Syria Country Brief

About

Context

In North West Syria (NWS), a civil movement that began in 2011 has developed into a prolonged armed conflict, resulting in a significant humanitarian crisis. The region's conditions have worsened in recent years due to an economic crisis compounded by forced displacement, the COVID-19 pandemic, a cholera outbreak, and a destructive earthquake in February 2023. This situation affects over 4.5 million people, including more than 2.8 million internally displaced individuals, predominantly women and children (79 percent). Many displaced persons live in overcrowded camps with limited access to essential services.

The humanitarian crisis is deepening, and cross-border aid is under pressure to meet long-term needs. There is a severe funding shortage, which caused essential services at nine hospitals to be temporarily halted last year. In addition, half of the health facilities have been destroyed, and 70 percent of health care providers have fled, leading to a significantly weakened health sector in the region. Challenges related to access, equity, continuity, and utilization of services persist amid the ongoing conflict.

In 2015, international organizations introduced the concept of community health workers in NWS. Although a unified package of services was successfully developed, implementation has faced challenges, and there have been inconsistencies in approaches both between and within different clusters.

Methodology

This mapping provides an overview/snapshot of the community health currently in place in NWS. It followed a mixed methods approach, combining:

1. A document review of publicly available documents and internal reports and evaluations shared by stakeholders.
2. Ten key informant interviews conducted virtually with representatives from the health, Expanded Programme on Immunization (EPI), nutrition, and Water, Sanitation and Hygiene (WASH) clusters and their partners, as well as community health workers (CHWs).
3. A validation workshop conducted with 36 key stakeholders.

The interviews and the workshop were recorded (after obtaining consent of informants and participants) and transcribed. Data was then coded using Dedoose software, focusing on health system pillars considered for this mapping, including governance and accountability, health management information system (HMIS), health workforce, service delivery, medicines and commodities, partnerships, and financing. Some insights related to cross-cutting themes, such as gender considerations, emergency preparedness, and integration of internally displaced persons (IDPs) in community health, were also extracted.

All primary and secondary data were then triangulated and summarized in this brief.