DOCSLIB.ORG

RAISING RETURNS: the DISTRIBUTION of HEALTH FINANCING and OUTCOMES in YEMEN Public Disclosure Authorized

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
RAISING RETURNS: the DISTRIBUTION of HEALTH FINANCING and OUTCOMES in YEMEN Public Disclosure Authorized HNP DISCUSSIO N P A P ER Public Disclosure Authorized RAISING RETURNS: THE DISTRIBUTION OF HEALTH FINANCING AND OUTCOMES IN YEMEN Public Disclosure Authorized About this series... Heba A. Elgazzar This series is produced by the Health, Nutrition, and Population Family (HNP) of the World Bank’s Human Development Network. The papers in this series aim to provide a vehicle for publishing preliminary and unpolished results on HNP topics to encourage discussion and debate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations or to members of its Board of Executive Directors or the countries they represent. Citation and the use of material presented in this series should take into account this provisional character. For free copies of papers in this series please contact the individual authors whose name appears on the paper. Enquiries about the series and submissions should be made directly to Public Disclosure Authorized the Editor Homira Nassery ([email protected]) or HNP Advisory Service ([email protected], tel 202 473-2256, fax 202 522- 3234). For more information, see also www.worldbank.org/hnppublica- tions. THE WORLD BANK 1818 H Street, NW Public Disclosure Authorized Washington, DC USA 20433 Telephone: 202 473 1000 Facsimile: 202 477 6391 Internet: www.worldbank.org E-mail: [email protected] February, 2011 RAISING RETURNS: THE DISTRIBUTION OF HEALTH FINANCING AND OUTCOMES IN YEMEN Heba A. Elgazzar February, 2011 Health, Nutrition and Population (HNP) Discussion Paper This series is produced by the Health, Nutrition, and Population Family (HNP) of the World Bank's Human Development Network. The papers in this series aim to provide a vehicle for publishing preliminary and unpolished results on HNP topics to encourage discussion and debate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations or to members of its Board of Executive Directors or the countries they represent. Citation and the use of material presented in this series should take into account this provisional character. For free copies of papers in this series please contact the individual author(s) whose name appears on the paper. Enquiries about the series and submissions should be made directly to the Editor, Homira Nassery ([email protected]). Submissions should have been previously reviewed and cleared by the sponsoring department, which will bear the cost of publication. No additional reviews will be undertaken after submission. The sponsoring department and author(s) bear full responsibility for the quality of the technical contents and presentation of material in the series. Since the material will be published as presented, authors should submit an electronic copy in a predefined format (available at www.worldbank.org/hnppublications on the Guide for Authors page). Drafts that do not meet minimum presentational standards may be returned to authors for more work before being accepted. For information regarding this and other World Bank publications, please contact the HNP Advisory Services at [email protected] (email), 202-473-2256 (telephone), or 202-522-3234 (fax). © 2008 The International Bank for Reconstruction and Development / The World Bank 1818 H Street, NW Washington, DC 20433 All rights reserved. ii Health, Nutrition and Population (HNP) Discussion Paper Raising Returns: The Distribution of Health Financing and Outcomes in Yemen Heba A. Elgazzara aHuman Development Middle East and North Africa, World Bank, Washington, DC, USA Paper prepared for World Bank Washington, DC, USA Abstract: Summary in 300 words maximum. Given relatively few resources and lagging health outcomes in Yemen, the quest for equitable, cost-effective health care delivery continues as long-term, sustainable development remains a priority. This paper assesses overall value for money of the health system mainly as indicated by an analysis of public expenditure trends from 1997 until 2008 and by the degree to which health care benefits are conferred equitably to the population. Total health expenditure in 2007 accounted for 5.2% of GDP, or only PPP$ 41 per capita, with nearly 70% sourced by direct household payments (67%). Despite recent improvements in health status, Yemen continues to lag behind countries of similar or lower income and health expenditure levels. Levels of health outcomes in Vietnam, Indonesia and the Kyrgyz Republic are 2 to 6 times better than levels found in Yemen regarding the proportion of infants with low birth weight, the prevalence of malnutrition amongst children, the rate of births delivered