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Guidelines for Referral Health Care in Lebanon - Standard Operating Procedures, Updated June 2020

Countries
Lebanon
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Sources
UNHCR
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Introduction

Since the onset of the civil war in Syria, people have fled to neighboring countries. By May 2020, there were 892,310Syrian refugees and approximately 18,000 refugees of other nationalities registered with UNHCR in Lebanon. Refugees are living predominantly in urban settings. UNHCR’s role is to facilitate and advocate for access to its persons of concern through existing services and health service providers and to monitor access to health care services. While the primary health care strategy is the core of all interventions; referral care is an essential part of access to comprehensive health services (UNHCR Public Health Operational Guidance, 2013). These standard operating procedures (SOPs) outline the policy and procedures for referral care applicable to all UNHCR recognized refugees and persons of concern in Lebanon.

Definition of Referral Care

Referral health care is care that is too advanced for primary health care facilities and therefore provided at health care facilities of secondary or tertiary level (i.e. hospitals). It usually requires admission of the patient.

Guiding Principles

The below principles are based on UNHCR’s Principles and Guidance for Referral Health Care for Refugees and Other Persons of Concern (2009):

The below principles are based on UNHCR’s Principles and Guidance for Referral Health Care for Refugees and Other Persons of Concern (2009):

  1. Equity of care and access between PoCs and host population UNHCR aims to provide refugees with access to and quality of referral care at similar levels as received by Lebanese citizens in government health facilities.

  2. Prioritizations should be based on prognosis and cost Since funds are limited, prioritization needs to be done in order to deliver the most necessary care to the highest number of people. The two most important factors determining whether to make treatments available are therefore prognosis and cost. Page | 7

  3. The decision to provide referral care is medical The medical aspect should always remain central in the decision making about what treatment should be available for whom and the responsibility for final decisions should lie with a medical doctor.

  4. The decision-making procedure should be consistent and transparent Decisions should be made following available SOPs and guidelines and involve qualified experts according to the nature of the different cases.

  5. Medical confidentiality is ensured throughout the referral care process Please refer to Annex 1