Afrah Borji – Women in Development and Peace
In our interconnected world, reproductive health remains a global challenge. Women, in particular, face numerous obstacles, ranging from poverty and inequality to cultural and religious discrimination. Despite international efforts, many factors prevent everyone from accessing the healthcare and reproductive services they deserve. While countries strive to meet the recommendations of global health organizations, many real-world challenges hinder the implementation of these recommendations.
Many organizations supporting the health sector strive to support Yemen by developing strategies based on rigorous analysis of local data and recommendations that align with the country’s cultural and demographic specificities. The aim is to help overcome barriers and challenges and provide comprehensive reproductive care for all.
Fatima Husain’s story represents a painful picture of the reality faced by many girls in rural Yemen. Early marriage and teenage pregnancy place a tremendous strain on their physical and mental health.
At the age of fourteen, Fatima was forced to confront challenges beyond her capacity. She took on family and marital responsibilities while still a child. During her pregnancy, she had to perform her household duties without adequate knowledge of how to care for herself or prepare for childbirth.
Fatima suffered greatly during the birth of her first child. She delivered her baby at home, not at a health facility many kilometers away. This resulted in the loss of her child due to a difficult birth and lack of adequate healthcare at home. Fatima is not alone in this situation. Geographical isolation, lack of healthcare services, and poverty contribute to the high maternal and child mortality rates in rural Yemen.
The Reality of Reproductive Health
A UN report titled “Millions of women and mothers around the world have lost access to sexual and reproductive health services” (2021) showed that the current situation reflects major challenges faced by women worldwide in the area of reproductive health and their fundamental rights. Millions of women have lost access to contraception and essential services, leading to increased rates of unplanned pregnancies and reducing their ability to control their health and reproductive lives. Restricting access to services for victims of gender-based violence has exacerbated the suffering of women who need protection and support, particularly during crises and conflicts.
According to reports, approximately 14 million women were denied access to contraception, while others faced a significant shortage of maternal healthcare services, both before and after childbirth.
The report also noted that many obstacles remain in the way of individuals enjoying their sexual and reproductive health rights. The reasons for these obstacles are numerous and rooted in complex historical and structural issues. Patriarchal systems impose restrictions on women’s rights to make their own healthcare decisions, affecting their access to the reproductive healthcare they need.
In addition, systemic inequalities such as poverty and limited education contribute to the persistence of these barriers, disproportionately affecting marginalized groups.
On the other hand, a UN report titled “Yemen: As the humanitarian crisis intensifies, and access to essential services is limited, the UN Population Fund provides for the needs of women, especially those displaced” (2020) explained that the escalation of conflict and humanitarian crises in Yemen has had a profound impact on women and girls, significantly worsening their conditions. The protective mechanisms that supported their rights and protected them from violence and abuse have eroded. With a lack of effective protection, women and girls are increasingly at risk of gender-based violence and exploitation.
The report stated: “Displaced girls are more likely to lose access to schools because families with limited resources deny them an education. It is estimated that 48% of Yemeni women are illiterate, and child marriage remains a common practice.”
In the report, Nestor Owomuhangi, UNFPA Representative in Yemen, said: “Women and children make up approximately 76% of the displaced population in Yemen, and amidst all these hardships, women have remained strong and resilient, in most cases bearing the burden of supporting their families.”
The UN High Commissioner for Refugees (UNHCR), in a report on sexual and reproductive health, confirmed that it prioritizes providing high-quality sexual and reproductive health services to refugees and vulnerable populations under its care. Working closely with host governments and partners, UNHCR ensures refugees access these services and improves their quality to meet their specific needs.
This aligns with Sustainable Development Goal 3, aiming to improve global reproductive health, including in refugee and humanitarian contexts.
Urgent Need
The World Health Organization (WHO) and the UN Population Fund (UNFPA) stressed the urgent need for life-saving reproductive health services for Yemeni women. Amidst the ongoing humanitarian crisis, millions of women and girls suffer from a severe lack of basic healthcare, endangering their lives and the lives of their children.
UNFPA estimates that over a million pregnant and breastfeeding women suffer from acute malnutrition, increasing the risk of premature births, difficult deliveries, and stunted fetal growth. Around 144,000 Yemeni women are at risk of complications during childbirth, highlighting the critical need for specialized reproductive healthcare services.
Local reports confirm Yemenis struggle to access healthcare due to the conflict-driven economic collapse. Nearly 50% of newborn deaths are reported.
A 2022 World Bank report titled ‘Despite Field Challenges, Health, Water, Sanitation, and Hygiene Services Reach the Neediest Yemenis’ noted that the conflict halted healthcare, water, and sanitation services, reducing efforts by healthcare workers and water and sanitation institutions to provide urgent assistance to families for child nutrition and healthcare.
Since the conflict began in March 2015, many hospitals, healthcare facilities, and water and sanitation infrastructures have suffered significant damage, severely impacting their ability to provide essential services. Even functioning facilities face challenges like lack of clean water, fuel for generators, or medical supplies.
The report mentioned WHO’s efforts to provide specialized nutrition for mothers and children, improving public health, especially given the difficult circumstances many Yemenis face. Over 1.3 million pregnant women received antenatal care, reflecting efforts to ensure maternal and newborn health.
Over 500,000 births were attended by trained healthcare workers under the emergency health and nutrition project. Over 10 million children benefited from improved health outcomes, and 8 million received vaccinations against preventable diseases, reducing child illness and mortality rates.
Expert Opinions
Midwife Saliha Muhammad noted a significant gap between international reports on reproductive health data and on-the-ground realities, despite the reports’ importance in guiding global health policies.
This gap stems from several factors, including variations in data quality, methodologies, sample sizes, and accuracy.
These reports often focus on specific indicators like fertility rates and family planning, neglecting other crucial aspects like reproductive health, violence against women, and mental health.
Overall, these reports emphasize the importance of providing comprehensive and sustainable health and nutrition services for mothers and children in Yemen, particularly in these exceptional circumstances. Continued support for these efforts is crucial to ensure the health of future generations.