Building Healthier Futures: Strengthening Community Health Systems in Middle East Region

Executive Summary

This proposal outlines a comprehensive initiative aimed at strengthening community health systems in the Middle East Region, with a focus on improving access to quality primary healthcare for vulnerable populations. Titled “Building Healthier Futures,” the program responds to persistent health inequities exacerbated by conflict, displacement, poverty, and weak health infrastructure. Implemented by [Your NGO Name], a local organization rooted in community-driven development, the initiative will support over 50,000 people, particularly women, children, and displaced communities, over a 36-month period.

The project aims to improve health outcomes by upgrading health facilities, training frontline health workers, delivering essential health services, promoting health awareness, and enhancing referral systems. It also focuses on strengthening local health governance and increasing community participation in health decision-making. By fostering sustainable, people-centered health systems, the program contributes to regional health resilience and aligns with national strategies and Sustainable Development Goal 3: Good Health and Well-Being.

Background and Problem Statement

The Middle East region faces complex health challenges stemming from prolonged conflict, economic instability, rapid urbanization, and population displacement. Many communities—particularly in rural, semi-urban, and refugee-hosting areas—struggle with limited access to primary healthcare, insufficient numbers of trained health workers, poor infrastructure, and under-resourced health facilities. The impact is especially severe on women, children, people with disabilities, and internally displaced persons, who experience disproportionately poor health outcomes and face significant barriers to care.

The COVID-19 pandemic further exposed the vulnerabilities of the region’s health systems, highlighting the urgent need for scalable, community-based interventions. Current public health infrastructure is often fragmented, reactive, and overstretched. There is a growing consensus among health actors and governments that strengthening community health systems—those closest to the population—is essential for improving health equity, achieving universal health coverage, and building resilience in the face of future crises.

Project Objectives

The overall goal of the project is to strengthen community health systems to deliver equitable, accessible, and quality health services in vulnerable communities of the Middle East. The specific objectives are:

• Enhance access to essential health services for at least 50,000 people through upgraded infrastructure and outreach services.
  • This objective seeks to bridge the critical gap in basic healthcare access for marginalized populations in the Middle East, particularly those residing in rural, semi-urban, and crisis-affected areas. The project will rehabilitate and equip local health facilities, ensuring they meet minimum service delivery standards. Mobile health units will be deployed to reach remote communities with limited access to health centers. By investing in infrastructure and deploying outreach services, the initiative aims to reduce geographic, financial, and cultural barriers to care, especially for women, children, and displaced individuals.

• Improve the capacity of 500 community health workers (CHWs) through training, certification, and supervision systems.
  • The success of primary healthcare delivery in underserved areas heavily relies on the effectiveness of community health workers. This objective focuses on strengthening the skills, knowledge, and motivation of 500 CHWs through comprehensive training programs, formal certification processes, and ongoing supportive supervision. The training will cover essential topics such as maternal and child health, mental health first aid, nutrition, and infectious disease prevention. Supervision and mentorship structures will ensure quality and consistency in service delivery, while equipping CHWs with digital tools will support real-time reporting and better decision-making.

• Promote community-based health education and awareness on key health issues including maternal health, child health, nutrition, and disease prevention.
  • Health education is a cornerstone of community resilience. This objective aims to improve public health literacy by engaging communities in participatory health education and behavior change communication. Targeted campaigns will be conducted on topics such as safe pregnancy practices, breastfeeding, childhood immunization, hygiene and sanitation, and mental well-being. Activities will include school-based health clubs, home visits, peer support groups, and culturally appropriate IEC (Information, Education, Communication) materials. Special efforts will be made to reach youth, caregivers, and men, promoting shared responsibility in health and fostering healthier households.

• Strengthen referral networks and health coordination between community facilities and regional health institutions.
  • Effective and timely referrals are vital to ensuring that individuals with complex health needs can access higher-level care. This objective will establish clear and coordinated referral pathways between community-based services, health posts, and secondary/tertiary care facilities. It includes developing standardized referral protocols, training CHWs and facility staff on referral practices, and improving communication and transport mechanisms. Partnerships will be formed with regional hospitals and local health departments to ensure continuity of care, especially for maternal emergencies, chronic disease management, and mental health services.

• Foster inclusive participation and accountability in health governance at the local level.
  • Sustainable health improvements require community ownership and transparent governance. This objective aims to strengthen local health systems by facilitating inclusive and participatory decision-making. The project will support the formation or revitalization of community health committees that include women, youth, persons with disabilities, and local leaders. These structures will engage in local health planning, budget monitoring, and feedback collection to ensure services are responsive to community needs. Training in rights-based approaches and social accountability will empower citizens to voice concerns and hold duty bearers accountable, ultimately enhancing trust in public health systems.

