[HeRAMS] Health Resources Availability Mapping System

Report: 2016

Turkey Hub Health cluster for

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HeRAMS (Health Resources Availability Mapping System) is a standardized approach supported by a software-based platform that aims at strengthening the collection, collation and analysis of information on the availability of health resources and services in humanitarian context. It aims to address the needs/gaps expressed by the health cluster on coordination and management by providing timely, relevant, and reliable information.

HeRAMS provides a tool for assessing, monitoring, and processing a comprehensive set of available data collected at health facility level. It covers; geographical location of the HF, demographic data on catchment area, type, functionality, building type, inpatient capacity, managing and supporting partners, health personnel, access and security, and health services provided at different levels of healthcare.

This report provides a summary of the analysis of the available health resources and services in Syria, the report is produced with the data provided mainly by hub health cluster members national and international non-governmental organizations as well as health authorities.

Map showing areas of operation

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1. Distribution of Health facilities Primary Health Care facilities are classified into different standard categories based on the provision of services, staff pattern and population coverage. The following graph provides the distribution of the existing health facilities (static and mobile); in terms of number of the functional facilities.

Figure 1.Distribution of functioning Health facilities

90 84 80 70 57 60 50 45 40 40 35 33 30 24 20 9 10 0 General Hospital Specialized Comprehensive Health Centre Health Unit Mobile clinic Specialized Care Other Hospital Health Centre Facility

352 Health facilities reported out which 327 functioning HFs*, 75(23%) are Hospitals, while 162(50%) are fixed PHCs and 57 (17%) are mobile clinics, 24 (7%) specialized care facility ** and 9 (3%) *** other health facilities.

A round 25 HFs were closed during the last quarter

*The number is declined after evacuation. ** Specialized health centers (Physical Rehabilitation centers, Leishmaniosis centers .Etc.) ***Ambulance network, Blood Bank, Central Lab

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2. Functionality status

Figure 2. Functinality status of Health facilities

Functionality has been assessed at three levels: fully functioning which mean open and providing full package of essential services, partially functioning means open but not providing the full package of essential services, or not functioning. Out of 327 66, 19% assessed health facilities, 74% (261) were reported fully Fully Functioning functioning, 19% (66) partially functioning, 7% (25) out of 25, 7% service, this result in 26% of the facilities are non-functioning Non-functioning or partially functioning with low capacity. See Figure 2. Partially Functioning 261, 74% 56% of the non-functioning health facilities were hospitals.

3. Condition of health facilities infrastructure

Figure 3 Level of Damage

The condition of the health facilities infrastructure has been 1% 12% assessed at three levels: fully damaged: major damage requiring complete reconstruction, partially damaged: requiring substantial to large scale repair, and not damaged, 29% (102) health facilities were reported damaged [1% fully damaged and 28% partially 28% damaged], 59% (215) were reported intact, while 12% (44) of 59% health facilities were not relevant to evaluate. See figure 3.

Not damaged Partially damaged Fully damaged Not relevant (e.g mobile clinic)

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4. Health facilities based on date of establishment

Figure 4 New establlished HFs

The health facilities has been assessed according to whether the health facility exist prior to the crisis or new established health facility, 67% (220) health facilities were new established, while 33% (107) of health facilities were prior to crisis facilities. See figure 4. 33% Out of the new established health facility 34% were established in new building, 26% works in residential Building, 15% in governmental Building, 5% in schools and 19% in others public building. 67%

New established HFs Prior to the crisis health facility

5. Health facilities resources

Figure 5: Accessability to patients Figure 6: Electricity Figure 7: Water Sources

6% Fully Functioning 1% 1% Fully accessible 36% Non-functioning Not accessible Available 56% Not available Partially Not available 7% Partially accessible 1% 93% Functioning 99%

7% of functioning facilities reported difficulties 48% of the functioning facilities works without/with 1% of the facilities with water sources in accessibility mainly due to security reasons an interrupted electricity services problem

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6. provision of General Clinical Services

