ArticlePloS one2022
"They cannot afford to feed their children and the advice is to stay home. How‥?": A qualitative study of community experiences of COVID-19 response efforts across Syria.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 18 citations in OpenAlex.
- Could home management of COVID-19 cases alleviate strain on the fragile healthcare system in Damascus, Syria: a prospective cohort study.BMC infectious diseases · 2026Article
- The 'Other' face of health security: Reimagining epistemic attachments in global health.PLOS global public health · 2026Article
- Forecasting COVID-19 inpatient mortality using fundamental parameters in resource-constrained settings: a countrywide multi-center cohort study.BMC infectious diseases · 2025Article
- Trust, Information and Vaccine Aonfidence in Crisis Settings: A Scoping Review.Public health challenges · 2025Review
- Post-crisis health reality and wellbeing of children within Syria: a scoping review of research from 2012 to 2024.Conflict and health · 2025Review
- Access to essential medicines for noncommunicable diseases during conflicts: The case cardiovascular diseases, diabetes and epilepsy in Northern Syria.PLOS global public health · 2025Article
- Regional Agriculture and Food Systems Amid the COVID-19 Pandemic: The Case of the Near East and North Africa Region.Foods (Basel, Switzerland) · 2024Review
- 'BMJ global health · 2023Article
- Article
- Lessons learnt from the first wave of COVID-19 in Damascus, Syria: a multicentre retrospective cohort study.BMJ open · 2023Article
- Article
- Revealing the significant shortcomings in the learning environment at the three largest medical schools in Syria: what's next?BMC medical education · 2023Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
Abstract
introductionCOVID-19 highlighted the importance of meaningful engagement between communities and health authorities. This is particularly challenging in conflict-affected countries such as Syria, where social protection and food security needs can hinder adherence to non-pharmaceutical interventions (NPIs) and vaccine uptake. This study explored community perspectives of COVID-19 and health authority responses across the three main areas of control in Syria, i.e. Syrian government-controlled areas (GCA), autonomous administration-controlled areas (AACA), and opposition-controlled areas (OCA).
methodsWe conducted a qualitative study, interviewing 22 purposively-sampled Syrians accessing health services in AACA, GCA, or OCA in 2021 to provide approximately equal representation by governance area and gender. We analysed data thematically using deductive and inductive coding.
findingsInterviewees in all areas described how their fears of COVID-19 and willingness to adhere to NPIs decreased as their local COVID-19 epidemics progressed and NPIs disrupted access to household essentials such as work and food. Community-level responses were minimal and ad hoc, so most people focused on personal or household protective efforts and many mentioned relying on their faith for comfort. Misinformation and vaccine hesitancy were common in all areas, linked to lack of transparency from and mistrust of local health authorities and information sources.
conclusionsThe COVID-19 pandemic has increased health actors' need to engage with communities to control disease spread, yet most NPIs implemented in Syria were inappropriate and adherence decreased as the pandemic progressed. This was exemplified by lockdowns and requirements to self-isolate, despite precarious reliance on daily wages, no subsidies for lost income, individual self-reliance, and mistrust/weak communication between communities and health authorities. We found minimal community engagement efforts, consisting entirely of informing with no efforts to consult, involve, collaborate, or empower. This contributed to failures of health actors to contextualise interventions in ways that respected community understandings and needs.
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