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Background: The prolonged presence of Syrian refugees in Jordan has highlighted the need for sustainable health service delivery models for refugees. In 2012, the Jordanian government adopted a policy that granted Syrian refugees access, free of charge, to the national health system. However since 2012, successive policy revisions have limited refugee access. This paper seeks to understand factors that initially put refugee integration into the health system on the policy agenda, as well as how these same factors later affected commitment to sustain the policy. Methods: This paper draws on data from a document review of 197 peer-reviewed and grey literature publications, a media analysis of newspaper articles retrieved from four officially recognized newspapers in Jordan, and 33 semi-structured key informant interviews. We used Kingdon's Multiple Streams Model – a well-established tool for analyzing policy adoption – to understand how political priority developed for integration of refugees into the health system. Results: We find that several factors helped bring attention to the issue, namely concerns over infectious disease transmission to host communities, high rates of chronic conditions among the refugee population and the increasingly urban and dispersed nature of refugees. At the outset of the conflict, the national mood was receptive to refugees. Politicians and government officials quickly recognized the crisis as an opportunity to secure material and technical support from the international humanitarian community. At the same time, global pressures for integrating refugees into national health systems helped move the integration agenda forward in Jordan and the region more broadly. Since 2012, there were several modifications to the policy that signal profound changes in national views around the continued presence of Syrian refugees in the country, as well as reduced external financial support which has undermined the sustainability of the policy. Conclusion: This case study underscores the dynamic nature of policymaking and the challenge of sustaining government commitment to the right to health among refugees. Our analysis has important implications for advocates seeking to advance and maintain momentum for the integration of refugees into national health systems. [ABSTRACT FROM AUTHOR]

Purpose: The current study examined employment rates and predictors of employment among Syrian refugees currently living in Lebanon and Jordan. This paper argues that men and women refugees have different experiences seeking out employment after resettlement due to patriarchal structures and attitudes toward women that are present in the Arab Middle East. The goals of this paper were a) to examine employment rates among Syrian refugees, b) to examine predictors of employment among male and female refugees, and c) to examine refugee status as a moderator of the relationship between attitudes toward women and employment status. Design/methodology/approach: Nationally representative data from the Arab Barometer on 600 refugees and 1400 native-born individuals living in Lebanon and Jordan from 2016–2017 were used. Findings: Native-born individuals living in Lebanon and Jordan were 2.16 times more likely to be employed than refugees. Men living in Lebanon and Jordan were 7.83 times more likely to be employed than women. Finally, refugee status moderated the relationship between attitudes toward women's rights and roles and employment. Among native-born women, a positive attitude toward women's rights and roles predicted employment status, whereas this positive relationship was not found for women refugees. Among refugee men, a positive attitude toward women's rights and roles was linked to a lower likelihood of holding a job. Practical implications: These findings suggest that agencies supporting refugees should communicate realistic expectations about employment during resettlement and should address the challenges that women refugees face when seeking employment. Originality/value: This study is the first study to identify attitudes toward women's rights and roles as a predictor of employment among refugee populations and highlights the unique struggles that refugee women face. [ABSTRACT FROM AUTHOR]

This paper examines how forcibly displaced people cope with prolonged liminality through identity work. Our paper is based on a longitudinal multiple case study of women refugees who fled Syria and experienced liminality in Amman-Jordan, the Zaatari Refugee Camp in Jordan and the United Kingdom. We contribute to the liminality literature by demonstrating how forcibly displaced people respond to extreme structural constraints and maintain cognitive control over their sense of self during liminality with an end date that is unknown. We develop the concept of liminality by illustrating how the actors were pushed into a state of 'indeterminate liminality' and coped by co-constructing it through three forms of identity work – recomposing conflicting memories, reclaiming existence and repositioning tradition. This enabled them to stretch the boundaries of indeterminate liminality, symbolically restore their familiar past and narratively construct a meaningful future. [ABSTRACT FROM AUTHOR]

The past decade has witnessed significant turmoil and political conflicts in several Middle Eastern countries, such as Egypt, Syria, and Libya, called the Arab Spring. These revolutions did not only affect the countries mentioned previously; their neighboring countries were also directly affected. This study explores the impact of the Syrian refugee influx on the stock exchange market of one of its neighboring countries, namely Jordan. The Syrian civil war represents a recent catastrophic event that has resulted in over three million refugees migrating to various countries worldwide. The main objective of this paper is to examine the effect of the Syrian war on Jordan's stock exchange market. The study utilizes the stock exchange indices as indicators of the performance of the exchange market, including Financials, Services, Industries, and General indices as dependent variables, and seven dummy variables are defined as representatives of the main events occurring in the Syrian civil war during the period 2011–2018 as independent variables. Multiple statistical analysis techniques, including correlation coefficients, error functions, and stepwise regression, are employed to analyze the selected variables. The findings reveal an inverse influence of the Syrian war on Jordan's stock market. These findings can potentially enhance the development of prediction models for stock indices in Jordan and other countries by incorporating relevant variables. [ABSTRACT FROM AUTHOR]

Analysis of gendered power struggles often describes men's use of power over women. In some academic research, as well as analysis by development and humanitarian agencies who seek to promote gender equality, power may be framed narrowly. Such analysis may neglect how family relationships are shaped not only by gender but also by intersections between gender and age. This article is based on feminist ethnographic research among Syrian refugees in Jordan as well as interviews with humanitarian workers. It uses accounts of power struggles between Syrian mothers-in-law and daughters-in-law to illustrate how family dynamics shift as women advance in age. The paper complicates assumptions about men's power, arguing that policy-makers and gender practitioners should also consider how older women use power. [ABSTRACT FROM AUTHOR]

The inefficient solid waste management (SWM) affects negatively the environment and the community health. That is why the SWM sector should take serious precautions and measures to address the growing rate of solid waste (SW) generation noting its characteristics (composition), proper collection and disposing methods in a manner aiming its impact decrease. The current situation of Municipal Solid Waste (MSW) is assessed in this paper. It reveals that the existing gaps in the legislations, the funding mechanisms, the capacities (or lack thereof) of the trained staff, the minimal public awareness, and the deficiencies in the equipment are determined to contribute to the overall inefficiencies of the SWM sector and its corresponding services. This paper highlights the SWM problem in Jordan and this problem amplification by the presence of large numbers of Syrian refugees reaching 600,000 individuals, 80 % of which settled in municipal jurisdictions. The improved management practices having the potential to mitigate the negative consequences of the large, improperly managed quantities of SW on health and environment are discussed in this paper. The improved management practices can positively affect Jordan's and municipal economies. [ABSTRACT FROM AUTHOR]

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The vast majority of refugees globally are hosted in developing countries. In Jordan and Lebanon, nearly one in ten people are refugees. This paper reviews how different policy environments in Jordan and Lebanon have shaped economic outcomes for Syrian refugees, focusing on education, work, social assistance, and welfare outcomes. The review summarizes key research on how to improve refugee economic outcomes. We demonstrate that there can be effective service delivery for refugees, dependent on state capacity. For example, differences in policy led to better education outcomes for Syrian refugees in Jordan than in Lebanon. A variety of interventions can support refugee livelihoods, while generally doing no harm to host communities. Both countries also demonstrate the difficulties of achieving refugee economic self-sufficiency. Although Jordan has allowed (limited) legal work opportunities for refugees, Syrian refugees in both countries remain primarily in precarious work and supported by international aid. [ABSTRACT FROM AUTHOR]

