185931 Healthcare needs, perceptions, and behaviors of Iraqi nationals attending NGO clinics in Amman, Jordan

Monday, October 27, 2008: 9:06 AM

Allen Andrews, MPH, MPhil , School of Medicine, Oregon Health & Science University, Portland, OR
Farah Bader , Johns Hopkins Bloomberg School of Public Health, Warner Robins, GA
Neerav Goyal , Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Jennifer Leigh , Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Rakhi Sinha , Johns Hopkins Bloomberg School of Public Health, Yucaipa, CA
Shannon Doocy, PhD , Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Adam Sirois, Graduate Student , International Health, Johns Hopkins University, Baltimore, MD
Purpose: To assess the health care needs, perceptions of quality of care, and health care seeking behaviors of Iraqi nationals seeking health care at Caritas and Jordan Red Crescent health clinics in Amman, Jordan.

Background: Many Iraqis fled due to the 2003 US invasion. Approximately 1.8 million refugees have sought refuge in Jordan and Syria. It is estimated that approximately 700,000 Iraqi nationals are living in Jordan. Because the Iraqis are highly mobile, difficult to reach, and have tenuous access to social services, little is known about their needs. Heightened financial concerns, concerns about their legal status in Jordan, and their fear of deportation are potential barriers preventing them from seeking health care.

Data: Interviewer administered survey

Methods: A surveys of patients seeking care Caritas and Jordan Red Crescent clinics in Amman, Jordan was conducted in January and February 2008. The Arabic questionnaire was administered by Iraqi physician interviewers, and most respondents were Iraqis. Respondents were selected using systematic randomization with the sampling interval dependant on clinic utilization data.

Results: Most clinic attendees were originally from Baghdad with more females seeking care. Overall, perceptions of clinic quality were positive. Staff, waiting time, and medication access and quality were cited as problems at specific clinics. Free services and medication availability were the strongest incentives for clinic utilization. There was a substantial need for mental health services. Though few Iraqis are registered with UNHCR overall, the survey showed that almost all clinic attendees had valid registration. There is some misinformation about UNHCR registration being required to attend clinics, or to receive free services. Results also provide information about patient access and barriers to care.

Recommendations and policy implications: Whereas our survey indicates that some services to meet the health needs of Iraqi nationals in Amman exist, additional and expanded services are needed. Emphasis should be placed on providing emergency and mental health services. The lack of appropriate information regarding clinic utilization eligibility needs to be addressed.

Learning Objectives:
1. To determine the health care needs of Iraqi nationals living in Amman, Jordan 2. To quantify the effects of a refugee population on the health care system of a host country 3. To determine the health seeking behaviors of Iraqi nationals living in Amman, Jordan 4. To determine how well UNHCR registration has been received by Iraqi nationals in Amman, Jordan

Keywords: Refugees, Health Needs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a co-author on the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Populations in Conflict / Displaced Populations
See more of: International Health