Coping with the Influx: Service Delivery to Syrian Refugees and Hosts in Jordan, Lebanon and Kurdistan, Iraq

Nandini Krishnan, Flavio Russo Riva, Dhiraj Sharma, and Tara Vishwanath


This paper characterizes rates of access to infrastructure and social services among host communities and refugees in Jordan, Lebanon, and the Kurdistan Region of Iraq (KRI), and related perceptions of quality of service delivery. In all three contexts, public service delivery systems have played a key role in addressing the needs of Syrian refugees in education, health and infrastructure (electricity, water and sanitation, solid waste management).

The empirical approach involved examining how outcomes are influenced by district-level estimates of Syrian refugee density (and IDP density in KRI) while accounting for timeinvariant governorate (or province) characteristics, individual characteristics, and location characteristics. The analysis relies on data from the Syrian Refugees and Host Communities
Survey (SRHCS), conducted in 2015-16, which includes detailed questions on demographics, employment, access to public services, health, migration, and perceptions.
Estimates from nationally representative surveys, where available, were also used to establish baseline or benchmark conditions.

Key findings:

  •  Refugees/IDPs have more limited access to infrastructure compared to hosts. Access to infrastructure services (water, electricity and sanitation) is worse for refugees/IDPs in camps than for those outside camps. Refugees/IDPs in camps reported lower satisfaction with access to services (compared with their situation in 2010, before they were displaced) than those outside camps.
  • Although service provision in high-refugee-influx areas has not deteriorated since 2010, substantial shares of the host populations reported that access to services has worsened. However, there is no significant association between the local density of refugees/IDPs and the proportion of host households who reported deteriorating access to services since 2010.
  •  Refugees/IDPs and the host community rely on public and private service providers for health care, with the relative reliance on private or public health services varying across countries, as well as between refugees/IDPs within camps and those living outside of camps. Despite the large overlap in the use of private and public health providers, the authors find no evidence that the influx of refugees negatively affected perceptions about health services in 2015 compared to 2010.
  •  Refugee children living inside camps primarily attend schools run by the UN, NGOs, or charitable groups, whereas refugee children living outside camps attend mostly public or private schools. Many school-age children are currently out of school in the three host countries due to economic hardship. Even though rates of enrollment for refugee/IDP children are uniformly lower than enrollment rates for host children, the influx likely has placed a burden on the preexisting stock of inputs in schools.
    Nevertheless, the authors find no evidence that perceptions about education services among hosts have worsened in 2015 compared to 2010.The authors conclude that the extent of competition between refugees and host communities depends on the degree to which the hosts relied on publicly provided services. However, the large and rapid inflow of refugees has unequivocally strained the public service delivery systems of host countries, and there is a need for more investment to expand the supply of services and delivery personnel.