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Health Care Grant Term Paper

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Introduction
Countries in war-torn areas face a lot of challenges that arise from the lack of peace. Peace allows governments to provide health care services to its citizens and ensure that they have enough health care providers. Health care is expensive in many countries, and its availability is limited to those that can afford it explaining its unavailability and beyond reach in Syria. Humanitarian agencies need to step in and address the health crisis facing the country because it is losing many men, women, and children to diseases and injuries. The violence in Syria complicates the process of distributing health care and resources because the war has destroyed infrastructure and displaced the citizens requiring health services.

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The Background of Poverty and Healthcare
The Syrian citizens find themselves in a position whereby they cannot influence the social, economic and political status that determine the access to health care services. Majority of the citizens fall under the low-income bracket that subjects them to mental illnesses, food insecurity, the absence of primary care services, depression, homelessness, and displacement. The lack of a stable government denies citizens access to health care services because war destroyed the infrastructure and the health professionals are displaced. The current situation in the country qualifies as a humanitarian crisis that denies people access to quality health care services. Increasing the financial resources of health providing institutions expands their capacity to buy drugs and vaccines, facilitate movement, pay additional health care providers and provide food when attending to the patients. Therefore, war disorients governments and leaves the responsibility of managing health care in the hands of charitable organizations that participate in planning, managing and delivering interventions to those afflicted by war.

Relationship between Poverty and Healthcare
Health care delivery depends on number and qualifications of health care professionals that deliver, maintain and improve the health of a community, country, and the globe. Additionally, the system achieves this through diagnosis, prevention, and treatment of existing physical and mental diseases. However, the access to the services varies from one community, country and individual to another. Moreover, socioeconomic and political factors influence the access to health care because the services must be readily available, affordable and meeting the required quality threshold to achieve its objective. The health care system in many countries relies on the government for financing, and the enacted policies affect the efficiency, equity, responsiveness, and effectiveness. However, the collapse of a government spells doom for a well-organized and funded healthcare system because infrastructure, human resource, drugs, and equipment become unavailable. The lack of a stable government leads to lawlessness which promotes theft of essential supplies such as drugs, food, water, and clothing that people require to lead healthy lives. Accessibility is a big challenge to many people in developing and developing economies because scarcity and high costs make the service unattainable to many.

Primary health care is vital to any community and the lack of financial capacity to access the services results from social, political and economic factors that affect healthcare. Poverty is multifaceted and is characterized by the lack of money or material possessions. The levels of poverty vary and determine the quality of health care services that a person can access. The destitute category lacks the means to even access basic personal needs such as clothing, food, and shelter. Therefore, the war in Syria has rendered all citizens helpless, and a majority fall under the destitute category.

The Need Statement
The Syrian health crisis led to the collapse of healthcare infrastructure, systems, and resources. However, the importance of health care services could not be overlooked, and it led to the establishment of the Syrian International Coalition for Health that is a consortium healthcare service providers and professionals. The organizations coordinate activities that improve health care services and delivery because of the five founding principles that guide their commitment. The principles are equity, broad participation, quality, shared responsibility and sustainability. The Organization enjoys the support of the Global Health Equity Foundation which a major contributor to the global community and human development. The concerted efforts by the different organizations aim at sustaining what the Syrian government had accomplished in addressing health concerns before the challenges reemerged after the the war crises began. Children and women suffer most during wars and succumb to the harsh social, economic and political environment. According to Kherallah, Alahfez, Sahloul, Eddin, & Jamil, Syria was undergoing an epidemiological transition from the prevalence of communicable diseases to non-communicable diseases (2012).

