Conflict and Health最新文献

{"title":"Exploring factors that shaped Syrian refugees integration into Lebanon's national health system using Kingdon's Multiple Streams Framework.","authors":"Fadi El-Jardali, Gladys Honein-AbouHaidar, Lama Bou-Karroum, Sabine Salameh, Sarah E Parkinson, Rima Majed","doi":"10.1186/s13031-025-00680-2","DOIUrl":"10.1186/s13031-025-00680-2","url":null,"abstract":"<p><strong>Background: </strong>Since the start of the Syrian conflict in 2011, neighboring country Lebanon has hosted the largest number of refugees per capita in the world. To meet refugees' health care needs, Lebanon adopted an integrated model of care. This paper explores the key factors and events that have shaped the policy on the integration of Syrian refugees into the Lebanese national health system through a policy analysis.</p><p><strong>Methods: </strong>The research team adopted a qualitative approach that employed in-depth interviews with 12 key informants (2 ministers, 4 non-governmental organizations, 3 advocacy group representatives, and 3 healthcare managers) and document review. Thematic framework analysis was used to analyze the data guided by the Kingdon's Multiple Streams Framework.</p><p><strong>Results: </strong>Problem factors that influenced Lebanese health policy towards Syrian refugees include the sheer number of refugees with urgent health care needs who entered a fragile, highly privatized health care system, and political and sectarian dissension around the refugee issue, both of which contributed to a slow government response. In the policy stream, international non-governmental organizations concerned with refugee health started to engage with local authorities. In December 2014, the Lebanon Crisis Response Plan strategy was issued by the government and various partners that iterated the strategy to respond to Syrian refugees' needs. Under the political stream, Lebanon's historical experience with Palestinian refugees, and specifically concerns regarding fear of domiciliation, influenced the unofficial implementation of a 'no camp policy' strategy at the onset of the crisis, which in turn shaped healthcare integration. Further, international non-governmental organizations joined efforts to fund and supplement health care services, while think tank policy organizations advocated for refugees right to healthcare and host community support.</p><p><strong>Conclusion: </strong>This study highlights the role of global actors, such as UNHCR, WHO among others, as the main entrepreneurs in integrating refugees into the Lebanese health care system. It also underscored the ad-hoc non-systematic approach with which the policies around refugee health response were made in Lebanon and the influence of political factors. Although the mutual benefits to both host and refugee communities were recognized, many challenges threaten integration, foremost among them the model's financial sustainability.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"18 Suppl 1","pages":"79"},"PeriodicalIF":3.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health and structural injustice: a qualitative investigation of interlocking patterns of disadvantage among displaced populations in Nairobi, Kenya.","authors":"D B Nieuwe Weme, M M Wanga, P B Mastaki, J Osur, W A Tol","doi":"10.1186/s13031-025-00660-6","DOIUrl":"10.1186/s13031-025-00660-6","url":null,"abstract":"<p><strong>Background: </strong>Urban refugees face systemic disadvantages that significantly impact their mental health and overall wellbeing. Research on refugee mental health often examines risk factors in isolation, overlooking broader systemic patterns. This study applies a structural injustice framework to investigate how interconnected disadvantages shape the mental health of urban refugees.</p><p><strong>Methods: </strong>A thirteen-month study examined the wellbeing of Somali and Congolese refugees in Nairobi, employing ethnographic methods, including 69 in-depth interviews, field notes, and observations. Findings were interpreted using Powers and Faden's structural injustice theory.</p><p><strong>Results: </strong>Analysis revealed a systemic pattern linking immigration status, sexual and gender-based violence, and limited access to livelihoods. These interconnected factors impact all six elements of wellbeing identified by Powers and Faden and exhibit the theorized characteristics of structural injustice: pervasive, profound, asymmetric, and near-inescapable.</p><p><strong>Discussion: </strong>The study highlights the structural nature of challenges faced by urban refugees in Nairobi, emphasizing the need to address interconnected systemic barriers. Understanding these patterns is essential for identifying effective interventions and mitigating risks to refugee mental health and overall wellbeing.</p><p><strong>Conclusion: </strong>The theory as used in this study sheds new light on the interconnected nature of the environment urban refugees live in. This holistic approach to wellbeing provides clarity on vulnerabilities related to specific social groups.