An analysis of humanitarian and health aid alignment over a decade (2011-2019) of the Syrian conflict
Authors: Alkhalil Munzer , Alaref Maher , Mkhallalati Hala , Alzoubi Zedoun , Ekzayez Abdulkarim 
Published: August 2022

Abstract
BackgroundThe 11 years of the devastating conflict in Syria resulted in more than 874,000 deaths, and in thirteen million refugees and internally displaced people.1,2 The health system was severely affected and has become aid dependent. This study examines aid alignment over a decade of the Syrian crisis from 2011 to 2019. MethodsAid alignment was explored as a part of the 2005 Paris Declaration Framework on aid effectiveness. Based on OECD’s survey on monitoring the Paris Declaration,3,4 and based on a proposed methodology to assess aid effectiveness by Burall and Roodman in 2007,5 we designed a sequential mixed methodology to address two main indicators: alignment with national strategies and local procedures, and aid delivery through local systems. The quantitative part investigated the financial alignment of aid using financial data trackers, such as Creditor Reporting System (CRS) and the UN-OCHA financial tracking system (FTS), and the relevant humanitarian needs estimations by the Humanitarian Assistance Response Plans (HARPs), Humanitarian Response Plans (HRPs), and Humanitarian Needs Overviews (HNOs). The qualitative part relied on four Focus Groups Discussions (FGDs) and four expert interviews with key policy makers and practitioners involved in the health response in northwest Syria, with the aim to interpret the quantitative findings.ResultsWhile the study found an improvement in aid budget alignment with local procedures in Syria from 34% in 2012 to 86% in 2019, we found limited alignment with local strategies. Our qualitative findings pose doubts in the ability of the various data sources of humanitarian needs to reflect the actual realities, especially before 2014, due to lack of comprehensive local engagement and data systems by then. Therefore, even if humanitarian budget seemed to be aligned with the national procedures, the national plans did not seem to align with the actual realities, let alone the increase in the financing deficit over the years of the conflict. The reliance of humanitarian and health aid on governmental structures, as a main recipient, in Syria was much lower than other developing and fragile countries. This is mainly due to the nature of the Syrian conflict where the government is a party to the conflict. Donors were found to have invested poorly in advancing national and sub-national planning in Syria, as a result of donors’ over reliance on the UN-led humanitarian system which struggles in armed conflict settings such as Syria. As a result, we found a disconnection between field realities, national planning, and humanitarian aid. ConclusionIn light of the dreadful humanitarian crisis in Syria, there has been an adverse aid alignment. There is an urgent need to improve aid alignment through more investment in local planning even at district or governorate level. This is especially important to navigate through conflict sensitivities while responding to local needs and initiating local developments. These approaches, combined with adopting health sector-wide approach (SWAp), could contribute to a better initiating of the humanitarian-development-peace nexus in Syria, which in turn can contribute to a better aid alignment and aid effectiveness.