Sustained and improved access to integrated health services for vulnerable and conflict-affected populations in Hama and Idleb. AAH proposes a 12-months project aiming at improving equitable and sustained access to health for 98,950 vulnerable women, men, boys and girls, mainly returnees, in Idleb – Khan Shaykun and Hama – Muhardeh. This is achieved through ensuring accessible and quality healthcare, restoring non-functioning health facilities, and supporting health staff and community capacity as essential components of provision of lifesaving and life-sustaining activities. These include rehabilitation and installation of gender-sensitive WASH facilities in Halfaya PHC in Muhardeh health district in Hama. Medical equipment, supplies, maintenance, and COVID-19 measures will be done in Halfaya Muhradeh PHC and Khan Shaykun PHC in Idleb (already rehabilitated by UNDP), in addition to support for mobile medical teams to provide a package of essential primary healthcare services targeting 8 communities surrounding Khan Shaykun health district to prevent any disruption of services and cover areas with scattered small communities. Two ambulances in Hama (including one for Mahradeh health district and another at Hama National Hospital) will also be lightly rehabilitated to restore vehicle functionality, and will be provided with necessary medical equipment, supplies, consumables, and COVID-19 measures to strengthen referrals within Muhradah health district, and across Hama city. The project will also have community-based interventions targeting a total of 240 CHWs with competency-based training on topics such as leishmaniasis, screenings, and mental health. The intervention is designed to strengthen the healthy villages program of MOH based on evolving needs and evidence. It will include monthly follow ups, provision of intervention kits, and structured home visits with linkages to governance and leadership teams within targeted districts. Competency-based capacity building of 115 HWs will be provided on 6 training topics (e.g., RH, CD/N-CD, nutrition, MHPSS, RCCE, and HIS) coupled with on-the-job supervision and structured follow up regimens as well. The main output is: “Primary healthcare capacity is strengthened to provide quality, safe and dignified access to primary health care and nutrition services, including emergency referral system.” The proposed project incorporates protection and gender principles to promote meaningful access, safety, and dignity. AAH has full access to the targeted areas and the capacity to start the operations timely through direct implementation. AAH ensures complementarity of work through coordination with HampN sector partners. 

Hama is home to 1,459,885 people, of which 830,000 PiN due to the disruption of service provision with 55% of households vulnerable or very vulnerable (HNAP, 2021). Whereas Khan Shaykun in Southern Idleb is a newly accessible area of strategic positioning and interest to returnees. It received an average of 400 households (HH) by May 2021, which was increased to 600 HH by June 2021, according to our assessment on 9 June 2021. The 2021 HRP explicitly targets Northern Hama and Southern Idleb as areas of greatest need for immediate lifesaving interventions together with provision of basic services. Psychological services were reported to be inaccessible to 90% of households in Hama and Idleb. The 2019 SMART survey results for Hama revealed that stunting, exclusive breastfeeding, and anemia are persistent. Similar results were reported in Idleb with significantly higher malnutrition prevalence requiring the need for integrated and community-based nutrition and psychosocial support to save lives through strengthening lifesaving primary healthcare access and delivery. Our assessments during June indicate that reported figures are lower than actual given the multiplicity of population displacements prior to return, deterioration in living conditions, devaluation of Syrian pound, and insufficient income.