Insights into theorizing social exclusion and inequities: A perspective from the Arab World

Abstract

Objective: To explore the influence of the global structural determinants and their pathways of action on health disparities and social exclusion, drawing on findings from research with four different population groups in an Arab context. We use a socio-ecological framework to categorise these determinants into levels to allow an in-depth look into their pathways of action on social exclusion and inequalities. Methods: We use findings from an ethnographic study on Palestinian and Iraqi refugees in Lebanon; a qualitative research study on women’s needs for labour support in three public hospitals in Egypt, Lebanon and Syria; and counselling experiences with university scholarship recipients in Lebanon. These findings were revisited using a social exclusion lens. Results: Global forces, such as modernism, inequitable foreign policies of resettlement countries, over-medicalization of health care, modern educational systems and armed conflicts fueled by global vested interests interact to cause and exacerbate social exclusion. Palestinian refugees relate their experiences of discrimination in what is perceived to be a hostile society to policies reducing their education and employment opportunities. Delays in processing resettlement applications of Iraqi refugees and the lack of power over the choice of resettlement countries are a source of reported stress and anxiety. Over-medicalization of maternity care disrupts the traditional ways of giving birth surrounded with family through policies and practices restricting labour companionship, resulting in the isolation and silencing of women during childbirth. Scholarship students reported inadvertent exclusion from their families, societies and colleagues. Scrutiny of the findings and re-examination of the data reveals the importance of global structural determinants in explaining the patterns of exclusion reported for the population groups observed. Conclusion: Expanding the ecological framework of determinants of social exclusion at the level of wider social/structural determinants is necessary to improve our understanding of social exclusion in impoverished and war affected places around the world. © 2019, Griffith University. All rights reserved.