Abstract
BackgroundBy 2017, more than 500,000 Syrian refugees had passed through Greece seeking safety and asylum. Understanding how their health needs evolved over the refugee crisis in Greece and in relation to changing migration policy, and exploring the challenges involved in delivering their healthcare is timely as non-governmental organizations (NGOs) transition health service provision to the Greek health authorities.MethodsWe conducted a qualitative study to explore stakeholders’ perspectives on delivering health services to Syrian refugees over the course of the humanitarian response in Greece from 2015 to 2017. Twenty-five in-depth interviews were conducted face-to-face or by Skype with healthcare providers, NGO staff, and organizational and government representatives involved in coordinating and managing healthcare for the Syrian refugee population in Greece. Following informed consent, interviews were audio-recorded or detailed summaries were manually recorded. Data were coded inductively to identify emerging themes.ResultsFollowing the implementation of the European Union-Turkey agreement in 2016, healthcare providers in refugee camps reported a shift from acute physical health issues to mental health disorders, and heightened risks of gender-based violence among Syrian refugees. Key challenges to service delivery included a narrow model of healthcare provision and insufficient referral mechanisms for social support and mental health services. Language and gender differences between refugees and healthcare providers, and a lack of privacy and space in clinics impeded the quality of care. Stakeholders observed deterioration in refugees’ mental health in relation to longer periods spent in the camps. Many also emphasized that services for gender-based violence and mental health should be prioritized.ConclusionThis study provides stakeholders’ perspectives on changes in refugee health needs over the course of the humanitarian response in Greece. With protracted encampment resulting from migration policy, addressing mental health disorders and gender-based violence should be prioritized, including psychosocial training for healthcare providers and strengthening referral mechanisms for specialized care. The findings also emphasize the importance of providing human-centered care and gender concordant services by incorporating female healthcare providers and interpreters into medical teams. Strategic communication and coordination is needed between NGOs and Greek health authorities to facilitate the transition of health service delivery to the Greek healthcare system and to improve access and quality of care for refugees.
Highlights
By 2017, more than 500,000 Syrian refugees had passed through Greece seeking safety and asylum
With protracted encampment resulting from migration policy, addressing mental health disorders and gender-based violence should be prioritized, including psychosocial training for healthcare providers and strengthening referral mechanisms for specialized care
Strategic communication and coordination is needed between Non-governmental organization (NGO) and Greek health authorities to facilitate the transition of health service delivery to the Greek healthcare system and to improve access and quality of care for refugees
Summary
By 2017, more than 500,000 Syrian refugees had passed through Greece seeking safety and asylum. Most refugees from Syria did not intend to remain in Greece and were seeking asylum and family reunification in other European Union (EU) Member States [6] They were typically transferred to the Greek mainland within one to three days before continuing on the Western Balkan transit route. In March 2016, an agreement between the EU and Turkey, known as the EU-Turkey Statement, came into effect, which called for all “irregular” migrants crossing into Greece to be returned to Turkey, as well as a commitment from Turkey to restrict new sea or land migration routes from Turkey to the EU [7,8,9] This agreement led to a diminished influx of refugees into Greece [10]. Refugee outflows from Greece decreased as a result of border closures to its East, leaving approximately 60,000 individuals, predominantly from Syria, stranded on the Greek mainland and islands waiting for asylum claims to be processed [10, 11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
