6535 The impact of armed conflict on paediatric healthcare consultations in Northwest Syria

Objectives Background The protracted armed conflict in Syria has profoundly impacted the health of children.¹ ² However, research on paediatric healthcare utilisation in this region is sparse. This study examined paediatric (<18 years) healthcare consultations in northwest Syria between January 2018 and December 2022 (5 years) and explored associations with conflict-related forced displacement. Objectives To analyse paediatric clinical consultation data from Syrian American Medical Society facilities in Northwest Syria between January 2018 and December 2022. To explore any potential associations of paediatric clinical consultations with forced displacement. Methods A retrospective quantitative analysis was conducted using paediatric consultation data from the Syrian American Medical Society (SAMS) facilities in Idlib and Aleppo governorates. To explore associations between forced displacement and consultations, data were utilised from the United Nations Office for the Coordination of Humanitarian Affairs Internal Displacement Monitoring Centre. Regional monthly displacement was divided into quartiles: Low (≤26,330 monthly IDP (internally displaced people) movements), Medium (26,331–41,936), High (41,937–82,051), and Severe (≥82,052). Preliminary descriptive analyses were completed. Seasonal-trend decompositions using locally estimated scatterplot smoothing were then performed to estimate the seasonality of clinical presentations. Following this, multivariate regressions were conducted. They incorporated age, gender, residency status, season, and a random district-level intercept to measure the association between the odds of clinical consultation and forced displacement. Results Across 51 reporting SAMS facilities in Idlib and Aleppo governorates, 2,687,807 clinical consultations were studied over a five-year period. Seasonal trends were observed within all clinical consultation categories; communicable disease consultations peaked in the winter, while consultations for injuries, nutritional, and non-communicable diseases increased in the summer. Higher levels of forced displacement were associated with increased odds of nutrition (AOR=1.55, 95%CI:1.46–1.66), trauma (AOR=1.21, 95%CI:1.19–1.23), non- communicable and mental health (AOR=1.19, 95%CI:1.18–1.20) disease consultations, but decreased odds of communicable diseases consultations (AOR=0.81, 95%CI:0.80–0.82). Aside from traumatic injury, IDPs had higher adjusted odds of clinical consultations compared to host populations. Many of these changes persisted in the months following displacement. Conclusion Different levels of forced displacement affected paediatric consultation categories differently. Further exploration of these patterns and the seasonal influence can inform health service provision for child health needs in this humanitarian setting, allowing better preparedness and resourcing. References Syria Network for Human Rights, Statista Inc, 2023. Euro-Med Human Rights Monitor, ReliefWeb, 2022.