Figure 8:Outpatient services: 100% The main reasons that explain the lack 11% 11% 8% 90% 20% of availability of Outpatient services are 21% 80% 38% 33% lack health Staff, Lack of finances and Lack 70% of medical supplies (drugs and 60% consumables). 50% 89% 89% 93% 40% 80% 79%

30% 63% 67%

20% 10% 0% Comprehensive Health Centre Health Unit Specialized Care General Hospital Specialized Mobile clinic Health Centre Facility Hospital

Available Not available

Figure 9: Inpatient capacity 100% 3% 5% 90% The availability of inpatient services in 80% the general and specialized hospitals is 70% 69% more than 90%, although of some 60% 82% 79% 97% obstacles 38% of the general hospital 50% 97% 95% provide it partially. 40% It’s worth to mention that only 31% of 30% 20% the comprehensive health centers 31% 10% 18% 21% providing inpatient service. 0% 3% Comprehensive General Hospital Health Centre Health Unit Specialized Care Specialized Hospital Health Centre Facility

Available Not available

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Figure 10:*Basic Laboratory Services 100% 6% 3% 90% 29% In hospitals basic laboratory Services 80% availability is more than 90%, while 70% 67% 72% of comprehensive health Centers 60% 85% 50% 94% 98% providing basic laboratory Services. 40% 71% 30% *CBC, urine analysis, stool microscopy, sputum 20% 33% microscopy 10% 15% 0% Comprehensive Health General Hospital Health Centre Health Unit Specialized Hospital Centre

Available Not available

Figure 11: Basic Imaging Service 100% 3% 13% 90% Basic imaging services provided in SHC 80% and PHC, however the provision in PHC 70% facilities is less than 40%. 67% 60% 80% 94% 50% 97% 88% 40% 30% 20% 33% 10% 20% 0% 6% Comprehensive Health General Hospital Health Centre Health Unit Specialized Hospital Centre

Available Not available

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Figure 12: Pharmacy of essential 100% 2% 8% 6% Drugs 90% 80% 50% Most health facilities reported have 70% 60% pharmacy of essential drugs however 50% 100% 98% 92% 94% 98% 49% provide it partially as there is with 40% 30% no sustainable drugs and consumables. 50% 20% 10% 0% Comprehensive General Hospital Health Centre Health Unit Specialized Care Specialized Hospital Health Centre Facility

Available Not available

100% 5% 7% 11% 90% 15% Figure 13:Referral capacity 80% 43% 46% 70% of the facilities have referral 70% 61% capacity. Main reasons that some 60% facilities provides referral partially is 50% 95% 93% 89% the shortage of vehicles and finance 40% 85% required for fuel. 30% 57% 54% 20% 39% 10% 0% Comprehensive General Hospital Health Centre Health Unit Mobile clinic Specialized Care Specialized Health Centre Facility Hospital

Available Not available

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7. Provision of Surgery services

Figure 14: *Primary Injury care 100% 0% 90% 20% 80% 33% 61% of the facilities are providing 46% 45% primary injury care. 70% 56% 63% 60% *Treatment of open wounds, fracture 50% 100% immobilization, patient stabilization and proper 40% 80% referral (including antibiotics and tetanus toxoid 68% 30% 55% when needed) 54% 20% 44% 38% 10% 0% Comprehensive General Hospital Health Centre Health Unit Mobile clinic Specialized Care Specialized Health Centre Facility Hospital

Available Not available

Figure 15:*Trauma, surgical care, 100% 0% and elective surgery 90% 20% 80% 89% of the hospitals are providing 70% Trauma, surgical care, and elective 60% 84% surgery. 50% 100% 40% 80% *At least 1 operation room with/without gas 30% anaesthetic 20% 10% 16% 0% Comprehensive Health Centre General Hospital Specialized Hospital

Available Not available

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Figure 16:Intensive Care Unit 100% 20% 65% of the hospitals are with 80% 48% Intensive care unit. 60%

40% 80% 25% of the general hospital provide 53% intensive care with lack of medical 20% supplies. 0% General Hospital Specialized Hospital

