Sectoral impact:
TThe nutrition situation in Syria is critically fragile, particularly for infants, young children, pregnant and breastfeeding women, and adolescent girls. Constrained access to nutritious diets, suboptimal feeding practices, and outbreaks of water-borne diseases and vaccine preventable diseases are exacerbating the crisis.
- RNA: The RNA conducted in February 2025 revealed that less than 25 per cent of respondents have access to essential nutrition services, including malnutrition screening, feeding counselling, and treatment for malnutrition.
- Nutrition services coverage analysis: A detailed analysis for 2024 highlighted poor coverage and high unmet needs in several governorates, especially As-Sweida, Al-Hasakeh, Ar-Raqqa, Damascus, Deir-ez-Zor, Rural Damascus, Daraa, and hard-to-reach areas of Hama, Homs, Idlib, and Aleppo.
According to key partners and technical experts in Syria, the fragile health and nutrition infrastructure limits access to services, compounded by long distances to service delivery sites and limited availability of community-level preventative and treatment services. Some locations were not accessible due to security challenges and the political situation. This is compounded by severe underfunding of nutrition-specific and nutrition-sensitive interventions faced by the nutrition sector over the years, with some locations underfunded due to the political situation that caused main donors to restrict funding.
Additionally, inaccurate population data, made worse by the recent IDP movements and demographic changes, has led to planning challenges and overestimation of the PiN and targets in certain subdistricts.
Several assessments were undertaken by joint UN Humanitarian missions and NGO partners, which have shown that most families rely on legumes and starchy diets, with limited access to dairy, fruit, and meat due to high inflation and unavailability in local markets. During these visits, many respondents confirmed observing signs of malnutrition, especially underweight, amidst many children under five across underserved regions of Syria. Recent violence escalation in the coastal regions is likely to worsen the nutrition status of women and children due to poor living conditions, restricted access to basic needs (food, shelter, protection and WASH) and disrupted health and nutrition services, thereby increasing the morbidity and mortality risks for the most vulnerable children and pregnant and lactating women (PLW) in the coastal regions.
Funding challenges facing the nutrition sector
The poor reach against the people in need of nutrition services in Syria, as shown by the analysis of 2024 nutrition data, was mainly due to severe underfunding of nutrition-specific and nutrition-sensitive interventions, exacerbated by the recent suspension of funding by the United States, leading to service delivery gaps and facility closures, especially in northern Syria.
The United States Executive Orders have placed 416,000 children in north-west and north-east Syria governorates at significant risk of malnutrition, especially wasting, which can lead to mortality if not addressed in time. The nutrition sector is currently facing significant challenges and an inability to provide essential curative nutrition interventions in Al-Hassakeh governorate, specifically support for the treatment of severe wasting cases with complications, due to a lack of funding for stabilization centres. The main partners who support this intervention are currently facing substantial financial shortfalls, resulting in 1,909 severe wasting cases with complications remaining untreated and under a high risk of mortality.
In north-west Syria, a total of 13 nutrition projects, implemented by 8 nutrition partners, have been impacted, affecting a total of 40,130 children and 17,705 pregnant and lactating women. A total of 17 health facilities and 116 mobile health and nutrition teams have been affected. A total of 213 communities that previously received services through the 116 mobile health and nutrition services no longer have access to preventative and curative nutrition services. Among the affected nutrition sites are 5 stabilization centres, for management of children with severe acute malnutrition and medical complications (4 in Idleb and 1 in Aleppo). This means that children with severe malnutrition with medical complications have no access to lifesaving nutrition treatment services.
If the low funding is not urgently addressed, it will likely lead to unprecedented levels of malnutrition and mortality among the most vulnerable children, especially those suffering from the most severe form of malnutrition (severe acute malnutrition).
Immediate needs:
- Maintain and expand the delivery of life-saving preventative and curative nutrition interventions for conflict-affected and displaced populations, targeting children under 5, pregnant and lactating women and adolescent girls, with more attention to the locations (sub districts) with very low reach within the above-named governorates under sectoral impact.
- Prevent micronutrient deficiencies and boost the immunity of children, women and adolescent girls through the provision of multiple micronutrient powders for 692,324 children 6-59 months; Vitamin A supplementation for children 6-59 months; micronutrients including iron folate for 495,008 PLWs and 215,607 adolescent girls; and deworming for 116,960 children 12-59 months.
- Prevent malnutrition in the 1,000 days window (from conception to a child’s second birthday) by providing skilled support to 651,592 pregnant women and primary caregivers of children aged 0-23 months to adopt recommended infant and young child feeding practices, including both breastfeeding and complementary feeding.
- Provide cash for nutrition vouchers to 52,642 PLWs/caretakers of children under 2 years and provide lipid nutrient supplement paste-small quantity blanket supplementary feeding programme (BSFP) for 167,400 children 6-23 months to support dietary diversity and prevent malnutrition.
- Provide treatment for children 0-59 months with severe acute malnutrition (SAM) through outpatient therapeutic programmes for 27,170 SAM children without complications, and through inpatient nutrition sites for 2,590 SAM children with complications.
- Manage moderate acute malnutrition (MAM) for 100,934 children 6-59 months without medical complications and 61,098 PLWs with MAM through a targeted supplementary feeding programme.
- Strengthen referrals and linkages between nutrition and other sector services including health/FSA/WASH/protection/education to strengthen prevention of malnutrition, and relapse for cases that have recovered.
Priority activities:
The response will be guided by the nutrition sector’s existing minimum service package, which covers both preventative and curative nutrition services, delivered through community and primary health care centres. The following activities will be prioritized:
- Scale up implementation of agreed nutrition sector integration package including nutrition specific treatment services across all PHC centres. Nutrition partners to ensure availability of all required nutrition commodities at “point of care” including stabilization centres and primary health care centres.
- Establishing and running a rapid response team to provide preventative and curative nutrition services (only in underserved and newly opened areas, where access to primary health care facilities may be limited).
- Implementing preventative activities, including screening for malnutrition; provision of micronutrients supplementation and deworming; provision of maternal, infant, young child and adolescent nutrition (MIYCN) counselling; monitoring and reporting of the code of breast milk substitute marketing across all governorates.
- Providing cash for nutrition vouchers and BSFP for mothers and children in the 1,000 days window to support dietary diversity and prevent malnutrition.
- Scaling-up screening of children and mothers at community level for early detection and management of children and PLWs with acute malnutrition. Ensuring admission of identified cases within the treatment programs to prevent loss of referrals.
- Implementing curative activities, including early detection and treatment of acute malnutrition for children 0-59 months (with and without medical complications) and PLWs.
- In collaboration with WASH partners, nutrition sector partners to ensure provision of WASH hygiene kits and hygiene promotion messages to caregivers of all malnourished children to ensure a safe hygiene environment is available at community and household-levels to prevent any relapse post-treatment.
- Generating evidence (SMART plus surveys, mid-upper arm circumference assessments, MIYCN assessments, etc.) to inform the nutrition response.
Response strategy:
The nutrition response will sustain preventative and curative services across severity 3 and 4 subdistricts in all governorates, along with prioritizing gaps arising from recent displacements while ensuring that subdistricts with low coverage in 2024 are prioritized. Efforts will target all who need nutrition services, including marginalized communities, PWD, internally displaced, and vulnerable residents without discrimination, while emphasizing the centrality of protection. Partners will maintain accountability, adhere to PSEA guidelines, and ensure zero tolerance for sexual exploitation and abuse while ensuring actionable measures and reporting mechanisms to guarantee accountable, high-quality, and inclusive programming, with specific attention to AAP, PSEA, gender, and protection.