Health system strengthening in Yemen

Programme description

Title: Health system strengthening with a focus on mother-and-child health and family planning
Commissioning party: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: Yemen
Overall term: 2013 to 2018

Newly delivered sterilization equipment   Photo Saleh Nagi

Context

The majority of the population in Yemen’s rural areas does not have access to formal health services. Many health facilities offer services of very low quality and medical staff do not possess the necessary expertise or management skills to improve the situation. Health education is often insufficient, particularly for women. The imposition of fees for services, and the limited confidence in health facilities limit the access to them. Moreover, since the outbreak of the civil war in 2015 salaries are paid in irregular intervals and only 45 per cent of the facilities are fully functional.

Objective

Subnational governorate health offices are able to offer basic health services of acceptable quality for mothers and children.

Health planning at the Health Unit Photo Saleh Nagi

Approach

Previous projects have aimed to improve basic services of the health system in Yemen since 2004. This included community-based education on sexual and reproductive health. It has also delivered advisory services for the creation of an inter-sectoral working group for financing the health system.

Working at village level with midwives Photo  Saleh Nagi

Results

By late 2013, more than 140 health facilities had achieved quality certification. Evaluation and training was taking place in 330 other health facilities. Involved in this process were approximately 40 facilities that were run by independent midwives. The rate of use of reproductive health services in the areas served by the certified health centres had risen by more than 50 per cent on average by 2014.

In the project communities, the rate of use of modern contraceptives was around 25 per cent higher than it was in comparable communities.

Other development partners, such as the European Union, have benefited from its networks of trainers and the guidelines it had produced.

The project has contributed to the resilience of the health system ever since the war began in 2015. Over 90 per cent of the facilities supported continue to offer services aimed at women and children. 180 volunteers in 122 communities have received training in reproductive health, health education and first aid. This makes it possible to provide low-threshold access to information and modern contraceptives.

In cooperation with WHO and UNICEF, the project has delivered training in cholera awareness, prevention and treatment to the staff of a number of health facilities, as well as community health volunteers. Hygiene kits, which have been designed for the particular situation, were distributed to the communities and help preventing the further transmission of the disease.