Informal healthcare provision in Lebanon: an adaptive mechanism among displaced Syrian health professionals in a protracted crisis

Table 2 Describing the nature of IHCWs community of practice

Main Theme	Sub themes	Examples
Motivation	Personal Factors	➢ Altruism ➢ Source of livelihood ➢ Professional
	Societal Factors	➢ Gender congruency ➢ Cultural competency
	Formal health services	➢ Affordability ➢ Filling in a gap
Facilitators	Networks enabling IHCWs to initiate work	➢ Professional ➢ Family & friends
	Building reputation among Syrian refugees
	Establishing a community of practice	➢ Social media ➢ Internal referrals among IHCWs
Challenges	Personal Level	➢ Constant threat ➢ Psychological wellbeing ➢ Mistrust ➢ Economic ➢ Continuous education
Challenges	Societal Level	➢ Resentment from the Lebanese community ➢ Competing with Lebanese providers
Implications	Status in Lebanon	➢ Detention/ deportation ➢ Losing residency status
Implications	Impact of care provided	➢ Compromising patient services/closing centers
Relationship with the formal system and reimbursement mechanisms	Government’s position	➢ Legal threat, yet keeping a blind eye
	Community-based NGO funded	➢ Collegiate atmosphere ➢ Equity in wages ➢ Lebanese and Syrian patients
	Hospital & pharmacies funded by Lebanese healthcare providers	➢ Assistance to Lebanese HPs ➢ Less wages for Syrians ➢ Mainly Syrian patients
	Linkage with formal practice	➢ Referring patients to formal providers when necessary

ISSN: 1752-1505