Summary of needs
- In 2025, malnutrition among children under five continues to rise, driven by inadequate diets among young children and women of reproductive age, alongside persistently high anaemia rates.Acute malnutrition (wasting) rose from 1.7 per cent in 2019 to 4.7 per cent in 2023 and reached 5.5 per cent in 2025. Several areas exceed this national average, with Rural Damascus (13.7 per cent) and Lattakia (11.9 per cent) classified as high wasting hotspots requiring urgent, targeted support. In 2023, Rural Damascus, Idlib, Ar-Raqqa, Quneitra, and Lattakia were hotspots. Lattakia’s high wasting could be due to the earthquake, limited-service access, and food insecurity. 2025 data shows that Rural Damascus and Lattakia still have high wasting, requiring ongoing assistance.
- The burden of wasting among children under five has surged by 17 per cent in 2025 compared to 2023, leaving 587,023 children urgently requiring life-saving treatment for Acute Malnutrition including 96,660 children with severe wasting, who face sharply elevated mortality risks. This reflects an additional 85,000 children wasted compared to 2023.
- Stunting affects an estimated 591,998 children under five ages. Stunting rates have consistently risen across Syria, from 12.6 per cent in 2019 to 16.1 per cent in 2023 and 17.1 in 2025. While As-Sweida Governorate exhibits the lowest rates of stunting, the prevalence in Idlib, Ar-Raqqa, Deirez- Zor, and Al-Hasakeh approaching or surpassing 20 per cent indicating entrenched chronic malnutrition and hence a need for geographically targeted and sustained nutritional interventions to mitigate chronic malnutrition.
- According to the August 2025 Population Taskforce update, at least 557,175 children under five years are living with disabilities, and face substantially heightened risks of malnutrition. They are 34 per cent more likely to be stunted and 53 per cent more likely to experience acute respiratory infections, increasing their vulnerability to malnutrition.
- National exclusive breastfeeding rates for infants under 6 months remain at around 45 per cent, similar to 2023, meaning more than half of infants under six months miss critical protection from malnutrition. Early initiation of breastfeeding declined sharply, from 44 per cent (2023) to 30.6 per cent (2025).
- The dietary intake of children aged 6–23 months remains critically inadequate. Only two in 10 receive a Minimum Acceptable Diet in 2025 and just 50 per cent achieve Minimum Dietary Diversity, a key driver of stunting.
- According to EWARS 2025 data, approximately half a million children under five years suffered from acute watery diarrhea. Recurrent diarrhea is associated with 50 per cent of undernourishment.
- Wasting among women and adolescent girls varies by region. While Lattakia and Tartous report <5 per cent, Ar-Raqqa, Idlib, and Dier-ez-Zor report >10 per cent, indicating significant nutritional vulnerability among women.
- The SMART Survey 2025 findings indicate low deworming coverage across governorates, below WHO’s 75 per cent target for at-risk children. This gap hinders nutrition improvements, as helminth infections worsen undernutrition, causing impaired absorption, deficiencies, and increased vulnerability to wasting and anemia. Scaling up deworming is crucial to reduce child malnutrition.
- Anemia remains widespread: at least 600,000 children under five and 1.5 million women (15–49 years) suffer from anemia, emphasizing the detrimental effects of sub-optimal diets lacking essential nutrients.
- Syria has experienced serious level of food insecurity for over seven years, as reflected in its Global Hunger Index score of 30.6. This represents a deterioration from a score of 26.1 in 2023 to 30.6 in 2025 reflecting worsening access to nutritious food.
- Key drivers of malnutrition in Syria include declining breastfeeding practices, inadequate dietary practices among children, girls, and women, constrained access to health and nutrition services, elevated morbidity rates, food insecurity, escalating food prices, compromised hygiene and sanitation, and adverse environmental circumstances. Addressing these requires comprehensive, multisectoral interventions.
Response strategy
In 2025-2026, the Nutrition Sector will address elevated rates of malnutrition, including wasting, stunting, and anemia. This will be achieved through prioritising prevention, implementing sustained and rationalized curative services, strategically integrating with health systems, and enhancing the use of evidence to refine the overall response.
The Sector specific objectives:
- Sector Objective 1: Improved access and quality to lifesaving preventive nutrition specific and sensitive interventions for 2,191,968 children (girls and boys) under five years of age, 786,075 adolescent girls, 1,412,747 pregnant and lactating women.
- Sector Object 2: Improved access and quality of lifesaving curative nutrition services to 95,207 severely malnourished children (girls and boys), 384,368 moderately malnourished children (girls and boys) between the ages of 6 and 59 months, 113,056 pregnant and lactating women (PLW) promoting a reinforced continuum of care across all levels.
- Sector Objective 3: Strengthened nutrition resilience through a principled humanitarian response mainstreaming effective coordination, capacity-building, contingency planning, and quality information management system to inform programming and decision-making.
In 2024, the Nutrition Sector established a costeffective Minimum Service Package (MSP) for nutrition, aligning with Lancet recommendations and updated WHO Wasting Guidelines and tailored to the Syrian context. Preventive strategies target children under five years of age, adolescents, and pregnant and lactating women (PLW), and include micronutrient supplementation, blanket supplementary feeding, infant and young child feeding (IYCF) counseling, and Nutrition Cash Voucher Assistance to ensure comprehensive nutritional support, with a focus on the first 1000 days.
