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Annual Referral Health Care Report 2018

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79,416 Referrals financially supported by UNHCR in 2018.

74,714 Beneficiaries supported by UNHCR with one or more referrals.

6,618 Monthly average of referrals supported by UNHCR.

78% Proportion of referrals of female patients, reflecting the high proportion of obstetric care (76% in 2017).

82% Proportion of accepted referrals in most utilized 20 hospitals.


Secondary and tertiary health care institutions in Lebanon are mostly private and cost is a significant access barrier. UNHCR has put in place Guidelines for Referral Health Care in Lebanon and standard operating procedures (SOP) to support access to life saving and obstetric care and to manage the costs of care for refugees. The costs covered by UNHCR vary according to the cost of service provided.
Additionally, UNHCR contracts a third party administrator (TPA) to manage and audit referral care processes and costs.
As of December 2018, there are 948,849 Syrian refugees and 18,200 refugees from other countries registered with UNHCR. The referral care programme also supports access to life saving care for nonregistered refugees.

  • The total number of approved referrals decreased from 82,894 in 2017 to 79,416 in 2018. This is a decrease of 4%.

  • The UNHCR network consisted of 40 hospitals during 2018. The majority (82%) of accepted referrals were treated in 20 hospitals.

  • As of July 2018, UNHCR introduced a revised cost-sharing scheme, under which coverage of UNHCR to a higher degree is determined by the cost of the provided service. The higher the cost, the higher percentage is covered by UNHCR. This is believed to have had an impact on health seeking behavior of the beneficiaries, who would increasingly seek care in primary health care facilities rather than hospitals for less severe conditions.

  • A high proportion (63%) of referrals were for maternity care which represents an increase from 59% in 2017.

  • The proportion of births performed by caesarean section was 33% in 2018, remaining almost at the same level as in 2017 (34%).

  • Out of the total annual approved referrals there were 921 mortalities, of which 57% were in children under one year of age, predominantly in the perinatal period.