OVERVIEW
Secondary and tertiary health care institutions in Lebanon are mostly private and cost is a significant barrier to access. UNHCR has put in place referral guidelines and standard operating procedures (SOP) to support access to life saving and obstetric care and manage costs. The costs covered by UNHCR vary according to the type of service provided and the vulnerability status of the refugee.
UNHCR contracts a third party administrator (TPA) to manage and audit referral care.
In September 2016, 1,017,433 Syrian refugees and 22,007 refugees from other countries were registered with UNHCR. However, the referral care programme also supports access to life saving and obstetric care for unregistered refugees.
The total number of referrals increased from 61,820 in 2015 to 76,535 in 2016. This is an increase of 24%.
The number of referral requests covered financially by UNHCR has increased slightly from 95% in 2015 to 97% in 2016.
In January 2016 the UNHCR network consisted of 56 hospitals. By the end of 2016 the number had been rationalized to 50. The majority (71%) of accepted referrals were treated in 20 of these hospitals.
The majority (53.0%) of referrals were for maternity care, 32% of deliveries were by C-section compared to 34% in 2015.
Of the approved referrals there were 869 deaths of which 52% were in children under one year of age, predominantly in the perinatal period.
TPA financial audit of hospital invoices led to a 7.3% deduction of the overall total cost invoiced by hospitals.
33.8% of total expenditure was spent on maternity care compared to 40.1% in 2015.
The average cost per referral was 586 USD compared to 544 USD in 2015.