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      The Health Needs of Syrian Refugees in Context of Social Determinants of Health: The Case of Turkey

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          Abstract

          Aim:

          This study aims to determine the health needs and access to health services among Syrian refugees.

          Methods:

          This cross-sectional study was carried out between March and September 2022 in a public setting that provides humanitarian aid in Istanbul Province. The sample included 150 participants who met the inclusion criteria. The data were collected through 20–30-minute face-to-face interviews using the Omaha System Problem Classification Scheme and the sociodemographic characteristics questionnaire. All data were transferred to IBM Statistical Package for the Social Sciences Statistics software, version 28.0, for analysis. Descriptive statistics and chi-square significance tests were performed.

          Results:

          The result of the analysis revealed that the health problems of Syrian refugees were mostly related to the physiological domain (13/39.3%), followed by the psychosocial domain (9/27.2%), health-related behaviors domain (7/21.2%), and environmental domain (4/12.1%).

          Conclusion:

          This study highlighted the fact that refugees continue to be vulnerable to social determinants of health. In this context, it is recommended to develop new policies to reduce poverty, increase access to health and other public services, and empower refugees.

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          Most cited references22

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          The Social Determinants of Refugee Mental Health in the Post-Migration Context: A Critical Review

          With the global increase in the number of refugees and asylum seekers, mental health professionals have become more aware of the need to understand and respond to the mental health needs of forced migrants. This critical review summarizes the findings of recent systematic reviews and primary research on the impact of post-migration conditions on mental disorders and PTSD among refugees and asylum seekers. Historically, the focus of mental health research and interventions with these populations has been on the impact of pre-migration trauma. Pre-migration trauma does predict mental disorders and PTSD, but the post-migration context can be an equally powerful determinant of mental health. Moreover, post-migration factors may moderate the ability of refugees to recover from pre-migration trauma. The importance of post-migration stressors to refugee mental health suggests the need for therapeutic interventions with psychosocial elements that address the broader conditions of refugee and asylum seekers' lives. However, there are few studies of multimodal interventions with refugees, and even fewer with control conditions that allow for conclusions about their effectiveness. These findings are interpreted using a social determinants of health framework that connects the risk and protective factors in the material and social conditions of refugees' post-migration lives to broader social, economic and political factors.
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            Assessment of the health needs of Syrian refugees in Lebanon and Syria’s neighboring countries

            Background Health needs of displaced Syrians in refugee hosting countries have become increasingly complex in light of the protracted Syrian conflict. The primary aim of this study was to identify the primary health needs of displaced Syrians in Iraq, Jordan, Lebanon, Turkey, and Syria. Methods A systematic review was performed using 6 electronic databases, and multiple grey literature sources. Title, abstract, and full text screening were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The target population was Syrian individuals displaced due to conflict in Syria and its neighboring countries. The outcomes of interest were health needs (i.e. health problems that can be addressed by health services), gaps in health services, training, and workforce. Studies on mixed refugee populations and Syrians displaced prior to the conflict were excluded. Results The Lebanon-specific results of the review were validated through two stakeholder roundtable discussions conducted with representatives from primary healthcare centers, non-governmental organizations and humanitarian aid agencies. A total of 63 articles were included in the analysis. Mental health and women’s health were identified as the greatest health needs in the region. The most common health problems were Non-communicable diseases in Jordan, women’s health in Lebanon and mental health in Turkey. Studies addressing gaps in services found the highest gap in general healthcare services, followed by women’s health, mental health, and vaccinations. Sub-optimal training and availability of health workers was also noted particularly in Syria. Results from the stakeholders’ discussions in Lebanon showed communicable diseases, women’s health and mental health as the main health needs of Syrian refugees in Lebanon. Reported barriers to accessing health services included geographical barriers and lack of necessary awareness and education. Conclusion There is a need for an enhanced synchronized approach in Syria’s refugee hosting neighboring countries to reduce the existing gaps in responding to the needs of Syrian refugees, especially in regards to women’s health, mental health, and communicable diseases. This mainly includes training of healthcare workers to ensure a skilled workforce and community-based efforts to overcome barriers to access, including lack of knowledge and awareness about highly prevalent health conditions. Electronic supplementary material The online version of this article (10.1186/s13031-019-0211-3) contains supplementary material, which is available to authorized users.
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              Syrian Refugees, Health and Migration Legislation in Turkey

              This paper discusses the crucial effects of Turkish health and migration laws on Syrian refugees’ access to public health services and social determinants of health. Key aspects of current Turkish laws affect the health of both refugees and Turkish citizens in many ways. The huge influx of refugees is increasing communicable disease risks, overcrowding hospitals, and more generally straining financial and health resources. Turkey’s United Nations membership and its candidacy for European Union (EU) have led to increased alignment of Turkey’s refugee and migration policies with international law. Major differences remain, however, and Turkey’s remaining non-compliance with international refugee laws is a major force driving Syrian refugee’s flight to EU countries, as refugees desperately seek the right to better health and social services.
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                Author and article information

                Journal
                Florence Nightingale J Nurs
                Florence Nightingale J Nurs
                Florence Nightingale Journal of Nursing
                İstanbul University-Cerrahpaşa Florence Nightingale Faculty of Nursing
                2687-6442
                February 2024
                01 February 2024
                : 32
                : 1
                : 36-42
                Affiliations
                [1 ]Department of Public Health Nursing , Koç University Faculty of Nursing, İstanbul, Turkey
                [2 ]Department of Fundamental Nursing , Koç University Faculty of Nursing, İstanbul, Turkey
                Author notes
                Corresponding Author: Özlem Çiçek DoğanE-mail: odogan21@ 123456ku.edu.tr

                Cite this article as: Doğan, Ö. Ç., Karadağ, A., & Beşer, A. (2024). The health needs of Syrian refugees in context of social determinants of health: The case of Turkey. Florence Nightingale Journal of Nursing, 32(1) , 36-42.

                Author information
                http://orcid.org/0000-0002-5642-3593
                http://orcid.org/0000-0001-6436-1647
                http://orcid.org/0000-0003-4039-7439
                Article
                fnjn-32-1-36
                10.5152/FNJN.2024.23138
                11059488
                31aa95d4-1a62-4ac8-ac6d-84500041a4cf
                2024 authors

                Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 21 June 2023
                : 3 November 2023
                Funding
                The authors declared that this study has received no financial support.
                Categories
                Research Article

                health status,refugees,social determinants of health,turkey.

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