Final evaluation of Health Recovery in Northeast Syria phase 2 At Expertise France

BACKGROUND

1. Context

The Syrian crisis continues to have severe and long-lasting effects on Syria and the surrounding area. As the conflict entered its eleventh year, the aid needs of the impacted populations, comprising 13,4 million people inside the country, remain enormous. The population of northeastern Syria has a dire need for basic services. From 2013 to 2017, the area was mostly occupied by the Islamic State in Iraq and al-Sham (ISIS) before it was gradually retaken by the Syrian Democratic Forces (SDF), with coalition support. During these five years, the tremendous amount of devastation produced by the anti-ISIS fight has had a substantial impact on economic activity and access to all services. Consequently, communities in the north-east of Syria continue to experience the long-term effects of the intense hostilities and military operations that resulted in significant loss of life, destruction of basic services and civilian infrastructures, loss of means of subsistence, and displacement of over one million people.

The area around Raqqa, Deir-Ezzor, Hassakeh, and East Aleppo was seriously affected, resulting in a total disruption of access to essential services including as healthcare, education, water, and power. As a result of the destruction’s effect on productive assets, a large number of Syrians were forced to leave their country due to a lack of employment prospects. Today, the North-Eastern provinces are still regarded as territories with the greatest degree of need. Beginning with the return of basic services that are required to enhance the living circumstances of the local community and to persuade IDPs to voluntarily return, the needs are significant.

The surge of IDPs and returns places further pressure on service providers, particularly in the health sector, which remains severely affected. The defeat of ISIS has undoubtedly put a stop to brutal military intervention, but it has also intensified population displacement, creating a devasting situation, particularly in terms of the provision of health care.

Furthermore, the possibility of ISIS reorganizing and resurfacing has not been eliminated entirely. In the absence of substantial international efforts and investment to ameliorate the living circumstances of the people in these war-affected regions, a revival of violence and terrorist threats is possible.

1. Project profile

Project title : Health Recovery in Northeast Syria (HERNES)

Donors: French Ministry of Europe and Foreign Affairs (French

MoEFA) and European Union (EU)

Project budget: 6,500,000 Euros

Project duration : Start date: 01/08/2022

End date: 31/01/2023

The project constitutes a second phase to the HERNES 1 project that was jointly financed by the Crisis and Support Centre (CDCS) of the French Ministry for Europe and Foreign Affairs and the European Union Foreign Policy Instrument (FPI) for a total amount of EUR 8 215 611. The project was implemented between 2019 to 2021, by Expertise France, in partnership with a local NGO.

The HERNES 2 project built upon the achievements, challenges and lessons learnt during HERNES 1. The context that has guided the elaboration of HERNES 1 has remained largely unchanged, and the project’s justification and relevance was still largely valid, although the protracted crisis also calls for a greater focus on issues of sustainability and durable interventions.

The approach was two-pronged. On the one hand, and to secure the achievements reached by HERNES 1, the project aimed to continue to support the delivery of basic health services, as well as maternity care in the 7 facilities supported: 3 Primary Health Care Centres (PHC) of

Mahmoudly, Al Karama, and Abu Hamam, 3 Comprehensive Primary Health Care Centres (CPHC) of Raqqa, Menbij and Hajin and the Maternity Hospital of Al Hol. This continuity of services was seen as essential in the context, whereby the health system and consequently health services in the NES could not be supported by public authorities and the State budget.

On the other hand, EF intended to further contribute to lay the foundation for a more durable recovery of the health sector in the NES. This was attempted through ensuring that the work that is performed in the supported centers can form the basis for a greater harmonization and coordination of practices, protocols and guidelines. To this purpose, EF provided technical assistance to the NES Forum and the Health Working Group in the fields of Reproductive Maternal Newborn and supply chain management. EF also intended to support NES health actors’ policy dialogue on the recovery and future prospects of a stabilized and functioning health system in Syria and strengthen its support to capacity building through trainings of and support to health workers.

The project was designed for a total duration of 18 months. While this enabled a needed continuity of services and facilitated greater harmonization and coordination, a more structured approach to the recovery of the health system in Syria continued to be needed. EF continued and expanded its dialogue with health actors in the NES in this perspective.

For the full terms of reference please open the link below:

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