Submission ID 131488
| Issue/Objective | Conflicts disrupt healthcare systems causing inequities in sexual and reproductive health (SRH) services, increased risks of mistreatment, and reduced quality of care. Lebanon's crises, including the 2024 war and displacement of over 1 million people, disrupted access to SRH services at the primary health care level. The Person-Centered Care (PCC) framework, emphasizing dignity, autonomy, trust, communication, and supportive care, is central to transformative primary care. This study applied a PCC framework to examine strengths and gaps in SRH in primary health care centers (PHCCs) in Lebanon and identify partnership-based implementation strategies that center community voices and strengthen resilient local health systems. |
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| Methodology/Approach | As part of a broader project on gender-transformative and person-centered SRH care (GEMSELF) - IDRC funded, we conducted a qualitative study across PHCCs using purposive sampling to recruit diverse stakeholders and service users. Data included 20 key informant interviews with officials, humanitarian actors, and health workers conducted between October 2024 and January 2025 and 20 focus groups with adult and adolescent service users conducted between January and June 2025, following a pause due to war. The PCC framework guided thematic analysis. |
| Results | Despite resource constraints and systemic gaps, PHCCs functioned as hubs of plurality and partnership, engaging multiple actors, including midwives, nurses, general practitioners, mental health specialists, NGOs, and governmental institutions to deliver equitable care aligned with PCC domains. Participants described efforts to provide respectful and consent-based SRH care including family planning and sexual health education. Outreach by midwives and providers' coordination strengthened access for displaced women, with midwives providing services across PHCCs and shelters while general practitioners received mental health training to address psychosocial needs. Service users reported positive experiences when care was consent-based and responsive, though coexisted with discrimination and inequities. Healthcare workers described efforts to provide dignified care despite unsupportive facilities. Collaborative strategies such as community outreach and coordination between governmental and non-governmental actors improved responsiveness to population needs, informed decision-making, and recognition of communities as active agents of change. |
| Discussion/Conclusion | Coordinated partnerships are essential for sustaining equitable, PCC SRH in fragile settings. These insights inform scalable implementation strategies for person-centered SRH care in humanitarian and crisis-affected settings globally. |
| Presenters and Affiliations | Tamar Kabakian-Khasholian Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut Lara Abi Jaoude Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut Ghada Saad Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut Stephen McCall Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut Faysal El Kak Faculty of Health Sciences, American University of Beirut and Department of Obstetrics and Gynecology, American University of Beirut Medical Center American University of Beirut Dalia El Shaar Faculty of Health Sciences, American University of Beirut Sohayla El Fakahany Faculty of Health Sciences, American University of Beirut |
