exposure to violence) among PRL and PRS children, highlighting the need to focus simultaneously on housing improvements and protection programmes. Deprivation in health and education were relatively low as PRS children have been included in the well-established UNRWA health and education systems, largely protecting them from poor health and education outcomes.
UNICEF Lebanon. The findings, interpretations, and conclusions do not necessarily reflect the view of UNICEF.
生活在黎巴嫩的巴勒斯坦难民（PRL）以及来自叙利亚且居住在黎巴嫩的巴勒斯坦难民（PRS）贫困率很高。由于儿童成长所处的社会、经济和物质环境是其健康与福祉的重要决定因素，因此需要一种全面的方法来认识多维贫困对儿童福祉的影响。本研究调查了巴勒斯坦儿童与黎巴嫩境内与其一同生活的其他弱势儿童（叙利亚难民儿童[SYR]和黎巴嫩本国儿童[LBN]）所经历的贫困指标重叠情况（共现情况）。
本分析采用生命周期方法，使用了联合国儿童基金会2016年黎巴嫩家庭调查的数据，纳入了2至17岁儿童的数据（PRL，n = 7106；PRS，n = 2768；LBN，n = 10555；SYR，n = 5891）。我们报告了与幼儿期（24 - 59个月）和学龄期（6 - 17岁）相关的指标，包括儿童生存（营养、健康、水、卫生设施和过度拥挤情况）、儿童发展（教育）以及儿童保护（劳动、遭受暴力和早婚），以及这些贫困指标的共现情况。使用单变量和多变量逻辑回归分析探讨了儿童贫困的社会人口学和地理相关因素，对同一家庭中的儿童使用抽样权重和聚类分析。分析使用Stata 15进行。
在24 - 59个月的儿童中，28.9%（1202例中的347例）的PRL儿童和46.2%（563例中的260例）的PRS儿童在至少两个维度上处于贫困状态，相比之下，LBN儿童为13.2%（508例中的67例），SYR儿童为68.5%（1335例中的915例）。在6 - 17岁的巴勒斯坦难民儿童中，保护和过度拥挤维度的共现贫困情况最为严重（PRL，14.2%[5421例中的769例]；PRS，26.7%[1985例中的531例]）。在所有年龄段中，PRS儿童比PRL儿童更有可能在两个维度上处于贫困状态。然而，PRL和PRS儿童的健康和教育贫困指标低于SYR儿童。所有四类人群中都存在贫困的地理差异，居住在黎巴嫩北部和贝卡的人群差异最大。较高的母亲教育水平（完成中等教育）一直与6 - 17岁儿童中至少有两项同时贫困的较低几率相关（LBN优势比[OR]0.1，95%置信区间0.1 - 0.2，p < 0.0001；PRL OR 0.3，95%置信区间0.3 - 0.5，p < 0.0001；PRS OR 0.5，95%置信区间0.3 - 0.7，p = 0.0002；SYR OR 0.4，95%置信区间0.2 - 0.7，p = 0.0004）。
PRL和PRS儿童贫困指标中最常见的重叠在于住房（过度拥挤）和保护（遭受暴力）方面，这凸显了需要同时关注住房改善和保护计划。由于PRS儿童已被纳入完善的近东救济工程处卫生和教育系统，健康和教育方面的贫困相对较低，这在很大程度上保护了他们免受不良健康和教育结果的影响。
联合国儿童基金会黎巴嫩办事处。研究结果、解读和结论不一定反映联合国儿童基金会的观点。