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"40"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-crisis health reality and wellbeing of children within Syria: a scoping review of research from 2012 to 2024.","authors":"Seba Harphoush, Fatema Ahmed, Ihab Harphoush, Rasha Kadoun, Soha Harphoush, Rami Al Asaad, Zhong Li","doi":"10.1186/s13031-025-00673-1","DOIUrl":"10.1186/s13031-025-00673-1","url":null,"abstract":"","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"39"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Support for children born of rape in the Democratic Republic of the Congo: mother's experiences and challenges.","authors":"Euphrasie Kaningini Wamunzila, Frieda Vandeninden","doi":"10.1186/s13031-025-00674-0","DOIUrl":"10.1186/s13031-025-00674-0","url":null,"abstract":"<p><p>The repercussions of rape extend far beyond the act itself. Women who become pregnant as a result of rape are frequently forced to keep unwanted children, as abortion is generally perceived as unacceptable and illegal within the community. The aim of this study is to examine the socioeconomic challenges encountered by mother of children born of rape in the care of this children. The methodological approach of this study is based on a qualitative analysis. Semi structured interviews were conducted with 33 female survivors of sexual violence with children born of rape in the eastern DRC in the Kabare territory of the Katana groupement. The findings reveal that while all survivors experience trauma, those who give birth require distinct support. Mothers face numerous challenges in their caregiving roles, including financial hardship, fear of employment, low educational levels, loss of assets, lack of spousal support, and social stigmatization. Consequently, children born of rape encounter significant obstacles, especially for boys, in accessing basic services because of their mothers' trauma, absence of paternal support, maternal ignorance, and societal stigma. Specific measures should be taken to improve the quality of life for both mothers and children affected by rape, fostering resilience and empowering them to overcome the numerous challenges they face.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"38"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the incidence of induced abortion among women in refugee settings in Ethiopia.","authors":"Yohannes Dibaba Wado, Stephanie Küng, George Odwe, Yadeta Dessie, Dagim Habteyesus, Bonnie Wandera, Caitlin Rich, Peter Kisaakye, Caroline W Kabiru, Francis Obare, Margaret Giorgio","doi":"10.1186/s13031-025-00676-y","DOIUrl":"10.1186/s13031-025-00676-y","url":null,"abstract":"<p><strong>Background: </strong>There is little evidence of the magnitude of unintended pregnancy and unsafe abortion in humanitarian settings, but the extent and consequences of unintended pregnancy and unsafe abortion are likely to be exacerbated among refugee populations. This study estimated the incidence of induced abortion among women in refugee settings in Ethiopia.</p><p><strong>Methods: </strong>This study was conducted in 22 of the 24 refugee camps located in Ethiopia. We used data from a Health Facilities Survey (HFS) of 75 health facilities providing postabortion care (PAC) or safe abortion care (SAC) services within or outside the 22 refugee camps and a Knowledgeable Informant Survey (KIS) of 69 individuals knowledgeable about induced abortion among refugee populations. We estimated the annual postabortion caseload, the number of induced abortions, and the induced abortion rate per 1,000 women of reproductive age.</p><p><strong>Results: </strong>We estimated that 9,044 (95% CI: 6,633 - 11,455) women in refugee settings received PAC across the 75 facilities in 2023, while some 2,946 (95% CI: 1,826-4,066) women received SAC. The overall induced abortion incidence rate among women in refugee settings living in camps in Ethiopia was estimated to be 38.3 per 1,000 women aged 15-49 years, with slight variations by region. The proportion of safe abortions obtained from the formal health system was 11.5% in all camps, with a slightly higher proportion of abortions estimated to take place within facilities in Western camps (12.9%) compared to Eastern and Northeastern camps (9.7%).</p><p><strong>Conclusion: </strong>The study found that abortion incidence is high among women in refugee settings in Ethiopia, and only a small proportion of induced abortions were conducted through SAC services. There is an urgent need to improve family planning, SAC, and PAC services in refugee camps.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"37"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"War and chronic illness: a health center-based study of Palestinians with non-communicable diseases in Gaza.","authors":"Belal Aldabbour, Yousef Barakat, Samah Elamassie, Fatima Hmeid, Manar Dughmoush, Maha Al-Rantisi, Doaa Abu-Helal, Lina Barakat, Diana Bader, Afnan Kwaik","doi":"10.1186/s13031-025-00679-9","DOIUrl":"10.1186/s13031-025-00679-9","url":null,"abstract":"<p><strong>Background: </strong>The war in the Gaza Strip has put immense strain on the infrastructure and health services. As a consequence, the population faces increased risks of morbidity and mortality, not only from violence but also from lack of access to healthcare. This study examines how the war affected Palestinians with non-communicable diseases (NCDs) in the Strip.</p><p><strong>Methods: </strong>This cross-sectional survey employed a structured questionnaire to recruit 968 patients with six common NCDs from seven leading PHC clinics located in northern and southern Gaza between October and November 2024. The survey collected sociodemographic data, assessed direct war impacts on participants, evaluated accessibility to PHC and medications, and examined health impacts on participants during the war. Following descriptive statistics, inferential analysis investigated the relationships between participants' perceptions of PHC and their areas of residence or displacement.