Social determinants and mental health needs of Palestine refugees and UNRWA responses in Gaza during the COVID-19 pandemic: a qualitative assessment

BMC Public Health

Research

Giulia Loffreda¹  Zeina Jamal¹  Sophie Witter¹  Karin Diaconu¹  Mohammed Waleed²  Zoheir ElKhatib²  Farah Fawaz³  Shatha AlBaik³  Akihiro Seita³  Masako Horino⁴ 

[1] Institute for Global Health and Development, Queen Margaret University, EH21 6UU, Edinburgh, Musselburgh, Scotland, UK;The United Nations for the Relief and Works Agency in the Near East (UNRWA) Field Office, Gaza, Palestine;The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan;The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan;Center for Human Nutrition and Sight & Life Global Nutrition Research Institute, Dept of Int’l Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;

关键词: Mental health;    Social determinants;    COVID-19;    Pandemic;    Refugees;    Occupied Palestinian territory;    Gaza;    UNRWA;   

DOI  :  10.1186/s12889-022-14771-9

 received in 2022-05-11, accepted in 2022-11-29,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundDue to pre-existing difficulties, refugees are especially susceptible to the negative effects of the pandemic; nonetheless, the pandemic’s effect on this group is still unclear. The purpose of this study was to determine the effects of the COVID-19 pandemic on the mental health of Palestine refugees in Gaza by identifying the role of social determinants. During the pandemic, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) enacted a number of policies and measures. The purpose of this research was to assess their efficacy and acceptability.MethodsThis qualitative study took place between August and November 2020. Twenty-nine key-informant interviews were conducted remotely with UNRWA Headquarters, field and clinical staff in Gaza and with community members, aged ≥18 years and residing in Rafah and Jabalia camps. We sought informed consent verbally or via email. Data was coded based on the framework for social determinants of mental health.ResultsInterview results indicated that the relationship might be unidirectional, with COVID-19 causing the degradation of living conditions and vice versa, with living conditions exacerbating the COVID-19 situation by facilitating virus transmission. In other instances, the association between mental health determinants and COVID-19 might be bidirectional. In terms of experiencing violence and anxieties, women, children, and daily-paid employees were significantly more disadvantaged than other groups in the community. UNRWA modified its service delivery techniques in order to continue providing essential services. In general, UNRWA’s strategies throughout the pandemic were deemed beneficial, but insufficient to meet the needs of Gazans.ConclusionThe pandemic highlights the need to go beyond disease treatment and prevention to address social determinants to improve refugees’ health and reduce their susceptibility to future shocks. UNRWA has rapidly implemented telemedicine and mental telehealth services, making it imperative to assess the efficacy of these novel approaches to provide care at a distance. A long-term option may be to employ a hybrid strategy, which combines online and in-person therapy.

【 授权许可】

CC BY   
© The Author(s) 2022

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