8 July 2021, Damascus – One in 10 people in Syria live with a mild to moderate mental health condition. Prolonged exposure to conflict and the COVID-19 pandemic have continued to strain the mental well-being of families. In response, WHO Syria and local nongovernmental organizations in Rural Damascus recently launched the “My Hero Is You” campaign, which aims to reduce anxiety and fear associated with COVID-19 among children, and enhance the ability of parents to effectively talk to children about their well-being.

The pilot campaign reached 5000 children and included messages about how to cope with stress delivered through a colouring book. The book was adapted to the Syria context and is based on a children’s story, entitled “My Hero is You”, developed by WHO and other members of an United Nations inter-agency committee on mental health and psychosocial support in emergency settings. The campaign also included the provision of psychosocial support sessions and focus group discussions, attended by 2000 parents, caregivers and health educators who discussed their concerns, coping mechanisms and support strategies for children experiencing stress in the context of the COVID-19 pandemic.

“In recent years, there has been increasing acknowledgement of the role of mental health in people’s overall well-being and, especially, children’s development. In Syria, the conflict was exacerbated by the COVID-19 pandemic and its adverse economic impact, so the need to address mental health has become even more acute. Thus, our increased focus on mental health aims at listening to communities – to their fears, concerns and experiences of coping with COVID-19 - and empowering them with tools and skills to stay mentally resilient and adapt to a new normal,” said Dr Akjemal Magtymova, WHO Representative in Syria.

The campaign, funded by the WHO Regional Solidarity Initiative, was made possible thanks to partnerships with Al-Tal and Al-Qutayfah nongovernmental organizations, members of which received training by WHO prior to the campaign launch. The training was based on the WHO global package and adapted to the Syrian context to tailor it to the current needs of community workers who provide basic psychosocial support services to parents and children.  

“I am proud to be part of the initiative through which I could teach parents and children how to overcome anxieties and stay positive despite the circumstances surrounding them. It was a joy to observe children reading and colouring the story and imagining themselves travelling around Syria with characters, like Ario, to share with other children what they have learned from the book and what to do to prevent transmission of COVID-19,” said Ahmed Sousan, 30, a volunteer from Rural Damacus who received WHO training.

“Maintaining a healthy lifestyle and work life balance were among the recommendations I received during the psychosocial support sessions, in addition to tips on how to talk to children about COVID-19 related fears. It was important for me to share how the pandemic affected the mental well-being of my family. I felt others shared the same concerns and together we can overcome the challenges of the current times,” said one of the parents at the Al-Tal centre.

Following the success of the pilot programme in Rural Damascus, WHO plans to replicate the initiative in Homs, Aleppo and other governorates this year to reach thousands of parents and children in need of mental health support; and in collaboration with the Regional Office for Eastern Mediterranean will also share the initiative’s best practices for other countries in the Region to replicate. 

Media contact

Gulalek Soltanova
External Relations/Communications Officer
WHO Syria Office
Damascus, Syrian Arab Republic
This email address is being protected from spambots. You need JavaScript enabled to view it.
+963 953 888 477

On Tuesday 13 April 2021, WHO in the occupied Palestinian territory held an online event with the Palestinian Ministry of Health and civil society partners to mark the launch of a year-long campaign towards Building a Fairer, Healthier World. The campaign focuses on addressing the preventable, systematic differences in health outcomes that result from the political, economic, and social conditions in which we are born, grow, live, work and age.

The Minister of Health, Dr Mai Al-Kaila, opened the event outlining how the COVID-19 pandemic has exposed and highlighted substantial challenges for the Palestinian health system. She emphasized that violations of the human rights of Palestinians living under occupation in the West Bank, including East Jerusalem, and Gaza Strip hinder access to and provision of health care and disproportionately affect certain communities – such as those in Area C of the West Bank and those living close to the separation barrier. Dr Al-Kaila highlighted how unequal access to vaccines for COVID-19 underscores the need for global justice and solidarity, and she welcomed the support provided by WHO and the international community, including through the COVAX initiative. She also thanked civil society health and human rights organizations for their efforts and support in tackling the COVID-19 pandemic.

