Strengthening access to quality secondary health care in northwest Syria (NWS) through dual approaches This project will address key live-saving humanitarian assistance in underserved areas in northwest Syria and will concentrate on enhancing access to critical life-saving secondary healthcare for highly vulnerable people under envelope 1 as per the allocation strategic objective referred in the 2021 needs and response strategy: "SO 1. Provide life-saving humanitarian assistance to the most vulnerable people with an emphasis on those in areas with high severity of needs".
Two distinct but interrelated aspects to achieve the aforementioned strategic goal are included in this project.
1. Supporting the general hospital in Afrin City, which aims to provide healthcare to 4,000 beneficiaries per month on average through the provision of secondary and tertiary healthcare services and provision of comprehensive emergency obstetric and newborns care service (CEmONC), emergency trauma care, and medical inpatient care services, including emergency room, intensive care (ICU), and general medical ward. In addition, providing hemodialysis services to 50 patients and essential laboratory services for the host and IDP communities at Afrin sub‐district. It is also noteworthy that the hospital is considered as one of the main hospitals to support the referral network in Afrin district.
2. Provide life-saving medical supplies to 803 end-stage renal diseases (ESRD) patients by covering the gap of dialysis kits in NWS for six months. Those patients are registered in 14 dialysis facilities and in three COVID-19 isolation hospitals in NWS, in close coordination with the dialysis TWG. Locations and numbers of patients for each facility can be found in the attached file "AFAQ_BAHAR_SA2_NEED_ASSMNT_V1". 
Bahar and AFAQ will provide this component of the project in two main lines: The 1st line in coordination with the health cluster "Dialysis Task Force" to finalize and update the distribution plan to meet the needs of the dialysis centers in northwest Syria. As AFAQ conducted research about the available resources and needs for each dialysis center and after coordination with the Dialysis TWG we set the following draft distribution plan to the health partners: AFAQ, SAMS, USSOM, HIHFAD, ALAMEEN, SEMA, IRW, SHAFAK, PAC, BAHAR, SRD. The plan will cover all (ESRD) patients in 17 dialysis facilities for three months, the detailed distribution plan is attached in the file "AFAQ_BAHAR_SA2_DISTR_PLAN_V1". The 2nd line is starting the logistic operations of supply chain management for securing the dialysis kits and then starting the distribution process to the partners based on the agreed plan. The list of items for the dialysis sessions will be accompanied by HBV and HCV test kits, covered from AFAQ, and the total amounts of dialysis kits (20,760) shall be divided into three shipments. The total expected end-stage renal disease (ESRD) patients in northwest Syria are 803 (425 males, 366 females, 8 boys, 4 girls) through this component of the project, 20760 sessions, and 800 test kits of HBV and 800 test kits of HCV will be secured. Services will be provided to the most vulnerable and conflict-affected people: These activities are in three main divisions: 
1- preparation for procurement, 
2- procurement and logistic operations,
3- receiving the shipments and distribution process prior to service delivery. 

As the COVID-19 has proven to be a massive disrupter of health systems of every size, shape, and location. This project of the two components will be managed and run with full compliance to COVID-19 safety and protective measures.