This paper presents descriptive statistics from the first wave of the Syrian Refugee Life Study (S-RLS), which began in 2020. S-RLS is a longitudinal study that tracks a representative sample of approximately 2,500 registered Syrian refugee households in Jordan. It collects comprehensive data on sociodemographic variables, health and well-being, preferences, social capital, attitudes, and safety and crime perceptions. We use these data to document sociodemographic characteristics of Syrian refugees in Jordan and compare them to representative populations in the 2016 Jordan Labor Market Panel Survey (JLMPS). Our findings point to lags in basic service access, housing quality, and educational attainment for Syrian refugees relative to non-refugees. The impacts of the pandemic may partially explain these disparities. The data also show that most Syrian refugees have not recovered economically after Covid-19 and have larger gender disparities in income, employment, prevalence of child marriage, and gender attitudes than their non-refugee counterparts. Finally, mental health problems were common for Syrian refugees in 2020, with depression indicated among more than 45 per cent of the phone survey sample and 61 per cent of the in-person survey sample. [ABSTRACT FROM AUTHOR]

Zoonotic diseases are projected to be a serious public threat in the coming decades. In 2016, the World Health Organization (WHO) recommended that Jordan prioritize their list of zoonoses, partially in response to the influx of Syrian refugees. We write this paper to expand the One Health framework by situating zoonotic diseases in peacebuilding and development theories in order to prioritize zoonotic diseases in Jordan. We employ an explanatory sequential mixed methods approach to create a modified version of the Center for Disease Control's (CDC) One Health Zoonotic Disease Prioritization (OHZDP) tool. We use an integrative literature review to develop a list of zoonoses to be prioritized. We expand the One Health framework by arguing health inequity is a form of violence, and thus promotion of health equity is a form of peacebuilding. We undertake thematic and statistical analyses to assess the 12 previously published OHZDP tools to evaluate necessity for change to the process given COVID-19 and the refugee situation in Jordan. In these analyses we use drivers of health indicators as measurements for peacebuilding and development, given these drivers are related to health inequities, to guide weighting of the criteria in our tool for Jordan. We apply our modified OHZDP tool to prioritize our disease list. We find it necessary to give socioeconomic factors greater consideration and to distribute weighting more evenly among all criteria within the tool when prioritizing zoonotic diseases in better reflect the Jordanian context and incorporate the refugee population. We find the priority zoonoses within Jordan to be bovine tuberculosis, brucellosis, and COVID-19, with most having a disproportionately negative impact on refugees. In Jordan's case, zoonotic diseases represent an area where promoting social equity for individuals is essential to the larger society. In this sense managing zoonoses is an area uniquely suited for peacebuilding. [ABSTRACT FROM AUTHOR]

This study aims to demonstrate how the Syrian civil war influences Jordan's economy from the perspective of the labour market and the educational backgrounds of the refugees. Based on the systematic analysis of literature and peer-reviewed papers, a comprehensive analytical framework was developed. This framework is provided with an overview to discover the wage differences between refugees and native-born citizens in Jordan. Three results accompany this analytical report: first, Syrian refugees will have more employment opportunities in the labour market, but vice versa, their employment will increase the ratio of unemployment of Jordanian natives. Second, the Syrian crisis and the influx of refugees should be expected to have a detrimental impact on average wages. A clear sign of this phenomenon can be seen in how Syrian refugees are ready to receive lower salaries and tougher working circumstances in the secondary sector than Jordanians. Finally, educational level and quality of education would be affected negatively. Moreover, the majority of Syrian refugee children are assumed to be registered in schools. Equally important is the need to emphasise that these children will also take quite a long time to adapt to their new educational system. [ABSTRACT FROM AUTHOR]

The Syrian Civil War displaced millions of Syrian women and children, many of whom face economic challenges and discrimination. This paper examines self-reported poverty and its relationship with perceived discrimination among women, as framed by social exclusion theory. The cross-sectional study included 507 Syrian refugee women visiting health clinics outside camps in Jordan. Consistent with our hypothesis, 79.09% of women reported poverty as a serious problem, and women reporting discrimination were found to have higher odds of reporting poverty as a serious problem post-migration (AOR: 3.489; 95% CI: 1.534, 7.937). Gender-responsive interventions, policy implications, and recommendations are addressed. [ABSTRACT FROM AUTHOR]

Refugee camps are complex systems in which very light structures are transforming into permanent cities with very deteriorated urban qualities, services, and infrastructures, producing a fragile environment. However, no previous study has assessed the fragility in refugee camps, often because of the lack of appropriate quantitative indicators to be adopted. Consequently, in this paper, we aimed to fill this gap by developing a fragility index for refugee camps by determining a set of quantitative indicators that could be applied to any refugee camp in the world. The proposed indicators are linked to track four types of fragility: sociopolitical, economic, educational, and health system fragility in refugee camps. In this study, we tracked the risks in 15 refugee camps in Jordan that accommodate Palestinian and Syrian refugees. We developed the schematic diagram for the fragility factors based on the analytical thinking approach and comparative analysis within the United Nations humanitarian organization camp planning standards and the descriptive analysis for the fragility indicators dataset. Therefore, classifying the fragility of refugee camps based on these risks creates a concrete means for planners to determine the most critical risks, to diminish their impacts, and to attain resilience. [ABSTRACT FROM AUTHOR]

Background: The Syrian conflict has resulted in major humanitarian crises. The risk is particularly high amongst female children who face additional gendered risks, such as harassment and sexual violence, including a rise in prevalence of child marriage. Despite the importance of this topic, current literature remains relatively scarce. Objectives: This study aims to explore the social and healthcare repercussions of Syrian refugee child marriages in Jordan and Lebanon. Methods: A systematic review of the literature was carried out to gather evidence, from a total of eight articles. Data analysis was conducted using the Critical Appraisal Skills Programme check tool to systematically assess the trustworthiness, relevance and results of the included papers. Results: The findings of this research identify tradition, honour, economics, fear, and protection-related factors as drivers of child marriage of refugees in Jordan and Lebanon. These motives overlap with findings regarding access to reproductive health and reproductive rights. The lack of autonomy of the child to give informed consent is augmented in the context of protracted violence and displacement. Conclusion: There is a need for a holistic approach to provide safe spaces, education, and protection to young girls and their families to reduce their acceptance of child marriage. [ABSTRACT FROM AUTHOR]

Since the Syrian crisis and the so-called "Arab Spring", new discourses have been created, sparking the discursive water governance debates around water scarcity and hydropolitics. In Lebanon and Jordan—where most water resources are transboundary, and where most Syrian refugees have flown in—new discourses of climate change and especially of Syrian refugees as exacerbating water scarcity are emerging, shaping water governance debates. The aim of this paper is to engage in comparative discourse analysis about narratives of water crises and refugees in Lebanon and Jordan. This study is novel because of the focus on the new discourse of refugees in relation to water governance debates in both Lebanon and Jordan. This paper finds that in both countries the new discourses of refugees do not replace previous and existing discourses of water crisis and scarcity, but rather they build on and reinforce them. This paper finds that the impact these discourses had on the governance debates is that in Lebanon the resources mobilized focused on humanitarian interventions, while Jordan focused on development projects to strengthen the resilience of its water infrastructure and its overall water governance system. [ABSTRACT FROM AUTHOR]

