Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Nancy N. Rea


Neonatal and maternal health indicators have been impacted due to Syrian refugees’ displacement in Lebanon and an increase in child marriage rates from 13% in pre-conflict Syria to 41%. Using the causal continuum framework, the retrospective cross-sectional study’s purpose was to examine whether there is a statistically significant association between adverse maternal and birth health outcomes among Syrian refugees in Lebanon and social determinants of health. The sample size drawn from UNHCR database included 48,083 maternal and 4,288 neonatal refugees admitted to the secondary health care in 2018. Pearson chi-square and binomial logistic regression results showed that employed, newcomers mothers aged 18 and above originating from Southwest Syria, residing in rural areas, accessing to cash and food assistance showed higher adverse maternal outcomes, while those educated and residing in Bekaa were protected. Socioeconomic vulnerability, employment, accommodations in collective shelters in the South, and fleeing in 2018 into Lebanon led to adverse neonatal outcomes. Moreover, mothers having access to cash, originating from Southwest Syria, and residing in Baalbeck, Akkar, and North governorates were less likely to experience adverse neonatal outcomes. Finally, employed mothers from the South were less likely to experience neonatal mortality. Further studies are suggested to enroll participants who delivered at noncontracted hospitals and follow up on their health status to monitor risk factors and outcomes. Standardized reporting of reproductive, maternal, newborn, and child health indicators is effective for monitoring and improving health outcomes. Strengthening the accountability framework for age, gender and diversity mainstreaming, and empowering women and girls is key to reach the Sustainable Development Goals to improve the health of women, girls, and children.