Inequity and benefit incidence analysis in healthcare use among Syrian refugees in Egypt

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• dc.contributor.author Fares, Hani, 1975-
• dc.contributor.author Puig i Junoy, Jaume
• dc.date.accessioned 2023-06-19T06:18:12Z
• dc.date.available 2023-06-19T06:18:12Z
• dc.date.issued 2021
• dc.description.abstract Background: The Syrian conflict has created the worst humanitarian refugee crisis of our time, with the largest number of people displaced. Many have sought refuge in Egypt, where they are provided with the same access to healthcare services as Egyptian citizens. Nevertheless, in addition to the existing shortcomings of the Egyptian health system, many obstacles specifically limit refugees’ access to healthcare. This study looks to assess equity across levels of care after observing services utilization among the Syrian refugees, and look at the humanitarian dilemma when facing resource allocation and the protection of the most vulnerable. Methods: A cross‐sectional survey was used and collected information related to access and utilization of outpatient and inpatient health services by Syrian refugees living in Egypt. We used concentration index (CI), horizontal inequity (HI) and benefit incidence analysis (BIA) to measure the inequity in the use of healthcare services and distribution of funding. We decomposed inequalities in utilization, using a linear approximation of a probit model to measure the contribution of need, non-need and consumption influential factors. Results: We found pro-rich inequality and horizontal inequity in the probability of refugees’ outpatient and inpatient health services utilization. Overall, poorer population groups have greater healthcare needs, while richer groups use the services more extensively. Decomposition analysis showed that the main contributor to inequality is socioeconomic status, with other elements such as large families, the presence of chronic disease and duration of asylum in Egypt further contributing to inequality. Benefit incidence analysis showed that the net benefit distribution of subsidies of UNHCR for outpatient and inpatient care is also pro-rich, after accounting for out-of-pocket expenditures. Conclusion: Our results show that without equitable subsidies, poor refugees cannot afford healthcare services. To tackle health inequities, UNHCR and organisations will need to adapt programmes to address the social determinants of health, through interventions within many sectors. Our findings contribute to assessments of different levels of accessibility to healthcare services and uncover related sources of inequities that require further attention and advocacy by policymakers.
• dc.format.mimetype application/pdf
• dc.identifier.citation Fares H, Puig‑Junoy J. Inequity and benefit incidence analysis in healthcare use among Syrian refugees in Egypt. Confl Health. 2021;15:78. DOI: 10.1186/s13031-021-00416-y
• dc.identifier.doi http://dx.doi.org/10.1186/s13031-021-00416-y
• dc.identifier.issn 1752-1505
• dc.identifier.uri http://hdl.handle.net/10230/57228
• dc.language.iso eng
• dc.publisher BioMed Central
• dc.relation.ispartof Conflict and Health. 2021;15:78.
• dc.rights © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Refugees’ health
• dc.subject.keyword Socioeconomic inequalities
• dc.subject.keyword Inequity
• dc.subject.keyword Horizontal inequity
• dc.subject.keyword Syrian refugees
• dc.title Inequity and benefit incidence analysis in healthcare use among Syrian refugees in Egypt
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion