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dc.rights.licenseCC BY-NC-ND license
dc.contributor.authorAlameddine, Mohamaden
dc.contributor.authorFouad, Fouad M.en
dc.contributor.authorDiaconu, Karinen
dc.contributor.authorJamal, Zeinaen
dc.contributor.authorLough, Grahamen
dc.contributor.authorWitter, Sophieen
dc.contributor.authorAger, Alastairen
dc.date.accessioned2018-10-29T10:40:38Z
dc.date.available2018-10-29T10:40:38Z
dc.date.issued2018-10-21
dc.identifier.citationAlameddine, M., Fouad, F. M., Diaconu, K., Jamal, Z., Lough, G., Witter, S. and Ager, A. (2018) Resilience capacities of health systems: Accommodating the needs of Palestinian refugees from Syria. Social Science & Medicine, 220, pp. 22-30.en
dc.identifier.issn0277-9536en
dc.identifier.urihttps://eresearch.qmu.ac.uk/handle/20.500.12289/9037
dc.identifier.urihttp://doi.org/10.1016/j.socscimed.2018.10.018
dc.descriptionAcknowledgments: We thank our colleagues from the United Nations Relief and Works Agency for Palestine Refugees (UNRWA), headed by Dr. Seita Akihiro - Director of UNRWA Health Programme. Our colleagues provided insights and expertise and we commend their commitment towards enabling further research under difficult conditions. We would like to show our gratitude to Dr. Nimer Kassim from the UNRWA Lebanon Field Office, Dr. Ishtaiwi Abu-Zayed from the UNRWA Jordan Field Office, Dr. Yassir Turki and Ms. Shatha Al-Baik from the UNRWA Headquarters- Jordan who participated in discussions, shared unpublished data and facilitated data collection in Lebanon and Jordan.en
dc.description.abstractResilience is increasingly recognised as a key process mitigating the impact of shocks and stressors on functioning. The literature on individual and community resilience is being extended to address characteristics of resilient service delivery systems in contexts of adversity. The validity and utility of a capacity-oriented resilience framework (including absorption, adaptation and transformation) is examined with respect to the functioning of United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) health systems in Lebanon and Jordan in the context of the Syrian crisis. We completed 62 semi-structured interviews (30 in Lebanon in November - December, 2016, and 32 in Jordan in January 2017) with professionals at primary care, area, and country management levels. Participants reflected on changes in population health status and health service delivery during the Syrian crisis, notably with respect to the influx of refugees from Syria. Interviews were analysed through inductive thematic analysis and used to critically interrogate health systems resilience against a pro-capacities framework. We find that UNRWA systems in Lebanon and Jordan were broadly resilient, deploying diverse strategies to address health challenges and friction between host and refugee populations. Absorptive capacity was evidenced by successful accommodation of increased patient numbers across most service areas. Adaptive capacities were reflected in broadening of collaboration and reconfiguration of staff roles to enhance service delivery. Transformative capacities were demonstrated in the revision of the service packages provided. While manifest as technical capacities, these clearly drew upon solidarity and commitment linked to the political context of the Palestinian experience. The study adds to the limited literature on health system and organizational resilience and indicates that capacity-oriented framings of resilience are valuable in extracting generalizable lessons for health systems facing adversity. The proposed resilience framework promises to guide strategies for sustained care delivery in these contexts.en
dc.description.sponsorshipThe current research is funded via an R2HC-ELRHA grant: Systems resilience in UNRWA health provision to Palestine refugees displaced by the Syria crisis. The funder had no input into study design, data analysis or manuscript preparation. Views expressed here may not necessarily reflect those of the funder.en
dc.description.urihttps://www.sciencedirect.com/journal/social-science-and-medicineen
dc.format.extent22-30
dc.language.isoenen
dc.publisherElsevieren
dc.relation.ispartofSocial Science & Medicineen
dc.rights© 2018 The Authors.
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectSyriaen
dc.subjectJordanen
dc.subjectLebanonen
dc.subjectResilienceen
dc.subjectRefugeesen
dc.subjectConflicten
dc.subjectCrisisen
dc.subjectHealth Systemsen
dc.titleResilience capacities of health systems: Accommodating the needs of Palestinian refugees from Syriaen
dc.typeArticleen
dcterms.accessRightspublic
dcterms.dateAccepted2018-10-20
dc.date.updated2018-11-05; 2019-01-14
dc.description.volume220
dc.description.ispublishedpub
rioxxterms.typeJournal Article/Reviewen
rioxxterms.publicationdate2018-10-21
refterms.dateFCA2018-10-21
refterms.dateFCD2018-10-29
refterms.depositExceptionpublishedGoldOAen
refterms.accessExceptionNAen
refterms.technicalExceptionNAen
refterms.panelAen
qmu.authorDiaconu, Karin
qmu.authorLough, Graham
qmu.authorWitter, Sophie
qmu.authorAger, Alastair
qmu.centreInstitute for Global Health and Developmenten
dc.description.statuspub
refterms.versionVoRen
refterms.dateDeposit2018-10-29


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