by skilled attendants, and the rate of coverage of antenatal services. Although health facilities are relatively evenly distributed across the population, the operational status and quality of these facilities is highly variable. The availability of pharmaceuticals at health facilities ranges from 31% of facilities having medications on site in the governorate of Al-Maharah to 94% in Amran. To more effectively alleviate inequities and inefficiencies in health service delivery in Yemen, national policies are recommended to more strategically prioritize resource allocation and develop innovative service delivery models to more efficiently connect rural communities. Keywords: public expenditure, financial management, efficiency, health equity, burden of disease Disclaimer: The findings, interpretations and conclusions expressed in the paper are entirely those of the authors, and do not represent the views of the World Bank, its Executive Directors, or the countries they represent. Correspondence Details: Heba A. Elgazzar, 1818 H Street Northwest, Washington, DC, 20433 USA. Email: [email protected] iii iv Table of Contents TABLE OF CONTENTS ..................................................................................................................... V LIST OF TABLES AND FIGURES ..................................................................................................... VI ACKNOWLEDGEMENTS ................................................................................................................. IX EXECUTIVE SUMMARY ................................................................................................................. XI I. BACKGROUND ......................................................................................................................... 1 Aims and Structure of the Paper .................................................................................................. 1 Methods, Data Sources and Limitations ...................................................................................... 1 II. COUNTRY CONTEXT .............................................................................................................. 2 Recent Economic Developments ................................................................................................. 2 Government Reform Program ..................................................................................................... 2 Health System Organization ........................................................................................................ 3 Trends in Health Outcomes ......................................................................................................... 3 III. HEALTH FINANCING TRENDS: AN OVERVIEW ....................................................................... 6 Total Health Expenditure ............................................................................................................ 6 Governmental Health Expenditure .............................................................................................. 9 Treatment Abroad ...................................................................................................................... 11 Public Expenditure Financial Accountability ............................................................................ 11 IV. HEALTH SYSTEM EQUITY: GEOGRAPHIC AND SOCIOECONOMIC PERSPECTIVES ............ 13 Health Outcomes ....................................................................................................................... 13 Distribution of Health Services ................................................................................................. 16 Utilization of Health Services ................................................................................................... 19 Household Out-of-Pocket Health Spending .............................................................................. 20 V. POLICY IMPLICATIONS: IMPROVING THE DISTRIBUTIONAL EFFECTS OF HEALTH FINANCING .................................................................................................................................... 23 STATISTICAL ANNEX .................................................................................................................... 25 Annex 1. Data sources .............................................................................................................. 25 Annex 2. Demographic and health indicators .......................................................................... 26 Annex 3. Millennium Development Goals indicators .............................................................. 29 Annex
Load more

Recommended publications
  • Macroeconomic Policies for Growth, Employment and Poverty Reduction in Yemen
