Yasmine Abdulhafeez – Women in Development and Peace
The conflict in Yemen has led to the deterioration of the health sector’s infrastructure in various Yemeni governorates. As a result, many Yemenis suffer from a shortage of access to basic health services, including reproductive health services, in many Yemeni areas, especially in rural and remote areas.
Mayyada Mansoor (24) recounts her experience of losing her mother, who passed away more than fifteen years ago during the birth of one of her siblings in a village in Taiz Governorate. She remembers with bitterness how her mother suffered from a lack of health care and resources; they lived in an area with a shortage of health facilities and a lack of specialists in reproductive health.
Mayada tells Women in Development and Peace newspaper: “We suffered greatly from poverty. My father, who works in seasonal agriculture, struggled to meet our basic needs. We couldn’t go to the city for treatment, and my mother suffered from malnutrition and anemia, which made her suffer every time she was pregnant.”
She points out that the only doctor in the area warned her mother of the dangers of pregnancy due to her poor health, but the lack of health services, whether care or medicine, posed a major challenge.
She continues: “On the second day after my mother gave birth, she died due to severe bleeding that did not receive treatment. The infant also died two days later due to lack of adequate care because of the lack of health services.”
Mayada’s story reflects the suffering of many women in rural Yemen; poverty and poor health care have put the lives of mothers and their children at risk.
The Importance of Reproductive Health
A report issued by the United Nations Population Fund entitled “Reproductive Health” indicates that more than six million Yemeni girls and women of childbearing age need reproductive health services.
The report highlights that malnutrition, which affects many women due to ongoing poverty and conflict, has increased the need for these services. It also indicates that more than one million pregnant women in Yemen suffer from malnutrition, increasing the likelihood of giving birth to children with diseases and deformities, especially stunting.
The report also warns of the risks women face during childbirth; approximately 114,000 women face the risk of serious complications during childbirth due to a lack of health support.
It adds that the challenges facing health facilities in Yemen contribute to the complexity of the situation; many of these facilities operate only partially, and only one-third provide reproductive health services due to a shortage of medical personnel, the suspension of employees’ salaries, the emigration of some of them abroad due to the conflict, a shortage of medical equipment, and damage to infrastructure due to destruction.
The National Strategy
Yemen needs to implement comprehensive solutions that support women and children, including improving reproductive health services, under the National Strategy for Reproductive Health issued by the National Population Council on August 2, 2012, entitled: “The National Strategy for Reproductive Health… Will it save Yemen from the danger of population explosion?”
The strategy highlighted the importance of providing reproductive health services to Yemeni families regardless of their economic or social status and included providing couples with family planning methods to space births to help reduce the country’s rapid population growth.
It called for providing comprehensive health care to pregnant women, mothers, and newborns to ensure their safety and the safety of their children.
Perspectives and Proposals
Women in Development and Peace newspaper conducted interviews with several specialists in the field of reproductive health to develop a future vision and proposals to contribute to strengthening reproductive health services in Yemen, especially during this exceptional phase that our country is going through.
Sabah Husain Al-Dhafri, head of the National Association of Midwives in Sana’a, emphasizes the importance of designing comprehensive training programs for midwives as a fundamental step in improving reproductive health services. These programs should be based on international practice standards and offer adequate training periods encompassing both theoretical and practical aspects. Proposals also include incorporating modules on women’s mental and social health, communication skills, and providing refresher training courses for midwives periodically to update their skills.
She explains that unemployment among qualified midwives poses a significant challenge to improving maternal and childcare services. The government and health facilities must provide job opportunities for midwives, especially in rural and remote areas lacking health services. She suggests offering financial incentives to midwives to work in these areas, thereby enhancing their presence and services in communities in need.
She believes that raising community awareness of the role of midwives requires organizing awareness campaigns including workshops and lectures, establishing model health centers run by midwives in provincial capitals, and encouraging unemployed midwives to open private clinics in remote areas to provide urgent health services during emergencies, directly improving the health of mothers and children.
