World Health Organization 24 February, 2015 WHO’s Humanitarian Response in Countries Hosting Syrian Refugees 3RP Countries Egypt, Iraq, Jordan, Lebanon and Turkey 1 | Background: Key Humanitarian Issues February 2015 - total registered Syrian refugees 3.8 million Large numbers of unregistered refugees Expected to reach 4.27 million by the end of 2015 < 20% of refugees in camps, remainder informal settlements/host communities Mostly substandard shelter especially out of camps (ITSs, overcrowding, makeshift or unfinished buildings), limited access to safe water & adequate sanitation Significant issues: Political turmoil in host countries, long term crisis & Refugee-Host population: Egypt 0.2%, Iraq displacement, economic hardships, unemployment 0.7% Turkey 2%, Jordan 10%, Lebanon 30% Dwindling host government resources, limited employment opportunities, exploitation, food Characteristics: M/F = 49:51; 18% < 5 years, security 34% 5-17 years, 45% 18-59 years, & 3% 60+ Tensions between refugees and host communities 2 | 1
World Health Organization 24 February, 2015 Background: Key Health Issues • Host governments granted access to public sector health services as for nationals (even nationals pay out-of-pocket for some health services) but health systems are becoming significantly stretched by additional needs • Health needs of Syrian refugees are multiple, including: – Access to quality services at the primary, secondary and tertiary levels, including referral services and emergency care – Prevention and management of communicable disease threats including immunization – Maternal, newborn and child health care / reproductive health / SGBV – Non-communicable diseases including medications – Trauma care – Services for the disabled – Mental health and psychosocial support 3 | WHO’s Presence/Capacity in 3RP Countries • Country offices with emergency staff in all 5 countries with significant refugee burden • Sub-national offices in turkey (Gaziantep) and Iraq (Erbil) specifically supporting response to refugee crisis • Emergency support team based in Jordan (Amman) supporting all 5 countries 4 | 2
World Health Organization 24 February, 2015 Key Health Sector Partners MoHs, local health authorities and other Line Ministries National Disaster Management Organizations UN Agencies – UNICEF, UNFPA, UNHCR, UNRWA, UNDP IOM National Red Cross / Crescent Societies INGOS – DRC, HI, IMC, SCI, IRC, Mercy Corps, Medair ++ National NGOs 5 | Health Sector Actions in 2014 Improved access to quality health services (primary, secondary and tertiary) Strengthened PHC services including: Immunization (routine & campaigns for polio & measles) Reproductive Health (incl. emergency obstetric care) Management of NCDs & MH support Essential medicines and supplies Strengthened referral systems Established/expanded EWARS & disease surveillance Monitored water quality (camps / host communities) Developed capacity of health workers and systems Raised health awareness (refugees & hosts) Established community health volunteer teams 6 | 3
World Health Organization 24 February, 2015 Specific Achievements Attributable to WHO Leadership and Coordination: In 2014 WHO took on the lead / co-lead of the HSWGs in the five countries Information Generating and disseminating health information (SitReps, Bulletins, Donor Snapshots, Health Impact Analysis) Supporting health assessments (20 assessments in 5 countries) Strengthening communicable disease and EWARS (early warning, alert and response system) 7 | Specific Achievements Attributable to WHO Technical Support Planning & implementation of immunisation campaigns against polio and measles 27 million children immunized across the Region Technical support to MoHs and other partners on strategy / policy for priority public health issues Building capacity of partners on detection & rapid response to outbreaks & public health threats 3,500 trained on EWARS & disease surveillance Developing capacity of front line health workers 2,000 trained in a range of disciplines Developing & disseminating technical guidelines Supporting cutting edge Mental Health programmes Supporting improvement of water quality in camps Supporting vector control in camps & communities 8 | 4
World Health Organization 24 February, 2015 Specific Achievements Attributable to WHO Health Service Provision (POLR) Improved access to quality preventive and curative health services Including 60 staff & 6 clinics within camps in Iraq Strengthened capacity of nearly 300 health facilities through providing equipment Supported provision of quality and equitable secondary & tertiary care services 2,400 services supported in Egypt and Jordan Supported referral services Provided medicine and medical equipment for services for hundreds of thousands of Syrians and host communities Provided support to refugees with disabilities 9 | Health Sector Response Plan for 2015 Major planned interventions for the health sector under 3RP Supporting equitable and sustainable access to and coverage of quality health care services (primary and essential secondary/tertiary) Strengthening existing national health systems with a focus on key components (NCDs, MH, MNCH / RH, SGBV & Emergency preparedness) Prevention and control of communicable diseases including timely detection and response to outbreaks Increasing immunization coverage among under-fives Supporting access to mental health and psychosocial services Monitoring health indicators and achievements through an improved health information system Enhancing the community health approach Effectively coordinating the inputs of health sector partners 10 | 5
World Health Organization 24 February, 2015 Specific Challenges Related to Operations and Programming Refugees Increasing numbers of refugees in camps and in impacted communities High mobility of Syrian population inside and cross border Funding Shortage of funds Bridging humanitarian activities to more sustainable development interventions in health requires strong advocacy at regional level in order to secure donor funding Health Services / Systems Strained / overwhelmed health systems Limited health system capacity and resilience Targeting / reaching the most vulnerable population groups for health services Fragmented health information systems Security Highly volatile security situation and unstable socio-political context in some host countries 11 | Funding Requirements for 2015 Gap (%) – Funding Requirements Required Received Carry-over for 2015 (US$) amount amount funds Range in 3RP Countries 369 million Health Cluster / Sector 22.7 million Not 92 – 100% (93.9%) (261m for refugees + 108m for available resilience) WHO 33.6 million 0 1.6 million 63 – 100% (95.1%) Current/recent donors (under the RRP6) Canada, China, EU, Kuwait, Norway, Republic of Korea, UK, and USA CERF (UNOCHA) 12 | 6
World Health Organization 24 February, 2015 Consequences of Funding Failures Reduced access for refugees and affected host communities to health services at all levels Reduction of immunization coverage Increased risk of communicable disease outbreaks Further movement of refugee to new areas where they feel that health services can be accessed Social tension among refugees and with host communities Economic consequences and burdens on the health system and other government services further straining limited resources All above have the potential to increase morbidity and mortality among refugee populations and host communities 13 | Key Interventions and Targets Responding to the immediate health needs of refugees with emphasis on life-saving activities through PHC Implementing a comprehensive PHC package including provision of medications for both refugees and impacted communities Strengthening communicable diseases surveillance, detection and response, including immunization Optimizing specialized secondary and tertiary health care & strengthening the referral mechanism Strengthening capacity of health workers and the national health system and promoting sustainable services Strengthening Health Information Systems Strengthening coordination and streamlining of decision making in partnership with health authorities and other actors Supporting MoH and other health partners in strengthening the health service delivery capacity at the community level for refugees and host populations Gender and age specific Behaviour Change Communication with broader engagement of communities Targeting the most vulnerable populations and special groups 14 | 7
World Health Organization 24 February, 2015 Thank You 15 | 8
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