Target Population

The project will directly benefit approximately 50,000 individuals, with a focus on:

• Women and girls of reproductive age (15–49):
  • This group is a core focus of the initiative due to their unique health needs, especially related to maternal, sexual, and reproductive health. Many women in this age range face challenges accessing antenatal care, family planning, and skilled birth attendance due to cultural barriers, distance to facilities, or lack of trained female healthcare providers. The project aims to ensure that women and girls have access to respectful, comprehensive health services—including maternal care, safe delivery, and postnatal support—while also promoting their autonomy in making informed health decisions.
• Children under five:
  • Young children in the target region are particularly vulnerable to malnutrition, preventable diseases, and limited immunization coverage. Poor access to pediatric care contributes to high infant and child mortality rates. This project will prioritize early childhood health by strengthening child immunization programs, promoting exclusive breastfeeding, providing nutrition screening and supplementation, and treating common illnesses such as respiratory infections and diarrhea. Community health workers will play a key role in monitoring child health and engaging caregivers in positive childcare practices.
• Elderly and people with chronic conditions:
  • The elderly population and individuals living with non-communicable diseases (NCDs) such as diabetes, hypertension, and heart disease are often overlooked in humanitarian and development settings. With limited access to long-term treatment and routine monitoring, these groups face increased risk of complications and premature death. The initiative will expand access to basic diagnostic services, regular check-ups, and health counseling for these populations, while also promoting lifestyle interventions to reduce the burden of NCDs. CHWs will be trained to provide home-based follow-up and support for patients with chronic conditions.
• Internally displaced persons (IDPs) and refugees:
  • Due to ongoing conflict, displacement, and insecurity in the region, large segments of the population live in informal settlements or overcrowded shelters with limited access to healthcare. These communities face heightened vulnerability to disease outbreaks, mental health issues, and maternal mortality. The project will target IDPs and refugees with mobile health clinics, psychosocial support, and culturally sensitive health education campaigns. Services will be designed to be inclusive, trauma-informed, and aligned with humanitarian health standards.
• Low-income families in rural and semi-urban areas:
  • Communities living in poverty, especially in underserved rural and peri-urban areas, often experience a severe shortage of health facilities, trained staff, and essential medicines. These families frequently postpone seeking care due to financial constraints, contributing to preventable morbidity and mortality. By upgrading local health centers, subsidizing essential services, and training local CHWs from within these communities, the project will ensure affordable, continuous, and culturally appropriate care that meets their everyday health needs.

Key Activities

• Infrastructure & Service Delivery

  • Renovate and equip 10 community health facilities with essential medical equipment.

  • Establish 5 mobile health clinics for hard-to-reach areas.

  • Supply essential medicines and maternal/child health kits.

•  Capacity Building

  • Train and certify 500 CHWs and volunteers in primary care, maternal health, nutrition, and disease prevention.

  • Conduct refresher courses and mentorship for existing healthcare staff.

  • Provide digital tools for community health data collection.

•  Community Engagement and Health Education

  • Launch health promotion campaigns targeting hygiene, immunization, nutrition, and mental well-being.

  • Host community dialogues and school-based education on sexual and reproductive health.

  • Develop culturally appropriate IEC (Information, Education, Communication) materials.

• Health System Strengthening

  • Establish referral pathways between community and regional health facilities.

  • Form local health committees involving civil society, women’s groups, and local authorities.

  • Support local health planning and budgeting through participatory workshops.

• Monitoring, Evaluation, and Learning (MEL)

  • Conduct baseline, midline, and end line assessments.

  • Implement real-time data tracking for service delivery.

  • Organize annual review meetings with stakeholders for adaptive learning.