Available Not available

Figure 17:Blood bank services 100% 90% 56% of the hospitals providing Blood 80% 40% 48% bank services. 70% 60% 87% 50% 2 blood banks in Idleb and Aleppo 40% governorates. 30% 60% 53% 20% 10% 13% 0% Comprehensive Health Centre General Hospital Specialized Hospital

Available Not available

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Figure 18: *Physical Rehabilitation 100% Services 80% Although of the increase number of 60% 78% 71% 75% 88% 88% 90% cases, 14% of the facilities provides 98% 40% physical rehabilitation services 20% 22% 29% 25% *Disabilities rehabilitation & support 12% 12% 10% 0% 2% Comprehensive General Health Centre Health Unit Mobile clinic Specialized Specialized Health Centre Hospital Care Facility Hospital

Available Not available

8. Provision of Maternal & Newborn and child health and services

Figure 19:*IMCI 100% 90% 80% 33% 46% of the facilities providing IMCI, 46% 48% of which 38% provide it partially 70% 61% 58% 60% 77% 83% this mainly due to Lack of finances 50% and trained health staff. 40% 30% 67% 54% 53% *Integrated Management of Childhood Illness 20% 39% 42% IMCI is an integrated approach to child health that 10% 23% 17% focuses on the well-being of the whole child. IMCI 0% aims to reduce death, illness and disability, and to Comprehensive General Health Centre Health Unit Mobile clinic Specialized Specialized promote improved growth and development Health Centre Hospital Care Facility Hospital among children under five years of age Available Not available

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Figure 20:*Screen of acute 100% 11% Malnutrition 30% 80% 44% 43% 54% 56% 60% of the facilities providing 60% 79% screening of acute malnutrition, of 40% 89% which 25% provide it partially this 70% 56% 58% mainly due to lack of staff and trained 20% 46% 40% health staff. 21% 0% Comprehensive General Hospital Health Centre Health Unit Mobile clinic Specialized Care Specialized *MUAC or Weight for Height, and/or bilateral Health Centre Facility Hospital pitting oedema Available Not available

Figure 21: outpatient treatment of 100% acute malnutrition 80% 38% 49% 55% 45% 68% 44% of the facilities providing 60% 74% 79% outpatient treatment of acute 40% 62% malnutrition, of which 45% provide 51% 45% 55% 20% 32% it with limitations. 26% 21% 0% Comprehensive General Hospital Health Centre Health Unit Mobile clinic Specialized Care Specialized Health Centre Facility Hospital Available Not available

Figure 22: *Antenatal Care 100% 7% 90% 65% of the facilities providing 20% 28% antenatal care. 80% 46% 42% 70% 54% 60% 79% *Antenatal Care: Assess pregnancy, birth and 50% 93% emergency plan, respond to problems (observed 40% 80% and/or reported), advise/counsel on nutrition & 73% 30% 54% 58% breastfeeding, self-care and family planning, 20% 46% preventive treatment(s) as appropriate 10% 21% 0% Comprehensive General Hospital Health Centre Health Unit Mobile clinic Specialized Care Specialized Health Centre Facility Hospital

Available Not available

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Figure 23: *BEmONC 100% 90% 29% 30% 41% of the facilities are providing 80% 47% Essential new-born care services. 70% 60% *Basic Emergency Obstetric and Newborn 50% Care (BEmONC) package includes Parenteral 40% antibiotics + oxytocic/anticonvulsant drugs + 71% 70% 30% manual removal of placenta + removal of 53% retained products with manual vacuum 20% aspiration (MVA) + assisted vaginal delivery 10% 24/24 & 7/7 0% new-born care includes: Basic new-born Comprehensive Health Centre General Hospital Specialized Hospital resuscitation + warmth (recommended Available Not Available method: Kangaroo Mother Care - KMC) + eye prophylaxis + clean cord care + early and exclusive breast feeding