Additionally, studies show that in 2009, the government spent an amount equivalent to 2.9% of the country’ Gross Domestic Product on health care. The expenditure explains why the current health care crisis requires additional funding to sustain the success realized in managing infectious diseases which are currently on the rise. The organization recognizes that coordinated healthcare provision controls inequalities in the access to healthcare that derail the realization of quality health care services. Additionally, increased funding assures Syrians the even distribution of health care professionals, drugs and resources because the transportation of drugs is expensive and prone to attacks by members of the radicalized groups. Inadequate coordination affects transparency because drugs and other medical supplies disappear before reaching the targeted group of patients who live in abject poverty. The war creates an untenable environment that leaves the citizens at the mercy of the health providing organizations and the lack of capacity to generate revenue limits their capabilities to get physical diseases and mental illnesses treatment resulting from the war.

Consequently, the financiers need to identify with the rationale that health care is compromised and needs to be addressed to avoid raising the number of war casualties. Therefore, increasing the funds that the organization uses to run its operations, transport deliveries and buy medical supplies guarantees increased budgetary allocation on health care. The initiatives ensure that equity, broad participation, quality, shared responsibility and sustainability are achieved.

Objectives
Sustaining the operations at St Louis Hospital and the Italian Hospital in Damascus, and the St Louis Hospital in Aleppo requires sufficient funds to provide specialized medical treatment to Syrians continuously. The hospitals are the primary contact point that offers medical services to Syrians, and the organization must work collaboratively with them. The hospitals need extra funding and medical health providers to operate at full capacity considering that the all Syrian need health care services The rise in communicable, non-communicable diseases and injuries require intensive medical care to meet the medical demands of the desolate natives. Free health care services are compulsory because the war-torn countries has a massive population of poverty-stricken people requiring medical attention services from the charitable organization. Their limitation should not determine their fate because the lack of timely medical services is a leading cause of death in the country.

Additionally, the charitable organization must create and operationalize a Social Services office that guarantees all Syrians health care and treatment services while updating their information. Health records are vital because they help healthcare professionals understand the medication requirements and the existence of any epidemics that require their attention. Additionally, more staff will be needed to perform the different tasks and dispense services that will enhance the operations of the three main hospitals.

The risk of an epidemic breakout is high in Syria because the collapse in many social services has led to difficulties in accessing energy, clean water and food, and sanitation services. Waterborne disease emerges as the greatest epidemic risk that Syria faces and the organization cannot provide primary health care services. Additionally, the health care system faces economic difficulties because they lack contributions from the private and public financiers. The lack of financial resources limits the hospitals’ capabilities to respond adequately to the medical needs of the entire Syrian population. The rise in the number of the poor and the poorest has created a crisis because they cannot pay the minimum costs required to access proper medical services. Furthermore, the mother and child care service is significantly affected, and expectant mother and those with younger children lack professional guidance. Therefore, epidemics are a serious health concern that the charitable organization foresees but it lacks the resource and capacity to manage.

Methodology
The implementation of dependable health care programs requires the attention and support of the security agencies and the natives. The absence of a stable government and the dominance of rebel groups led to the imposition of sections and embargoes on Syria. The restrictions do not affect humanitarian aids, but they limit the entry of medical supplies and spares required to fix medical equipment. The sanctions and embargo hurdle must be overcome to enable charitable organizations and medical centers to obtain drugs cheaply and timely. The lack of medicine is an enormous challenge because the war led to the destruction of many pharmaceutical companies and storage centers.

Additionally, the destruction of infrastructure makes transportation costly because the organization relies on foreign security helicopters to ferry the supplies and medical support teams. Identifying alternative transportation means is essential. The organization intends to use drones to transport drug and medical supplies to different mobile clinics spread across the country. Some areas are inaccessible due to intense military activity, and this poses significant threats to the lives of the medical health providers who equally value their lives. The lack of sufficient medical supplies and a reliable local source means that the charitable organization must depend on foreign military officers’ support as they support the embattled government. However, the organization intends to space its shipments of medical supplies from different countries to create a consistent availability and guarantee continuous drug supplies. Therefore, the organization will establish a number of mobile medical centers across Syria and utilize a number of drones that an Israel security firm offered to overcome the transportation challenge.

