AI Article Synopsis

  • Anbar province, specifically Hadeetha, experienced significant health care disruptions during the conflicts from the U.S. invasion in 2003 and ISIS occupation from 2014-2017, leading to changes in health-seeking behaviors among caregivers of young children.
  • The mixed-methods study conducted from 2019 to 2021 involved a household survey of 415 caregivers and focus groups with healthcare workers to understand shifts in healthcare access and practices post-conflict.
  • Findings revealed that post-conflict, 79% of caregivers sought care from physicians compared to just 47% during the conflict, while healthcare workers identified major challenges in service delivery during the ISIS years due to infrastructure damage and threats to safety.

Article Abstract

Background: The western province of Anbar, and the district of Hadeetha, have suffered direct impacts from the second United States led invasion (2003) through the ISIS invasion (2014-2017). With the primary health care centers being closed or inaccessible, the remaining population experienced changes in health seeking. The area of Anbar, Iraq remains largely remote from the discourse of health system recovery post-conflict. The objective of this study was to describe changes in health seeking behaviors of caregivers of children ages 12-72 months of age in Hadeetha, Anbar, Iraq from the conflict period of ISIS (Islamic State of Syria and Iraq), 2014-2017, to the post-conflict period, 2021.

Methods: This was a mixed-methods study composed of a cross-sectional 415 household survey and focus groups in Hadeetha, Anbar, Iraq. Caretakers of children were interviewed from February to April 2021. Children were sampled from a list of children who missed at least one vaccination appointment without a return for follow-up from the birth cohorts of 2014 to 2020. Healthcare workers focus groups and key informant interviews occurred from 2019 to 2021 centered around experiences from the 2014 to 2021 period.

Results: In the post-conflict period, there were no differences in health seeking based upon provider type between respondents. Physicians were primary healthcare providers in the post-conflict period for 79% of respondents versus only 47% in the conflict period. Healthcare workers described major barriers to delivering services in Hadeetha during the ISIS occupation due to infrastructure damage, threats of violence, decreased medical personnel, lack of compensation and disruptions in medical supplies from 2014 to 2017.

Conclusion: This study provides insight into health seeking challenges among the many individuals who remained in Hadeetha during the ISIS occupation. Health use patterns by provider type mirror the concerns the healthcare providers shared: limited availability, efflux of professional workers, limited resources and security challenges to providing care. Positive trends toward increased access to physicians during periods of peace are an encouraging marker for continued population resilience during the post-conflict period. Recovery efforts continue to be hampered by internal sectarian discord within Iraq as well as insufficient resources to maintain health services as well as provide catch-up health services, such as immunizations.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495094PMC
http://dx.doi.org/10.1186/s13031-024-00622-4DOI Listing

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