N O R T H E R N   L E B A N O N

The Impact of Gender Identity on Access to Healthcare Services for Refugees

Our newest project, a case study on the intersectionality of gender and refugee status and its effects on healthcare access in Lebanon, is in development in partnership with the Institute for Migration Studies at the Lebanese American University (LAU).

Preliminary Findings from convenings

Convenings with participants from UN Agencies, international humanitarian organizations, health facilities, and local non-government organizations (NGOs) and civil society organizations (CSOs) that work at the intersection of health, refugees and gender were conducted in May 2022. Prominent themes are listed below:

  • Lack of registration as potenial vulnerability
  • The economic crisis has a similar effect on refugee and host population
  • Need for multidisciplinary, intersectional, holistic and inclusive approach and services
  • Notable increase in gender-based violence in light of COVID-19
  • Conservative region in Northern Lebanon and stigma does not allow for open access of services to gender minorities.
  • Main barriers to accessing healthcare: Transportation, cost of fuel, internet connection, lack of privacy, possibility of harassment, retaliation and outing when seeking gender-inclusive services
  • Lack of healthcare providers trained in dealing with gender-minority cases and hence lack of gender-inclusive services
Creator: Bilal Hussein | Credit: AP

Over the past decade, more than 1.5 million Syrian refugees have fled to Lebanon. With a total population approaching 4 million people, Lebanon presently hosts the highest number of refugees per capita in the world. The Lebanese government’s response to the influx has been a series of patchwork legislation and ad hoc policies. In this climate, refugeehood, gender, and health remain at a sensitive and overlooked intersection particular regarding their access to health services. The country’s highly privatized healthcare system is expensive, inaccessible, and unattainable for many migrants and refugee groups. And while the UNHCR financially supports this marginalized group, it only covers life-saving services or parts of doctor’s feeds, leaving few options for those with serious or chronic health conditions such as cancer and kidney disease.

Beyond the economic and financial challenges, geographic disparity poses a major obstacle for the refugee community in Lebanon. Most recently, the country’s ongoing fuel crisis has exacerbated barriers to accessing healthcare. Additionally, women and LGBTQI+ refugees in Lebanon continue to endure extreme forms of violence, discrimination, stigmatization, and isolation in the “safe” places they seek. Their specific needs are often discounted from mainstream refugee services, and very little humanitarian programming is tailored specifically for them. More research is needed to understand the lived experience of refugees living at the intersectionality between immigration status and gender, and to inform gender and LGBTQI-inclusive policies and humanitarian programming.

How has gender identity impacted access to healthcare services in Tripoli and Akkar
since 2019 for the registered refugee community?

Other research questions include:

  • How does this impact women, LGBTQI+, and children refugees’ access to healthcare specifically?
  • How does registration with UNHCR assist/impede healthcare access? How has the ongoing economic and financial crisis in Lebanon impacted the health sector, as well as the provision of health services to the refugee community in general?
  • What specific impediments to access to healthcare services are associated with this region specifically in Tripoli?

This case study will focus on the region of Tripoli in North Lebanon.  The city of Tripoli has been marred by decades of armed conflict and instability, resulting in a fragile economy that is struggling to support the local population, let alone the influx of refugees from neighboring Syria in the past decade. 

Syria and northern Lebanon have a long-shared history, with common cultural and religious characteristics. With the influx of Syrian refugees, the ongoing economic crisis and the COVID-19 pandemic, Tripoli’s capacity to meet host community and refugee health needs is severely strained, particularly when it comes to the most vulnerable refugees such as women and LGBTQI+ populations.

This study will apply a mixed-methods approach that is participatory, inclusive, and target-group sensitive. The data collection will be conducted in hybrid mode (i.e. remote and in-person).

The data collection phase will encompass convenings and key informant interviews with UN Agencies, international humanitarian Organizations, health facilities and local non-government organizations (NGOs) and civil society organizations (CSOs) that work at the intersection of health, refugees and gender.

Subsequently, Focus Group Discussions will be held with Syrian refugees in Tripoli.