How Covid-19 financially hit urban refugees: evidence from mixed-method research with citizens and Syrian refugees in Turkey

The vulnerability to COVID-19 of migrants in large urban areas: structural exacerbators and community-level mitigators

BACKGROUND

Despite research on large urban areas in the context of COVID-19, evidence on how these settings impact migrants is still limited.

OBJECTIVE

To explore exacerbating and mitigating factors of large urban areas on migrants' vulnerabilities during the COVID-19 pandemic.

METHODS

We conducted a systematic review of peer-reviewed studies published between 2020 and 2022, focused on migrants (foreign-born individuals who have not been naturalized in the host country, regardless of legal immigration status) in urban areas with a population >500 000. After screening 880 studies, 29 studies were included and categorized within the following thematic framework: (i) pre-existing inequities, (ii) governance strategies, (iii) urban design and (iv) engagement of civil society organizations (CSOs).

RESULTS

Exacerbating factors include pre-existing inequities (e.g. unemployment, financial instability and barriers to healthcare access), exclusionary government responses (e.g. ineligibility for relief funds or unemployment benefits) and residential segregation. Mitigating community-level factors include the engagement of CSOs to fill institutional and governmental gaps through service provision and use of technology.

CONCLUSIONS

We recommend increased attention to pre-existing structural inequities faced by migrants, more inclusive governance strategies and partnerships between government and CSOs to improve the design and delivery of services to migrants in large urban areas. More research is needed on how urban design can be utilized to mitigate COVID-19 impacts on migrant communities. The factors identified in this systematic review should be considered as part of migrant-inclusive emergency preparedness strategies to address the disproportionate impact of health crises on migrant communities.

Efficiency Analysis of Syrian Refugees' Healthcare Services in Turkey and Other 3RP States

Access to healthcare for refugees is often contextually and conceptually diverse. This study set out to evaluate the efficiency of the healthcare services provided for Syrian refugees in Turkey and other refugee response and resilience plan (3RP) states. Data envelopment analysis is utilized for efficiency analysis using primary healthcare system indicators. Efficiency is broken down into pure technical efficiency and scale efficiency to identify causes of inefficiency. Normative analysis is used to employ a teleological approach to better understand current refugee healthcare policies. The findings show a decline in the overall efficiency for Turkey and other 3RP states. However, Turkey's operational practices could be a model for other 3RP states due to its relatively high pure technical efficiency. Scale inefficiency negatively impacts the overall efficiency of Turkey's service, while other 3RP states exhibit a rather consistent performance. The study concludes that Turkey's healthcare system for refugees is inefficient, resulting in inadequate access for Syrian refugees. As such, operational and scale efficiency must be synergized for Turkey to fulfill its obligation to provide adequate healthcare for Syrian refugees. Additionally, COVID-19 was found to have exacerbated the challenges Syrian refugees face accessing healthcare. Policy recommendations have been made in line with the findings of the study.