Majority of the citizens in Syria suffer from trauma that causes mental health concerns or posttraumatic stress disorder. The rehabilitation process requires the available hospital and mobile service providers to identify people that the victims can trust. Establishing people and services that encourage the displaced victims to cultivate the health-seeking behavior emerges as a challenge that the organization must overcome. The strategy that the organization aims at using is key opinion leaders among the internally displaced persons and refugees to influence the decisions of the different groups. Men leave in denial and suffer most when compared to women because society sees them as strong and that they should not suffer from mental illnesses. Some of the health providers from Syria believe that only women and children can experience post-traumatic stress disorder and other mental illness. The assumption causes men to suffer in silence without seeking medical attention, and this emerges as a significant challenge that the organization aims at overcoming by involving the leaders of each camp and group. Mobilization and coordinating the activities of the program require funds because the victims expect the organizations to provide primary health care services and basic needs. The other challenge that the mental illness program faces is the movement of the families from one place to another to flee violence and conflict. Fleeing affects the continuity of treatment which enables the sick to overcome depression and stress. The sight of dead people and others succumbing to injuries terrifies human beings, and the Syrian citizens witness this on a daily basis leading to significant mental health issues. Children are among the group of persons that are affected and managing them is mandatory because they hold the future of the nation. Therefore, people suffering from post-traumatic stress disorder and other mental illnesses should receive medical treatment. Managing children and enrolling them to the program requires the consent of their parents and guardians who find themselves struggling to live up to their expectations. Additionally, funding the record keeping program is essential because it helps in recording the progress that patients make and the social history they provide helps them in assessing the required health services. Therefore, the crisis in Syria requires the organization to conduct extensive mobilization programs and understand the probable movement pattern that the group under review may prefer.

Personnel
The shortage of healthcare personnel in Syria is a challenge that charitable organizations and operational hospitals have to overcome because many died in the war. It is estimated that only 45% of healthcare professionals are available to support health initiatives. The massive displacement of Syrian compelled people to flee the country and health care professionals were among the groups. Additionally, it is estimated that the number of expectant mother stands at three hundred thousand and they lack professional guidance, prenatal treatment. Training medical professionals takes approximately three to six years, and it is equally expensive and unrealizable in a country that needs immediate health solutions. The organization aims at hiring members that can support and help the medical health professionals perform their duties. The appointed members will receive training while assisting healthcare professionals in managing patients.

Interpreters fall under the category of support team members that the organization intends to hire because the communication barrier causes animosity, wrong diagnosis, and treatment. The belief in the country that neighboring and developed countries have failed them because of the persistence of the complicates the process of patient disclosure. Additionally, disclosing the physical and mental illnesses to foreign health professionals becomes a challenge, and it justifies the need to hire health care enablers that guarantee the delivery of services to the Syrians. The financial aid that the organization is requesting will help in recruiting new healthcare providers and support members leading to social and economic empowerment within Syria. Therefore, socioeconomic and political factors influence the access to health care because the services must be readily available, affordable and provide required quality services.

Evaluation
The Organization has successfully engaged local hospitals and partnered with them to avail quality medical services. The records that the organization keeps help it understand the number of poverty-stricken patients that it handles, and the information is compared among the health care providers. Records showing medical follow up visits are filed to establish the effectiveness of the therapeutic intervention programs. The documents help the executive manager to address the shortfalls and loopholes that compromise the quality of service. Worth noting about the organization is its sustainability plan to remain in Syria for a year and help the government reestablish its operations within the healthcare sector. The health records that the organization collects from the patient will enable them to ascertain the survival rate of Syrians during the war. The information will form the basis of healthcare planning and financing which depend on the population size. Conducting a census immediately after the crisis may be untenable by the government and the health records will enable them to allocate sufficient health professionals and resources. Additionally, the organization has a dedicated team of accountants that record the expenditure, and they subjected to audit annually. Therefore, the initiatives by the organization demonstrate that they value the contribution that donors make and it is willing to account for its expenditure on an annual basis.

