title: Health service utilization and access to medicines among Syrian refugee children in Jordan.
abstract: BACKGROUND
  With over one million Syrian refugee children in the region, we undertook this study to characterize care-seeking behaviors and health service utilization for child refugees with the aim of informing humanitarian programming for non-camp settings in Jordan.
  
  
  METHODS
  A survey of Syrian refugees living outside of camps in Jordan was conducted using a 125 × 12 cluster design with probability proportional to size sampling to obtain a representative sample. The questionnaire focused on access to health services, including a module on care seeking for children.
  
  
  RESULTS
  Care seeking was high with 90.9% of households with a child less than 18 years seeking medical care the last time it was needed. Households most often sought care for children in the public sector (54.6%), followed by private (36.5%) and charity sectors (8.9%). Among child care seekers, 88.6% were prescribed medication during the most recent visit, 90.6% of which obtained the medication. Overall, 49.4% of households reported out-of-pocket expenditures for either the consultation or prescribed medications at the most recent visit (mean $US21.1 and median $US0).
  
  
  CONCLUSIONS
  Syrian refugees had good access to care for their sick children at the time of the survey; however, this has likely deteriorated since the survey because of the withdrawal of free access for refugees. The number of refugees in Jordan and relative accessibility of care has resulted in a large burden on the health system; the Jordanian government will require additional support if current levels of health access are to be maintained for Syrian refugees.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Shannon
authors.initials: S
authors.lastname: Doocy
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Lyles
authors.affiliation: Jordan University of Science and Technology, School of Nursing, Irbid, Jordan.
authors.forename: Laila
authors.initials: L
authors.lastname: Akhu-Zaheya
authors.affiliation: United Nations High Commissioner for Refugees, Geneva, Switzerland.
authors.forename: Ann
authors.initials: A
authors.lastname: Burton
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: William
authors.initials: W
authors.lastname: Weiss
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D004358:Drug Therapy / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007597:Jordan; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012036:Refugees / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013593:Syria / Q000208:ethnology*
keywords: Jordan; Syria; child health; humanitarian assistance; refugees