Expected Results and Outcomes

• 50,000 people gain improved access to quality health services:
  • Through the rehabilitation of health facilities, deployment of mobile clinics, and expansion of outreach services, at least 50,000 individuals—including women, children, the elderly, and displaced persons—will benefit from accessible, affordable, and culturally sensitive healthcare. These services will reduce travel time, waiting periods, and financial barriers, enabling timely diagnosis, treatment, and prevention of common illnesses. Importantly, this outcome reflects a substantial step toward achieving universal health coverage in marginalized and underserved areas.
• 10 health centers are fully rehabilitated and operational:
  • The project will upgrade and equip 10 community health centers, transforming them into functional, safe, and patient-friendly facilities. Improvements will include infrastructure repairs, provision of essential equipment and medical supplies, and the establishment of clean water and sanitation systems. These centers will serve as hubs for both preventive and curative services, ensuring continuity of care and better health outcomes for the surrounding population. Their revitalization will also restore community trust in public health institutions.
• 500 trained CHWs deliver outreach and home-based care in underserved areas:
  • A trained cadre of 500 community health workers (CHWs) will be mobilized and deployed to deliver health services at the household level, focusing on populations who face the greatest barriers to care. These CHWs—many of whom will be women from the local communities—will provide health education, monitor maternal and child health, support immunization efforts, deliver home-based treatment for minor illnesses, and refer serious cases to health centers. Their presence will extend the reach of the formal health system and contribute to early intervention and disease prevention.
• Community health knowledge and practices improve measurably:
  • Through structured health education campaigns, interactive community sessions, and distribution of IEC materials, the project will increase awareness and positive health behaviors related to maternal health, hygiene, nutrition, and disease prevention. These efforts will lead to improved health-seeking behavior, greater uptake of preventive services such as immunization and antenatal care, and reduced reliance on traditional or informal care methods. Baseline and endline surveys will be used to measure progress in knowledge, attitudes, and practices (KAP) across different demographic groups.
• Functional referral systems and local health governance mechanisms are established:
  • The project will put in place a robust referral network linking community health workers, local clinics, and regional hospitals. Standard operating procedures, communication tools, and transportation plans will be developed to ensure efficient and timely movement of patients who require higher levels of care. Simultaneously, local health governance structures—such as community health committees—will be established or strengthened to oversee health planning, service delivery, and accountability. These mechanisms will ensure community voices are reflected in decisions and contribute to long-term sustainability.

Budget Overview

The total estimated cost for the successful implementation of the 36-month project is USD XXXXX. This budget has been strategically allocated across six core components to ensure a balanced, efficient, and results-driven approach. Each component directly supports the project’s overall goal of strengthening community health systems and ensuring equitable access to quality healthcare.

• Health Infrastructure and Equipment: USD XXXXX
  • A significant portion of the budget is allocated to the rehabilitation and equipping of 10 community health centers across the target region. This includes structural renovations to ensure safety and functionality, installation of basic utilities such as water, sanitation, and electricity, and procurement of essential medical equipment such as examination beds, diagnostic kits, cold chain systems, and delivery room setups. Investments in infrastructure are foundational to restoring confidence in the local health system and enabling the delivery of comprehensive health services in a dignified environment.
• Training and Capacity Building: USD XXXXX
  • To ensure sustainable service delivery, the project will invest in training and certifying 500 community health workers (CHWs) and selected facility-based health personnel. The budget will cover costs related to training materials, facilitators, venue rental, transportation, stipends, and ongoing mentorship and supervision. The training curriculum will focus on maternal and child health, nutrition, mental health, disease prevention, and referral systems. Continuous learning and support mechanisms will also be built into this component to reinforce quality and consistency.
• Community Engagement and Education: USD XXXXX
  • Community ownership and participation are vital for long-term impact. This component will fund large-scale community outreach campaigns, health education materials (posters, leaflets, radio spots), and the facilitation of community health dialogues. Special focus will be placed on promoting behavior change around key topics such as hygiene, breastfeeding, immunization, and mental health. Budget allocations will also support the formation and operation of community health committees, ensuring diverse community representation in local health governance.
• Health Supplies and Medicines: USD XXXXX
  • To respond to community health needs effectively, the project will procure and distribute essential medical supplies, medications, and hygiene kits. This includes antibiotics, maternal and child health supplies (e.g., iron tablets, oral rehydration salts, delivery kits), and protective equipment for frontline workers. Supplies will be delivered through both fixed facilities and mobile health units. Buffer stocks will also be established to respond quickly to potential disease outbreaks or emergencies in the region.
• Monitoring, Evaluation, and Administration: USD XXXXX
  • Robust monitoring and evaluation (M&E) mechanisms are essential for tracking progress, ensuring accountability, and informing adaptive management. This portion of the budget will support baseline and endline surveys, routine data collection, field visits, and external evaluations. Administrative expenses—such as project staff salaries, office costs, reporting systems, and compliance management—are also included in this component. These operational supports ensure efficient project delivery and strong stewardship of donor resources.

Conclusion

The “Building Healthier Futures” initiative presents a timely and strategic intervention to address the multifaceted health needs of vulnerable communities across the Middle East. Rooted in evidence and shaped by local realities, the project offers a holistic and community-centered approach that not only delivers essential services but also strengthens the foundation of local health systems. By focusing on inclusive access, workforce development, community engagement, and systems coordination, this initiative responds directly to the gaps that have historically undermined health equity in the region. It prioritizes the needs of women, children, displaced persons, and other marginalized groups, ensuring that no one is left behind in the pursuit of health and well-being.

We believe that through strategic partnerships and shared commitment, this initiative can catalyze lasting change far beyond its immediate outcomes. We respectfully invite [Donor/Funding Agency] to join us in bringing this vision to life—one where health is not a privilege, but a guaranteed right for all. Together, we can empower communities with the tools, knowledge, and systems they need to thrive, even amid adversity. By investing in this project, we take a collective step toward a healthier, more just, and more resilient future for the Middle East.