{"id":5483,"date":"2022-12-07T15:01:24","date_gmt":"2022-12-07T15:01:24","guid":{"rendered":"https:\/\/www.unhcr.org\/blogs\/?p=5483"},"modified":"2022-12-07T15:18:40","modified_gmt":"2022-12-07T15:18:40","slug":"more-countries-are-including-refugees-in-national-health-systems-development-partnerships-are-key","status":"publish","type":"post","link":"https:\/\/www.unhcr.org\/blogs\/more-countries-are-including-refugees-in-national-health-systems-development-partnerships-are-key\/","title":{"rendered":"More countries are including refugees in national health systems, and development partnerships are key to the process"},"content":{"rendered":"\n

By Mike Woodman<\/a>, Senior Public Health Officer, UNHCR Division of Resilience and Solutions<\/p>\n\n\n\n

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After advocacy by UNHCR, a Palestinian refugee living with chronic disease in Tunisia has been granted access to free public healthcare, which is an exception rather than the rule for foreigners in the country. \u00a9 UNHCR\/Hallouli Mohamed Ameur<\/em>.<\/figcaption><\/figure>\n\n\n\n

For several decades, UNHCR advocated for and has supported refugee-hosting countries as they move towards the inclusion of refugees in their national health systems. Yet, as the COVID-19 pandemic has highlighted, many hosting countries are struggling to meet the health needs of their populations due to weak infrastructure and inadequate domestic funding allocations compounded by factors such as a slow post-COVID-19 economic recovery, food insecurity and extreme weather events caused by climate change.<\/p>\n\n\n\n

To what extent are refugees currently included in host country health systems?<\/strong><\/p>\n\n\n\n

Refugee access to national health systems depends on the host country\u2019s policies and practices. In some countries, refugees access systems under the same conditions as nationals (subsidized rates or free). In others, refugees can only access services as \u201cforeigners\u201d, often at a higher cost. There are also countries where refugees have limited access to health services due to policies or geographic, linguistic, cultural, and financial barriers.<\/p>\n\n\n\n

Good progress but\u2026<\/strong><\/p>\n\n\n\n

Results from UNHCR’s biannual health inclusion survey<\/a> of 49 countries indicate that 77% include refugees in their national health plans, up from 62% in 2019. All countries reported that refugees could access primary health facilities, with 94% enjoying access under the same conditions as nationals. However, access is far lower when it comes to receiving care at hospitals, where 17% of countries report no or unequal access compared to citizens. Increasingly, more countries are including refugees in communicable disease programmes and related Global Fund Applications<\/a> for malaria, HIV and tubercolosis.<\/p>\n\n\n\n

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Encouragingly, when it came to COVID-19 vaccination roll outs, most governments overwhelmingly supported the inclusion of refugees in national responses \u2013 refugees have received vaccinations through national systems in 153 countries.<\/p>\n\n\n\n

Social health insurance, one of the strategies towards Universal Health Coverage<\/strong><\/p>\n\n\n\n

Of the 49 countries in the inclusion survey, just under 60% report having a social health insurance scheme. Of those 29 countries with such schemes, only 12 (41%) include refugees. A significant barrier to inclusion is economic sustainability. Insurance premiums must be covered somehow, yet many refugees cannot work to afford the regular payments. <\/p>\n\n\n\n