An analysis of humanitarian and health aid alignment over a decade (2011-2019) of the Syrian conflict.

2005 Paris Declaration Aid alignment Aid effectiveness Conflict Health aid Humanitarian aid Humanitarian crisis Syria

Journal

Conflict and health
ISSN: 1752-1505
Titre abrégé: Confl Health
Pays: England
ID NLM: 101286573

Informations de publication

Date de publication:
09 Nov 2022
Historique:
received: 27 07 2022
accepted: 01 11 2022
entrez: 10 11 2022
pubmed: 11 11 2022
medline: 11 11 2022
Statut: epublish

Résumé

The 11 years of the devastating conflict in Syria resulted in more than 874,000 deaths, and in more than thirteen million refugees and internally displaced people (UNHCR, Syrian refugee crisis: aid, statistics and news, USA for UNHCR, Washington, 2020; Alhiraki et al. in BMJ Glob Health 7:e008624, 2022). The health system was severely affected and has become aid dependent. This study examines aid alignment over a decade of the Syrian crisis from 2011 to 2019. Aid alignment involves donors using national systems and institutional structures to manage their aid to recipient governments and aligning their aid policies with development priorities and strategies defined by the partner countries (ROSA Newsletter, Moving towards increased aid alignment in the food and nutrition security sector, 2013. Available from: http://oxfamilibrary.openrepository.com/oxfam/bitstream/10546/141974/1/ ). Aid alignment was explored as part of the 2005 Paris Declaration Framework on aid effectiveness. Based on OECD's survey on monitoring the Paris Declaration (OECD, Harmonisation, alignment, results: report on progress, challenges and opportunities, OECD, Paris, 2005; OECD, Survey on harmonisation and alignment of donor practices, OECD, 2006. Available from: https://www.oecd-ilibrary.org/development/survey-on-harmonisation-and-alignment-of-donor-practices_journal_dev-v6-sup1-en ) and based on a proposed methodology to assess aid effectiveness by Burall and Roodman (Developing a methodology for assessing aid effectiveness: an options paper, Overseas Development Institute, 2007. Available from: www.odi.org.ukhttp://www.cgdev.org ), we designed a sequential mixed methodology to address two main indicators: alignment with national strategies and local procedures, and aid delivery through local systems. The quantitative part investigated the financial alignment of aid using financial data trackers, such as creditor reporting system and the UN-OCHA financial tracking system, and the relevant humanitarian needs estimations by the humanitarian assistance response plans, humanitarian response plans, and humanitarian needs overviews. The qualitative part relied on four focus groups discussions and four key informants interviews with key policy makers, experts and practitioners involved in the humanitarian and health response in Syria, with the aim of interpreting the quantitative findings. While the study found an improvement in aid budget alignment with local procedures in Syria from 34% in 2012 to 86% in 2019, we found limited alignment with local strategies. Our qualitative findings pose doubts in the ability of the various data sources of humanitarian needs in Syria to reflect the actual realities, especially before 2014, due to lack of comprehensive local engagement and data systems by then. Therefore, even if the humanitarian budgets seemed to be aligned with the national procedures, the national plans did not seem to align with the actual realities, let alone the increase in the financing deficit over the years of the conflict. The reliance of humanitarian and health aid on governmental structures, as a main recipient, in Syria was much lower than other developing and fragile countries. This is mainly due to the nature of the Syrian conflict where the government is a party to the conflict. Donors were found to have invested poorly in advancing national and sub-national planning in Syria due to donors' over reliance on the UN-led humanitarian system which struggles in armed conflict settings. As a result, we found a disconnection between field realities, national planning, and humanitarian aid. In light of the dreadful humanitarian crisis in Syria, there has been an adverse aid alignment. Considering the chronicity of the conflict, there is an urgent need to improve aid alignment through more investment in local planning at district or governorate levels. This is especially important to navigate through conflict sensitivities while responding to local needs and initiating local developments. These approaches, combined with adopting health sector-wide approach, could contribute to the humanitarian-development-peace nexus in Syria, which in turn can contribute to a better aid alignment and aid effectiveness.

