UNITED NATIONS POPULATION FUND
Country programme for the Syrian Arab Republic
I. Situation analysis
1. The Syrian Arab Republic, a mediumincome country, ranked 106 out of 177 countries on the 2005 human development index. By implementing political, social and economic reforms, the Syrian Arab Republic is changing from a centralized economy to a social market economy. The tenth national development plan (2006-2010) emphasizes effective stakeholder participation and decentralization to achieve sustainable development. The plan focuses on creating balanced and equitable development, and addresses regional disparities in socioeconomic indicators.
2. The national development plan seeks to ensure a close correlation between population dynamics and socio-economic development, in order to reduce poverty and improve the quality of life. Population variables, reproductive health and gender have been integrated into the national plan. The Government requires continued support to strengthen this integration at all levels.
3. The population of the Syrian Arab Republic was 17.8 million in 2004. The population growth rate was 2.45 per cent during 2000-2005, down from 3.3 per cent between 1981 and 1994. Improvements in health care contributed to declining fertility rates, a sharp fall in mortality rates, and increased life expectancy at birth (70 years for males and 72.1 years for females in 2004). Other factors contributing to the fertility decline include: (a) increased access to education for both women and men; (b) an increase in the age of first marriage (29.4 years for males and 25.6 years for females); and (c) a preference for smaller families among younger couples.
4. The total fertility rate declined from 5.1 children per woman during 1991-1995 to 3.58
children per woman in 2004. In some regions, however, the total fertility rate is as high as 6.21. The coverage of family planning services remains modest, with the contraceptive prevalence rate increasing from 39.6 per cent in 1993 to 47.4 per cent in 2004. Modern contraceptive use is only 35.1 per cent, and the unmet need for contraception is estimated at 30.6 per cent.
5. The maternal mortality ratio dropped from 143 deaths per 100,000 live births in 1990 to 57.4 deaths per 100,000 live births in 2004. Disparities exist, however, ranging from 34.3 deaths per 100,000 live births in Damascus to 81 deaths per 100,000 live births in Al-Raqqa governorate, in the northern part of the country. Home births accounted for 44.6 per cent of total births during 1996-2001, with 21.3 per cent of these births assisted by traditional birth attendants. In rural areas, 50.8 per cent of all births occur at home, with traditional birth attendants assisting 30.9 per cent of these births. These statistics highlight the challenge of making high-quality reproductive health services and family planning more readily accessible and affordable, and of changing traditional social norms, behaviour and attitudes that hinder the use of such services.
6. Early marriage and early childbearing, particularly among poorer and less-educated
families, remains high. In 2001, 47 per cent of all pregnancies were among women younger
than 24 years of age.
7. Young people aged 10-24 represented 34.2 per cent of the total population in 2004. Data
indicate that many young people are marginalized, unemployed and at high risk for early marriage, early pregnancy, unsafe behaviour, sexually transmitted infections (STIs) and HIV/AIDS. Thirty-four per cent of registered HIV/AIDS cases in the Syrian Arab Republic were among people aged 15-24 years. Recent data indicate a need for increased awareness of these issues among young people.
8. In 2005, there were 369 reported cases of HIV/AIDS. The modes of transmission are as
follows: (a) sexual (77 per cent); (b) contaminated blood transfusions (12.4 per cent); (c) intravenous drug injections (6.5 per cent); and (d) mother-to-child transmission (4 per cent). Although prevalence rates are low, there is a growing concern that risk factors could make the country susceptible to an increase. The challenge is to maintain the low prevalence rate while focusing on prevention efforts among young people and people at risk.
9. The legislative base for gender equality is strong. However, the implementation and
enforcement of gender equality laws require more active participation from the public, the
Government and non-governmental organizations (NGOs), especially to reduce gender-based violence and increase women’s representation in power and decision-making bodies. Despite achieving national gender parity in education, regional disparities persist, and drop-out rates among girls remain a concern.
II. Past cooperation and lessons learned
10. In the sixth country programme (2002-2006), the Government recognized UNFPA for
its leadership in the areas of reproductive health, population and development, and
gender. UNFPA played a key role in integrating population and gender issues into the national development plan and in ensuring contraceptive commodity security. In 2005, the Ministry of Health allocated $1.6 million from the central health budget to procure contraceptives, covering the needs for 2005, 2006 and 2007.
11. Key lessons emerged from the previous programme. The programme should strengthen technical, institutional and managerial capacities at all levels, and foster community ownership and social mobilization for new and improved services. Future support should reach poor and vulnerable populations with highquality services and improve their reproductive health status. The programme should promote coordination and partnerships among stakeholders, the private sector and NGOs. There also a need to generate and utilize accurate, up-to-date, disaggregated data at national and subnational levels.
III. Proposed programme
12. The programme reflects the analysis of the common country assessment and the priorities
of the United Nations Development Assistance Framework (UNDAF), the 2004-2007 UNFPA multi-year funding framework, and the UNFPA strategic direction. The programme cycle has been harmonized with the programme cycles of other United Nations agencies in the Syrian Arab Republic.