Kidney Stone Disease (KSD) is a globally prevalent condition that can be effectively addressed through proper education. This study investigated the awareness of kidney stones among refugees residing in northern Jordan. A questionnaire was administered to 487 refugees of diverse ages and socioeconomic backgrounds. Notably, 97.3% of the respondents had not attended university, and 30.8% held unskilled jobs. Upon familiarizing themselves with the signs and symptoms of kidney stones, 16.22% of men and 12.32% of women reported experiencing such symptoms. This revealed a significant association, suggesting that men might be more susceptible to developing kidney stones than women due to a lack of medical follow-up and examination for men in the camp. However, 38.77% of individuals were uncertain whether they had kidney stones. Furthermore, 38.96% of refugees were unsure about which healthcare professional to consult when experiencing kidney stone symptoms. This report highlights a serious issue with refugees' knowledge of the symptoms, causes, and treatments for kidney stones. The results indicate that Syrian refugees face challenges in acquiring adequate disease awareness, potentially related to issues of migration and war, including low levels of education, limited income, living in camps, and difficulties accessing treatments when needed. Implementing additional policies is necessary to address these challenges among Syrian refugees; however, further studies are needed to validate these findings. [ABSTRACT FROM AUTHOR]

Biometric technologies are increasingly used by governments and international organizations in the context of refugee protection and control. The purpose of this paper is to highlight the 'double bind' embedded in the collection and processing of biometric data by exploring the experiences of Syrian refugees residing in Jordan. While taking biometric data is part of the UNHCR-registration, it is also used for other purposes, such as providing assistance and tracking movement. The findings are based on desk research and empirical data collected in Jordan. While stakeholders with vested interests argue for the benefits of technology, critical research is more concerned with human rights, unintended consequences of humanitarian governance or surveillance humanitarianism. Refugees, upon registration, seem to be more concerned with smooth and uninterrupted access to aid. While due to their vulnerable position they cannot really afford considering the consequences of giving their biometric data when they are asked to do so, sharing their biometric data entails a double bind situation. On the one hand, international organizations (such as the UNHCR and the WFP) in cooperation with commercial actors use iris scans as a payment method promising better food security for Syrian refugees in Jordan. On the other hand, the very same biometric data can be used for controlling, if not blocking, their free movement. The double bind logic implies that refugees registered with their biometrics can enjoy care only if they tolerate sophisticated control too. [ABSTRACT FROM AUTHOR]

Aim: The main objective of this study is to identify the level of self-care practices and the determinants of Gestational Diabetes Mellitus (GDM) among pregnant women residing in one of the refugee camps in Jordan. Method: A cross-sectional study was conducted on a convenient sample of forty women diagnosed with GDM from the high-risk maternity clinic in one of the Syrian refugee camps in Jordan. The study used the Gestational Diabetes Management Self-Efficacy Scale (GDMSES), Diabetes Knowledge (DMK) assessment, and Diabetes Self-Care Activities Questionnaire (SDSCA) to measure the variables of interest. Descriptive analysis and Multiple logistic regression were used to assess for significant factors. Results: Significant associations were found between the subcategories of diet, exercise, and blood sugar control in both the self-efficacy and self-activity scales (p < 0.01, p < 0.01, p < 0.05), respectively. Two factors were associated with higher GDM self-care: diabetes knowledge and higher self-efficacy toward GDM self-care (p < 0.05). Conclusion: The findings of this study highlight that pregnant women with GDM who have higher levels of self-efficacy and diabetes knowledge are more likely to achieve higher levels of GDM self-care. Beside developing health promotion programs to enhance women's self-efficacy in adhering to GDM care, adequate support and relevant resources to facilitate GDM management among refugee women are recommended. Future research for identifying other potential factors affecting GDM self-care among refugees is highly recommended. [ABSTRACT FROM AUTHOR]

Background: The Syrian refugee crisis has led to massive displacement into neighboring countries including Jordan. This crisis has caused a significant strain on the sexual and reproductive health (SRH) services to the host communities and Syrian refugees. The Minimum Initial Service Package (MISP) is a standard package of services that should be implemented at the onset of an emergency. Due to their importance in protracted humanitarian crisis, this systematic review aimed to assess the utilization of SRH and MISP after 9 years of the crisis. Methods: We searched PubMed, Medline/Ovid and Scopus for both quantitative and qualitative studies from 1 January 2011 to 30 November 2019. Our search included both free text key words and Medical Subject Headings (MeSH) for various forms and acronmym of the following terms: (Sexual and) Reproductive Health, Sexual/Gender-based/Family/Intimate partner violence, Minimum Initial Service Package, MISP, Women, Girls, Adolescents, Syrian, Refugee, Jordan, Humanitarian crisis, War, (armed) conflict, and Disaster. Boolean operators and star truncation (*) were used as needed. We further conducted an in-depth review of the available grey literature published during the same timeframe. Using a narrative synthesis approach, two authors independently extracted and analyzed data from published papers. After removal of duplicates, screening, and assessing for eligibility of 161 initially identified citations, 19 papers were selected for review. Results: Findings from this review indicated a number of barriers to access, utilization, and implementation of SRH services, including lack of reliable information on sexual and gender-based violence (SGBV), aggravation of early marriages by crisis setting, gaps in the knowledge and use of family planning services, inadequate STIs and HIV coverage, and some issues around the provision of maternal health services. Conclusion: The findings from this review are suggestive of a number of barriers pertaining to access, utilization, and implementation of SRH services. This is especially true for transitioning from MISP to comprehensive SRH services, and particularly for refugees outside camps. Following are needed to address identified barriers: improved inter-agency coordination, better inclusion/engagement of local initiatives and civil societies in SRH services delivery, improved quality of SRH services, adequate and regular training of healthcare providers, and increased awareness of Syrian women and adolescent girls. Also, more implementing research is required to identify ways to transition SRH provision from the MISP to comprehensive care for the Syrian refugee population in Jordan. [ABSTRACT FROM AUTHOR]

This paper presents lessons from the process of creating and implementing an engineering design course in the Azraq refugee camp in Jordan over multiple iterations from 2016 to 2019. This design course used an innovative localised engineering in displacement curriculum, integrating an active, blended, collaborative, and democratic learning environment. The idea of 'localisation,' building off of authentic learning and participatory design, was central to the contextualised design we use, tailored to local assets, and showcased in capstone projects at the end of the course. The capstone projects consisted of realistic design solutions to problems that refugees faced in their daily lives. We present findings that include a description of the course design and the students' localised products. Further, our thematic analysis provides insights into both the contextual challenges in implementing engineering courses and co-design in refugee camps as well as the pedagogical response to these challenges. Overall, we describe as a general outcome of our study the novel approach to teaching engineering design for learners in the Azraq refugee camp, which could be applied in other contexts. [ABSTRACT FROM AUTHOR]

