Washington, February 22, 2011 — Around a million women and children in the poorest rural and urban slum areas of Yemen will be the first priority of a World Bank-supported effort to decrease child mortality and increase the well being of mothers. Many of these women and children have not before been reached by any health services.
The $35 million Yemen Health and Population Project was approved by the Board of Directors of the World Bank today. It is designed to deliver maternal, neonatal, and child health services to those districts in Yemen where there are high concentrations of poor health indicators. In the first phase these include districts in the governorates of Sana’a, Ibb, Reimah, Al Dahla’a, Al Baydah, and urban slums in Aden before the services roll out to additional rural governorates.
"This project is all about reaching people living in remote areas who have real difficulty getting the services they need for better health and well-being," said Alaa Hamed, Senior Health Specialist at the World Bank. “In development language we talk about this as MDGs 4 and 5 – the Millennium Development Goals designed to fight infant mortality and improve the mothers’ health. For around one million Yemenis in remote areas this will mean health services reaching them for the very first time.”
The child mortality rate in Yemen is 69 deaths for each 1,000 live births, the highest rate in the Middle East and North Africa region. At 58% for children under 5, Yemen also has the second-highest rate in the world of stunting, a measure of child malnutrition for height and age. Maternal mortality is the second highest in MENA after Djibouti with 210 deaths for each 1,000 live births in 2008.
Less than half Yemen’s population of 23 million people have access to basic health services, a problem made all the more complicated in rural areas by widely scattered and remote geographical locations. The challenge is to both improve the quality of health services and to get those health services – and the supporting logistics of medical supplies and drugs – to communities not served by fixed health facilities which are unreachable for around half the rural population.
To help tackle this geographical challenge, the Yemeni Government requested the Bank’s assistance in designing Outreach Services as an essential element of the health service delivery system. The $35 million project will focus on around one million children and just over a million child-bearing age women, about half of whom currently do not have access to basic health services.
“The government continues to address the challenges and contributes to the design of a national program for better delivery of health and population services. But there remains the pressing need to deliver services through population-based and disease-specific programs, which this project provides,” said Dr. Abdul Kareem Rasea, Minister Public Health and Population.
The model designed for the project offers service in three ways. Integrated Outreach Services will deliver a core package of maternal and child health services at temporary sites using mobile teams on a periodic basis of about four times a year. This will be complemented by community-based services focusing on health education, active case finding, and referral, in addition to home-based delivery. The third element of the model comprises referral facilities for management of complicated cases that cannot be treated at the outreach level. All of this is designed to complement the routine delivery of services at existing fixed facilities and is not intended to replace it.
“This is an ambitious project given the geography and a long history of struggling to improve health service delivery,” said Benson Ateng, Sana’a-based World Bank Country Manager. “We are combining our efforts with donor partners, namely, WHO, UNICEF, and UNFPA, with the shared goal of really making a difference in the health of many poor people in Yemen.”