    Macroeconomic Policies for Growth, Employment and Poverty Reduction in Yemen i Copyright 2006 By the Sub-Regional Resource Facility for Arab States (SURF-AS) United Nations Development Programme (UNDP) UN House, Riad El-Solh Square P.O.Box: 11-3216 Beirut, Lebanon All rights reserved. No part of this publication may be reproduced, stored in a retreival sys- tem, or transmitted in any form or by any means, electronical, mechanical, photocopying, recording or otherwise, without prior permission of UNDP/SURF-AS Design, Color Separation and Printing by Virgin Graphics Email: [email protected] ii Case Study Team Advisory Group Contributing Authors: Flavia Pansieri (Resident Representative, (Authors of background papers) UNDP Yemen) Ahmad Ghoneim: Trade Yahya Al Mutawakel (Vice Minister and Ahmad Kamaly: Fiscal Policy Head of the Poverty Reduction Strategy Anis Chowdhury: Monetary Policy Follow-up and Monitoring Unit, Ministry of Antoine Heuty: Fiscal Policy Planning and International Cooperation.) Farhad Mehran: Employment Moin Karim, (Former Deputy Resident Frederick Nixson: Trade and Industry Representative, UNDP Yemen) Haroon Akram-Lodhi: Agriculture Mohammad Pournik, (Senior Country Heba Nassar: Macroeconomics Economist, UNDP Yemen) Hyun Son: Poverty Ibrahim Saif: Industry Core Team John Roberts: Macroeconomics Massoud Karshenas (Team Leader and Karima Korayem: Agriculture and Poverty Principal Investigator, Professor of Khalid Abu-Ismail: Macroeconomics and Economics, SOAS, London) Poverty Khalid Abu-Ismail (Macroeconomics and Matias Vernengo:
    [Show full text]
  • Enabling Poor Rural People to Overcome Poverty in Yemen
    ©IFAD/G. Ludwig Enabling poor rural people to overcome poverty in Yemen Rural poverty in Yemen The Republic of Yemen is one of the driest, poorest and least developed countries in the world. Poverty and food insecurity are strongly linked with the depletion and degradation of land and water resources. It is one of the most water-stressed countries in the world – each Yemeni’s average share of renewable water resources is about one tenth of the average in most Middle Eastern countries and one fiftieth of the world average. Poverty affects nearly 42 per cent of the country’s population and is mainly a rural phenomenon. Over 80 per cent of poor people reside in rural areas, and almost half of them live on less than US$2 a day. Small-scale farmers, sharecroppers, landless people, nomadic herders and artisanal fishers all suffer from inadequate access to basic necessities such as land, safe water, health care services and education. The population is young and growing rapidly. Two thirds of Yemenis are under 24 years old, and half are less than 15 years of age. More than 50 per cent of all children suffer from malnutrition. Women are also particularly disadvantaged. In addition to their heavy domestic workload, they provide 60 per cent of the labour in crop cultivation and more than 90 per cent in tending livestock. Despite their vital contributions to the rural economy, women have very limited access to economic, social and political opportunities. Many are illiterate and on average they earn 30 per cent less than men.
    [Show full text]
  • World Bank Document
    ReportNo. 15158-YEM Republic of Yemen Poverty Assessmzent Public Disclosure Authorized June26, 1996 Middl(e I st I IlImmi RemMIrcesD)ivi,(fln ( o LIltrV DX I IeeItII Middle East mindNorthi Africa Retgion Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Document of the World Bank ClURRENCY EQuIVALENTS Currency Unit = Yemeni Rial (YR) YR 1.0 = 100 Fils Exchange Rate as of.June 1, 1996 Official exchange rate: YR II 5/US$ Parallel exchanigerate: YR I1 5/1US$ Yemen Fiscal Year January I - December 3 1 LIST OF ACRONYMS ARI Acute Respiratory Infectionis DHS Demographilc and Maternal and Child Health Survey EPI Expanded Program of Iin Inllnizationis FAO Food and Agriculture Organization GDP Gross Domestic Product GNP Gross National Product HBS-92 Household Budget Survey, 1992 LCCD Local Counicils for Cooperative Development LDA Local Developmenlt Association MOSL Ministry of Social Affairs, Social Insiuranice,and Labor NGO NongoverinmenltalOrgan ization OECD Organ isation for Economic Co-operation aiid Development PDRY Peoples' Democratic Republic of Yemen TFR Total Fertility Rate UNDP lUnited Nations Development Programine UNHCR ULited Nations High Commission for Reftugees WDR World Development Report YAR Yemen Arab Republic YR Yeienl Rial REPUBLIC OF YEMEN POVERTY ASSESSMENT TABLEOF CONTENTS i EXECUTIVESUMMARY ................................................................ I THE POVERTY PROFILE ................................................................ ,. 2 THE EXTENTAND DEPTHOF POVERTY.......................................................................