The number of Syrian refugees has increased in light of the deteriorating political, economic, and humanitarian situation in the country, and they have spread to various parts of the world in search of security and stability, whether in Syria's neighbouring countries or other countries in the Middle East, North Africa, and Europe. International reports have revealed the tragic situations resulting from protracted refugee situations in which Syrian refugees, including children, are often denied access to essential services or have difficulty exercising their rights, including their right to education, as a fundamental right guaranteed by international charters and conventions. The current research pays special attention to the reality of the education of Syrian refugee children in Jordan, given the obstacles and difficult educational conditions encountered by many of these children, taking into account the achievements and gains made in this context that must be preserved and generalised, as well as identifying the difficulties and challenges encountering the Jordanian State, in an attempt to overcome them, work to confront them, and ultimately improve the situation of Syrian refugee children with regard about education and provide them with hope for a better future. Background: Since the outbreak of political violence in Syria in 2011, vast numbers of Syrians have gone to the Jordanian border to escape one of the most devastating civil wars in recent times, and about one-third of the refugees fleeing their countries, i.e., about one million three hundred thousand Syrian refugees, have arrived. These refugees are distributed within the Zaatari, Azraq, Rakban, and Emirati-Jordanian camps. Some of them live outside the scope of these four camps, especially in the governorates of Irbid, Mafraq, Amman, and Zarqa. More than half of these refugees are children. Methods: The research uses the descriptive analysis method, which is based on the detailed description and in-depth analysis of the topic of the study through gathering detailed data related to the research problem, analysing legal texts and relevant information as well as their clear interpretation, concluding with proposing appropriate solutions and recommendations aimed at supporting the right of Syrian refugee children in Jordan to obtain their right to education. Results and Conclusions: The study concluded the importance of the efforts made by the Jordanian government, with the support of donors and humanitarian organisations, regarding assisting Syrian students in obtaining a quality education and its contribution to the steady increase in the percentage of children enrolled in education. On the other hand, the study confirmed the many obstacles and difficulties that impede the education of Syrian refugees in Jordan, such as child labour and early marriage, the lack of appropriate educational infrastructure in light of the scarcity of essential financial resources, the lack of international funding; the limited availability of school, the shortage of qualified human resources to deal with refugee children, and the lack of the necessary documentation to enrol in education. However, despite all the challenges and difficulties related to the education of Syrian refugees in Jordan, the opportunity remains to overcome the difficulties effectively, develop the educational reality, achieve an increase in the rates of absorption in the educational systems, and improve the quality of education provided to these students, which will contribute to the realisation of their dreams and aspirations and help them rebuild their society and host society alike. [ABSTRACT FROM AUTHOR]

We measure the prevalence of discrimination between Jordanian host and Syrian refugee children attending school in Jordan. Using a simple sharing experiment, we find only a small degree of out-group discrimination. However, Jordanian children with Palestinian roots do not discriminate at all, suggesting that a family history of refugee status can generate solidarity with new refugees. We also find that parents' narratives about the refugee crisis are correlated with their children's degree of out-group discrimination, particularly among Syrian refugee children, suggesting that discriminatory preferences are being transmitted through parental attitudes. [ABSTRACT FROM AUTHOR]

This is a summary of a two-day symposium on migrations in Jordan, by the symposium coordinators Amal Khaleefa and Valentina Napolitano. The event, held in May 2023 at the French Institute for the Near East (IFPO) in Amman, aimed to challenge prevailing political narratives on migration in Jordan and deconstruct stereotypes, while exploring the role of archives in the production of these narratives. It featured four panels and a Policy Council, bringing together researchers, humanitarian workers, and migrants. Presentations focused on the role of humanitarian actors in producing narratives on migrations, highlighting UNRWA's history, archiving projects involving Palestinian youth, and reconstructing familiar and village histories. Participants also explored narratives and archives produced by other non-conventional and marginal actors, including Circassian accounts and the Melkite Church involved in assistance to Palestinian refugees. Lived experiences and representations were discussed with a focus on Rohingya migrants, the racialization of Black refugees, and solidarity practices among Syrians settled in Jordan during the 1980s. The symposium also addressed the production of spaces and norms, including narratives of Syrian refugees in Palestinian camps in Amman, an experience put in perspective with that of Syrians in the Biqa' Valley in Lebanon. [ABSTRACT FROM AUTHOR]

Through the theoretical frameworks of the media system dependency model and uses and gratifications theory, this study examined the uses of social media by Syrian refugees in Jordan and Turkey. A mixed-methods approach was used to increase the credibility and validity of the study's findings by combining a qualitative method with quantitative data. The findings show that there were some factors that affected the Syrian refugees' use of social media before seeking refuge in Jordan and Turkey, which were mainly its ban due to the regime's censorship and a bad Internet connection due to the bad infrastructure. The absence of these two factors led to an increase in their social media dependency after seeking refuge. There are variances in which social media sites Syrian refugees use the most and why. The majority relied on Facebook for various reasons, and this dependency had varying repercussions on individuals. Furthermore, many immigrants were acquainted with new platforms, implying that refugees became social-media-literate and participated in the updates of the new platforms, even if such sites were not well known to the general public. The Syrian refugees' dependency on social media varies from person to person due to differences in personal goals, social status, locations, living characteristics, and easy access to the Internet. Furthermore, this dependency on social media has different effects on them according to the media system dependency model. The refugees become increasingly dependent on social media to satisfy their needs and, because of that, social media dependency will become more important in their lives and will increase its influence and effects on them. Furthermore, the study found that the Syrian refugees depended on social media for various gratifications, such as educational, work, and business; information access; cultural and social aspects; connecting with networks and families; establishing friendships; learning new skills; self-expression; making business; and finding work, in addition to reaching routes and contacting smugglers to help them leave the country. [ABSTRACT FROM AUTHOR]

Training nonspecialists in providing evidence-based psychological interventions (i.e. task-sharing) can effectively increase community access to psychological support. However, task-sharing interventions for this purpose are rarely used at scale. The aim of this study was to examine the factors influencing the potential for scaling up (i.e. scalability) of a task-sharing psychological intervention called Problem Management Plus (PM+) for Syrian refugees in Jordan. Semi-structured individual (n  = 17) and group interviews (n  = 20) were conducted with stakeholders knowledgeable about PM+ and the mental health system for Syrian refugees in Jordan. Using 'system innovation perspective', this study conceptualized the context as landscape developments, and systemic considerations were divided into culture (shared ways of thinking) and structure (ways of organizing). Political momentum was identified as a landscape trend likely facilitating scaling up, while predicted reductions in financial aid was regarded as a constraint. In terms of culture, the medicalized approach to mental health, stigma and gender were reported barriers for scaling up PM+. Using non-stigmatizing language and offering different modalities, childcare options and sessions outside of working hours were suggestions to reduce stigma, accommodate individual preferences and increase the demand for PM+. In relation to structure, the feasibility of scaling up PM+ largely depends on the ability to overcome legal barriers, limitations in human and financial resources and organizational challenges. We recommend sustainable funding to be made available for staff, training, supervision, infrastructure, coordination, expansion and evaluation of 'actual' scaling up of PM+. Future research may examine the local feasibility of various funding, training and supervision models. Lessons learned from actual scaling up of PM+ and similar task-sharing approaches need to be widely shared. [ABSTRACT FROM AUTHOR]

