The Aga Khan Health Service’s plan for Salamieh District incorporates the World Health Organization’s six building blocks for health systems at three levels: community, primary health care and secondary health care. It focuses on strengthening the public health system, principally the still-operational 23 primary/basic health centres (BHCs) and the district hospital. Eight strategically located primary healthcare centres are being improved to provide a “Basic Package of Essential Health Services”.

In areas of the district that are secure but where there are access problems, AKDN has introduced mobile health services, especially for critical services such as immunisation, growth monitoring, and antenatal and postnatal care.

The AKDN Health Programme trained around 1,200 community members in different health topics. This has enabled them to disseminate health messages to families and contribute to community health activities such as home visits, awareness sessions, interactive activities and the distribution of health kits and educational materials. These programmes reached more than 30,000 families.

AKDN has worked towards reducing maternal and child mortality in Salamieh District through the following measures:

• renovation of Salamieh Hospital’s Emergency Department, increasing its capacity to 10 plus six beds, providing emergency power, equipment, and essential medicines and supplies;


• renovation and upgrading of Salamieh Hospital’s Operating Theatres Unit, increasing the capacity from four to seven operating rooms plus provision of surgical and anaesthesia equipment, medicines and supplies;


• repair of the existing CT scanner, provision of a new CT scanner and new x-ray machine;


• training of Salamieh Hospital and other emergency healthcare workers;


• formation of 11 CERTs, including the provision of emergency supplies and kits, regular training of the 141 members, simulations and evaluations;


• establishment of an alternative makeshift AKDN-managed Trauma Unit to divert, accommodate and treat triaged cases away from Salamieh Hospital if needed;


• provision of five ambulances for Salamieh District; and


• development of an MCM response plan, including the establishment of an emergency operations centre in partnership with health and emergency authorities.

AKDN has provided technical and material assistance in the forms of essential and advanced medical equipment, renovation of health facilities and training for more than 500 health workers in different health topics to improve diagnostic and therapeutic capacity. AKDN has also added to stockpiles of equipment and supplies.

Nutrition

The Aga Khan Foundation (AKF) identifies nutritional problems by conducting assessments. It then monitors nutritional status, providing nutritional supplements and improving families’ knowledge and practices around adequate nutrition.

AKF works to enhance the integration of quality nutritional services with health services by improving guidelines and procedures and training health workers.

Non-communicable Diseases

To fill the gap in non-communicable disease (NCD) services, particularly for vulnerable patients, an AKDN-managed clinic established a patient registry in Salamieh in 2015. Patients come for diagnosis, treatment, awareness and counselling sessions. The most common diagnoses are hypertension, cardiovascular disease, diabetes and cancer.

Mental Health

Through the training of general practitioners and health workers in mental health disorders, and many more community workers in basic psycho-social support and trauma counselling, much more attention is being given to this area of work. However, there is still a large unmet need as more individuals (including AKDN/AKF staff) have been directly affected by violence.

The AKDN NCD/mental health clinic with a consultant psychiatrist has treated well over a thousand patients with mental health problems. The not-for-profit Aga Khan Medical Centre-Salamieh (AKMC-S), with a major focus on complementary, locally non-available services for NCDs and mental health issues, aims to commence outpatient and day-care services in 2022.

As well as providing essential health services, AKDN acts to improve the capacity of public health facilities to plan, organise and deliver services.

A unique community health programme is training over 200 health workers and 2,000 volunteers to reach over 20,000 families with essential messaging about communicable disease care and prevention, maternal and child health, and healthy living. The programme’s success can be measured by the absence of major outbreaks of communicable diseases, stabilisation in the number of cases of typhoid, hepatitis A and cutaneous leishmaniasis, the relatively high level of exclusive breastfeeding and low prevalence of undernutrition amongst these families.

The Aga Khan University has been improving the nursing sector since 2002. It continues to support nursing leadership through BScN, MScN and post RN programmes and scholarships. Twenty-six Syrian students have now graduated from these programmes.