</p><p><strong>Results: </strong>Hypertension (64.9%), type II diabetes mellitus (44.4%), and cardiovascular disease (17.1%) were the most frequently reported NCDs. 98.0% of participants were displaced during the war, and 68.1% were still displaced. 29.9% had lost a first-degree relative, and the majority suffered inaccessibility to adequate food and drinking water, lost property and income, and suffered adverse impacts on their sleep and physical exercise habits. 92.8% rated their pre-war quality of life (QoL) as excellent or good, while 81.3% rated their QoL during the war as poor. Adherence to regular follow-ups decreased from 96.7% before the war to 40.7% during the war (p < 0.001). Satisfaction with PHC dropped from 92.9% to 57.33% (p = 0.002). In terms of access to PHC, more than 93% changed their PHC doctor or clinic, and most stated that reaching the clinic was dangerous and necessitated long journeys. Medication unavailability or high cost were the most frequently reported reasons for non-compliance during the war, reported by 42.7% and 18.1%, respectively. Nearly one in five participants spent two or more consecutive months without medication. Participants from the southern enclave were significantly less satisfied with PHC and medications (p = 0.001), and their subjective QoL was significantly worse (p = 0.007).</p><p><strong>Conclusions: </strong>The study offers important insights into the impacts of high-intensity armed conflicts on people with NCDs. The war in the Gaza Strip has profoundly impacted patients with NCDs and hampered their access to healthcare, leaving the population at risk for higher morbidity and excess mortality rates now and well into the future.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"36"},"PeriodicalIF":3.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring diabetic patients experiences during war in Sudan: insights from a multi-city study.","authors":"Mohamed Hisham Alamin, Manasik Mamoun, Leina Elfatih Salah Mohamed Ali Elomeiri, Sarah Hashim Mohammed Osman, Shrouk M Abdou, Fatima Mohamed Osman Yasin, Ekhlass Ahmed Musa Mohamed, Abdelrahman Idris Mohamed Idris, Marwa Adil Abdelwahab Hag Ahmed, Lina Ahmed Ali Mohmmed Ahmed, Abdalmahmoud Asadig Kanan Ahmed, Mariam Abdelgadir Hago Taha, Moneer Ali Abdallah Ali, Esra Abdallah Abdalwahed Mahgoub","doi":"10.1186/s13031-025-00671-3","DOIUrl":"10.1186/s13031-025-00671-3","url":null,"abstract":"<p><strong>Background: </strong>The health system in Sudan was severely compromised by the ongoing conflict, jeopardizing the lives of millions of vulnerable people suffering from chronic health conditions, including diabetic patients. This study explored the experiences of diabetic patients, focusing on the challenges they faced in accessing medical consultations, medications, and blood glucose monitoring during the ongoing war.</p><p><strong>Methods: </strong>A descriptive facility-based cross-sectional study was conducted across seven hospitals and diabetes centers in Sudan from May to July 2024, enrolling 350 diabetic patients. Convenient sampling was used to select the participants from the outpatient clinics of the targeted health facilities. Data was collected by interviewing patients using a structured questionnaire.</p><p><strong>Results: </strong>Sixty percent of participants faced challenges accessing medications, with drug shortages (65.9%), the closure of pharmacies (44.1%), and safety concerns (39.8%) being the major barriers. Insulin users experienced significant difficulties, with 69.1% reporting problems storing their medications due to frequent power outages. The majority of patients (81.1%) faced challenges accessing medical care during the war. The most common difficulties included transportation issues and long wait times or overcrowding. The war disrupted the healthy eating habits of 34.9% of patients. Moreover, 54.3% of patients experienced a decline in blood sugar testing frequency, often due to the unavailability of laboratories and financial constraints. Displaced patients and patients in Al Mangal City suffered the most from these challenges.</p><p><strong>Conclusion: </strong>This study reveals the devastating impact of the ongoing conflict on diabetes care in Sudan. Severe disruptions to healthcare access, including medication shortages and limited resources, have forced patients to adopt hazardous coping mechanisms. Urgent action is needed, including humanitarian aid and innovative interventions, to ensure equitable and sustainable diabetes care for all Sudanese patients.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"35"},"PeriodicalIF":3.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Growing up amidst violence: mapping mental health ecologies with young people on Colombia's Pacific Coast.","authors":"Sanne Weber, Francy Carranza, Ana María Arango, Juan Roberto Rengifo, Mónica Pinilla-Roncancio, Sarah-Jane Fenton, Germán Casas, Paul Jackson, Juan Pablo Aranguren","doi":"10.1186/s13031-025-00677-x","DOIUrl":"10.1186/s13031-025-00677-x","url":null,"abstract":"","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"34"},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-traumatic stress disorder and its temporal relationship with quality of life in war-affected districts of North Shewa Zone, Amhara Region, Ethiopia.","authors":"Mesfin Tadese, Saba Desta Tessema, Abebe Mihretie, Solomon Hailemeskel, Getaneh Baye Mulu, Tesfalidet Beyene, Tesfa Dejenie Habtewold","doi":"10.1186/s13031-025-00651-7","DOIUrl":"10.1186/s13031-025-00651-7","url":null,"abstract":"<p><strong>Background: </strong>People in war-affected and politically violent areas often experience traumatic events that can lead to long-lasting physical and mental health issues. This study aimed to assess the prevalence of post-traumatic stress disorder (PTSD), identify associated risk factors, and examine its relationship with the quality of life.