This study aims to recognize the possible role of social media in forming xenophobia and hate speech against Syrian refugees and to understand the reinforcing causes and negative effects of that speech on the refugees, as well as the refugees' response mechanisms against that speech. A mixed approach was used in this study. In addition to a questionnaire tool that was used to collect data, focus group discussions were conducted to support the obtained data. The study used a statistically representative sample of Syrian refugees who live in Turkey and Jordan. The participants see the negative representation of their image via social media as leading to hatred towards them. The findings showed that there are some causes that reinforce xenophobic speech, such as otherization and demonization of refugees, by the negative representation and spreading of fake news on social media, which are published continuously. Moreover, gatekeepers have a role in promoting negative representation by approving xenophobic speech transmission without filtering or ethical control. The results also showed that the negative representation containing hate speech contributes to more negative effects on the refugees, such as psychological effects, as a sense of hatred towards refugees is created in the host country, and the effect of changing the feelings of the public from empathy to compassion fatigue concluding to hatred towards those refugees. Furthermore, the results showed that the Syrian refugees follow different defense mechanisms against xenophobia and hate speech against them published and circulated through social media platforms. The participants were divided into two main categories; the first one is those who prefer replying, not being silent, and defending the refugees, and the second category is those who prefer keeping silent. The first category of refugees stated that they do not accept keeping silent and they prefer to reply using logical, emotional, or defensive and offensive ways to bad comments against Syrian refugees in general. While the second category claimed that either they do not have time to reply or they sometimes agree that it was only a reaction to the behavior of some individual refugees. Some of them explained that they are afraid of being subjected to more bad comments and negative reactions against them. When they encounter aggressive comments and see that such views represent the majority, they prefer to keep silent to avoid being attacked. This is understood within the framework of the spiral of silence theory, where refugees hide their opinions, views, and preferences when they think that they fall within a minority group. They fear social isolation through social media. [ABSTRACT FROM AUTHOR]

Background: The conflict in Syria has required humanitarian agencies to implement primary-level services for non-communicable diseases (NCDs) in Jordan, given the high NCD burden amongst Syrian refugees; and to integrate mental health and psychosocial support into NCD services given their comorbidity and treatment interactions. However, no studies have explored the mental health needs of Syrian NCD patients. This paper aims to examine the interaction between physical and mental health of patients with NCDs at a Médecins Sans Frontières (MSF) clinic in Irbid, Jordan, in the context of social suffering. Methods: This qualitative study involved sixteen semi-structured interviews with Syrian refugee and Jordanian patients and two focus groups with Syrian refugees attending MSF's NCD services in Irbid, and eighteen semi-structured interviews with MSF clinical, managerial and administrative staff. These were conducted by research staff in August 2017 in Irbid, Amman and via Skype. Thematic analysis was used. Results: Respondents describe immense suffering and clearly perceived the interconnectedness of their physical wellbeing, mental health and social circumstances, in keeping with Kleinman's theory of social suffering. There was a 'disconnect' between staff and patients' perceptions of the potential role of the NCD and mental health service in alleviating this suffering. Possible explanations identified included respondent's low expectations of the ability of the service to impact on the root causes of their suffering, normalisation of distress, the prevailing biomedical view of mental ill-health among national clinicians and patients, and humanitarian actors' own cultural standpoints. Conclusion: Syrian and Jordanian NCD patients recognise the psychological dimensions of their illness but may not utilize clinic-based humanitarian mental health and psychosocial support services. Humanitarian agencies must engage with NCD patients to elicit their needs and design culturally relevant services. [ABSTRACT FROM AUTHOR]

This study investigates the use and linguistic properties of refusal strategies by Jordanians and Syrian refugees in Jordan. To achieve this objective, a Discourse Completion Test (DCT), consisting of 10 situations: three requests, three offers, two invitations, and two suggestions was used. The participants were 40 (20 male and 20 female) Jordanians and 40 (20 male and 20 female) Syrian refugees in Jordan. The mixed-method data analysis resulted in a total of 1351 refusals: 719 Jordanian refusals and 632 Syrian refugees' refusals. The refusals were classified by semantic formulas, directness (a dimension of communication style), and frequency of semantic formulas. The results show that the two groups utilize different semantic formulas with different frequencies when making their refusals. The two groups used a different number of direct and indirect formulas. Although the two groups belong to the Arabic culture, the differences were significant. One main difference is that Jordanians' refusals were more direct and were often expressed as negative willingness, while the Syrian refugees' refusals were less direct, providing an explanation of their refusals. The results also indicate that gender is a significant variable where females in the two samples tended to respond with lengthy responses when making their refusals, employing at least three refusal strategies. [ABSTRACT FROM AUTHOR]

This research examined the effect of Jordan's humanitarian diplomacy strategy for Syrian refugees on its foreign policy and attempted to determine whether the strategy is financially sustainable. Humanitarian diplomacy is persuading decision-makers and leaders worldwide to act at all times and in all circumstances in the best interest of vulnerable populations by completely respecting fundamental humanitarian principles. Jordan has allowed many Syrian refugees to cross over and settle in Jordan. This study used a qualitative systematic literature review and quantitative data from the UNHCR to determine the effect of the strategy on Jordan's foreign policy and whether the strategy could be sustained. The findings showed that Jordan's stature in terms of its foreign policy has grown, leading to bilateral agreements and participation in international negotiations. However, its humanitarian strategy may not be sustainable with the current level of funding. The funding from foreign countries and international organizations has been insufficient to support the growing number of Syrian refugees in Jordan. The literature on this topic is limited, and comprehensive quantitative research is recommended to determine the future effect of the strategy on health care and education for Syrian refugees in Jordan. [ABSTRACT FROM AUTHOR]

Background: There is growing global evidence that girl child marriage (CM) increases during humanitarian crises. Norms, attitudes, and policies that sustain CM are deeply entrenched within families and communities, and may be further exacerbated by conflict and displacement. The purpose of this study is to understand how the social and normative environment influences attitudes and practices related to CM in two diverse humanitarian settings. Methods: We held a total of eight focus group discussions, four in each country, with Syrian refugees in Jordan and Rohingya Refugees in Bangladesh. FGDs were conducted with fathers, mothers, and adolescent boys and girls. Results: Similar themes emerged from both settings. Participants discussed a desire to hold onto tradition in displacement and how norms are reinforced across generations. Social influence emerged in positive and negative ways, including peer pressure and conformity and the positive influence of host communities. In both settings, girls themselves described having little agency. Participants described resistance to change, which was exacerbated by conflict and displacement, though they discussed how social influence could be an effective way to challenge existing norms that drive the practice of girl child marriage. Conclusions: Our findings represent a more robust understanding of how norms operate within the social ecological system, and how they are reinforced across social relationships, offering an opportunity to more effectively challenge norms that sustain the practice of girl child marriage. [ABSTRACT FROM AUTHOR]

Background: Despite broad interest of the Syrian refugee plight in the academic and media circles, there are still limited studies analyzing the lived experiences of torture survivors under the Syrian regime. This qualitative study interviewed torture survivors to examine the form and function of the Syrian regime's security apparatus, and the personal aftermath of survivors. Methods: Thirteen in-depth interviews were conducted in Arabic with Syrian refugees who endured torture. Study participants were at least 19 years of age, resided as refugees in Jordan, and voluntarily agreed to participate in the study. Participation was anonymous and no incentives were provided. Only oral consent was required. Audio-recorded interviews were transcribed and translated to English, and then analyzed for repetitive themes utilizing the narrative approach. Results: Major themes were observed across three experience-phases: pre-captivity, during captivity, and post-captivity. The pre-captivity phase included two sub-themes: the Syrian regime's initial detection and arrest system, and the intelligence system. The captivity phase was also divided into two sub-themes: environmental conditions in detention facilities, and torture methods including physical and psychological torture. Some of the environmental conditions in detention facilities included lack of sanitation, crowding, starvation, and withholding of medical care. Torture methods encompassed beatings, electric shocks, nail-pulling, hanging, drowning, suffocation, rape, and the witnessing of killing, sexual assault, or torture of others. The post-captivity phase included their release from captivity, escaping Syria, and post-displacement conditions and activism. Conclusions: The Syrian regime employs a vast security apparatus to track, detain, interrogate, torture, and subjugate its civilian population. A systematic mechanism commences even before captivity and continues for years after release, with negative implications on the well-being of survivors, their families, and the Syrian people as a collective community. The Syrian war saw a shift toward mass detention, torture as a form of social punishment, subjugation, and indeterminate imprisonment. Intervention agencies, host countries, and policymakers must be informed of survivors' experiences to better address their needs. Moreover, the international community must advocate for a firm stance against torture, demand justice, and prosecute all parties engaged in perpetuating such extreme forms of suffering and trauma. [ABSTRACT FROM AUTHOR]