Figure 24:Comprehensive 100% emergency obstetric care (CEMOC) 90% 25% 80% 55% of the hospitals and the 50% 58% comprehensive health centers are 70% providing CEMOC. 60% 50% CEMOC includes BEmONC +surgery+ 40% anesthesia+ blood transfusion. 75% 30% 50% 20% 42% 10% 0% Comprehensive Health Centre General Hospital Specialized Hospital

Available Not available

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9. Provision of Non Communicable Diseases and Mental Health

Figure 25: Treatment of High Blood 100% 0% 4% 9% Pressure and Cardiovascular 90% Diseases 80% 42% 37% 38% 70% Overall provision of treatment of 71% 60% HBP and cardiovascular diseases 50% 100% 96% 91% 77% of the facilities provide this 40% services, however 63% provide it 30% 58% 63% 63% 20% partially mainly due to lack drugs and 29% 10% consumables. 0% Comprehensive General Hospital Health Centre Health Unit Mobile clinic Specialized Care Specialized Health Centre Facility Hospital

Available Not available

Figure 26:treatment of diabetes 100% 0% 6% 1% 90% 35% 79% of the facilities are providing 80% 42% 38% 70% 67% treatment of diabetes. 60% 50% 100% 94% 99% 40% 30% 58% 65% 63% 20% 33% 10% 0% Comprehensive General Hospital Health Centre Health Unit Mobile clinic Specialized Care Specialized Health Centre Facility Hospital

Available Not available

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Figure 27:Mental Health Care 100%

80% Only 15% of the facilities provide 60% 81% 81% mental health although of the 91% 94% increase number of mental health 40% cases 20% 19% 19% 9% 6% Mental health includes: Support 0% Comprehensive Health Centre Health Centre Health Unit Mobile clinic of acute stress and anxiety, front line management of common and severe mental Available Not available disorders

10. Community health services

Figure 29:Health Education

Out of functioning HFs 66% of the 100% facilities provide Health education 90% 18% 28% 33% services.72% of the mobile clinics 80% 41% 40% 36% 38% provide the service, 68% of PHC 70% facilities and 61% of the hospitals 60% provide Health education services. 50% 40% 82% Its worth to mention 29% of the 72% 64% 67% 63% facilities provide it partially mainly 30% 59% 60% 20% due to lack of health staff. 10% 0% Comprehensive General Hospital Health Centre Health Unit Mobile clinic Specialized Care Specialized Health Centre Facility Hospital

Available Not available

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Figure 28:screening for malnutrition 100% with MUAC 90% 13% 80% 47% 51% 45% 70% 50% of the facilities providing 61% 67% 60% 79% screening for malnutrition with 50% MUAC through outreach services. 40% 87% 87% of the comprehensive health 30% 53% 49% 55% centers providing the service. 20% 39% 33% 10% 21% 0% Comprehensive General Hospital Health Centre Health Unit Mobile clinic Specialized Care Specialized Health Centre Facility Hospital

Available Not available

Figure 29: Follow up of 100% malnourished children 18% 80% 52% of the facilities follow 47% 46% 52% 45% 61% malnourished children, out of which 60% 79% 43% provide this partially mainly due 40% 82% to lack of medical supplies. 53% 54% 48% 55% 20% 39% 21% 0% Comprehensive General Hospital Health Centre Health Unit Mobile clinic Specialized Care Specialized Health Centre Facility Hospital

Available Not available

Figure 30:Screening for pregnancy 100% 4% for referral to ANC: 18% 28% 80% 35% 42% 60% Screening for pregnancy for referral 60% 96% to ANC provides in 70% of the 40% 82% 73% 65% 58% facilities. 20% 40% Highest provision is through 0% Comprehensive centers 96%. Comprehensive General Hospital Health Centre Health Unit Mobile clinic Specialized Hospital Health Centre

Available Not available

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Figure 31:Follow up of treatment 100% mental health patients 80% 71% 67% 23% of the facilities provide the 60% 80% 81%

service. 40%

20% 29% 33% 20% 19% 0% Comprehensive Health Centre Health Centre Health Unit Mobile clinic

