Shelter from the storm: health service access and utilization among Syrian refugees in Turkey

Abstract

Aim: Since 2011, the conflict in Syria has led to the migration of 5.6 million refugees, mainly to neighbouring countries. By the start of 2019, over 3.5 million people had moved to Turkey to seek safety, meaning that Turkey is hosting the majority of these refugees. Most of them are today settled in urban and peri-urban locations. A large part of the health services of these populations had been cut before their move, leaving a significant population that had been unprotected and under-provided for. The Turkish health system has provided a cost-free way for these populations to use health services, especially public health services at the primary and secondary levels. The objective of this study was to identify the size and the geography of the health shock as a result of the Syrian influx, starting in 2011. The resulting health effects of the refugee integration and the resilience of the health system are also assessed. Subject and methods: We investigated the medical treatment given in public hospitals for the Syrian population for the years 2012–2014, at the primary and secondary health levels. We investigated 10,444,290 cases of health visits, 7,211,342 of them occurring at the secondary level and representing more than 70% of total applications. The overall coverage of the health system for the Syrian population is estimated to be 64%, with 115,000 live-births among Syrian refugees occurring in the same time period. Results: Since the influx of Syrian refugees, there has been a considerable shock to the regional part of the Turkish health system located closest to the Syrian border. From the Syrian refugee point of view, no significant over-crowding or lowered quality effect was observed in the health system. The Syrian refugee’s health demand was observed to be different from that of the Turkish average, as this population’s unique vulnerabilities and access evolution came to the fore. However, significant convergence was then observed in the health demand, as urgent needs were converted into more routine health requirements over time. Conclusion: This initial investigation of the Turkish health system after the Syrian integration underlies the case for a significant resilience being shown, especially in areas where it has been most severely tested.