Syria

Elevating Married Adolescents’ Voices for Responsive Reproductive Healthcare in Syria

Increases in early marriage and pregnancy resulting from Syria's humanitarian crisis highlight a critical gap in adolescents' access to life-saving sexual and reproductive health information and services, and a larger need for adolescent-specific interventions grounded in gender transformative approaches. Seeking to address this, CARE, UNFPA and Syria Relief and Development adapted global evidence-based approaches to humanitarian contexts to create the Adolescent Mothers Against all Odds (AMAL) Initiative for pregnant girls and first-time mothers aged 10 to 18 years. Designed to improve the lives of young girls through responsive health systems and enabling environments, AMAL includes three components: a Young Mothers Club for first-time mothers and pregnant girls, participatory dialogues with health providers, and reflective dialogues with girls' marital family and community members. The AMAL Initiative intends to ensure responsiveness to the unique vulnerabilities of adolescent sub-groups by co-implementing with them. Select girls undergo additional leadership training and serve as adolescent representatives on community advisory groups sharing feedback for program improvement. One hundred-four first-time mothers and pregnant girls, 219 community members, and 120 health providers participated in AMAL in northwest Syria. In a mixed methods evaluation, facilitators administered monitoring tools to identify program improvements, pre-post surveys to assess outcomes, and end-line discussions to gather perceptions of impact. Girls reported a 47% overall increase in self-esteem, confidence, health-seeking capacity, and communication ability. Community support for girls' use of family planning increased by 27% and girls' equal access to services by 35%. Findings across all participant groups demonstrate decreased expectations of early marriage and increased acceptance of family planning post-marriage. Areas that participants cited for potential improvement included programming for girls/women above the age of 18 years, and additional training for health providers on long-acting contraceptive methods. These results show that participatory adolescent-centered sexual and reproductive health programming is not only feasible in crisis settings but can improve the self-efficacy of vulnerable adolescents to overcome barriers to accessing healthcare and improving well-being. The AMAL Initiative is now being scaled up through local partners in Syria and piloted in northern Nigeria. Read More...

Adolescent Mothers Against All Odds Learning Report

Adolescent Mothers against All Odds (AMAL) Initiative was designed to meet the immediate needs of pregnant adolescents and first-time mothers in crisis-affected settings, while simultaneously addressing community consciousness and engagement around gender, power, and social norms. Using Syria’s context as a frame, this program was developed through an iterative process of adapting global approaches for humanitarian crisis-affected settings. Read More...

Rapid Gender Analysis Policy Brief: Türkiye & Northwest Syria Earthquake Response

Earthquakes are gender neutral - they affect everyone in their vicinity - but their impacts are not. Gender inequality exacerbates the impact of disasters, and the impacts of disasters exacerbate gender inequality. The earthquake in Türkiye and Northwest Syria (NW Syria) – the largest earthquake to affect the region in 200 years - occurred in areas already affected by mass displacement and population movements for over a decade, as well as long-standing protection issues. One thing is clear, however, where the impacts of the earthquake are gendered, the response must be too. This first Rapid Gender Analysis (RGA) Brief explores existing gender, age and disability data and information to understand pre-existing vulnerabilities and capacities and how best humanitarians can respond to meet people’s different needs. Read More...

Sacrificing the Future to Survive the Present: North East Syria RGA

Amid a tense and fragile security situation, both male and female participants in this rapid gender analysis (RGA) identified their main concerns as their loss of income and livelihoods and the increased cost of food. The intensifying food crisis is further aggravated by disruptions to wheat production, climate change, continued insecurity and the war in Ukraine, which has significantly reduced Syria’s grain imports.
The fragility of the food system, combined with the water crisis and the near collapse of the labor market, has aggravated chronic food insecurity and malnutrition in the region, leading to profound short and long-term impacts on health and resilience. One in three children face malnutrition, and those under five need nutritional interventions, as do pregnant and lactating women.
Most households that took part in this RGA said their food needs were not being met despite aid distributions. Female-headed households, widows and people with disabilities are particularly vulnerable. About 38% of households living in camps for internally displaced people (IDPs) are female-headed.
The number of female heads of household and other women in the labor market has increased, but limitations on women’s mobility, economic participation and decision making persist, as do social and cultural expectations about the role of men as main decision makers and community leaders.
All respondents said the conflict was increasingly restricting their freedom of movement. Women’s main fears in terms of their mobility related to harassment and exploitation, and men’s to kidnap or recruitment by armed actors. All respondents identified lack of transportation, high costs and insecurity as the main obstacles to accessing health services. Read More...

