International Journal of Health Planning and Management
Volume 27, Issue 1, 2012, Pages e51-e64

Understanding the impact of conflict on health services in Iraq: Information from 401 Iraqi refugee doctors in Jordan (Article)

Burnham G.* , Malik S. , Dhari Al-Shibli A.S. , Mahjoub A.R. , Baqer A.Q. , Baqer Z.Q. , Qaraghuli F.A. , Doocy S.
  • a Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
  • b Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
  • c Department of Obstetrics and Gynecology, University of Texas, Houston, TX, United States
  • d Department of Medical Oncology, Texas Medical Center, Houston, TX, United States
  • e Department of Internal Medicine, University of Texas, Houston, TX, United States
  • f Department of Internal Medicine, University of Texas, Houston, TX, United States
  • g Department of Weill Cornell Medical College Cardiology, New York, NY, United States
  • h Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States

Abstract

Objectives: This study aims to assess how conflict has affected the function of Iraqi health services and its doctors. Methods: Interviews were conducted in person or by mobile phone with 401 Iraqi doctors entering Jordan since 2003, using respondent-driven sampling methods. Results: Of the Iraqi doctors interviewed in 2008, 94% came from Baghdad, although 25% had moved within Iraq in the past year. They reported a steady year-by-year decline in Iraqi health services from 2003 through 2006, with perhaps some improvement in 2007. By 2006, 67% of doctors said essential drugs were present less than half of the time (95% confidence interval [CI] 54-81), and 69% (95% CI 56-84) said essential equipment was available or working half the time or less. By 2006, 95% said their facilities lacked skilled health workers, and 90% noted reduced quality of care. Violent death rates among doctors in Baghdad reached 47.6/1000/yr (95% CI 42.0-53.7) in 2006. In the same year, migration rates for Baghdad doctors moving elsewhere in Iraq were 143.8/1000/yr (95% CI 134.0-154.1), and departure from Iraq was 299.5/1000/yr (95% CI 285.3-314.3). Conclusions: Deterioration of health services quality, staffing levels and violence against doctors continued from 2003 through 2006, although these may have improved slightly in 2007. In 2009 and 2010, reports suggest that assassinations of doctors and out-migration have continued. Few have returned. © 2011 John Wiley & Sons, Ltd.

Author Keywords

Doctors Health systems Iraq Refugees Conflict

Index Keywords

information processing refugee psychological aspect Jordan human Refugees middle aged war Aged Physicians Iraq War, 2003 - interview Young Adult political conflict Humans Interviews as Topic male female health services Article adult migration physician health worker Delivery of Health Care Data Collection health care delivery
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84856297054&doi=10.1002%2fhpm.1091&partnerID=40&md5=7945ba804d502c3708dfbd3088a4bf98
DOI: 10.1002/hpm.1091
ISSN: 07496753
Cited by: 20
Original Language: English