Type: Article

Date: April 11, 2023

Summary

Armed conflict in Syria has severely damaged the healthcare system, impacting medical education and health professional training (MEHPT) in both government-controlled and non-government-controlled areas. In northwest Syria, a new MEHPT system has emerged, described as a "hybrid kinetic model," to address the urgent need for health workforce development in a fragile setting. This mixed-methods study analyses this system to inform future policy.

Key findings highlight three main challenges, akin to "gaps" in service or understanding:

• The governance gap: The MEHPT system relies heavily on external NGOs and donors, leading to weak internal decision-making capacity and a lack of autonomy among local governance bodies. This results in bureaucratic complexities and a hesitance to initiate change.

• The institutional and individual capacity gap: There is a significant lack of capacity building and specialised qualifications for teaching staff and senior management. Institutions struggle to create needs-focused curricula due to a lack of local standards. Individuals face job insecurity from unstable funding and insufficient continuous professional training.

• The coordination gap: Polarisation and politicisation of MEHPT hinder effective coordination and communication among stakeholders. This leads to negative competition for funding, duplication of efforts, and a lack of standardisation in curricula, assessments, and quality control.

Despite these challenges, opportunities exist, including the resilience of the MEHPT system, a proactive culture for positive change, the dedication of the local population, and the support from the Syrian diaspora and technology for remote training. By addressing the governance, capacity, and coordination gaps, there is an opportunity to strengthen the MEHPT system and contribute to peacebuilding in the region. The study suggests formalising efforts through technical coordination units and shifting power from external funders to internal governance structures to build trust and achieve sustainable partnerships.