In the global political economy, special economic zones are considered an established instrument for promoting social and economic "development" and recently also for refugee activation and integration. The Jordan Compact, a bilateral agreement between Jordan and the European Union adopted in 2016, represents an exemplary practical political implementation of this approach. So far, however, Syrian refugees' integration is meager. Extending the existing critique of the Jordan Compact, we propose to bring in an uneven and fragmenting development perspective. We in particular focus on the global production networks of the textile and garment industry and the working and living conditions in their Jordanian special economic zones. Referring to current debates on global production and labor regimes, and with a strong empirical focus, we underline the need of a multiscalar or glocal political-economic approach to the zones and we discuss their specific repressive labor regime, including the significance of transcontinental circular migration for it. We show how this zonal labour regime functions as a barrier to "integration" of Syrian refugees. Overall, we argue that contemporary fragmenting globalization produces uneven, non-substitive forms of socio-spatial disintegration, and that a break with the prevailing logic of "activation" and "development" is required. [ABSTRACT FROM AUTHOR]

Relations between Turkey and the Kingdom of Jordan have been among the most stable in the Middle East. This article argues that, nevertheless, the relationship gained momentum following the Arab uprisings, which forced both countries to tackle mounting security concerns. One major challenge has been the influx of a huge number of Syrian refugees accompanying the continued instability in Syria, as well as the prolonged Palestinian‐Israeli dispute and the destabilizing impact of sectarian cleavages in Iraq since 2003. What is more, the new power balance since 2011 has alarmed both Turkey and Jordan, and motivated them to reinforce the goal of regional order and stability. Within this changing context of the redistribution of power in the Middle East, the aim of this article is to explore the motivations of each country to perceive the other as a "partner," specifically in the post‐uprisings era, as well as the limitations to such a partnership. [ABSTRACT FROM AUTHOR]

The refugee movement creates urban and environmental pressures at their destination locations. This pressure often presents in the form of Land Use/Land Cover (LULC) change. This study seeks to understand the impact of the Syrian refugees' influence on changing the urban and agricultural land dynamics in Irbid district in northwestern Jordan from 1985 to 2021, including the period of the civil war in Syria, using Landsat Thematic Mapper (TM) images for the years 1985 and 2004, and the Landsat-8 Operational Land Imager (OLI) for the years 2013 and 2021. The Google Earth Engine (GEE) platform was used to conduct all image processing and perform calculations and classification analysis using the Random Forest (RF) approach. The study of the classified images compared LULC before and during the Syrian crisis using images from 1985, 2004, 2013, and 2021. The results show that the urban area increased. In parallel, agricultural land increased. During the Syrian refugee crisis, agriculture became a significant livelihood activity for Syrian refugees. In summary, the movement of the refugees to Irbid district caused an increased demand for land and housing, which accelerated the building and construction process. [ABSTRACT FROM AUTHOR]

Background: Despite the extensive research on war atrocities and risk factors for psychopathology, there is a paucity of research on the potential mediating and moderating effect of neuroticism in refugee children and adolescents. Objective: This study aimed to analyze whether neuroticism mediated and/or moderated the relationship between war atrocities and different types of psychopathology in Syrian refugee children and adolescents who resettled in Lebanon and Jordan. Participants and Setting: Participants were 1,000 Syrian refugee children and adolescents of both sexes. Methods: Questionnaires were administered in an interview format with children at school by two trained psychologists. Descriptive statistics and inter-correlations among variables were used Then the mediator and moderator effect of neuroticism in the relationship between war atrocities and posttraumatic stress, emotion regulation and behavioral and emotional disorders were examined. Results: A partial mediating effect of neuroticism on posttraumatic stress disorder (PTSD), emotion dysregulation, and emotional and behavioral disorders was revealed. Findings also indicated full moderating effects of neuroticism on PTSD as well as partial moderating effects on emotion dysregulation, and emotional and behavioral. Conclusions: Findings contribute to the neuroticism literature by showing that high-N children develop more problems that are psychopathological and have more severe affective reactions to war atrocities in post- resettlement contexts. Early interventions aimed to reduce neuroticism might contribute to a better prognosis in refugee children at high-risk for psychological disorders. [ABSTRACT FROM AUTHOR]

Background: The mental health of refugee women is often affected by multiple risk factors in their social ecology. Assessing these risk factors is foundational in determining potential areas for intervention. We used the social ecological model to examine risk factors associated with self-reported mental health symptoms among clinic-attending Syrian refugee women in Jordan. We hypothesize that individual (older age, unmarried, have more children under 18, difficulty reading/writing with ease), interpersonal (intimate partner violence [IPV]), community and societal level risk factors (greater number of postmigration stressors), will be associated with depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms. Methods: We surveyed 507 women using a cross-sectional clinic-based systematic sampling approach between April and November 2018. We used multivariable regressions to examine associations between different risk factors in the social ecology on depression, anxiety, and PTSD. Additional multivariable regressions explored associations between specific postmigration stressors and mental health conditions. Results: We found rates of depression among our sample to be 62.92%; anxiety 57.46%; and PTSD 66.21%. Our hypothesis was partially supported. At the individual level, age was directly associated with anxiety (aOR 1.04, 95% CI [1.02, 1.06]) and PTSD (aOR 1.03, 95% CI [1.01, 1.06]), while marriage decreased odds for depression (aOR 0.41, 95% CI [0.19, 0.92]) and PTSD (aOR 0.36, 95% CI [0.15, 0.87]). IPV was associated with depression (aOR 2.78, 95% CI [1.72, 4.47]); anxiety (aOR 3.30, 95% CI [2.06, 5.27]); and PTSD (aOR 5.49, 95% CI [3.09, 9.76]). Each additional community and societal risk factor (postmigration stressor) increased the odds for depression (aOR 1.32, 95% CI [1.22, 1.42]), anxiety (aOR 1.28, 95% CI [1.19, 1.39]), and PTSD (aOR 1.46, 95% CI [1.33, 1.60]). Conclusion: Understanding social ecological risk factors associated with mental health conditions of Syrian refugee women is vital to addressing their mental health needs. IPV and postmigration stressors are consistently impactful with all mental health conditions. IPV resulted in the largest odds increase for all mental health conditions. Multilevel interventions are needed to address mental health risk factors at multiple levels of the social ecology. [ABSTRACT FROM AUTHOR]

Copyright of Co-herencia is the property of Universidad EAFIT and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The popularity of implant dentistry is increasing dramatically, but the success of implant treatment depends on a patient's knowledge and expectations. Methods: This study aimed to assess dental implant knowledge among refugees as a treatment option (n = 565), using face-to-face interviews. The frequency distribution of the responses in general and according to age, gender and education was calculated. Results: 81.8% of the interviewees had missing teeth, however, only 26.2% replaced them. 16.6% of participants had never/hardly heard about implants. Females who never heard of implants were more than males (P < 0.001). 51.3% of participants described dental implants as a screw, and only 35.4% knew implants were placed in jawbones. 6.2% of respondents reported that implants required more care than a natural teeth, with 47.6% believing that diseases affect implant success. Friends were the main source of information (61.4%). Highly educated participants showed higher knowledge about implants. Conclusions: The surveyed sample revealed limited knowledge about dental implants with high cost being a major obstacle, warranting more strategies to increase awareness and to make implants more affordable for this population. [ABSTRACT FROM AUTHOR]