The event was split into three sessions. The first outlined barriers to health due to policies and practices in Area C of the West Bank, with presentations provided by Medicins Du Monde, the Palestinian Medical Relief Society, and Action Against Hunger. Speakers detailed the impact on mental health of precarity and home demolitions; the challenges to mobile clinic access and the substantial health needs of communities in this area; and the barriers to establishment of infrastructure for water and sanitation, essential for livelihoods and for the protection and realization of good health. The second session of the online briefing addressed the impact of severe movement restrictions in the Gaza Strip, focusing on the effect on health of limitations to access for patients, including specifically for women, livelihoods in the Access Restricted Areas close to the Gaza perimeter fence, and food insecurity and poverty. Presentations were delivered by the Culture and Free Thought Association in the Gaza Strip, Première Urgence Internationale, the Palestinian Agricultural Relief Committee, and the Palestinian Centre for Human Rights. Finally, the event concluded with a presentation by the Palestinian human rights organization Al Haq, which examined how protection and human rights vulnerabilities for Palestinians throughout the occupied Palestinian territory contribute to health challenges and health inequities.

Dr Richard Peeperkorn, WHO Representative to the occupied Palestinian territory, thanked the Palestinian Ministry of Health and partner organizations and praised the collective efforts to tackle the COVID-19 pandemic in the face of difficult circumstances. He stated, “The central message of the World Health Day campaign this year is that health is a right, not a privilege. The COVID-19 pandemic has highlighted the profound health inequities that exist globally and that are evident for Palestinians in the West Bank, including East Jerusalem, and the Gaza Strip. This is exemplified by the distribution of COVID-19 vaccines, where it is clear that no one is safe until everyone is safe.” Dr Peeperkorn invited participants to join in collective advocacy efforts for the right to health of Palestinians and wished all a successful World Health Day 2021 campaign towards Building a Fairer, Healthier World.

31 March 2021 – On 16 March 2021, the WHO country office in Oman invited representatives Dr Badar Al-Alawi and Ms Mona Al-Battashi from the Oman Medical Specialty Board to discuss inititiation of a collaborative project related to online courses that had been agreed between WHO and the Board in February 2021. 

The discussion, led by Dr Lamia Mahmoud and Dr Kamila Al-Alawi from the WHO country office, focused on the various stages of course design, how to elicit engagement of relevant national and international experts and who from WHO and the Oman Medical Specialty Board should be involved in the development of courses.

The Oman Medical Specialty Boards specified that courses should cover 4 categories of participants – Board trainees, trainers and faculty and health care workers. The WHO country office expressed full support for the project that would not only benefit Oman but the Region as a whole.

AMMAN (Reuters) – Syria will take delivery within weeks of its first COVID-19 vaccines from the global vaccine sharing platform COVAX, allowing it to kick off its national inoculation programme as early as next month, the U.N. health agency’s country head said on Wednesday.

The first shipments are from a consignment of one million doses of AstraZeneca Serum Institute India (AZSII) vaccines, Akjemal Magtymova, head of the World Health Organisation’s Syria mission told Reuters from Damascus in a phone interview.

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8 تشرين الثاني/ نوفمبر 2020 لقد عدتُ مؤخراً من بعثة إلى سوريا استغرقت أربعة أيام، حيث التقيتُ بمسؤولين على جميع المستويات، وعاملين صحيين، وشركاء، ودوائر أكاديمية، وغيرهم، لمعرفة المزيد عن الوضع الصحي بوجه عام، وللتوصُّل إلى سُبُل جديدة للعمل معاً من أجل تعزيز تقديم الخدمات، ولحماية السوريين من التهديدات الحالية، وللمساعدة في تقوية النظام الصحي الذي دمّرته الأزمة.

