Recommendations for Reproductive, Maternal and New-born Health Services in Northeast Syria

The protracted Syrian crisis has disproportionately impacted women and children’s health. Despite complex requirements, little has been known about the reproductive, maternal and new-born health (RMNH) services available to meet needs in Northeast Syria.

Preliminary evidence from Expertise France’s Health Recovery in Northeast Syria (HERNES) project has revealed the need for a better understanding of the gaps in the availability and level of RMNH.

The study, which took place between September – December 2020 assessed the availability, quality, and accessibility of RMNH services at both the facility and community level in Ar Raqqa and Deir-ez-Zor Governates to support effective RMNH programming.

Long term planning

The study used a mixed-methods approach – including a desk review, key informant interviews with a range of stakeholders at the community, facility, (I)NGO and governmental levels, surveys, facility observations, and exit interviews. The findings showed that available RMNH care suffers from many of the general weaknesses affecting the health systems in Ar Raqqa and Deir-ez-Zor. Gaps in available care, clinic practices and equipment reflect shortages in trained medical personnel and medical supply chains. As few public facilities in either governorate have the capacity to provide the essential components of different levels of required care, women often face significant barriers to accessing adequate services – particularly emergency care.

Based on these findings, the study calls for long term planning to ensure the reconstruction of the health system and the provision of accessible and quality RMNH services, including:

• Large-scale investment in existing health infrastructure
• Addressing gaps in the medical supply chain including for equipment, essential drugs and vaccinations
• Improving access to health education and medical training as well as working conditions for medical personnel Mitigating financial barriers to ensure health access for the most vulnerable without exacerbating their current financial vulnerability.

Within this context, the study suggests that RMNH actors operating in this region should consider:

• Making use of and strengthen existing health infrastructure, rather than working in other properties such as private homes or industrial buildings.
• Conducting an urgent review and improvement of the supply chain in relation to RMNH essential equipment, consumables, and supplies. This includes developing relevant procurement strategies, warehouses, distribution practices, and consumption tracking.
• Conducting a comprehensive mapping of existing RMNH facilities across the two governorates to strengthen referral systems and women’s ability to access different levels of care.
• Pairing short and medium-term projects to provide certified medical trainings, competency-based short courses, ‘on-the job’ clinical training and supportive supervision with longer-term programmes focused on restoring formal health education in universities and other pre-service training institutions.
• Coordinating with the local health authorities to identify allocation strategies to ensure sustainable services.