Envelope 2: 
Critical dialysis centers support with dialysis sessions. The proposed project seeks to ensure life-saving continuity of care to most vulnerable people living in under-served areas in Idleb and Aleppo Governorates. This will be achieved by supporting 14 dialysis centers, 6 in Aleppo and 8 in Idleb (Annex A-List of targeted dialysis centers). IR has already supported these centers with dialysis sessions in the previous years and currently supports fully 2 of these (Darkush DC and Azaz DC). However, further financial support is required to ensure uninterrupted provision of dialysis sessions to the registered patients in these centers starting in Feb/Mar of 2023. The total number of registered ESRD patients in these centers is 878. Following IR standard procurement process, the basic dialysis sessions will be procured. According to recent assessment of the market in Turkey, which witnessed a significant recent rise in the prices of medical supplies (ِAnnex B-the decree raising the prices of medical items), a total of 23,061 sessions will be provided, and they will be provided to the targeted dialysis centers. Based on the monthly consumption rate of the dialysis sessions each patient will receive 9 sessions per month and 27 sessions in 3 months including the regular and emergency sessions. IR program and Monitoring, Evaluation, Accountability and Learning (MEAL) team will ensure to keep a close liaison and follow up with the targeted centers. This will help to monitor that the free of cost and quality regular dialysis sessions are provided to registered patients without any discrimination. This will also support in receiving regular feedback from the relevant stakeholders which will be incorporated to ensure quality project implementation. The registered patients be a mix of IDPs and HCs members. Thereby the project will ensure to comply with do no harm principles and conflict sensitivity. This project is part of the emergency response of the IR Syria Mission. IR being an active part of health cluster and dialysis task force has conducted a preliminary discussion to ensure that the support provided is complementary and in line with the objectives of reserve allocation. The project duration of 5 months is planned as through this allocation IR intends to fill in the critical gap in support of the dialysis centers as highlighted by dialysis TF. The dialysis task force conducted the detailed and comprehensive need assessment for all the dialysis centers in northern Syria with details of patients, facilities infrastructure, available resources, and stock. The first month of the project will be dedicated to the procurement and the last month will provide time for proper exit and if possible, mobilize further funds to ensure continuity of service. The current humanitarian context does not allow a more sustainable approach. however, it is designed in such a way that the dialysis centers are provided and equipped with dialysis kits to operate until another source is found to continue these activities. However, by ensuring the continuity of care, the project will participate in keeping the dialysis centers running enabling health professionals from bonding with the communities they work in and reducing the chances of leaving the area. Beneficiaries will be informed prior to the implementation that the project is available upon funding. Furthermore, IR supported dialysis centers operate referral services which are integrated in the referral network of NWS and provide vulnerable dialysis patients with access to transportation to all health facilities and protection service providers in NWS. Furthermore, dialysis patients will have clear, consistent, and repeated communications with stakeholders at all levels to prevent a spontaneous closure of the project.
With great experience extending to 10 years in responding to Syrian crisis and the health sector in particular, IR supported its team with specialized medical technicians and prepared the necessary infrastructure to implement similar projects.