OVERVIEW
UNHCR’s public health approach is based on primary health care (PHC) strategy1. Secondary and tertiary health care institutions in Lebanon are mostly private and cost is a significant barrier to access. Not all adhere strictly to the Ministry of Public Health (MOPH) flat rate of hospital care. To harmonize access to secondary healthcare and manage costs, UNHCR has put in place referral guidelines in Lebanon. The costs covered by UNHCR vary by estimated cost of care, vulnerability status, and type of care (e.g. emergency life-saving, obstetric, medical and surgical).
At the end of 2014, 1,119,079 Syrian refugees were registered with UNHCR in Lebanon. Since October 2014, 15,200 refugees from Iraq, Sudan and Somalia were also covered under the UNHCR referral health care programme.
• The number of referrals both accepted and declined, based on the Standard Operating Procedures (SOP), was stable over time.
• The majority of accepted referrals are covered in the 20 receiving hospitals.
• Most of the referrals, 56%, were for obstetric care, of which 36% of obstetric referrals resulted in a C-section.
• Almost half of reported in-hospital deaths were among infants under 1 years mainly due to neonatal and congenital disease.
• UNHCR paid 76% of the 35.9 million USD spent on referral care in 2014.
• 38% of total expenditure was spent on obstetric care • 1.5% of expenditure was for cases costing more than 1,500 USD • Annual cost of referral care per capita was 33.4 USD.