وقد التقيتُ بالعاملين الصحيين في الخطوط الأمامية والمرضى في دمشق وحمص وحماة، ومن بينهم الطفل جعفر البالغ من العمر 6 سنوات الذي يتردد على أحد مراكز الرعاية الصحية في حمص التابع لإحدى المنظمات غير الحكومية والذي تدعمه منظمة الصحة العالمية للخضوع لجلسات الغسيل الكلوي ثلاث مرات في الأسبوع للمساعدة في بقائه على قيد الحياة ونموه. وأخبرني الأطباء في المركز نفسه عن أم لطفليْن أعميَيْن ظلّت منتظرة طوال سنتين لإجراء عملية رأب الأوعية الدموية في القلب، وتمكَّنت أخيراً من إجراء هذه العملية المنقذة للحياة الأسبوع الماضي فقط.

وفي مستشفى الأطفال في دمشق، زرتُ قسم الطوارئ الجديد الذي أعادت المنظمة تأهيله بدعم من اليابان، والذي يستقبل في المتوسط 300 طفل يومياً، حيث رأيتُ طاقماً متخصصاً يستقبل المرضى المحالين من جميع أنحاء البلاد المصابين بحروق وإصابات وحالات عدوى مهددة للحياة.

والتقيتُ طوال فترة وجودي في سوريا بالأطباء وطواقم التمريض وغيرهم من العاملين الصحيين الذين تحمّلوا سنوات من العمل بكل شجاعة تحت تهديد الهجمات خلال الحرب، وما زالوا صامدين حتى الآن من أجل إنقاذ الأرواح على الرغم من قلة الموارد. وقال لي أحد الأطباء: «كنا نخدم شعبنا في الظروف العادية؛ ونحن نخدمه في هذه الظروف الاستثنائية فلكَ أن تتخيل ما واجهناه وما نواجهه الآن».

ونحن في منظمة الصحة العالمية نتحدث عن قدرة النُظم الصحية على الصمود، وأهميتها في ضمان صحة جميع الناس وعافيتهم، لا سيّما أثناء الأزمات. ولكن في سوريا، رأيتُ القدرة على الصمود والروح الإيجابية لهذا الشعب الذي لم يستسلم، ولا يزال عازماً على إعادة السلام والازدهار إلى بلده على الرغم من اليأس الذي واجهه على مدى قرابة عقد من الزمان.

لكن الدمار الناجم عن الحرب لا يزال جلياً في سوريا، كما أن التعقيدات المستجدة - مثل كوفيد-19 - فاقمت أعباء الناس الذين أنهكهم بالفعل الصراع المستمر وفاشيات الأمراض والكوارث الطبيعية، ومنها الحريق الهائل الأخير الذي دمّر سُبُل عيش الكثيرين.

ولا يزال نصف جميع المهنيين الصحيين خارج البلاد، ولا يعمل سوى 48% من المستشفيات العامة و48% من مراكز الرعاية الصحية الأولية بكامل طاقتها. ولا يزال هناك نقص في أعداد العاملين الصحيين واللوازم الطبية والمعدات والأدوية، حيث لا يتوفر ما يقرب من خُمس الأدوية المنتَجة محلياً بسبب الآثار السلبية للأزمة الاقتصادية على إنتاج المستحضرات الصيدلانية المحلية.

فالناس يعانون ويموتون بسبب نقص الأدوية اللازمة لحالات مثل ارتفاع ضغط الدم والسُكري والفشل الكلوي. وتتعرّض المعدات الرديئة النوعية التي تُستخدم على مدار نوبتيْن ليلاً ونهاراً للضغط الشديد بسبب ارتفاع الطلب عليها والقيود المفروضة على استيراد قطع الغيار؛ وقد أدّت العقوبات إلى تفاقم الوضع الذي كان متردياً أصلاً، الأمر الذي أثّر على جميع الناس وجميع القطاعات، ولا سيّما قطاع الصحة.

