CC BY-NC-ND 4.0 · Avicenna J Med 2019; 9(03): 94-106
DOI: 10.4103/ajm.AJM_190_18
ORIGINAL ARTICLE

Women’s health in Northwestern Syria: Findings from Healthy-Syria 2017 study

Abdullah Sulieman Terkawi
Syrian Expatriate Medical Association (SEMA), SEMA-US, Charlottesville, VA, USA; Department of Anaesthesiology, University of Virginia, Charlottesville, VA, USA; Department of Anaesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia; Outcomes Research Consortium, Cleveland, OH, USA
,
Basil Bakri
Syrian Expatriate Medical Association (SEMA), SEMA-US, Cincinnati, OH, USA
,
Amena S. Alsadek
Syrian Expatriate Medical Association, Idlib, Syria
,
Rawaa H. Alsibaee
Syrian Expatriate Medical Association (SEMA), SEMA-Turkey, Gaziantep
,
Esraa M. Alasfar
Charlottesville, VA, USA
,
Amna H. Albakour
Syrian Expatriate Medical Association, Idlib, Syria
,
Abdulhannan Y. Aljouja
Syrian Expatriate Medical Association (SEMA), SEMA-Turkey, Gaziantep
,
Nour A. Alshaikhwais
Syrian Expatriate Medical Association, Idlib, Syria
,
Feras A. Fares
Syrian Expatriate Medical Association (SEMA), SEMA-Turkey, Gaziantep
,
Pamela D. Flood
Department of Anaesthesiology, Stanford University, Menlo Park, CA, USA
,
Hussam Jnaid
Syrian Expatriate Medical Association (SEMA), SEMA-Turkey, Gaziantep, Turkey; Section Head of Polyclinics, Department of Family Medicine and Polyclinics, King Saud University, Riyadh, Saudi Arabia
,
Amina A. Najib
Syrian Expatriate Medical Association, Idlib, Syria
,
Diaa A. Saloom
Syrian Expatriate Medical Association, Idlib, Syria
,
Noran A. Zahra
Syrian Expatriate Medical Association, Idlib, Syria
,
Khalid A. Altirkawi
Department of Paediatrics, King Saud University, Riyadh, Saudi Arabia
› Author Affiliations
Financial support and sponsorship Nil.

Abstract

Objectives: Since the uprising in 2011, there have been limited health-care data from inside Syria regarding women’s health. This study aimed to provide an updated account of women’s health, including pregnancy, perinatal care, childbirth, and other conditions to identify obstacles and challenges to health-care delivery in Northwestern Syria. Methods: This is a prospective data registry study, using a medical electronic records system that builds on the International Classification of Diseases, Tenth Revision (ICD-10) codes. We collected data from one medical center in Northwestern Syria during 2017. We conducted a survey to understand patients’ knowledge of and barriers limiting antenatal care (ANC). Results: We studied 7213 patients’ health status and surveyed 134 regarding ANC. Prenatal care, delivery, and miscarriage treatment represented the most common (70%) reasons for women’s health-care visits, followed by menstrual disorders (17%). From 2057 delivery records, 70% delivered vaginally and 30% required cesarean delivery. Our findings showed that 1169 (24%) of the pregnant women (4936) in 2017 were adolescents, of them 22 (0.44%) were 14 years old. Regarding ANC visits, 85% of respondents did not have a single ANC visit in the first trimester, 82% had no visits in the second trimester, and 44% had no visits in the third trimester. Thirty-one percent had no ANC visit throughout the entire pregnancy. Only 13% had postnatal care (PNC) visits. Women who live in the refugee camp are 2.7 times less likely to meet the World Health Organization (WHO) criteria for focused ANC (FANC = 4 visits) compared to those who reside in town (P < 0.001), with only 14% having met the FANC. The major barrier to ANC is related to transportation (34%), followed by factors related to the study center (29%) and knowledge and education (19%). We estimated the number of obstetrics-gynecology doctors per 1000 populations to be 0.02. Conclusions: We found a huge deficiency in ANC and PNC visits, a high adolescent birth rate, and a higher cesarean-to-vaginal delivery ratio than what is recommended by the WHO. We also found a severe shortage in the number of obstetrician-gynecologists serving this population.



Publication History

Article published online:
09 August 2021

© 2019. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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