Background: Feedback on satisfaction regarding healthcare services is vital for continuous improvement of the service delivery process and outcome.Aims and Methods: The objective of this study was to assess the satisfaction of refugees with the medical and dental services in Zaatari camp, under 3 domains with 20 key indicators (human and physical health resources, interaction and reactivity, and administration) using a self-administered questionnaire.Results: Of the 500 participants, the satisfaction rate was 72.5%. Young participants and participants with a shorter stay in the camp showed higher overall satisfaction rates (P ≤ 0.01). Within the domains, 'interaction and reactivity' achieved the highest satisfaction score, whereas 'administration efficiency' was ranked the lowest. As for elements within the domains, the most acceptable were the sufficient number of staff and the working hours, availability of radiological services and proper care for children, reasonable waiting time and asking for medical history in every visit. Whereas difficulty to access healthcare services, difficulty to be referred to hospitals, lack of follow up and lack of dental services were the least acceptable.Conclusion: In conclusion, whereas refugees were generally satisfied with the provided services, this study indicates that there are areas for further service improvement. This study highlights a significant gaps in healthcare services which if not addressed have the potential to amplify oral/medical health problems. [ABSTRACT FROM AUTHOR]

With its diachronic focus on socio-historical processes and life and family histories, sociological biographical research can analyse the emergence of new spatial figurations. It does so from the perspective of the experiences of individuals in their changing belonging to different groupings at different times. In this article, I investigate changing (meanings of) spaces in the Bilad ash-Sham region (roughly today's Lebanon, Israel, Palestine, and parts of Jordan and Syria). I discuss how the process of the formation of nation-state borders and citizenship in the twentieth century transformed translocal relations into transnational networks, combined spatial diffusion with (forced) emplacement in nation-states, and initiated accelerating national closure processes. At the family level, the growing relevance of citizenship and borders in the region came about with knowledge of, and family dialogue about, border crossing, and the increasing spatial diffusion of the family, as well as intrafamilial discussions on the "value" of different nation-states. These processes affected all families in the Bilad ash-Sham region to a varying extent. They constitute a type of figuration of space that influenced the gradual formation of societies within the framework of nationstates defined by colonial rulers. As an example, I will discuss the regional family history of a Syrian refugee in Amman, Jordan. [ABSTRACT FROM AUTHOR]

Background: In response to the rising global NCD burden, humanitarian actors have rapidly scaled-up NCD services in crisis-affected low-and-middle income countries. Using the RE-AIM implementation framework, we evaluated a multidisciplinary, primary level model of NCD care for Syrian refugees and vulnerable Jordanians delivered by MSF in Irbid, Jordan. We examined the programme's Reach, Effectiveness, Adoption and acceptance, Implementation and Maintenance over time.Methods: This mixed methods retrospective evaluation, undertaken in 2017, comprised secondary analysis of pre-existing cross-sectional household survey data; analysis of routine cohort data from 2014 to 2017; descriptive costing analysis of total annual, per-patient and per-consultation costs for 2015-2017 from the provider-perspective; a clinical audit; a medication adherence survey; and qualitative research involving thematic analysis of individual interviews and focus group discussions.Results: The programme enrolled 23% of Syrian adult refugees with NCDs in Irbid governorate. The cohort mean age was 54.7 years; 71% had multi-morbidity and 9.9% self-reported a disability. The programme was acceptable to patients, staff and stakeholders. Blood pressure and glycaemic control improved as the programme matured and by 6.6 mmHg and 1.12 mmol/l respectively within 6 months of patient enrolment. Per patient per year cost increased 23% from INT$ 1424 (2015) to 1751 (2016), and by 9% to 1904 (2017). Cost per consultation increased from INT$ 209 to 253 (2015-2017). Staff reported that clinical guidelines were usable and patients' self-reported medication adherence was high. Individual, programmatic and organisational challenges to programme implementation and maintenance included the impact of war and the refugee experience on Syrian refugees' ability to engage; inadequate low-cost referral options; and challenges for MSF to rapidly adapt to operating in a highly regulated and complex health system. Essential programme adaptations included refinement of health education, development of mental health and psychosocial services and addition of essential referral pathways, home visit, physiotherapy and social worker services.Conclusion: RE-AIM proved a valuable tool in evaluating a complex intervention in a protracted humanitarian crisis setting. This multidisciplinary programme was largely acceptable, achieving good clinical outcomes, but for a limited number of patients and at relatively high cost. We propose that model simplification, adapted procurement practices and use of technology could improve cost effectiveness without reducing acceptability, and may facilitate replication. [ABSTRACT FROM AUTHOR]

Objective: Violent conflict forced millions of Syrians to flee their homes to host countries. This study examines Syrian refugee women's experiences from the war's outset through their journey to Jordan. It addresses the toll this journey had on their lives. Methods: Twenty-four in-depth interviews were completed with Syrian refugee women who currently reside in urban areas of Jordan. Researchers translated, transcribed, and analyzed the interviews using group narrative methodology. Results: The Syrian women had unique nostalgic memories of times before the war. They experienced atrocities during the war that forced their decision to escape Syria. Their journey narratives testify of internal displacement, personal and collective traumatic journeys via legal and illegal routes. Almost all the women were placed in refugee camps during their transitions to host country residency. In Jordan, they faced diverse hurdles of displacement and extremely different realities compared to the ones they had in Syria. Despite how very different but difficult each of their journeys were, every single woman longed to return home to Syria. Conclusions: This study presents a new understanding of the role and process of the journeys undertaken and highlights the concept of "return" as the defining element for Syrian refugee women. Regardless of the hardships women endured to escape their homeland to find safety, "return" marks an ending to their horror journey and the beginning of a new journey of hope for a better future. [ABSTRACT FROM AUTHOR]