والأطباء المهرة بحاجة ماسّة إلى موارد تمكّنهم من إجراء العمليات الجراحية المنقذة للحياة وغيرها من الإجراءات الطبية اللازمة. وطلاب الطب مصممون على خدمة بلادهم ولكنهم يشعرون بالإحباط بسبب الثغرات العديدة التي سيواجهونها باعتبارهم مقدمي خدمات في الخطوط الأمامية.

ومع أن الشعب السوري يعيش حالة من الحرب والجوع والمرض، فقد أصبح يواجه الآن تهديداً آخر يلوح في الأفق: مثل العديد من البلدان في جميع أنحاء العالم، إذ نتوقع موجة أخرى من كوفيد-19 في سوريا.

وبينما نواصل تقديم الإمدادات وتوسيع نطاق القدرة على إجراء الاختبارات في جميع أنحاء البلاد من خلال اتباع نهج "جميع الأساليب"، رأيت التزاماً رفيع المستوى عبر جميع مستويات الشركاء وجميع القطاعات لمكافحة الجائحة بما يتماشى مع توصيات منظمة الصحة العالمية. ومع ذلك، لا تزال القدرة على إجراء الاختبارات محدودة، ويظل التزام عموم الناس باستخدام الكمامات والتباعد البدني منخفضاً، ولا يزال العاملون الصحيون معرّضين بشدة للخطر بسبب الافتقار إلى معدات الوقاية الشخصية.

إن الشعب السوري أمامه طريق طويل وشاق. ولكن على الرغم من الدمار والحرمان، فإن هناك قدرة هائلة على الصمود وأملاً مشجعاً؛ وسنواصل دعمنا لجميع السوريين في كل خطوة على الدرب، ولا سيّما الفئات الأكثر ضعفاً، مهما كانت الظروف التي يواجهونها. ورغم كل هذه التحديات، فقد تمكّن السوريون من الحفاظ على مستوى أساسي من الرعاية الصحية يمكننا البناء عليه بدعم من المجتمع الدولي وشركائنا الملتزمين داخل البلاد وخارجها.

{tab-ex=What is PHC?}

Primary health care (PHC) addresses the majority of a person’s health needs throughout their lifetime. This includes physical, mental and social well-being and it is people-centred rather than disease-centred. PHC is a whole-of-society approach that includes health promotion, disease prevention, treatment, rehabilitation and palliative care.

A primary health care approach includes three components:

• meeting people’s health needs throughout their lives;
• addressing the broader determinants of health through multisectoral policy and action; and
• empowering individuals, families and communities to take charge of their own health.

By providing care in the community as well as care through the community, PHC addresses not only individual and family health needs, but also the broader issue of public health and the needs of defined populations.

All people, everywhere, deserve the right care, right in their community. This is the fundamental premise of primary health care.

The principles of PHC were first outlined in the Declaration of Alma-Ata in 1978, a seminal milestone in global health. Forty years later, global leaders ratified the Declaration of Astana at the Global Conference on Primary Health Care which took place in Astana, Kazakhstan in October 2018.

PHC, because it is about how best to provide health care and services to everyone, everywhere, is the most efficient and effective way to achieve health for all.

{tab-ex=Areas of work} {tab-ex_sub1=PHCMI Initiative}

PHCMI country profiles

Egypt

Egypt’s 2030 Health Vision identifies several goals to improve quality of life – with special attention paid to achieving equitable access to essential health services. National policies are moving towards measurable PHC outcomes to improve population health and reduce inequities in health.

PHC Country Profile

Vital Signs Profile

Islamic Republic of Iran

In recent years, there has been a drive to expand PHC service packages for improved health outcomes in Islamic Republic of Iran. Following development of the country’s Health Transformation Plan, there has been a focus on the family practice programme and the Iranian National sixth 5-year development plan.

