Syrian Arab Republic

Sectoral impact:

• The health sector in Syria faces a disruptive supply of medicines and medical supplies, exacerbated by years of conflict.
• Access to and functionality of basic health services remain a significant challenge in the health sector due to damage and non-functionality of health facilities. The WoS Q3 2024 Health Resources and Services Availability Monitoring System analysis indicates that 38 per cent of hospitals and 59 per cent of primary health facilities are either partially functioning or not functional.
• Massive displacements in Syria continue to put enormous strain on the already fragile health sector, overburdening existing facilities and resources.
• The number of UXO and landmine explosions has increased significantly in several locations in north-west Syria and Deir-ez-Zor, resulting in an increasing number of civilian deaths and injuries, including women and children. Yet, health facility capacity (human and health resources) to address mass casualties remain very limited. These invisible threats of UXO have become the leading cause of child casualties in Syria.
• Attacks on healthcare facilities in Syria severely undermine the already fragile healthcare system: Between January 2024 and February 2025, 88 attacks were reported, resulting in 135 injuries and 23 deaths. 69 of these incidents were reported since 27 November 2024, resulting in damage to health facilities and ambulances, and injuries among healthcare personnel.
• Increased risk of emerging and re-emerging infectious diseases and outbreaks including AWD/cholera, measles and other water-borne diseases, as well as respiratory diseases, due to disrupted access to safe water, sanitation, poor shelter and overcrowding, as well as damaged water and sanitation infrastructure, congested displacement sites, and environmental pressures.
• Significant shortage of health workers, affecting access to health services. 8 out of 14 governorates are still below the standard threshold of health workers' availability per 10,000 population.
• A shortage of specialists continues in obstetrics and gynaecology, neonatology, trauma and emergency care, intensive care, orthopaedics, psychiatry, anaesthesia, oncology, and prosthetics.
• Underfunding of the health sector over the years has had a substantial impact, resulting in the exacerbation of suffering among an already vulnerable population and making long-term recovery efforts more difficult. The health sector in Syria is currently experiencing severe shortages of essential medicines, medical supplies, laboratory materials, renal dialysis supplies, blood bank collection equipment, testing and transfusion kits, reproductive health kits, and personnel due to a massive funding gap. As a result, numerous health facilities have to operate at reduced capacity or close entirely. Health partners are currently able to reach 243 out of 272 sub-districts in Syria that rely on humanitarian health assistance. A reduction in funding would have an impact on health services in those locations.
• As of the end of February 2025, 4.4 million people in nine governorates in Syria have been affected by United States funding cuts that have closed more than 150 health facilities, including 19 hospitals, 97 primary healthcare centres (PHC), 20 mobile teams and 15 specialized centres. Additionally, a recent assessment conducted in north-west Syria showed that foreign aid cuts have impacted 178 health facilities in Idleb and Aleppo governorates.
• In north-east Syria, only 1 in 16 public hospitals is fully functional, as the health facilities rely entirely on humanitarian partners, many of which now face closure due to the recent United States Executive Orders. According to projections and reports from health partners, 68 health facilities will run out of funding by the end of April 2025.
• Limited access to antenatal and postnatal care is evident, as only 1,327 (78 per cent) of 1,702 health facilities have functional basic emergency obstetric and new-born care services. In the most recent RNA, 54 per cent of female IDPs interviewed reported unavailability of essential sexual and reproductive health services in their locations.
• Non-communicable diseases contribute to 50-70 per cent of all mortality, exacerbated by limited access to services and treatments for these conditions. Furthermore, the recent RNA indicated that 32 per cent of the people surveyed (the majority of whom are IDPs) across Syria need medicines and treatment for non-communicable diseases.
• Oncology patients face limited access to diagnosis, treatment, and palliative care, with a lack of oncology specialists and essential medicines, including chemotherapeutic drugs.
• Patients with end stage renal failure are struggling to access life-saving care due to shortages in dialysis sessions and supplies, recent damage to facilities and non-functioning dialysis machines.
• Psychological effects of the conflict have raised demand for mental health services, which are already scarce and constrained by a shortage of mental health professionals and psychotropic drugs.