Background: Little is known about the content or quality of non-communicable disease (NCD) care in humanitarian settings. Since 2014, Médecins Sans Frontières (MSF) has provided primary-level NCD services in Irbid, Jordan, targeting Syrian refugees and vulnerable Jordanians who struggle to access NCD care through the overburdened national health system. This retrospective cohort study explored programme and patient-level patterns in achievement of blood pressure and glycaemic control, patterns in treatment interruption, and the factors associated with these patterns.Methods and Findings: The MSF multidisciplinary, primary-level NCD programme provided facility-based care for cardiovascular disease, diabetes, and chronic respiratory disease using context-adapted guidelines and generic medications. Generalist physicians managed patients with the support of family medicine specialists, nurses, health educators, pharmacists, and psychosocial and home care teams. Among the 5,045 patients enrolled between December 2014 and December 2017, 4,044 eligible adult patients were included in our analysis, of whom 72% (2,913) had hypertension and 63% (2,546) had type II diabetes. Using visits as the unit of analysis, we plotted the following on a monthly basis: mean blood pressure among hypertensive patients, mean fasting blood glucose and HbA1c among type II diabetic patients, the proportion of each group achieving control, mean days of delayed appointment attendance, and the proportion of patients experiencing a treatment interruption. Results are presented from programmatic and patient perspectives (using months since programme initiation and months since cohort entry/diagnosis, respectively). General linear mixed models explored factors associated with clinical control and with treatment interruption. Mean age was 58.5 years, and 60.1% (2,432) were women. Within the programme's first 6 months, mean systolic blood pressure decreased by 12.4 mm Hg from 143.9 mm Hg (95% CI 140.9 to 146.9) to 131.5 mm Hg (95% CI 130.2 to 132.9) among hypertensive patients, while fasting glucose improved by 1.12 mmol/l, from 10.75 mmol/l (95% CI 10.04 to 11.47) to 9.63 mmol/l (95% CI 9.22 to 10.04), among type II diabetic patients. The probability of achieving treatment target in a visit was 63%-75% by end of 2017, improving with programme maturation but with notable seasonable variation. The probability of experiencing a treatment interruption declined as the programme matured and with patients' length of time in the programme. Routine operational data proved useful in evaluating a humanitarian programme in a real-world setting, but were somewhat limited in terms of data quality and completeness. We used intermediate clinical outcomes proven to be strongly associated with hard clinical outcomes (such as death), since we had neither the data nor statistical power to measure hard outcomes.Conclusions: Good treatment outcomes and reasonable rates of treatment interruption were achieved in a multidisciplinary, primary-level NCD programme in Jordan. Our approach to using continuous programmatic data may be a feasible way for humanitarian organisations to account for the complex and dynamic nature of interventions in unstable humanitarian settings when undertaking routine monitoring and evaluation. We suggest that frequency of patient contact could be reduced without negatively impacting patient outcomes and that season should be taken into account in analysing programme performance. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate the association between socio-demographic characteristics and perceived health among Syrian refugees in Jordan. Method: A cross-sectional quantitative descriptive design was adopted, where a sample of 151 Syrian refugees living inside and outside camps in Amman, Jordan was surveyed for physical, psychological, social and environmental perceived health using a 12-item questionnaire. Results: Each domain's score was computed out of 60. The mean perceived physical health was 27.6±11.5; perceived psychological health 27.1±10.1; perceived social health 32.6±10.3; and perceived environmental health 30±9.1. Predictors of perceived physical health included age group F(2) = 3.12, p = .012, marital status F(3) = 4.71, p = .004, and income level F(2) = 1.75, p = .047. Predictors of perceived psychological health included income level F(2) = 2.79, p = .005, place of living t = 3.32, p = .007, and marital status F(3) = 4.09, p = .034. Predictors of perceived social health included gender t = 2.04, p = .026, age group F(2) = 3.64, p = .000, living place t = -3.61, p = .031, and household size r = .61, p = .048. And the only predictor of perceived environmental health included was place of living t = 5.64, p = .000. Conclusion: Living inside refugee camp, large household, poverty, older age, and being divorced or widow are associated with lower perceived health. Modifying some factors may help improve perceived health among Syrian refugees in Jordan and beyond. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article examines the implications and impact of the Syrian refugee crisis in Jordan and Lebanon caused by the Syrian civil war. Topics discussed include the role of host governments, the international community, and the humanitarian stakeholders in shaping perception toward the crisis, the adoption of an open-door policy by Jordan and Lebanon from 2011 to 2014, and the impact of the crisis on the two countries' education, energy, and housing sectors.

This study aims to investigate the impact of social adjustment policy on Syrian refugees, whereas the study population is composed of all Syrian refugees in Jordan. The sample of refugees in different regions of Jordan was surveyed (1675 in total). In order to achieve the objective of the study, the social adjustment scale was constructed in the final form of 20 items. After confirming its validity and stability, it was applied to the sample. The results show that the impact of the social adjustment policy on Syrian refugees in Jordan depends on gender factors, duration of asylum, and the place of residence, but does not depend significantly on the education level. Social adaptation more characterizes men, and there are significant differences between the level of social adaptation in Badia, as well as between urban residences and in rural ones. [ABSTRACT FROM AUTHOR]

In migration studies, humanitarian work and workers are studied as benefactors or managers of migrants and refugees. This article inverts the gaze from "researching down" refugees to "studying up" the humanitarian structure that governs them. The article studies how the humanitarian industry ballooned after the Syrian refugee response in Jordan due to the influx of expatriate humanitarians as economic migrants from the global North to refugee situations in the host country in the global South. It examines the global division of mobility and labor among expatriate, local, and refugee humanitarian workers, investigating the correlation between geographic (horizontal) mobility and social/professional (vertical) mobility, demonstrating that the social and professional mobility of workers depends on their ability to access geographic mobility. Thus, rather than advocating for and facilitating global mobility, the humanitarian industry maintains a colonial division of labor and mobility. This raises the question: who benefits most from humanitarian assistance? [ABSTRACT FROM AUTHOR]

This article explores refugee economic subjectivity in the context of restrictive asylum policies and disrupted transnational family lives. Drawing on fieldwork with young Syrian refugees pursuing IT training in Jordan, I focus on the "coding boot camp," an emerging educational format in the field of refugee professional training. I thus explore how Syrian youths approach humanitarian policies in which, in the absence of full social and economic rights for refugees, the question of livelihoods is addressed through the paradigms of self‐reliance, creativity, and innovation. Reframing the refugee from a "protected" to a "productive" subject, and offering individual solutions to a structural economic impasse, these policies produce tensions between individual responsibilities and more‐than‐individual relations and identifications—with families, religious identities, and national communities—that remain unresolved. The findings contribute to geographical scholarship on economic subjectivity, familial relations, and the migrant and refugee condition, while shedding light on some of the effects of the encounter between technology‐centred, neoliberal approaches to humanitarianism and restrictive migration regimes in responses to the Syrian displacement. [ABSTRACT FROM AUTHOR]

Background: Noncommunicable diseases including cancer are widespread amongst the 5.6 million Syrian refugees currently hosted in the Middle East. Given its prevalence as the third leading cause of death in Syria, cancer is likely to be an important health burden among Syrian refugees. Against this background, our aim was to describe the clinical, ethical and policy decision-making experiences of health actors working within the current refugee cancer care system; the impact of refugee cancer care health policies on health care providers and policy makers in this context; and provide suggestions for the way delivery of care should be optimised in a sustained emergency situation. Methods: From April-July 2016, we conducted in-depth interviews with 12 purposively sampled health officials and health care workers from the Jordanian Ministry of Health, multilateral donors and international non-governmental organisations. Data were analysed using a framework analysis approach to identify systemic, practical and ethical challenges to optimising care for refugees, through author agreement on issues emerging from the data and those linked more directly to areas of questioning. Results: As has been previously reported, central challenges for policy makers and health providers were the lack of quality cancer prevalence data to inform programming and care delivery for this refugee population, and insufficient health resource allocation to support services. In addition, limited access to international funding for the host country, the absence of long-term funding schemes, and barriers to coordination between institutions and frontline clinicians were seen as key barriers. In this context where economic priorities inevitably drive decision-making on public health policy and individual care provision, frontline healthcare workers and policy makers experienced significant moral distress where duties of care and humanitarian values were often impossible to uphold. Conclusions: Our findings confirm and expand understanding of the challenges involved in resource allocation decisions for cancer care in refugee populations, and highlight these for the particular situation of long term Syrian refugees in Jordan. The insights offered by frontline clinicians and policy makers in this context reveal the unintended personal and moral impact of resource allocation decisions. With many countries facing similar challenges in the provision of cancer care for refugees, the lessons learned from Jordan suggest key areas for policy revision and international investment in developing cancer care policies for refugees internationally. [ABSTRACT FROM AUTHOR]