Available Not available

11. Gap on health staff

Figure 32: percentage of HFs without general medical doctors Figure 33:percentage of HFs without nurses

Specialized Hospital 43% Specialized Hospital 0%

Specialized Care Facility 58% Specialized Care Facility 25%

Mobile clinic 42% Mobile clinic 4%

Health Unit 36% Health Unit 3%

Health Centre Health Centre 40% 0%

General Hospital 0% General Hospital 18%

Comprehensive Health Centre 2% Comprehensive Health Centre 38%

0% 5% 10% 15% 20% 25% 30% 0% 10% 20% 30% 40% 50% 60% 70%

Figure 34: Percentage of HFs without internists Figure 35: Percentage of HFs without Paediatrician

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Specialized Hospital 65% Specialized Hospital 30%

Specialized Care Facility 79% Specialized Care Facility 79%

Mobile clinic 89% Mobile clinic 75%

Health Unit 85% Health Unit 76%

Health Centre 35% Health Centre 33%

General Hospital 29% General Hospital 38%

Comprehensive Health Centre 33% Comprehensive Health Centre 4%

0% 20% 40% 60% 80% 100% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

Figure 36:Percentage of HFs without Gynaecologist Figure 37:Percentage of HFs without Midwifes

Specialized Hospital 35% Specialized Hospital 28%

Specialized Care Facility 83% Specialized Care Facility 83%

Mobile clinic 91% Mobile clinic 58%

Health Unit 91% Health Unit 58%

Health Centre 62% Health Centre 20%

General Hospital 59% General Hospital 53%

Comprehensive Health Centre Comprehensive Health Centre 31% 9%

0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100%

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Figure 38:Percentage of hospitals without surgeons

60% Specialized Hospital 35%

12% General Hospital 9%

0% 10% 20% 30% 40% 50% 60% 70%

Orthopaedic surgeon General surgeon

Table 1: Distribution of health staff by districts/populations (Aleppo//)

Governorates/Distri Populatio #Hospit #PHCs General medical General Orthopedic Pediatrici Gynecolog Interni Midwi Nurs CHW Pharmacist/ ct n* als ** doctor surgeon surgeon an ist st fe e s dispenser Aleppo/Jebel 540,456 4 26 22 10 7 11 12 12 32 182 44 18 Saman Aleppo/Al Bab 19,352 1 0 0 0 1 0 1 0 1 0 0 Aleppo/Afrin 298,248 1 5 14 2 2 5 8 8 15 28 28 9 Aleppo/A'zaz 373,760 6 21 33 22 5 29 10 12 35 138 107 26 Aleppo/Ain Al 126,644 0 1 1 0 0 0 0 0 0 3 0 1 Arab* Aleppo/As-Safira 64,224 0 1 0 0 0 0 1 1 1 4 4 1 Aleppo/Jarablus 131,640 0 5 1 0 0 5 0 4 1 6 3 1 Hama/Hama 57,128 3 5 12 8 7 5 0 2 6 71 16 10 Hama/As- 44,880 0 16 7 0 0 8 1 4 8 70 14 11 Suqaylabiyah Hama/As- 18,104 0 3 3 0 0 2 1 2 5 11 6 3 Salamiyeh Hama/Muhradah 57,128 3 3 6 7 6 2 1 2 3 50 9 5 Idleb/Idleb 643,232 8 20 63 15 16 30 23 35 49 320 58 35 Idleb/Al Ma'ra 719,968 9 20 43 25 11 29 28 21 67 293 80 33

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Idleb/Harim 585,280 11 39 50 16 19 39 39 30 71 341 145 47 Idleb /Jisr-Ash- 224,728 4 15 18 14 9 15 8 13 34 163 64 21 Shugur Idleb/ 319,384 3 13 11 8 4 18 11 14 30 105 33 13

*population data source is Immunization unit, Ain Al Arab source NPM

*Total of the 4 levels of PHC

Gaps in primary health care provision in Aleppo and Idleb northern Syria Turkey hub

