Project title • Health Recovery in Northeast Syria – Phase IV (HERNES IV)

Donors • French Ministry of Europe and Foreign Affairs (French MoEFA)

Project budget • 5,000,000 Euros

Project duration • Start date: • End date: 01/02/2024 31/01/2026

The HERNES program, implemented by Expertise France in partnership with the NGO Mehad, has been active since August 2019 across three phases with funding from the French Ministry for Europe and Foreign Affairs (CDCS), and the European Union for the two first phases, amounting to EUR 16.7 million. The fourth phase is funded solely by the French MoEFA (CDCS), for two years for an amount of 5 million Euro. Early phases focused on rehabilitating health facilities, expanding access to primary health care in Northeast Syria (NES), responding to COVID-19, and training health professionals. The third and fourth phases emphasized sustainability, strengthening the focus on Reproductive, Maternal, Newborn and Child Health (RMNCH), expanding capacity-building to health workforce, and conducting operational research. Since the first phase of the HERNES project the program has improved access to primary and obstetric care, rehabilitated and equipped six health centers, four mobile clinics, a dialysis center, and a maternity hospital, delivering over one million consultations—75% of which were for women and children under five. More than 1,500 health providers have been trained, and quality improvement initiatives such as clinical protocols, supervision, and audits have been introduced. Despite these achievements, the health context in NES remains fragile. Conflict, displacement, and weak public systems continue to disrupt services, particularly for vulnerable populations, while demand grows due to IDP influxes. Key challenges include sustainability, human resource gaps, and uneven service delivery, especially in remote and hard-to-reach areas. Addressing these requires durable interventions, stronger health system capacity, and harmonized coordination among actors. The current phase builds on lessons learned, aiming to consolidate service delivery, expand workforce capacity through in-service and pre-service training, strengthen RMNCH coordination, and continue operational research. It also sustains support to critical facilities such as Al Hol Maternity Hospital, Al Karama and Abu Hamam PHCs, and Raqqa Maternity Hospital. With a 24 month duration, the project seeks to maintain continuity of services, enhance quality of care, and contribute to long-term recovery of human resources in the health sector.

Theory of Change If the coordination among health sector stakeholders in North East Syria (NES) is strengthened, approaches and evidence-based practices are adopted and harmonized in the field of reproductive, maternal, newborn and child health; If healthcare providers and leaders have the capacity to identify and address health needs of the population; If healthcare facilities are supported to provide continuously essential and quality services, especially for women and children; Then the population’s health needs will be better addressed through coordinated availability and quality of healthcare and health sector readiness to manage future shocks and emergencies will be improved.

Project objectives and expected results:

Overall objective Overall objective: Strengthen stability and resilience of conflict-affected populations in North East Syria by improving their living conditions

Specific objective

Outcome 1: Coordination platforms and health actors have access to high quality information to enhance RMNCH practices and policies development.

Outcome 2: RMNCH health services providers improve and expand knowledge and practices.

Outcome 3: The most vulnerable population, particularly women and children, have better access to quality health service

Project main achievements6 Service delivery:

• Provided essential health services, medicines, equipment, Infection prevention and control (IPC), and data collection to two Primary Healthcare centers and one Maternity Hospital.

• 181,295 consultations were provided to 156,825(43601 male and 113224 female) beneficiaries through the two healthcare facilities and one maternity hospital.

Capacity building supports the recovery of the health system:

• 8 clinical guidelines developed and disseminated that support HWG actors in improving health interventions.

• 8 working sessions organized as lead of the RMNCH sub-working group.

• 343 healthcare providers (of 18 healthcare facilities in the NES) trained on RMNCH topics