Impact of armed conflict on health professionals' education and training in Syria: a systematic review

Yamama Bdaiwi; Ammar Sabouni; Preeti Patel; Abdulkarim Ekzayez; Safwan Alchalati; Omer Abdrabbuh; Aula Abbara; Margaret Glogowska

doi:10.1136/bmjopen-2022-064851

Impact of armed conflict on health professionals' education and training in Syria: a systematic review

BMJ Open. 2023 Jul 20;13(7):e064851. doi: 10.1136/bmjopen-2022-064851.

Authors

Yamama Bdaiwi¹, Ammar Sabouni², Preeti Patel¹, Abdulkarim Ekzayez¹, Safwan Alchalati³, Omer Abdrabbuh⁴, Aula Abbara⁵, Margaret Glogowska⁶

Affiliations

¹ Department of War Studies, King's College London, London, UK.
² Syria Development Centre, London, UK.
³ Syrian Board of Medical Specialities, Idlib, Syrian Arab Republic.
⁴ Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey omar.abdrabbuh@gmail.com.
⁵ Department of Infection, Imperial College London, London, UK.
⁶ Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.

Abstract

Objectives: To provide an overview of the holistic impact of the armed conflict on medical education and health professionals' training (MEHPT) in Syria.

Setting: Syria is a country which underwent an armed conflict for 10 years and suffered from the weaponisation of health.

Methods: A mixed-methods systematic review including quantitative, qualitative, mixed-methods and textual literature between 2011 and 2021 including papers on the Syrian MEHPT undergraduate and postgraduate education and training personnel (including medicine, dentistry, pharmacy, nursing, midwifery and allied health professionals). The electronic search was conducted in October 2018 in Embase, Global Health, Medline, PsycINFO, Web of Science, PubMed, Scopus, CINAHL and grey literature. And an update to the search was conducted in August 2021 in PubMed, Google Scholar and Trip database.

Outcomes: The impact of conflict on the MEHPT system, personnel, experiences, challenges and channels of support.

Results: Of the 5710 citations screened, 70 met the inclusion criteria (34 quantitative, 3 qualitative, 1 mixed-method, and 32 reports and opinion papers). The two major cross-cutting themes were attacks on MEHPT and innovations (present in 41% and 44% of the papers, respectively), followed by challenges facing the MEHPT sector and attitudes and knowledge of trainees and students, and lastly health system and policy issues, and narrating experiences.

Conclusion: Conflict in Syria has politicised all aspects of MEHPT. Influenced by political control, the MEHPT system has been divided into two distinguished geopolitical contexts; government-controlled areas (GCAs) and non-GCAs (NGCAs), each having its characteristics and level of war impact. International and regional academic institutes collaboration and coordination efforts are needed to formulate educational platforms using innovative approaches (such as online/blended/store-and-forward/peer-training/online tutoring) to strengthen and build the capacity of the health workforce in conflict-affected areas.

Keywords: education & training (see medical education & training); health education; medical education & training.

Publication types

Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Allied Health Personnel
Armed Conflicts
Education, Medical*
Health Personnel* / education
Humans
Syria