She stresses the importance of strengthening cooperation with international organizations and local bodies to improve and develop reproductive health programs; these partnerships support government and community efforts.
Al-Dhafri points to the necessity of creating a central database containing information on midwives, service distribution, and the number of pregnant women in each area. This data, in her view, will aid in effective planning and resource allocation. The system should also include mechanisms for monitoring and evaluating the quality of services provided and working to improve them based on the results, enabling the identification of strengths and weaknesses in the health system to better direct efforts.
She adds that regulatory legislation is crucial to ensuring the quality of health services. Laws regulating the midwifery profession, ensuring midwives’ rights, and setting clear practice standards must be developed. Standardizing licensing criteria for practicing the profession should prevent unqualified individuals from working in this field, improving the quality of healthcare and boosting public confidence in midwifery services.
In closing, Al-Dhafri emphasized the importance of establishing centers providing psychosocial support to pregnant women and new mothers, especially those facing health and psychological challenges such as obstetric fistula. These centers would provide the necessary support for women to cope with the psychological and social challenges they may face, enhancing the mental and physical health of mothers and children alike.
Creating Emergency Maternity Centers
Muhammad Salim Zighaifi, Deputy Director of Al-Qataba Health Center in Al-Khawkha district, Al-Hodeidah Governorate, emphasizes that one of the most important services needed by Yemeni society is the establishment of equipped emergency maternity centers with operating rooms, an incubator unit, and qualified staff working around the clock to provide continuous health care for mothers and children.
He points to the importance of training community midwives to conduct home visits, providing health care to pregnant women and nursing mothers, educating them, and supplying them with reproductive health supplies such as delivery kits, baby supplies, and mosquito nets to protect against diseases.
Zighaifi also believes in the necessity of supporting existing reproductive health departments in health centers and units by providing them with medicines, special nutritional supplements for pregnant women and nursing mothers, hygiene kits, and mosquito nets, as well as providing other supplies to help mothers and children receive appropriate health care. He suggests intensifying health education programs for mothers and children through various media channels and dedicating a daily or weekly program focusing on maternal and child care issues.
He stresses the importance of coordination between health offices, local authorities, and civil society organizations to support pregnant women and nursing mothers and to pay greater attention to this important group.
Dr. Maha Abdu, an obstetrician and gynecologist, offers future visions for improving reproductive health services in Yemen, including ensuring the availability of life-saving drugs and equipment in health centers and providing mobile medical teams and clinics to cover health needs in various regions. She also calls for planning and implementing effective awareness programs through various media outlets. She also stressed the need to identify and disseminate family planning methods within the health system, in addition to developing training programs and training trainers in the governorates in coordination with the relevant departments in the Ministry of Health.
Wafa Ibrahim, a midwife, believes that economic challenges hinder women’s attention to their reproductive health, especially during pregnancy and childbirth. She points to the importance of clinics offering reproductive health services in areas far from city centers to facilitate access for women without hardship.
She explains that poor families in remote areas find it difficult to access health facilities, leading to high population growth and a lack of spacing between births. She stresses the need to provide specialized doctors to offer free consultations and provide family planning methods, encouraging pregnant women and their infants to visit health centers.
She emphasizes the importance of facilitating access for organizations working in the field of reproductive health to areas suffering from a lack of services, especially areas affected by customs and traditions that hinder women’s access to health care, and the need to rebuild health facilities destroyed by the conflict in Yemen to ensure women’s access to reproductive health services in these areas.
Given the challenges facing Yemen, strengthening maternal and child health care is considered a cornerstone of community health. This urgent need requires collective efforts and comprehensive coordination between the government, non-governmental organizations, and the local community. Collaboration among these parties can support and enhance the provision of health services. By implementing innovative solutions and proposals, such as training and qualifying midwives and providing essential reproductive health services even in remote areas, significant improvements in the health of mothers and children can be achieved, ensuring they receive the necessary care. Investing in supporting midwives is not only an investment in women’s health but also a direct contribution to the well-being of the family and the progress of society as a whole.