Rebuilding Yemen’s Health System, One Facility at a Time
Strengthening the skills of health care providers improves children’s health in Yemen
Ameed is the father of three young children in the Lahj Governorate in southern Yemen, where recurring war and conflict have made life difficult for the past seven years. Like Ameed and his family, two-thirds of Yemenis lack basic health services, and children — about 10 million of them — need these services the most.
Children, especially those under 5, are vulnerable to serious and potentially lifelong complications without routine immunizations against preventable diseases such as polio or treatment of common childhood illnesses. The mortality rate of children under 5 in Yemen is about 60 deaths per 1,000 live births — well above the global average of 37 deaths per 1,000 live births.
The conflict also has weakened Yemen’s health system: Only 50 percent of health facilities throughout the country are currently fully functioning.
Of those, only 20% offer adequate care for maternal, newborn, and child health services.
Many Yemeni families have to either travel long distances to receive care, or seek treatment at private health facilities. But neither of these are affordable options for most families. An estimated three-quarters of the population in Yemen live below the poverty line and more than half are defined as extremely poor, according to the World Bank.
Ameed explained the difficulties his family used to face when any of his children became sick because the public health center closest to his village, the Mohsen Al-Kaylah Health Center, did not provide child health services.
“I don’t have sustainable work, and the costs of the transportation and treatment in distant health facilities and private clinics are too much for me,” he said.
The Mohsen Al-Kaylah Health Center in the Tuban District of Lahj Governorate currently serves 40,000 people. Nabil Saleh, the deputy director of the health center, explained that prior to the conflict in 2015, the center operated as a rural hospital that provided maternal, newborn, and child health care; immunizations; and dental care, among other services. That facility was destroyed when armed conflict erupted in the area, leaving thousands without access to any health care.
A smaller building (the Mohsen Al-Kaylah Health Center) was reconstructed in 2019 to replace the destroyed hospital, but it was staffed with fewer health workers, and downgraded from a hospital to a health center. Additionally, the health center staff lacked the technical expertise to support pediatric health services, so families had to seek treatment at more costly private health facilities. Many families were simply priced out of the health care they needed.
Health workers like Fadhl and Amal felt helpless seeing young children come to the health center and not being able to provide proper care for them. A recent USAID-funded assessment of 232 health facilities in Yemen backed these emotions with hard facts.
It found gaps in service due to staff’s lack of knowledge in several technical areas, including the integrated management of child illness, community management of acute malnutrition, immunization programs, and community-based maternal, newborn, and child health care. To build back this expertise, the USAID-funded Systems, Health and Resiliency Project (SHARP), implemented by John Snow Inc., tailored its training program to focus on these critical services.
Amal, a nurse, and Fadhl, a medical assistant, participated in a 14-day USAID-funded training to learn better ways to deliver essential child health care at community health facilities. As soon as they completed the training in December 2021, Amal and Fadhl began providing child health services at the center. Within two months, they had provided health services for 948 children.
“Most of the children complained of diarrhea or acute respiratory infections, which were treated according to the standards we learned in the training,” said Amal, one of nearly 500 USAID-trained health workers at 90 health facilities in Yemen. “As a mother, I consider any child as my own, so I was overwhelmed with happiness when I knew that I now had the skills to treat them.”
USAID also worked with the Lahj Governorate Health Office to coordinate a steady inventory of medicines and other supplies for the health center.
When the health center began providing child health services after Amal and Fadhl took the USAID-funded training, Ameed was overjoyed.
“I bring my children to this center for treatment — no more traveling long distances or high treatment costs,” he said. “There is nothing more important to me than seeing my children healthy and happy.”
About the Author
Omar Al-Gunaid is a Communications Specialist for USAID SHARP.