“In the Eye of the Storm”: Assessment of how Culture, Customs and Conflict are Deepening Protection Risks in Northwest Syria

Across Syria, there are estimated to be 6.9 million IDPs and a total of 14.6 million people in need of humanitarian assistance – an increase of 1.2 million from 202113 in NWS, around 4 million people, including around 3 million IDPs14, need regular humanitarian aid to meet their basic needs. This includes 1.72 million people residing in 1,397 last-resort sites, of whom 80 percent are women and children15.
According to OCHA’s Multisectoral Needs Assessment (MSNA) data from August 2021, the income gap has widened everywhere in Syria, with average household expenditure exceeding income by fifty per cent. Only 10 percent of households have an income above the cost of Syria’s Minimum Expenditure Basket. Across the country, food insecurity remains extremely high – with an estimated 12 million severely food-insecure people, Syria ranked amongst the ten most food-insecure countries globally in mid-202116. More recent data, from Humanitarian Situation Overview in Syria (HSOS)17 in May 2022, and from Mercy Corps’ research18 into the wider impacts of the conflict in Ukraine, suggest a significant deterioration in 2022.

Additionally, in September 2022, Government of Syria declared the Cholera outbreak. As of the 29th of October, a total of 4526 suspected cholera cases have been reported from NWS with 1517 (33.5%) suspected cases reported from IDP camps.26
It is essential to note that these emerging pressures have specific – and different – impacts on men and women; CARE’s commitment to Gender Equality as both a goal and an impact area (Vision 2030 Gender Equality Impact Strategy) reflects an understanding of the differing social positions of men and women, and the disproportionate impacts of conflicts, crises and disasters on women and girls27. Aligned with CARE’s commitment to Gender Equality, Gender is the primary axis of disaggregation and as such, this PNA recognizes that the consequences of increasing food insecurity, increasing prices, and the on-going impact of public health crises have implications for women and girls, not least their increased exposure to gender-based violence28. This PNA, therefore, gives dedicated attention to the specific vulnerabilities of women and girls.
The PNA is further disaggregated by age, and diversity, in alignment with CARE’s commitment to accounting for intersecting vulnerabilities, inequalities and diversity, and recognizing the varying protection needs that arise from these. The data is also analysed through the lenses of age and disability particularly, to ensure that the distinct risks and needs of different groups are both identified and addressed. This means, for example, that the specific needs of boys (gender + age) are recognized and articulated, with the acknowledgement that child labour has a particular impact on adolescent boys, ending their education and putting them at risk of injury, recruitment into criminal activity, and isolating them from support. Child marriage is recognized as a specific concern for adolescent girls as both a mechanism of attempted ‘protection’ and as a way of reducing the resource needs of a family. Women and men with disabilities have protection needs related to their gender, in relation to care (the giving and receiving of), to employment and income-generating opportunities, and to their exposure to sexual exploitation and abuse. These risks and needs are explored throughout this report.

CARE Türkiye has been providing humanitarian programs in NWS since 2013.To deliver its programs in NWS CARE currently works in partnership with five Syrian NGOs and implements directly in Jarablus, Aleppo governorate. CARE’s expertise lies in emergency response (implemented via cash, vouchers, and in-kind assistance); water, sanitation, and hygiene services; shelter and settlement; sexual and reproductive health services; protection and gender- based violence response, prevention, and risk mitigation; livelihoods and economic recovery assistance.

In December 2021, CARE Türkiye commissioned SREO Consulting to conduct a comprehensive protection needs assessment (PNA) in NWS. The main goal of this PNA was to assist CARE, as well as other protection and non-protection actors, in developing protection-responsive humanitarian interventions and addressing NWS's complex humanitarian situation. The assessment aimed to include an age, gender, and diversity (AGD) lens to better understand critical protection concerns and needs of the diverse groups in the targeted communities. Particularly, the specific protection needs, concerns, and service access barriers of adolescents and youth, as well as persons with disabilities, have been assessed to inform well-tailored and well-targeted humanitarian responses. In July 2022 CARE engaged with Heather Cole, an independent technical writer to propose a revised analysis and the final shape of this report. Read More...

