Yemen

STC_Yemen

Dr. Amal Abduallah Afre is part of the first of two mobile health teams that support ten health centres in Amran, Yemen. Credit: Ala’a Al-Eryani/Save the Children

Dr. Amal Abduallah Afre is 26 years old. She lives in Sana’a, the capital of Yemen. Her working day starts by making a 1.5 hour trip from her home in Sana’a, to the Save the Children office in Amran. Dr. Amal forms part of the first of two mobile health teams that support ten understaffed health centres in four districts in Amran.

Ever since Save the Children started the mobile health clinic project, women in the west Al-Baida area keenly visit whenever the mobile health team is in town. The numbers of those coming to the centre is increasing day by day and Dr. Amal says she is seeing a marked difference in the rise of women’s confidence and their eagerness to come every two weeks for check-ups.

One of Dr, Amal’s patients is Abeer Issa Mohammed, 30, who is 8 months pregnant. She says “I am a mother of two children who are Adel (10 years old) and Faisal (8 years old), and I’m also waiting for my new baby to be born.

Before this project started, I used to go to a health center in Al-Salkhana, which is 15 minutes away from my home by car. This has cost us so much, especially now that I’m always keen to follow-up on my pregnancy. Now with the mobile health team, my husband and I are both so relieved that we can easily come for a check-up and my husband can use the money for other necessary things. I started my follow-up with the doctor and this is my second visit here. My baby and I are now better after they discovered that I have a small case of anemia. I was advised to eat certain foods and was also given some medicine, which really benefited me.

The doctor Salwa is really good and I put all my trust in her. I’ll keep coming here for follow-up and even after giving birth I won’t stop taking her advice. I really hope that this mobile health team can be available for us all the time so that we can get help whenever we need it.”

Neonatal mortality rate  (per 1,000 live births) (2011) 32
Under-five mortality rate (per 1,000 live births) (2011) 77
Maternal mortality ratio (per 100,000 live births) (2010) 200
Number of doctors, nurses and midwives per 10,000 people (2010) 8.7
Births attended by skilled personnel (2006) 35.7%
Total expenditure on health as a percentage of gross domestic product (2011) 5.5%
General government expenditure on health as a percentage of total expenditure on health (2011) 20.9%

About half of the population in Yemen is estimated to have access to basic health services, and user fees are common. While there are exemption policies for the poor, there is evidence that these may not be properly functioning in practice. The burden of disease relates to a mix of communicable and non-communicable causes. Some progress has been made towards meeting MDG 5, but child mortality is still a concern.

There are challenges across all four domains of availability, accessibility, acceptability and quality of the health workforce. The density of skilled health professionals is low and unlikely to meet indicative thresholds by 2035; inequities in geographic distribution and accessibility persist. The percentage of female doctors is 25%. In terms of quality control mechanisms of the workforce, very limited information is available. Governance and coordination for HRH require strengthening to effectively tackle these challenges.

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