Health System Resilience in Northern Syria: Reflections from ReBUILD for Resilience Projects
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Background
The health system in Northern Syria has faced unprecedented challenges in recent years, due to the chronic stressor of ongoing conflict and displacement as well as multiple shocks including the cholera outbreak and the recent earthquake. In this video, Dr Ibrahim Bou-Orm presents a synthetic analysis of health system resilience in Northern Syria through reflections from many research studies conducted in this fragile setting.
Methods
Our research stream included four projects using mixed-methods research approach and exploring the provision of Mental Health and Psychosocial Support (MHPSS) services, the implementation of integrated service delivery model, private sector engagement and healthcare utilisation. Using the ReBUILD for Resilience resilience framework and revisiting the key findings of our studies, we extracted the obstacles and opportunities to enhance the resilience capabilities of the health system in Northern Syria.
Findings
Through coordination platforms, the health sector succeeded to mobilize resources to maintain the delivery of essential services despite the continuous instability due to security challenges and displacement shocks as well as chronically volatile funding. However, resource scarcity including the intermittent short-term type of funding and the absence of skilled health personnel remained a key obstacle especially for non-communicable disease (NCD) care and MHPSS services. Moreover, attempts for care integration within a primary care-oriented approach and task shifting through capacity building of low-cadre staff showed some transformative capabilities of the health system. Nonetheless, fragmented stewardship, limited organizational capabilities of local health authorities, and limited oversight over the private sector put these achievements at risk due to the unregulated growth of ‘profitable’ private services competing for limited human resources and increasing inequities among communities. Limited emergency preparedness and generation and use of health data especially on and from private services are additional obstacles in Northern Syria.
Conclusion
Reinforcing the availability of sustainable financial and human resources covering a comprehensive range of community needs and improving collaborative governance including with the private sector are required to build a resilient health system in Northern Syria. This would help the system cope with chronic stressors and manage future shocks.
Resources referenced in this presentation
- Paper: Evolution and lessons from an integrated service delivery network in Northwest Syria
- Paper: Provision of MHPSS Services to Health Workers and Community Members in Conflict-affected Northwest Syria: A Mixed-Methods study
- Report: Exploring approaches for complementary private sector engagement in the health sector in Northern Syria