With hundreds of thousands of Syrian refugees risking their lives trying to reach Europe in the last couple of years, wealthy governments have woken up to the need to do more than simply provide food, tents and emergency medical care.

And a growing number of organisations, including the United Nations and World Bank, are shifting their approach to offer longer-term help for refugees to become more self-sufficient.

The majority of Syria's nearly 5 million refugees are hosted outside the European Union, but the crisis on Europe's doorstep has brought to a head a predicament that many poorer nations have struggled with for decades, experts say. "Governments are having to grapple with a whole set of different issues - like in Turkey, competition in the labour market; like in Lebanon, vastly over-subscribed schools," said Joanna de Berry, who led the World Bank's response for Syrian refugees in Turkey until January.

As war in Syria approached its sixth year, donor governments and international institutions met in London in February, recognising that a sticking-plaster response to assist Syrians fleeing to overwhelmed neighbouring states was insufficient. At that conference, Lebanon, Jordan and Turkey agreed to act to open up their labour markets to refugees.

Donors pledged funding and expertise to help create up to 1.1 million jobs for refugees and host-country citizens by 2018, aided by private-sector investment. "We tend to look at refugees either as humanitarian victims or as an inevitable burden when they are often people with skills, talents, capacities," said Alexander Betts, director of the Refugee Studies Centre at the University of Oxford. "If we empower them, they can often help themselves and their communities."

Betts had worked with Oxford economics professor Paul Collier on a proposal for Syrian refugees in Jordan to receive work permits to do manufacturing jobs in special economic zones. The idea proved popular with Jordan, the World Bank and donors like Britain, and is now being rolled out with a target of 150,000 permits for Syrians to work in five zones. The scheme is due to start soon, Betts said, although challenges remain in securing trade concessions for Jordanian exports to the EU, persuading multinational companies to invest in the zones, and working out how best to run them.

For Betts, an approach like this is "a second-best solution" for situations where host governments are unwilling to let refugees work freely, as they can in Uganda. "The ideal is that you have full economic participation by refugees until they are able to go home," he said. "The practical reality is that you have to look at the political constraints in different countries."

The London conference also saw a pledge to put 1.7 million young Syrian refugees and vulnerable host-community children into quality education by the end of the 2016/17 school year. Philippa Lei, director of policy for the Malala Fund, which advocates for every girl to receive 12 years of education, said the deadline would be hard to meet - not least because donors have been slow to deliver billions of dollars in aid promises.

Meanwhile, refugee children are missing out on the education they need - particularly at secondary level - to turn their hopes into reality, she said. "The majority of young refugee girls we talk to want to go back to their countries, and they want to go to school so they can become something that will help rebuild their country - an architect or a journalist," said Lei.

The UN refugee agency (UNHCR) said this week that, as of the end of 2015, nearly 6.7 million refugees out of a total of 21.3 million, were in a "protracted situation" - meaning they had been in exile for at least five years. The world's 32 long-term refugee situations have lasted 26 years on average, the agency said. Overall, it said, the refugee burden falls mainly on developing countries, which host nearly 14 million refugees, excluding Palestinians, the highest figure in over two decades.

The Horn of Africa, for example, has some 2.2 million refugees and more than 6.5 million people uprooted within their own countries, many of whom have been displaced for more than 20 years, according to a 2015 World Bank report. When the bank's researchers spoke to refugees in Djibouti, Kenya, Ethiopia and Uganda, they were told conditions for the communities they were living in had deteriorated in the past two decades, threatening initial hospitality towards them.

Refugees housed in camps run by aid agencies had better access than local people to education, healthcare, water supplies and opportunities for a decent living. Where the displaced had settled in villages and towns, basic services, infrastructure and the environment could not cope with the additional strain. "It was a downward spiral for development in these areas," said Varalakshmi Vemuru, a social development specialist with the World Bank.

Ethiopia hosts the largest number of refugees in Africa - some 736,000 who have fled conflict and drought in nearby countries including Somalia, Eritrea and Sudan. Ethiopia's economy is growing at around 11 percent annually, but parts of the country remain impoverished - often places where refugees have lived for years. Governments in the region are realising they need to "look at this refugee presence differently" to develop stressed areas that could otherwise put a brake on their growth, said Vemuru.

The World Bank met the governments of Ethiopia, Uganda and Djibouti and proposed they act before the worsening circumstances for communities hosting refugees provoked even bigger problems, including social tensions. In May, the World Bank approved $175 million for a five-year programme to improve conditions for refugees and their hosts alike. De Berry, who now heads up another World Bank project in Africa's Great Lakes region to support displaced people and host communities, said the bank realises that to end poverty, it must concentrate efforts on hard-to-reach populations like these.

The aim in Zambia, Democratic Republic of Congo and Tanzania is to work with governments to include refugees and migrants in wider development plans - such as integrating them better into local economies by building new roads so they can reach markets. "With the right set of opportunities and tools, there is ample evidence to show that displaced people can be an economic asset to their hosting countries," De Berry said.