Fostering inclusive health governance: overcoming barriers to refugee inclusion in local decision-making - Session 419 - Keynote summary

Sep 30, 2026

Upload by Mimi

Lebanon’s governance faced intensifying pressures from sectarian politics, corruption, and clientelism, with Syrian refugee influx since 2011, the 2019 economic collapse, the COVID-19 pandemic, and the 2024 war further straining healthcare oversight. The Lebanon ReBUILD for Resilience (R4R) initiative worked with local stakeholders in Majdal Anjar to establish a Municipal Health Committee (MHC) for decentralized health governance, but encountered resistance to inclusive governance and Syrian professionals’ participation. The study examines barriers to equitable governance and strategies to foster inclusion within the MHC, using thematic analysis of meeting documentation and reflective transcripts.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Aim

Context and governance strain

Study objective

Methods

Data sources

Analysis approach

Results

Barriers to Syrian doctor inclusion

Inclusion strategies and integration outcomes

Conclusion

Challenges and successes

Implications for sustained advocacy

vi60 European Journal of Public Health, Vol. 35, Supplement 6, 2025 Abstract citation ID: ckaf180.165 419 Fostering inclusive health governance: overcoming barriers to refugee inclusion in local decision-making Joanna Khalil1, Rouham Yamout1, Wesam Mansour2, Fouad Fouad2, Joanna Raven2 1American University of Beirut, Beirut, Lebanon 2Liverpool School of Tropical Medicine, Liverpool, United Kingdom OP 25: Exclusion and Discrimination 3, B207 (FCSH), September 4, 2025, 14:45-15:45 Aim: Lebanon has faced escalating crises due to decades of sectarian-driven governance, corruption and clientelism. The influx of Syrian refugees since 2011, the economic collapse starting in 2019, the COVID-19 pandemic in 2020 and the war on Lebanon in 2024 have severely strained governance, particularly in healthcare. The Lebanon ReBUILD for Resilience (R4R) initiative partnered with local stakeholders in Majdal Anjar to establish the Municipal Health Committee (MHC), a decentralized governance model aimed at improving local healthcare oversight. However, the initiative faced challenges due to entrenched political dynamics and resistance to inclusive governance, particularly regarding the participation of Syrian healthcare professionals. This study examines the barriers to equitable governance and the strategies used to foster inclusion within the MHC. Methods: Data was extracted from process documentation, including meeting minutes, field journal notes, and transcripts of reflective meetings. Thematic analysis was applied to interpret the data. Results: Resistance to the inclusion of Syrian doctors initially stemmed from broader societal biases against refugees. To promote equity, transparency, and collaborative leadership, the team worked with municipal authorities, local health professionals, and community members. Key efforts included training on decentralized governance, highlighting the benefits of inclusivity, and bridging gaps between political and technical stakeholders. As a result, the doctors gained recognition for their contributions and were fully integrated into the MHC. Conclusion: This study highlights the challenges and successes of fostering inclusive governance in a politically fragmented environment. By emphasizing equity, participation, and compromise, the initiative demonstrated that inclusive models can enhance healthcare governance and service delivery. The case underscores the importance of sustained advocacy, strategic engagement, and demonstrating practical benefits to overcome resistance and institutionalize inclusive decision-making in local governance structures.

FAQs

What problem does the study address in Lebanon’s local healthcare governance?

It addresses barriers to equitable and inclusive governance for refugee inclusion in local decision-making, particularly within healthcare oversight during a politically fragmented environment.

How did the initiative support the creation of the Municipal Health Committee (MHC)?

The Lebanon R4R initiative partnered with local stakeholders in Majdal Anjar to establish the MHC as a decentralized governance model aimed at improving local healthcare oversight.

What strategies helped overcome resistance and integrate Syrian healthcare professionals?

The team promoted transparency and collaborative leadership, trained municipal actors on decentralized governance, emphasized inclusivity benefits, and bridged political and technical stakeholders to enable recognition and full integration of Syrian doctors.

Sep 30, 2026

Upload by Mimi