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Elbab Manbaj Tahna Elakhdar Shjif Kherbet Dabaa Zuraikat Baruz Arima Little Little Bab Elhadid - Sinnara Kharzan Qarzihel Abin - Refaat Issa Kafr Ghoz Qubbet Olasha Qatmet Dahabiyeh Bashar Big Sayyeda Upper Baselhaya Noman Osajli Khishfet Damer Qabusi Kherbet Kawkabeh Efrin Tal Elward Shdud Elsheikh Manbaj Fors Sandaliyeh Masrab Khatuniyeh Maskeh Teltana Hota Um Adaseh Nmuqbilet Northern Eljamal Burj Tellef Basuta Oqayba Zahrat Maled Tweis Sheikh Hadath Jeb - Kafr Bseileh Harbal Abla Hassan Agha Qana Abu Elhayat Eskar Makhzum Kherbet Halula Dandushan Athamiya - Lower-Marwana Safra Kmush Tal Hamo Kafr Kafir Kimar Tal Refaat Hissiyeh Elwan Olan Um Adae Abu Little Kherbet Daameh al Bir Kreidan Saflaniyeh Elsawda Eastern Krana Western Zeid Kafin Hazwan Ajami Big Mandil Maqtaa Jeb Qeshlet Bakkar Ramadiyeh Mayasa Manbaj Elrus Massoudieh Bir Eshkab Jandairis Maqri Sukariyeh Elhajar Elkajli Yusef Siyaha - Ghazawiyet Brad Nabul Mayer Maarset Taanah Eldam Em Al-Qura Bazagha Jeb Little Jeb Western Haj Eskandar Afrin Burj Elkhan Telqraq Nayrabiyeh Basha Naqut Hamam Tal Slur Qemmet Al Bab Mostarihet Ghorra Sheikh Saykul Jalma Baee Elqas Hardatnin Tal Btoshiyet Bir Elhamam Abu Kahf Ramala Qaderiyeh Eskan Sheikh Jafatlak Bir Nisriyeh Upper Byanun Retyan Jbine Maratet Tal Daghelbash Tadaf Elbab Tafreeah Big Sultan Obeid Kherbet Tiba Ein Kif Little Baroudiyeh Bathiyeh - Dalleh Diwan Kabashin Hayyan Elmosalamiyeh Rahhal Kherbet Nabata Amudiyeh Zamala Arab Tal Sheer Biret Arbaa Big Rummana Kardoshan Fafertein Tamura Tal Seifat Kiyar Shash Atma Selwa Bashmra Simaan Deir Qaq Elbab Oweishiyeh Um Khorzet Mazyunet Arbaa Kafrantin Msebin Little Tlilet Talhuthan Hamdan Zarzita Andan Toman Arran Elbab Tal Jeb Ramilet Daret Hilan Muqbia Big Manbaj Elhomor Kafr Sheikh Magharet Shanhasa Aswad Khamis Elhenno Wadi Elnur Azza Qabtan Kafr Al-Mallah Aleppo Mran Sarja Sarhan Manther Shajra Dan Abu Jabbar Big - Kur Wadin Eljabal Bssin Kafr Sheikh Suran Eisheh Eljarf Rasm Khofiyet Kasra Marufa - Tilaada Shamer Mazbura Um Elamad Babis Hamra Zayat Barlahin Tal Qatar Njara Manatir Elhamam Maarada Big Sakuleh Bab El Bijan Rasm Elhomor Hur Aleppo Naqqarin Aabad Sein Maksur Tal Elsifer Miri Qobab Hawa - Darhashan Termanin Kafr Aleppo Afrin Sharbaa Elbab Rasm Haram Elharmal Harim Torlaha Anjara Aleppo Jeb Hattabat Ashini Tlul Ras Dana Dael Aleppo Sifa Big El-Imam Um Rsum Kherbet Arhab Bsartun Tiyara Fah Ghabsheh Elbab Um Tinet Ein Elbikara Kafr Hum Tal Tuwama Hoteh Aleppo Kayariyeh Salameh