CARE Rapid Gender Analysis – North-west Syria: SACRIFICING THE FUTURE TO SURVIVE THE PRESENT

The war in Syria has fueled one of the world’s most complex protracted humanitarian crises. The combination of mounting insecurity, economic decline, environmental stressors and the Covid-19 pandemic has had a catastrophic impact. After 11 years of conflict, north-west Syria, which is home to more than 4.6 million people, continues to experience recurring waves of violence and forced displacement and disruptions in the provision of humanitarian assistance. Idleb governorate recorded the highest death rate as a result of the conflict countrywide in 2021, accounting for more than 19% of the national toll, followed by neighboring Aleppo with 18%.
More than 90% of Syrians live below the poverty line, compared with 10% before the start of the conflict, and as of the end of 2021, 60% of the population were food insecure, a 57% increase on the figure for 2019. The agricultural sector continues to decline, and average food prices have risen by more 97% in a year.
The situation in the north-west is even more acute. Food prices have gone up by more than 120%, further increasing households’ dependency on humanitarian aid.5 The ongoing food crisis is expected to significantly amplify stressors on the most vulnerable, particularly the region’s 2.8 million internally displaced people (IDPs), as well as female-headed households, widows, women in general and children.
All participants in this rapid gender analysis (RGA), including adolescents, identified food, livelihood and health support as their main needs. Adolescents also highlighted the need for better education opportunities. The conflict and severe economic strain have led to more women becoming main breadwinners, but social and cultural barriers continue to impede their greater participation in decision making in the household and the public sphere. Read More...

The Impact of Integrating Cash Assistance into Gender-Based Violence Response in Northwest Syria

Traditionally, refugees and internally displaced persons (IDPs) have received aid in the form of in-kind assistance. Increasingly, however, cash and voucher assistance (CVA) is being used in humanitarian response to meet the diverse needs of those displaced by crisis and conflict. Preliminary findings by the Women’s Refugee Commission (WRC) indicate that CVA supports gender-based violence (GBV) prevention and response activities, yet humanitarian GBV programming does not comprehensively or consistently consider using CVA. This is a critical gap, as a refugee, internally displaced, and migrant women and girls face multiple risks and incidents of GBV before, during, and after crises. Read More...

CARE RAPID GENDER ANALYSIS IN SYRIA: 11 years of crisis

”Life is mentally and physically exhausting. We can no longer go to hospitals because healthcare and medicines are so expensive. My children eat less. They no longer have milk because I had to sell my cows. We eat a lot less and we no longer eat vegetables because they are expensive” --- Woman living in a camp in Northeast Syria ---
* 90% of people live below the poverty line
* 12.4 million people are food insecure
* 50% of water systems DO NOT WORK Read More...

Final Report for the Final Evaluation of OFDA Response program

This report presents the final evaluation of the United States’ Agency for International Development (Office of Foreign Disaster Assistance ( Response Program implemented by CARE Turkey and its partners in Aleppo and Idleb governorates of Northwest Syria. The evaluation aimed to assess the program’s relevance, efficiency, effectiveness, impact, sustainability and coordination using the Organization for Economic Co operation and Development's Development Assistance Committee (OECD DAC) evaluation criteria and was carried out from July to October 2021.

“I am very satisfied with this assistance in terms of gravelling the road, providing the camp with water and upgrading the tents for the entire camp. All of those interventions were desperately needed. People are satisfied because the situation has improved within the camp.”
-Camp Manager
“I can say that this service is very important in all aspects because it is securing clean and safe water for the neighborhood (…). Everyone in the neighborhood is satisfied with the services.”
-FGD participant Read More...

Final evaluation of the FFP III program 2021

Jouri for Research and Consulting was commissioned by CARE International (CARE) to undertake a final evaluation of the Food for Peace project, “Emergency and Regular Food Assistance in Syria” implemented in Aleppo and Idleb in Northwest Syria (NWS), funded by USAID’s Food for Peace (FFP) program. The project is implemented through four local partner organizations as well as CARE’S area office in Jarablus.
The project consisted of cash distribution (both one-off as well as multi-round cash for food (MRCFF) support and livelihoods activities, which included wheat value chain support (wheat purchase from selected farmers, milling into flour, distribution to bakeries for subsidized bread and infrastructure rehabilitation) and cash for work (CFW) activities. The project was implemented through the local partners Shafak, Ihsan, Syria Relief (SR) and Insani Yardımlaşma Derneği (IYD), as well as CARE’s area office (AO) in Jarablus.
The evaluation addressed the key evaluation questions organized under the Organization for Economic Co-operation and Development's Development Assistance Committee (OECD DAC )evaluation criteria, including Relevance, Efficiency, Effectiveness, Impact and Sustainability. The impacts of coordination among other actors and between partners was also investigated. In total, Jouri conducted 587 surveys, nine focus group discussions (FGDs) and 40 key informant interviews (KIIs). Data was collected face to face and in some cases, remotely due to COVID-19. The evaluation was conducted between July and September 2021. Data was collected in August and September 2021. Read More...

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