Immediate needs:

• Ensure provision of essential life-saving health services including primary healthcare (PHC), reproductive, maternal and child health, communicable and non-communicable diseases, mental health and psychological support and rehabilitation.
• Support provision of secondary health services, including specialized services such as kidney dialysis, oncology care, blood banks and clinical management of severe acute malnutrition with medical complications.
• Strengthen disease surveillance for infectious diseases, particularly waterborne, respiratory and vector-borne illnesses, as well as vaccine-preventable diseases, to ensure quick detection and response to disease outbreaks. In addition, build capacity of rapid response teams and enhance laboratory testing capacities.
• Enhance the referral mechanism to ensure continuum of care, particularly for pregnant women/girls and critically ill cases from camp settings. This includes emergency medicine, paediatric, trauma, obstetric and gynaecological care.
• Increase access to health services and provision of emergency trauma care, including deployment of emergency medical teams.
• Improve access to mental health and psychosocial services, including community-based support as well as psychotropic medicines, to affected populations and healthcare workers.
• Ensure efficient supply chain of emergency medicines and medical supplies including basic medicines, trauma, sexual and reproductive health kits, non-communicable disease (NCD) medicines and dialysis sessions.
• Support immunization efforts for routine childhood vaccinations and priority diseases.
• Implement training for healthcare providers, including midwives and community healthcare workers, on emergency response, disease management, and psychosocial support.

Priority activities:

• Ensure continuity of essential life-saving and life sustaining mobile, primary and secondary health services to the affected population. This includes referral mechanisms to emergency and secondary care, including emergency obstetric and new-born care; trauma care; treatment of severe acute malnutrition with complications; treatment of critical NCD/chronic diseases; and enhancing access to mental health and psychosocial response services, including outreach teams.
• Strengthen routine vaccination and supplementary and emergency campaigns.
• Support acute health emergency preparedness and response by strengthening the capacity building of health workers and the provision of emergency medicines and supplies such as trauma kits and enhance emergency preparedness by sustaining stockpiles of medicines. This includes the procurement of reagents, lab/testing kits and consumables for specimen collection and diagnosis of water-borne diseases, and respiratory diseases.
• Strengthen outbreak prevention, preparedness, early detection, and response capacity throughout Syria: including enhancing surveillance, lab capacities, and the capacity of rapid response teams, communication, coordination and information-sharing and stockpiles. This includes the procurement of reagents, lab/testing kits and consumables for specimen collection and diagnosis of water-borne diseases and respiratory diseases.
• Respond to emergency and preventative mass vaccination campaigns, including supplementary, catch-up and outbreak emergency response campaigns.
• Expand access to sexual and reproductive health services through strengthening the antenatal, post-natal, basic emergency obstetric and new-born care and comprehensive emergency obstetric and new-born care service facilities, and response to violence against women and children. Also complement service delivery through the procurement and distribution of reproductive health kits and essential medicines and supplies.
• Strengthen the capacity of health care providers and community health care workers to provide essential health services and ensure risk communication and community engagement activities.
• Light rehabilitation and re-equipping of critical infrastructure in 5 per cent of the health facilities that are non- or partially functional.
• Conduct a rapid assessment to identify the most urgent health needs and risks among the affected population, as well as available resources and key gaps.
• Strengthen leadership, coordination and IM to ensure effective management and monitoring of the public health emergency.

Response strategy:

All modalities will be utilized to ensure access to health services delivery through health facilities, mobile medical and outreach teams, and referral services. This enables health sector partners to reach newly displaced, rural, or access-constrained populations without access to static health facilities.

Health partners will support the operation of ambulances to move and refer patients between healthcare levels. Health sector partners will ensure critical rehabilitation and refurbishment of health facilities as well as the availability of essential medicines and supplies to maintain the functionality of primary and secondary care health facilities, as well as support for immunization services for IDPs and host communities.

The health sector will continue to strengthen preparedness capacity to detect and deliver a timely response to disease outbreaks, including enhanced surveillance, laboratory testing and diagnostic capacities, rapid response teams, and the provision of essential medical supplies.

The health sector supports a multi-layer response: community engagement, early warning, health security measures, clinical care, emergency obstetric and new-born care, and specialized services with integrated MHPSS, GBV services, and physical rehabilitation. Partners will incorporate PSEA into response programming, ensure AAP and monitor its implementation. Health partners will enhance maternal and new-born outcomes through high-quality care, leveraging technology and innovations such as the safe delivery app and CVA.

The health system is impacted by insufficient WASH and power supply infrastructure, and health outcomes are affected by social and environmental determinants. Thus, the health sector will maintain strong collaboration with WASH, nutrition, protection, and GBV for an integrated response, including multisectoral interventions for disease prevention and response. The health sector also enhances AAP by including affected people in health program design and implementation, including health needs, priorities, and preferred service delivery modalities.