Kafr Mu Elhisn Abu Arbid Big Jeser Kafr Sahara Aleppo Zaalana Manbaj Aridiyeh Mashrafet Kafrahlat Ariba Qalb Elkaramej Oweijel Khan Danneh Ahmadia Maksour Deryan Aleppo Western Hmeimeh Abu Qurb Khifseh Lozeh Burj Maaret AbzemoKafr Aleppo Kaskis Dayr Lala Rasm Allani Jallad Radwa Al-Asal Tal Balat Kweires Akula Hanaya Jakara Eskat Bshendlaya Elnumra Big Orm Kafr Rayan Mufliseh Eljis - Elhamed Boz Ghaz Taal Tal Hasel Rasm Hafir Mohammed - Rashadiya Atareb Naha Tal Dikwaneh Southern Um Adase Jeb Madi Kafr Batbu Little Shgheib Um Arkileh Elabed Big Eastern Babiri - Delbiya Kafr Saqlaya Tal Aran Salihyah Establ Tal Khalilieh Kafr Koknaya Jeineh Orm Western Khantuman Rasm Lower Babiri Abu Mars Aruq Kelly Terkan Hweijeineh Sabeen Aasimiyah Tal Ayub Jafr Mansur Rasm Elkhamis Dreisiyeh Hamziyeh Takharim Sheikh Kafr Jum Qarras Haddadin Elharmal Talha Abin Tal Abur Tal Naam Manbaj Kisumeh Qawas Kuku - Hazano Kafr Ali Esan Samaan Arada Hmeira As-Safira Jbul Khan Ein Eljaj Thoran Atireh Mazyunet Kafr Kafr - Kafr Zarbah Azzan Tal Tellemar Shekh Zeitan Ein Abu Jrin Eljaberi Elshaar Nabi Kafrehmul Ketyan Aleppo Hassan Ghazala - Bahr Qamari Abtin Assan Sadaaya Bashkwi Al-Safira Biret Ram Mashehad Jdarya Barqum Abu Dreikha Mgheidleh Berna Diman Safira Ras El Ein Armanaz Hamdan Kassibeh Sfira Al Safira Upper Community Population Hafasraja Taltuneh Bawabiyeh Jalaghim Bumane Zanbaqi Kharab Milis Batenta Al-Swagheih Ballas Rasm Ziraa Jalghum Nasriyeh Kafraya Tal Heddiyeh Mamimeh Kafr Kafr Kar Zanyan JneidHekleh Majmaa Darkosh Sultan Habat Teftnaz Iss Hadher Kafr Elsafa Habshiyeh Kabta Kafr Maar Foah Jeb Kas Eibesh Jaara Mbaqer Sheikh Kafruhin Toum Rasim Obeid Banan Tata Um Amud Mahsana Maskana - Jales Tamsarin Talhiyeh Sheikh Tleilat Hmeidi Mashrafet Maskana Mujamaa Nasra Sawadiya Yousef Sahrij Sarj Bluzeh Smad Khefseh Kherbet Onaiza < 5,000 Zarzur Bennsh Maryuda Tal Elhallaj Aqraba Hettin Foz - Tal Ahmed - Nabhan Makhala Dadine Mashrafet Fare Burj Jafret Elkhathdraf Samuqet Zuf Jdidet Northern Tal Mamu Tal Big Idleb Karatine Tal Abad Hawir Saeebiyeh Burda Qteirat Elhos Fajdan Madinet Manbaj Eljisr Mreimin Ora Elbuwaiditein Azawi Anbar Raddeh Athar Tabariz Elis Zyare Rasm Abu Jlus Elghar Qaderiyeh Qulaia Mazuleh Afs Hober Madrasa Aziziyeh Armala Ein Shib Semaan Assan Kafr Shur Manaaya - Qayqun Jeb Big Batranah Rasm 5,000 - 10,000 Aqrabat Berjhab Falyun Qminas Hoot Jarmakiyeh Ein Janudiyeh Alsafa Rasafa Othmaniya Hazani Elnafal Neimiyeh Thaheriya Nayrab Tal Eastern Jafr Mansur El-Bayda Shaturiyeh Bkafla Eastern Kniseh Korin