</p><p><strong>Method: </strong>A community-based cross-sectional study was conducted Between April 1 and May 15, 2022, in 812 individuals living in war-affected districts of the North Shewa Zone, Amhara Region, Ethiopia. A multistage sampling technique was employed to select the study subjects. Sociodemographic and pre-existing illness data were collected through face-to-face interviews using a pre-tested instrument. The Post-Traumatic Stress Disorder Checklist (PCL-5) was used to measure the PTSD symptoms and cut-off above 33 was used to identify individuals with PTSD. Health-related quality of life was measured using the World Health Organization's (WHO) Quality of Life-brief version (WHOQOL-BREF) questionnaire. Binary logistic regression analysis was used to identify PTSD associated factors, while the independent T-test was applied to compare the quality of life (QOL). The model's fit was evaluated using the Hosmer-Lemeshow goodness-of-fit test and a p-value of 0.05 was considered statistically significant.</p><p><strong>Result: </strong>The prevalence of PTSD was 42.4%. Khat use (AOR = 2.33, 95% CI: 1.33-4.07, p < 0.001), having friends or family who died from mental illness (AOR = 3.91, 95% CI: 1.66-9.20, p < 0.01), conflicts with family, friends or loved ones (AOR = 1.89, 95% CI: 1.18-3.01, p < 0.01), poor social support (AOR = 3.84, 95% CI: 2.53-5.81, p < 0.001), and being coerced into accepting ideas against their will (AOR = 2.04, 95% CI: 1.37-3.03, p < 0.001) were significant factors associated with PTSD. Further, quality of life (QOL) was significantly lower by 0.87 points among individuals with PTSD compared to those without PTSD (t-value = 12.279, p < 0.001).</p><p><strong>Conclusion: </strong>About 4 in 10 individuals living in war-affected districts of the North Shewa Zone, Amhara Region experienced PTSD. Avoiding substance use (a negative coping style) and providing psychotherapy that can adequately addresses the community's medical, social, and psychological needs is essential for improving QOL in war-related PTSD.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"33"},"PeriodicalIF":3.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the organization and delivery of health services following the repatriation of South Sudanese refugees from the West Nile districts in Uganda.","authors":"Henry Komakech, Lynn Atuyambe, Fadi El-Jardali, Christopher Garimoi Orach","doi":"10.1186/s13031-025-00672-2","DOIUrl":"10.1186/s13031-025-00672-2","url":null,"abstract":"<p><strong>Background: </strong>Low- and middle-income countries face several challenges in providing health services, particularly to displaced populations, during all phases of emergencies. However, little is known about how health services are organized to displaced populations following repatriation. This study examined the organization of health services following the repatriation of South Sudanese refugees from the three West Nile districts of Arua, Adjumani, and Moyo in Uganda.</p><p><strong>Methods: </strong>We conducted a qualitative case study in three West Nile refugee hosting districts, Arua, Moyo, and Adjumani. We used the World Health Organization Health System Framework, focusing on four blocks: health services, financing, medicines and supplies, and human resources. We conducted in-depth interviews with 32 purposefully selected respondents, including health service providers, district civil leaders, local government staff, and non-government organization staff. The data were analyzed using content analysis.</p><p><strong>Results: </strong>Following repatriation, the district health teams in the three districts assumed overall responsibility for planning, managing, and providing health services. Health services followed an integrated model within a decentralized framework in all three districts. Health services were available in most areas except for former refugee settlements where facilities were either closed or relocated. After repatriation, funding for health services was provided through the government's primary health care grant with minimal support from aid agencies. Districts, however, face several challenges, including shortages of medicines and essential supplies, inadequate health workers, and poor infrastructure.</p><p><strong>Conclusion: </strong>Refugee repatriation disrupted health service delivery in the refugee hosting districts, leading to a reduction in funding; inadequate skilled health workers and equipment; and the closure of some facilities. To ensure the continuity of health services, government and aid agencies should plan for repatriation and establish strategies to sustain health services in refugee-hosting areas.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"32"},"PeriodicalIF":3.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}