Al-Abdulla Orwa, Alaref Maher, Kallström Agneta, Kauhanen Jussi
Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, The University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.
Strategic Research Center (SRC), Gazi Muhtar Paşa BUL, Sehitkamil, 27090, Gaziantep, Türkiye.
Health Res Policy Syst. 2025 Jul 1;23(1):85. doi: 10.1186/s12961-025-01352-6.
This study provides a detailed overview of Syria's health system from 2000 to 2024 by synthesizing existing literature and data. Its goal is to inform the health sector recovery plan following recent political changes in Syria, detailing the health system's characteristics and evolution on the basis of the WHO's conceptual framework. A scoping review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Data sources included PubMed, MEDLINE, Scopus, Google Scholar, grey literature and government reports. The analysis identified service delivery, financing, and governance as the most frequently discussed aspects of the health system. It revealed a distorted health system that retained aspects of the Semashko model whilst also incorporating elements of liberalization from the 2003 modernization program. The study underscores major challenges, including the politicization of healthcare, workforce shortages, fragmented financing, and disparities in access to healthcare services. The findings indicate that the Syrian health system has been characterized by centralized governance, inconsistent financing strategies, a fragmented health information system, and a growing dependence on the private sector. The post-conflict recovery phase offers a chance to rebuild a more equitable and resilient health system. Policymakers are urged to consider necessary reforms to the health system recovery plan in Syria.
本研究通过综合现有文献和数据，详细概述了2000年至2024年叙利亚的卫生系统。其目标是为叙利亚近期政治变革后的卫生部门恢复计划提供信息，在世卫组织概念框架的基础上详细说明卫生系统的特征和演变。按照系统评价和元分析扩展版的范围综述首选报告项目（PRISMA-ScR）指南进行了范围综述。数据来源包括PubMed、MEDLINE、Scopus、谷歌学术、灰色文献和政府报告。分析确定服务提供、筹资和治理是卫生系统讨论最频繁的方面。研究揭示了一个扭曲的卫生系统，它保留了苏联卫生体系模式的一些方面，同时也纳入了2003年现代化计划中的自由化元素。该研究强调了主要挑战，包括医疗保健政治化、劳动力短缺、筹资分散以及获得医疗服务的差距。研究结果表明，叙利亚卫生系统的特点是治理集中、筹资策略不一致、卫生信息系统分散以及对私营部门的依赖日益增加。冲突后恢复阶段为重建一个更公平、更有韧性的卫生系统提供了机会。敦促政策制定者考虑对叙利亚卫生系统恢复计划进行必要的改革。