Mastumeh Tromba Jazraya Big Hajeb Hawir Big Shallala Bab Saraqab Salamin Allush Atshana Simaan Ajuziyeh Muftahiyeh Marj Akhdar Hila Badriyeh Abul Tal Madayen Jeb Elhus Rasm Hanbushiyeh Ein Ellah San Tal Jeb Kniset Beftamun Khos Tal Aqareb Gharirifeh Rabeeah Tineh Hamad 10,000 - 15,000 Elsoda Ariha Fukhar Habs Elali Nakhleh Ainata Kafr Tufan Elhanuteh Zabad Badama Sanghara Tal Shweihet Bisheh Hawaz Bteibat Salhiyeh Sokkariyeh Motaram Omeim Tawil Ras El Tal Tweim Harbikeh Yunesiyeh Orm Kafrlata Mustariha Masih Ellahib Bales Maar Ein Sultan Wasita Andan Maktaba Tuffahiyeh Halluz Mhambal Kafr Anqrati Elsheikh Khanaser Qleiah Kafir Kafr Eljoz Dibsi Sheikh Elsheikh Tal Hawasid Ebneh Battikh Tal Sukariyeh Big Kinda Ghanya Mintar Maalali Khan Lof Idris Mansura - Hanuteh Jannet Shalaya Sarja Elaghar Baragethi Rasm Hajjara 15,000 - 30,000 Frikeh Elsobol Um Elhoteh Wadi Elqora Qrsaya Marayan Hatamiyeh Thahabiyeh Abul Elsayaleh Tal Awar Shinan Ruwaiha Jdideh Magharet Hamidiyet Um Graf Eldibis Tal Thohur Tal Eliyeh Joseph Merza Busra - Al-Shadad Um Elamad Ablin Banin Dibis Silmo Um Tinet Nuwara Ramleh Little Littler Tal Northern Deir Dana Babilla Khwein Qabli Rasm Bayaa Simaan Sabha > 30,000 Laj Bara Barsa Elshaer Zafar Heisa Nayyas Ghaytal - Ferwan Rabeeah Little Kulet Hmeimat Maarrat An Thahrat Ghaythal Hraki Brennan Karatin Elbweider Numan Talamnas Qatra Qoqfin Kafr Idleb Oleis Kafr Kafruma Telamnas Abu Harmala Oweid Ejaz Mardagana PHC coverage 5Km Al-Halubi Nobol Has Hamdieh Maar Abu Sqiah Thijeh Um Tmakh Shamarin Makki Burtuqala Rasm Basqala Western Samaan Milaja Karsanti Sanjar Elmofakker - Maar Maar Deir Qaratli Saree Western Tal Dam Dwadiyeh Hilu Mofakker Tesin Jbala Hattat Northern Karsaa Kafr Sarja Um Qrun - Inaccessabile to Turkey Hub Maar Sheikh Um Tini Mahatet Thleijeh Rasha Basin Raffa Um Jaran Um Nir Tahroma Dames Tah Abu Northern Um Rejim Abul HawaNibaz Habbeh Eleij Qasr Little Aleppo Lweibdeh Rakaya Tellemara Um Jalal Elabyad Khayrieyh Sijneh Niha Mashraf Big Rajmel Madaya Maksar Khwein Abu Omar Mashraf Eastern Um Zaytuna Tamanaah Khan Tal Abu Dali Lweibdeh Kafr Ein Shaykun Maraq Tal Rweideh Skik Hamadaniyeh Qabliyeh Khanzir Tama

The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever Data Source:HeRAMS on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, Population:NPM Dec 2016 or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines World Health Organization, for which there may not yet be full agreement. Info:[email protected] 0 5 10 20 Kilometers © WHO 2016. All rights reserved.