Health Status of internally displaced persons in Georgia and Ukraine

Abstract Background Internally displaced persons (IDPs) are a vulnerable groups of population in Eastern European countries, such as Georgia and Ukraine. As of 2019, according to the Ministry of Social Policy of Ukraine, there are 1,355,375 IDPs in Ukraine. The number of IDPs in Georgia today is 273,411. After leaving the shelter, IDPs must deal with various obstacles. However, the health status of this vulnerable group, their access to health services and their needs have not been properly addressed in these countries. The aim of this study was to systematically review the literature on the mental health outcomes, and to evaluate the access to the health services among IDPs in Georgia and Ukraine. Methods The study follows the principles of PRISMA extension for scoping reviews. We used following databases for searching relevant literature on mental health outcomes: PubMed, Web of Science, Cochrane Library, Google Scholar and PsychINFO. We additionally searched national policy documents from the ministries, local journals in Georgia and Ukraine, and a grey literature. Results 773 results obtained from selected scientific databases were screened against exclusion criteria. We included 15 studies in final analysis, 9 examined the health status of IDPs in Georgia, and 6 in Ukraine. We found that majority of the IDPs are women and children, among whom, the largest share on mental disorders comes from women. In general, post-traumatic stress disorder (PTSD), anxiety and sleeping disorders and alcohol dependence were the most frequently examined mental health outcomes among IDPs in both countries. Included studies showed 43% less mental health service usage among alcohol users when compared to non-alcohol users in Ukraine and Georgia. Conclusions Despite the increased need, the study found that IDPs are facing barriers to access health care, especially mental health services are limited. This further worsens health outcomes, such as PTSD and anxiety disorders. Key messages IDPs in Georgia and Ukraine need better access to mental health services, such as health insurance coverage, mental health screening services and effective referral system. Primary health care providers are encouraged to provide comprehensive information to IDPs on where and how they can get health services.