[Herams] Health Resources Availability Mapping System

[HeRAMS] Health Resources Availability Mapping System Report: 2016 Turkey Hub Health cluster for Syria P a g e | 2 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 Turkey hub health cluster members national and international non-governmental organizations as well as health authorities. Map showing areas of operation P a g e | 3 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 Aleppo evacuation. ** Specialized health centers (Physical Rehabilitation centers, Leishmaniosis centers .Etc.) ***Ambulance network, Blood Bank, Central Lab P a g e | 4 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) P a g e | 5 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 P a g e | 6 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 P a g e | 7 Figure 10:*Basic Laboratory Services 100% 6% 3% 90% 29% In hospitals basic laboratory Services 80% availability is more than 90%, while 70% 67% 60% 72% of comprehensive health Centers 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% 50% 94% 97% 88% 40% 30% 20% 33% 10% 20% 0% 6% Comprehensive Health General Hospital Health Centre Health Unit Specialized Hospital Centre Available Not available P a g e | 8 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 P a g e | 9 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 30% 68% 54% 55% when needed) 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 P a g e | 10 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 P a g e | 11 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

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