Through multisectoral collaborative, partners will implement nutrition-sensitive interventions to address the underlying determinants of malnutrition including improved water quality and hygiene through WASH kit distribution and hygiene promotion and prioritised general food assistance by the FSAL Sector in Priority 4 subdistricts. Lifesaving curative nutrition services, with emphasis on early screening and referral, will be provided through outpatient therapeutic programs (OTP), stabilization centers, and targeted supplementary feeding programs (TSFP). Integration with the Health sector will continue by embedding nutrition services within Essential Health Service Package and integrating nutrition services into Primary Health Care Centers (PHC). Enhanced risk analysis and monitoring, informed by evidence from surveillance systems and 4Ws data at sub-national forums, will strengthen the quality and utility of the monthly nutrition dashboard.
Nutrition services will be delivered through PHCs (static sites), outreach programs, integrated health and nutrition mobile teams, and community-level interventions. Prioritisation will be given to nutrition service delivery through functional PHCs to ensure readily accessible MSP services. In areas that are difficult to reach and in inaccessible camps, essential services will be extended through outreach programs and mobile teams affiliated with PHCs, in accordance with global and national standards and operational policies. Community health and nutrition approaches, including family mid-upper arm circumference (MUAC) measurement, are crucial entry points for ensuring prevention, early screening, referral, and follow-up. A comprehensive review and rationalization of nutrition services at the community, PHC (including Outreach and mobile teams), and Stabilization Centers levels is planned to ensure effectiveness and efficiency for greater equity and impact. Emphasis is placed on the co-location of OTP and TSFP services and a robust referral system for stabilization centers. Community platforms and schools will be leveraged to reach adolescent girls for anemia prevention.
Targeting & prioritization
- In view of the funding outlook in 2025 and 2026, Nutrition sector must adopt a more focused approach to prioritisation and targeting. To guide this process, the Nutrition sector has developed a strategic MSP that takes into account the severity of geographical areas and the operational capacity of partners, differentiating between preventative and curative interventions based on assessed needs and severity levels. All sub-districts classified as Severity 3 and 4 will receive targeted prevention activities, including Vitamin A supplementation (VAS) and counseling, with coverage targets of 30-50 per cent and 100 per cent, respectively. In sub-districts with high severity levels (3 and 4), curative services for wasting will be prioritised for children aged 0-59 months and pregnant/lactating women. The objective is to achieve 100 per cent coverage for severe wasting (severity levels 3 and 4), 70 per cent coverage for moderate wasting (severity level 3), and 100 per cent coverage for moderate wasting (severity level 4).
- To further mitigate malnutrition risks in areas experiencing moderate to severe food insecurity, blanket supplementary feeding and nutrition cash/voucher assistance will be prioritised for children aged 6–23 months and pregnant and lactating women identified as part of the PiN in Severity 3 and 4 subdistricts. These prioritisation decisions are grounded in a twolayer analytical process, incorporating food security and livelihood assessments from 2025 to ensure that limited resources are directed where nutritional vulnerability and deprivation are greatest.
Promoting accountable, quality & inclusive programming
- The Nutrition sector will ensure that all interventions are safe, inclusive, and responsive to the distinct needs of women, men, girls, boys, and persons with disabilities, recognising that unequal access to food and services often worsens during emergencies. AAP will be embedded by promoting meaningful participation, transparent communication, and accessible feedback mechanisms across all delivery platforms. Motherto- mother and caregiver support groups will integrate protection, psychosocial first aid, and discussions on GBV risk mitigation, ensuring safe spaces for caregivers.
- The Nutrition sector will work closely with Protection, GBV, and Child Protection partners to establish and maintain clear referral pathways, prioritizing the safety and dignity of children and pregnant and breastfeeding women. Nutrition personnel and community workers will be trained to identify protection concerns, including GBV and child protection risks, and to facilitate safe, confidential referrals in line with PSEA commitments and humanitarian safeguarding standards.
Cost of response
- The Nutrition Sector adopted a unit cost approach to budget planning in 2024, which guided a detailed financial review by the SAG in December 2025 to inform the 2026 HNRP.
- The 2025 budget stood at $164 million while the 2026 financial requirement is $125.5 million, a 24 per cent reduction driven by strategic prioritisation, focusing on critical curative activities exclusively in high-severity areas. Concurrently, the Sector is maintaining cost-effective, life-saving preventive services across sub-districts categorized as Severity 3 and 4, taking into consideration food security status to drive BSFP and Cash prioritisation.
- Approximately 60 per cent of overall requirements are concentrated in Severity 4 areas. Preventionfocused activities, particularly BSFP and cash/ voucher assistance, represent around 80 per cent of costs under the first Strategic Objective, while curative services account for roughly 34 per cent of total financial needs.
- Costing covers procurement, delivery, and storage of ready-to-use specialised foods, essential medicines for wasting treatment, and BSFP operational costs ensuring efficient and accountable use of resources across the response.