The Resilience of Health Systems in Conflict Zones: A Study from Iraq: VARN 2023 Presentation
The Resilience of Health Systems in Conflict Zones: A Study from Iraq
In the heart of conflict-ridden Iraq, amidst the shadows of decades-long turmoil and the recent COVID-19 pandemic, a significant study emerged, shedding light on the resilience and challenges of health systems in crisis. This blog post delves into the findings of a comprehensive research project conducted in the Anbar province of Iraq, exploring the impact of the coronavirus pandemic on childhood immunizations within a recovering health system.
The Backdrop of Conflict and Health
Iraq, a nation that has endured four decades of conflict, presents a unique landscape for health research. The study, part of a doctoral dissertation at Johns Hopkins University, was conducted in the Anbar province, known for cities like Fallujah and Ramadi. This region, largely Sunni, has witnessed the rise and fall of Al Qaeda and ISIS, leaving a lasting impact on its health infrastructure.
The Study's Focus: Childhood Immunizations During COVID-19
The research focused on the effects of the COVID-19 pandemic on childhood immunizations, particularly during the shutdowns. It was a time when primary care services for children were severely disrupted, leading to a significant drop in immunization rates. The study revealed a 10% decrease in child immunizations between 2019 and 2020 across Iraq, with a more pronounced impact in the Anbar province.
Methodology and Findings
The study employed a mixed-method approach, examining both the usual predictors for childhood immunization completion and the added variables of conflict and COVID-19 impact. A key finding was the disparity in immunization rates between children born during the ISIS occupation and those born during the pandemic. Surprisingly, children born during the pandemic fared better in receiving timely immunizations than those born during ISIS rule.
Challenges on the Ground
The research team faced numerous challenges, including navigating dangerous roads littered with IEDs and addressing the needs of communities with deep-seated trauma. The study involved visiting 171 households, representing 468 children under five, to provide immunizations and gather data.
Key Insights
Parental Awareness: A significant predictor of immunization rates was parental awareness of vaccine schedules. The focus on COVID-19 vaccines overshadowed the importance of routine childhood immunizations.
Healthcare Access: The study highlighted the need for flexible healthcare provision, especially in conflict-affected areas. The community expressed a preference for immunization campaigns and personalized healthcare counseling.
Long-term Impact: The research underscored the long-term effects of conflict on healthcare systems, suggesting that recovery could take up to a decade.
Conclusion and Acknowledgments
The study concludes with a call to explore the dual impact of COVID-19 and conflict on health systems in similar settings. It emphasizes the need for targeted interventions and sustained efforts to bridge the immunization gap in conflict zones.
The research was made possible by the dedication of the Iraq team and the support from UNICEF Iraq, highlighting the collaborative effort in bringing crucial health insights to the forefront.
