Reflecting on Inclusive Health Services in North West Syria (NWS) – Syrian Arab Republic

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Introduction

After a decade of crisis, Syria remains one of the most complex humanitarian crises in the world. Continued hostilities, new and protracted displacements, increased returns and the continued destruction of communities have had a devastating impact on the lives and future of Syrians. The 2021 Humanitarian Needs Overview (HNO) identified that 13.4 million people, more than half of the country’s pre-crisis population, are in need of humanitarian assistance. Of this figure, 12.4 million need health care.

In northwestern Syria (NWS), mainly in the governorates of Idlib and Aleppo, 3.4 million people have extreme and catastrophic humanitarian needs. By the end of 2021, there is a significant 29% increase in people in need (PIN) compared to 2020 in Idlib and Aleppo, where the majority of people in need are internally displaced people of the country (IDPs), women and children. Attacks on healthcare facilities have declined, while the Covid-19 pandemic, coupled with the economic downturn, has pushed the healthcare system to the brink. According to UNOCHA’s financial tracking service (October 2021), the humanitarian response plan in Syria is underfunded at 64.1% and the health sector also faces serious challenges with coverage of only 23 .8%.

The most vulnerable and at risk groups are women and girls, the elderly and people with disabilities. Women and girls are at higher risk of experiencing gender-based violence (GBV) as well as domestic, physical and emotional violence, which impedes their access to basic human rights, including health¹. Recent data suggests that the prevalence of persons with disabilities (PWDs) living in Syria, aged 12 and over, is 25%, nearly double the global average². In the governorates of Aleppo and Idlib, the prevalence of internally displaced persons (IDPs) shows that women and girls are more likely to be disabled than men and boys. This cohort also faces heightened protection risks and infection with Covid-19 due to their interactions with and reliance on caregivers and personal assistants.

Thanks to the generous financial support of the Swedish International Development Cooperation Agency (Sida), Islamic Relief (IR) responds to the immense health needs of vulnerable women, girls, men and boys in the NWS, where we work in the governorates of ‘Idlib and Aleppo. The program includes the provision of support to the NWS health system to ensure the vulnerable population of NWS has better access to health care. The main objective of the program is to maintain the fundamental protection elements of prioritizing safety and dignity and avoiding harm, ensuring people’s meaningful access to assistance and health services , to put in place comprehensive accountability measures and to support the participation and empowerment of affected communities. By enabling the delivery of health care services to a highly vulnerable population in the NWS, the intervention addresses one of the key protection issues in the region – safe and equitable access to health care services.

As part of the AIDS 2020 program, IR operated inclusive car services to strengthen referral pathways – that is, transporting communities to and from relevant health facilities. IR is committed to improving its approach to protection and inclusion and, to this end, has conducted a learning and reflection exercise to document best practices, lessons learned and ways forward. The findings of this discussion paper will be used to improve future interventions on mainstreaming protection and inclusion into Islamic Relief in Syria’s health programming.

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