Sustained and improved access to integrated health services for vulnerable and conflict-affected populations in Dar’a. With a protracted crisis approaching nine years, the operating environment in Dar’a continues to be extremely complicated as a conflict hotspot in Syria. Tensions continue to mount following an increase in armed attacks and assassinations. Dar’a is home to 972,441 people of which 685,000 people need humanitarian aid due to the disruption of basic service provision and assistance.  Dar’a received the highest number of spontaneous IDPs and returnees during the first half of 2019 estimated at 50,935 (from an estimated total of 72,939) according to health sector data of June 2019. Only 14 out of 105 primary healthcare centers are fully functioning. The health system is struggling to respond to trauma, mental health and rehabilitation needs. The 2019 HRP explicitly states that without a holistic approach to addressing immediate lifesaving needs together with provision of basic services, any impact from humanitarian interventions will be negligible.  Additionally, the 2019 SMART survey results revealed that stunting, exclusive breastfeeding and anemia are persistent, requiring the need for integrated nutrition and psychosocial support coupled with community-based interventions to save lives through strengthening lifesaving primary healthcare access and delivery.   
The project aims at improving equitable and sustained access to health of vulnerable women and children through accessible and quality healthcare, restoring non-functioning and partially functioning health facilities, and supporting health staff capacity as essential components of provision of lifesaving and life-sustaining activities. These include rehabilitation of three primary healthcare centers in three distinct health areas in Dar’a Al-Balad, Ash Shajara and Busra Esh-Sham. Medical equipment, supplies, maintenance and installation of gender-sensitive WASH facilities will also be done. One maternity hospital in Ash Shajara will also be lightly rehabilitated with necessary medical equipment, supplies and consumables with referrals strengthened within Ash-shajara, and across the four targeted health areas (Ash Shajara Dar’a Al-Balad, Busra Esh-Sham and Nawa). The project will also support mobile medical teams targeting four health areas (Ash Shajara Dar’a Al-Balad, Busra Esh-Sham and Nawa) to prevent any disruption of services and cover areas with scattered small communities. Besides, it will strengthen the preparedness and response of the referral system. Select primary health staff in those four areas will also be trained on mental health and psychological first aid with regular supervision by a psychiatrist/mental health professional. Community Health Workers (CHWs) will also be trained to integrate and deliver MHPSS at the primary healthcare centers, community and household levels within the selected health areas. 
Beneficiaries of the project are approximately 250,000 individuals of host communities, returnees, and IDPs. 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 mainstreams and incorporates protection and gender principles to promote meaningful access, safety and dignity. Despite the challenging environment, AAH has a formal MOU with MOH (effective 1 August 2019). As a result, approvals from local authorities and the department of Dar’a (DOH-Dar’a) were granted. AAH was able to fully proceed with its initial assessments. Results were discussed with relevant authorities, and approvals from local authorities, including DOH-Dar’a, were obtained by mid-September corresponding to negotiated needs and in compliance with rules, regulations and standards. AAH has full-access to targeted areas and has capacity in place to initiate operations according to workplan set through direct-implementation. Attention has been paid to ensure activities implemented by AAH are not undertaken by other agencies.