PHC Country Profile

Vital Signs Profile

Jordan

As part of Jordan’s National Strategy for the Health Sector 2016-2020, improving the quality of, and access to, PHC services was identified as a main objective achievable through the development of integrated and quality PHC services.

Access Jordan’s PHC Country Profile

Access Jordan’s Vital Signs Profile

Libya

In 2019, a prime objective for Libya’s heath sector was to begin a process of recovery of the public health services system, which has been largely disrupted due to conflict. The response priorities included identifying gaps and scaling up of PHC services and improving quality of services in all crises-affected areas.

PHC Country Profile

Vital Signs Profile

Morocco

Morocco’s 2017-2021 health reform aims to implement projects and programmes to improve positive health outcomes by reforming health care provision to improve access to health care services.

PHC Country Profile

Vital Signs Profile

Pakistan

Pakistan’s National Health Vision 2016-2025 outlines improvements in coverage and functionality of primary health care (PHC) services as one of the strategic priorities for the federal and provincial governments. Following the national consensus, provincial and Islamabad Capital Territory health strategies have prioritized PHC reforms.

Access Pakistan’s PHC Country Profile

Access Pakistan’s Vital Signs Profile

{tab-ex_sub1=Online training}

The WHO Regional Office for the Eastern Mediterranean, World Organization of Family Doctors (WONCA) and United Nations partners, including the Joint United Nations Programme on HIV/AIDS (UNAIDS), United Nations Population Fund (UNFPA), United Nations High Commission for Refugees (UNHCR) and United Nations Children's Fund (UNICEF) developed a guidance document for primary health care policy-makers and providers on the role of primary health care during the COVID-19 pandemic.

WHO, WONCA and United Nations agencies, as part of the regional workplan for implementation of the SDG 3 "Global Action Plan for Healthy Lives and Well-being for All", used the guidance to develop an online training course to help ensure that PHC was fully integrated into every country’s response to COVID-19 pandemic in WHO's Eastern Mediterranean Region.

The training seeks to support primary health care personnel to maintain essential services and assist in controlling the pandemic as frontline health professionals, while ensuring their own protection through effective infection prevention and control mechanisms and maintaining the community’s trust in the health system.

The course identifies 4 main functions of primary health care in relation to COVID-19:

• maintaining essential health services;
• preventing COVID-19 through supporting effective public health measures;
• diagnosing COVID-19 cases and ensuring adequate referral; and
• managing mild and moderate COVID-19 cases.

Development partners strongly encourage primary care physicians, working in the public and private sectors in the Region, to undertake this training.

Register

Objectives

The programme has been designed to:

• highlight the important role of PHC in maintaining the essential health services;
• inform PHC team with WHO most updated policies and guidelines related to COVID-19;
• identify the role and responsibilities of PHC team in prevention and control of COVID-19;
• present and discuss WHO health workforce infection control procedures recommended for COVID-19 prevention and control.

Features

• Online interactive multimedia and mobile application-based training, based on the latest WHO technical guidance on COVID-19.
• Trainees will receive certificates of completion from WHO, accredited for 15 hours under the category 1 credit system of the American Association of Continuing Medical Education (AACME) and endorsed by the Arab Board of Health Specializations.
• Comprises 5 modules lasting an estimated total of 15 contact hours.
• Content is designed to be periodically updated every 8 weeks, to include the latest manuals, guidelines and evidence-based information. The second version will be available on 7 November 2020.
• Arabic, Farsi, and French versions are available.

WHO Regional Director introducing online training on the role of PHC in COVID-19

{tab-ex_sub1=Diploma in Family Medicine}

Introduction

Many countries around the world and especially countries in the Region have a severe shortage of qualified trained family doctors, essential to achieve the goal of universal health coverage. In many countries, the specialty of family medicine has not been developed so the first point of contact for patients remains either untrained general practitioners, who have neither training nor experience in family medicine, or secondary care doctors, with internists, pediatricians and obstetrician-gynaecologists providing care for their respective groups. Yet most physicians working as family doctors are eager to pursue postgraduate training, gain due accreditation and ultimately raise the contribution of family medicine to national health care systems.