Sections du résumé

BACKGROUND BACKGROUND
The 11 years of the devastating conflict in Syria resulted in more than 874,000 deaths, and in more than thirteen million refugees and internally displaced people (UNHCR, Syrian refugee crisis: aid, statistics and news, USA for UNHCR, Washington, 2020; Alhiraki et al. in BMJ Glob Health 7:e008624, 2022). The health system was severely affected and has become aid dependent. This study examines aid alignment over a decade of the Syrian crisis from 2011 to 2019.
METHODS METHODS
Aid alignment involves donors using national systems and institutional structures to manage their aid to recipient governments and aligning their aid policies with development priorities and strategies defined by the partner countries (ROSA Newsletter, Moving towards increased aid alignment in the food and nutrition security sector, 2013. Available from: http://oxfamilibrary.openrepository.com/oxfam/bitstream/10546/141974/1/ ). Aid alignment was explored as part of the 2005 Paris Declaration Framework on aid effectiveness. Based on OECD's survey on monitoring the Paris Declaration (OECD, Harmonisation, alignment, results: report on progress, challenges and opportunities, OECD, Paris, 2005; OECD, Survey on harmonisation and alignment of donor practices, OECD, 2006. Available from: https://www.oecd-ilibrary.org/development/survey-on-harmonisation-and-alignment-of-donor-practices_journal_dev-v6-sup1-en ) and based on a proposed methodology to assess aid effectiveness by Burall and Roodman (Developing a methodology for assessing aid effectiveness: an options paper, Overseas Development Institute, 2007. Available from: www.odi.org.ukhttp://www.cgdev.org ), we designed a sequential mixed methodology to address two main indicators: alignment with national strategies and local procedures, and aid delivery through local systems. The quantitative part investigated the financial alignment of aid using financial data trackers, such as creditor reporting system and the UN-OCHA financial tracking system, and the relevant humanitarian needs estimations by the humanitarian assistance response plans, humanitarian response plans, and humanitarian needs overviews. The qualitative part relied on four focus groups discussions and four key informants interviews with key policy makers, experts and practitioners involved in the humanitarian and health response in Syria, with the aim of interpreting the quantitative findings.
RESULTS RESULTS
While the study found an improvement in aid budget alignment with local procedures in Syria from 34% in 2012 to 86% in 2019, we found limited alignment with local strategies. Our qualitative findings pose doubts in the ability of the various data sources of humanitarian needs in Syria to reflect the actual realities, especially before 2014, due to lack of comprehensive local engagement and data systems by then. Therefore, even if the humanitarian budgets seemed to be aligned with the national procedures, the national plans did not seem to align with the actual realities, let alone the increase in the financing deficit over the years of the conflict. The reliance of humanitarian and health aid on governmental structures, as a main recipient, in Syria was much lower than other developing and fragile countries. This is mainly due to the nature of the Syrian conflict where the government is a party to the conflict. Donors were found to have invested poorly in advancing national and sub-national planning in Syria due to donors' over reliance on the UN-led humanitarian system which struggles in armed conflict settings. As a result, we found a disconnection between field realities, national planning, and humanitarian aid.
CONCLUSION CONCLUSIONS
In light of the dreadful humanitarian crisis in Syria, there has been an adverse aid alignment. Considering the chronicity of the conflict, there is an urgent need to improve aid alignment through more investment in local planning at district or governorate levels. This is especially important to navigate through conflict sensitivities while responding to local needs and initiating local developments. These approaches, combined with adopting health sector-wide approach, could contribute to the humanitarian-development-peace nexus in Syria, which in turn can contribute to a better aid alignment and aid effectiveness.

Identifiants

pubmed: 36352438
doi: 10.1186/s13031-022-00495-5
pii: 10.1186/s13031-022-00495-5
pmc: PMC9644630
doi:

Types de publication

Journal Article

Langues

eng

Pagination

57

Subventions

Organisme : National Institute for Health and Care Research
ID : 131207
Organisme : National Institute for Health and Care Research
ID : 131207
Organisme : National Institute for Health and Care Research
ID : 131207
Organisme : National Institute for Health and Care Research
ID : 131207
Organisme : National Institute for Health and Care Research
ID : 131207

Informations de copyright

© 2022. The Author(s).

Références

Health Policy. 2011 May;100(2-3):116-24
pubmed: 20828855
BMJ Glob Health. 2022 May;7(5):
pubmed: 35589154
Lancet Glob Health. 2020 Mar;8(3):e374-e386
pubmed: 32035034
PLoS Med. 2009 Jun 9;6(6):e1000090
pubmed: 19513098
Bull World Health Organ. 2004 Dec;82(12):893
pubmed: 15654401

Auteurs

Munzer Alkhalil (M)

Research for Health System Strengthening in Northern Syria (R4HSSS), Union for Medical and Relief Organizations, Gaziantep, Turkey. d.monzerk@gmail.com.
Syria Public Health Network, London, UK. d.monzerk@gmail.com.
, Nottingham, UK. d.monzerk@gmail.com.

Maher Alaref (M)

Research for Health System Strengthening in Northern Syria (R4HSSS), Union for Medical and Relief Organizations, Gaziantep, Turkey.
MIAD, Paris, France.
Strategic Research Center SRC, Gaziantep, Turkey.

Hala Mkhallalati (H)

Research for Health System Strengthening in Northern Syria (R4HSSS), Union for Medical and Relief Organizations, Gaziantep, Turkey.
Syria Research Group (SyRG), Co-hosted By the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, UK.

Zedoun Alzoubi (Z)

Research for Health System Strengthening in Northern Syria (R4HSSS), Union for Medical and Relief Organizations, Gaziantep, Turkey.
MIAD, Paris, France.

Abdulkarim Ekzayez (A)

Syria Public Health Network, London, UK.
Research for Health System Strengthening in Northern Syria (R4HSSS), The Centre for Conflict and Health Research (CCHR), King's College London, London, UK.

Classifications MeSH