We aim to enhance institutional governance of health human resources and improve coordination among health sector stakeholders in the region. This is through a series of roundtable discussions with health syndicates in northwest Syria for the UFUQ Project. These syndicates, primarily established post-2011, operate in a volatile transitional environment. Key challenges identified include a lack of unified legal frameworks, weak electoral legitimacy, disorganised databases, precarious financial models, and limited administrative expertise. Relationships with health authorities are informal. Despite these, syndicates exhibit a strong will for reform, structural flexibility, and potential for collaboration with Syrian diaspora experts. Lessons learned highlight the need for accurate member data and real elections for legitimacy, the insufficiency of mere political recognition, and the foundational role of internal governance. The transitional period is a critical opportunity for legal reform.

Recommendations focus on: drafting a modern, unified syndicate law; reforming internal governance (e.g., separation of powers, financial oversight); improving membership databases and financial sustainability; enhancing administrative capacity; formalising relations with ministries and diaspora associations; boosting community awareness; and actively mainstreaming gender inclusion through quotas and training. These reforms are crucial for syndicates to become independent professional institutions that regulate health human resources and contribute to national health policies.

To discuss the topic, we were joined by representatives from:

• Aleppo Syria Pharmacists

• Idlib Pharmacists Syndicate

• Aleppo Pharmacists Syndicate

• Midwifery Syndicate

• Healthcare Workers Syndicate

• Central Syndicate in Damascus

• Idlib Dentists Syndicate

• Health Professions Syndicate

• Central Nursing Syndicate

• Aleppo Dentists Syndicate

• Aleppo Doctors Syndicate

• Idlib Doctors Syndicate

• Damascus Doctors Syndicate