Regional Professional Diploma in Family Medicine

To reach the target of 3 family physicians per 10 000 population by 2030, WHO in collaboration with UNICEF, Asia United Bank and the World Organization of Family Doctors (WONCA) developed the Regional Professional Diploma in Family Medicine as a bridging programme, which can be defined as a transitional period when a general practitioner will be introduced to family medicine and gain improved knowledge and skills in service delivery.

Students are often full-time employed physicians, and many cannot gain training placements in training centres so they receive on-the-job training in various hospital posts. The Regional Professional Diploma in Family Medicine is flexible, offering part-time and full-time options and enrolment while working/training in primary and secondary health care.

To build capacity of trainers, the WHO Regional Office organizes training of trainers workshops to introduce the Diploma to family medicine departments and provides training on the use of the online component of the course. It encourages family medicine departments to customize the Diploma programme to meet the needs of  populations in respective countries.

Teaching modality

The programme uses a blended format of online (self-directed, instructions, discussions), face-to-face (teaching, discussions) training sessions with both academic and clinical supervisory support and on-the-job training.

Moodle is used as the learning management system for the online part of the training.

Duration and credit hours

The duration of the course is 12 months (900 hours/30 European Credit Transfer System (ECTS)/ around 16 American credits) divided into 4 terms. The programme comprises 8 "blocks" each spanning a 5-week period.

Curriculum

The curriculum was mapped according to the WONCA defined 6 main competencies that a general practitioner/family physician has to master. These competencies include: primary care management, person-centred care, specific problem-solving skills, comprehensive approach, community-orientation and holistic approach.

These competencies cover the main characteristics of the discipline of general practice/family medicine:

• Acting as the first point of contact in the health care system, dealing with all health problems of the individuals regardless of their age and sex.
• Coordinating care with other specialists, professionals and health care resources in an efficient way, taking an advocacy role for the patient when needed.
• Developing a person-centred approach that is oriented to the individual within the context of his/her family and community.
• Promoting patient empowerment.
• Providing longitudinal continuity of care depending on the needs of the patient.
• Applying a specific decision-making process as determined by the prevalence and incidence of the illness in the community.
• Managing both acute and chronic health problems of individual patients.
• Managing illnesses presenting in an undifferentiated way, namely at an early stage of their development.
• Promoting health and well-being through appropriate and effective interventions.
• Assuming specific responsibility for the health of the community.
• Dealing with health problems in their different physical, psychological, social and cultural dimensions.

Eligible institutes

Institutes that eligible to teach the Regional Professional Diploma in Family Medicine:

• are recognized in the country by the supreme council of universities, ministry of health or medical syndicates as a medical postgraduate training body offering professional or academic certificates (Diploma, Masters, Fellowships, M.D);
• must have a family medicine department or scientific board;
• must have family medicine specialty training among its programmes offered;
• agree to develop, in collaboration with the WHO Regional Office, a clear concept note, outline plan and budget plan;
• have a long-term vision and plan to adapt and adopt the Regional Professional Diploma in Family Medicine for multiple cohorts.

Eligible trainers

An eligible trainer:

• is a member of an academic institute/training body in the implementing country;
• attended a WHO training of trainers workshop;
• agrees with the terms of reference which include:

supervising the progress of each trainee;

chatting online with trainees once a week;

conducting on-the-job training;

conducting live review sessions;

correcting assignments and providing feedback to trainees.

Eligible trainees

Students eligible for the diploma must:

• be a licensed practising physician;
• sit for an interview with an appointed committee;
• be ready to put an average of 15 hours per week into studying for the Diploma;
• allocate time during clinic hours (live review sessions, on-the-job training);
• be fluent in English;
• have internet access from work and home.

{tab-ex_sub1=Priority Benefits Package} {tab-ex_sub1=Private sector}