13. The programme contributes to government efforts to reduce poverty by improving living
conditions and by balancing demographic and economic growth. It will have three interrelated
components: reproductive health; population and development; and gender. The focus of interventions, especially at the serviceprovision level, will be in selected geographical areas with high needs. The programme will support advocacy, policy dialogue and capacitybuilding
at the national level.
14. The programme contributes to three UNDAF outcomes: (a) interregional and intraregional disparities related to access and quality of health, education and other basic social services are reduced, focusing on the eastern, northern and Badia regions and other disadvantaged areas; (b) efficiency and accountability of governance structures at central and local levels are strengthened by government, civil society and the private sector, to achieve sustainable development; and (c) risk and impact of natural and man-made disasters are reduced.
Reproductive health component
15. This component contributes to two UNDAF outcomes: (a) reducing disparities in access and quality of basic social services; and (b) disaster management.
16. The outcome of the reproductive health component is: increased access to and utilization of comprehensive, high-quality reproductive health services and information, including family planning, with a special focus on the eastern, northern and Badia regions and other disadvantaged areas. Two outputs contribute to this outcome.
17. Output 1: Increased availability of highquality, comprehensive, integrated reproductive
health services and information, including family planning and emergency obstetric care, in selected underserved areas. This output will be achieved by providing a comprehensive package of reproductive health services in selected areas, specifically in family planning and safe motherhood. Reproductive health services will be integrated into services to prevent and treat reproductive tract infections, including HIV/AIDS, and into screening for breast and cervical cancer. The programme will provide support that will enhance institutional, managerial and technical capacities; develop and review reproductive health guidelines and
protocols; and upgrade the national logistics management information system. The programme will also support policy dialogue and advocacy activities. In order to create demand, the programme will strengthen the national capacity to enhance awareness of reproductive health services and to mobilize communities to support reproductive and sexual
health.
18. Contributing to the UNDAF outcome on disaster management, the country programme
will enhance knowledge, skills and attitudes related to reproductive health in emergencies, including integrating reproductive health issues into the national disaster management action
plan. It will also support advocacy and awareness-raising regarding the right to reproductive health services in crisis situations.
19. Output 2: Increased availability of reproductive and sexual health information and counselling services for young people, with a special focus on preventing HIV/AIDS and
STIs among young people and populations at risk. This will be achieved by: (a) strengthening
the national capacity to deliver high-quality, youth-friendly education, information and counselling, including a minimum package of services; (b) strengthening voluntary counselling and testing services; and (c) scaling up service-provider skill training, building peereducator networks and creating demand through a holistic communication strategy. Key
strategies include mobilizing community leaders and reinforcing alliances with NGOs, peer leaders and faith-based organizations.
Population and development component
20. The population and development component contributes to the UNDAF outcome on strengthening the efficiency and accountability of governance structures at central and local levels.
21. The outcome of this component is: national, sectoral and local policies take into account population dynamics, reproductive health and gender issues, in the context of poverty reduction, development and the Millennium Development Goals. Two outputs will contribute to this outcome.
22. Output 1: Enhanced national capacity to integrate population, reproductive health and
gender issues into national, sectoral and local plans and programmes. The programme will
help to build the technical capacities of key institutions to integrate population, reproductive health and gender issues into development planning. Advocacy and policy dialogues will seek to better mainstream population, reproductive health and gender issues into all plans and programmes.
23. Output 2: Strengthened national capacity to generate, analyse, disseminate and utilize
disaggregated data, including support to research for policy decision-making. This will be achieved by enhancing national skills and capacities to collect and use social development
and demographic data. The programme will support in-depth, policy-oriented analysis to broaden evidence-based dialogue and advocacy.
Gender component
24. The gender component also contributes to the UNDAF outcome on strengthening the
efficiency and accountability of governance structures at central and local levels.
25. The outcome of this component is: strengthened policies and institutional mechanisms to improve the legal status of women and the implementation of related policies, eliminating gender-based violence, promoting women’s and girls’ rights, and promoting gender equity in decision-making and policy frameworks. One output contributes to this outcome.
26. Output 1: Strengthened institutional capacity of the Government and NGOs to integrate the prevention of gender-based violence into national plans and strategies. This will be achieved by: (a) building knowledge on the extent, severity, effects and forms of gender-based violence and the ways to address it; (b) building the capacity to integrate genderbased
violence into national gender strategies and plans; and (c) raising public awareness to create an enabling environment to prevent gender-based violence. This involves building capacity and reinforcing alliances with key government bodies, women’s groups, faithbased organizations, NGOs, the police, the judiciary, policymakers and local communities.
IV. Programme management, monitoring and evaluation
27. The country programme will use a national execution and implementation modality. UNFPA and the Government will cooperate closely with other United Nations agencies, NGOs and development partners. Annual programme reviews and a final evaluation will take place according to the UNDAF plan. The Government will provide in-kind contributions and funding, equal to 50 per cent of the level of UNFPA support.
28. The UNFPA country office in the Syrian Arab Republic consists of a representative, an assistant representative, a national programme officer, and administrative and support staff. Programme funds will be earmarked for three national programme posts and two administrative support posts, within the framework of the approved country office typology. National project personnel may also be recruited to strengthen implementation. The UNFPA Country Technical Services Team in Amman, Jordan, along with international and national consultants, will provide technical support.
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