Budget
UNICEF approximates that over 3.4 million children in Syria require healthcare services and compels the organization to budget for approximately one million children. The children need vaccines and syrup medication that are costlier compared to those consumed by adults. Additionally, the organization cannot charge for the medical services because UNICEF approximates that 75 percent of the youth are unemployed and 6.5 million live in abject poverty (UNICEF, 2018). The statistics show that the budget estimates foresee the high levels of poverty in Syria as a threat to quality healthcare sustainability. The decline in the national immunization coverage from ninety percent to seventy percent affirms the budgetary needs and the estimated allocation for the year is $ 40,000,000 million. The money will assist in purchasing drugs and hire new health care and support team members. The budget aims at getting the healthcare professionals decent accommodation, food, and supplies because they survive on the little that the Red Cross society supplies to the Syrians. Additionally, the money will enable the organization to set up temporary medical centers and camps that will move health care services closer to the public especially when conducting vaccination programs. The amount will facilitate the movement from one location to another and the distribution of medical supplies from on point to another without over depending on the military personnel within the area.

Dissemination Plan
The organization intends to engage the World Health Organization, UNICEF and existing charitable organizations to avoid running parallel programs. Additionally, the organization shall pool all the grant allocations together and draw a budget that addresses the most pressing issues. Military medical personnel try to serve the public but a majority of the time they lack the resources to provide primary health care services. The organization intends to partner with them because they are well conversant with the distribution of the population in the country. Additionally, the medical personnel shall receive GPS systems that will track their movement to enhance their safety and accountability.

Moreover, finding a place to settle the health providers emerges as a priority because the team consistently demands security assurances. Locating the different settlement camps and drawing a plan to address specific health concerns will be necessary because different groups require different health care services. Therefore, the dissemination plan will lay the platform for the establishment of health care programs that address physical diseases and mental illnesses.

Continuation Plan
The charitable organization in Syria will come up with edited financial records that support its expenditure. Financial accountability holds the organization accountable for its expenditure and ensures that finances are not wrongly used. Additionally, the organization intends to obtain weekly reports from its staff, volunteers and support team members that will explain the accomplished goals and objectives. Statistical data from different workstations will enable future grantors to establish whether the organization fulfilled the objectives as stipulated in its grant proposal. Moreover, the organization will set quarterly expectations that they will use to determine their success. The expectations will be drawn from the needs of different internally displaced persons spread across the area of coverage, and compared to the GPS coordinates that the system will provide.

The vaccination and mental health programs that the organization conducts shall be recorded, and any changes reported to justify any deviations. Additionally, a brief description of existing community partners and their collaboration shall be published to guide future planning. Records showing whether previous programs adhered to the schedules shall be attached to help understand how different factors affected them. Some intervention programs run year in year out, and organizations should include the reason in the reports and records that they provide because they justify the need for continuity. Consequently, the program goals determine the activities that the organization conducts to achieve specific outcomes. The results shall be submitted together with the original grant application to justify that the funded programs lead to the realization of the set goals.

The program administrators shall provide detailed reports showing the steps and actions taken throughout the year. The initiative aims at increasing accountability which important to win the confidence of grantors for continuing and future projects. Additionally, they shall report whether the program will be self-sustaining at the end of the year because grantors cannot continue funding a program without understanding how long it may run. The programs support team members, and their contributions shall be evaluated to ascertain whether they added value to the quality of services that the organization offered the Syrian citizens. Therefore, the grant continuity report shall highlight what the program accomplished and those that require continued funding because the adverse effects of war will leave the citizens poor even after the war comes to an end.

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References
Kherallah, M., Alahfez, T., Sahloul, Z., Eddin, K. D., & Jamil, G. (2012). Health care in Syria before and during the crisis. Avicenna journal of medicine, 2(3), 51-53.
UNICEF. (2018). Retrieved from https://www.unicef.org/emergencies/files/2018-04_-_UNICEF_response_to_the_Syria_Crisis.pdf

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