    [Show full text]
  • Eastern Mediterranean La Revue De Santé De La Health Journal Méditerranée Orientale
    Eastern Mediterranean La Revue de Santé de la Health Journal Méditerranée orientale Nurses make up the largest group of health-care providers and are the first point of contact in health service delivery of diabetes in terms of detection, treatment and rehabilitation. This year’s World Diabetes Day coincides with the International Year of the Nurse and the Midwife, as designated by the World Health Assembly, and looks to focus on and promote the role of nurses in the prevention and management of diabetes. المجلد السادس والعشرون / عدد Volume 26 / No. 11 2020 11 نوفمبر/تشرين الثاني November/Novembre Eastern Mediterranean Health Journal Members of the WHO Regional Committee for the Eastern Mediterranean IS the official health journal published by the Eastern Mediterranean Regional Office of the World Health Organization. It is a forum for Afghanistan . Bahrain . Djibouti . Egypt . Islamic Republic of Iran . Iraq . Jordan . Kuwait . Lebanon the presentation and promotion of new policies and initiatives in public health and health services; and for the exchange of ideas, concepts, Libya . Morocco . Oman . Pakistan . Palestine . Qatar . Saudi Arabia . Somalia . Sudan . Syrian Arab Republic epidemiological data, research findings and other information, with special reference to the Eastern Mediterranean Region. It addresses Tunisia . United Arab Emirates . Yemen all members of the health profession, medical and other health educational institutes, interested NGOs, WHO Collaborating Centres and individuals within and outside the Region. البلدان أعضاء اللجنة اإلقليمية ملنظمة الصحة العاملية لرشق املتوسط املجلة الصحية لرشق املتوسط األردن . أفغانستان . اإلمارات العربية املتحدة . باكستان . البحرين . تونس . ليبيا . مجهورية إيران اإلسالمية هىاملجلة الرسمية التى تصدر عن املكتب اإلقليمى لرشق املتوسط بمنظمة الصحة العاملية.
    [Show full text]
  • Yemen Six Month Economic Analysis Economic Warfare & The
    HUMANITARIAN AND DEVELOPMENT PROGRAMME Yemen Six Month Economic Analysis Economic Warfare & the Humanitarian Context January 2017 HUMANITARIAN FORESIGHT THINK TANK HUMANITARIAN FORESIGHT THINK TANK Yemen Six Month Economic Analysis / January 2017 EXECUTIVE SUMMARY An inclusive political solution to the conflict is unlikely in the next six months, despite the high possibility of state economic collapse and a metastasizing humanitarian crisis across the country. President Hadi’s refusal to accept the terms of a recent UN peace plan is likely stalling Saudi financial relief and threatens to fracture his support base in the south. Meanwhile, the crippled state economy is supporting a thriving shadow economy, which will fragment power structures on both sides of the conflict as stakeholders engage in war profiteering. Not only will this diminish the chances for unity in the long run, it also increases food insecurity and poverty for the most vulnerable, while benefiting those in power who already dominate the parallel market. Amidst this turmoil, AQAP and IS influence will increase. This report will examine the economic context affecting humanitarian needs in Yemen, and present scenarios offering potential trajectories of the conflict to assist in humanitarian preparedness. Source: Ali Zifan (6 December 2016), Insurgency in Yemen detailed map, Wikipedia INTRODUCTION The slow progress in the war between the internationally-recognized Yemeni government of Abd Rabbu Mansour Hadi and the Zaidi Shia Houthi-Ali Abdallah Saleh alliance has caused the Saudi- backed Hadi coalition to instrumentalise the Yemeni economy, conducting a war of attrition. As Sanaa’s Central Bank of Yemen (CBY) hemorrhaged through its reserves in the previous two years of war, growing criticism of the governor’s alleged complicity in Houthi embezzlement culminated in the 18 September decision by the Hadi government to move the CBY from the Houthi-controlled capital to Aden and position a new governor to run the institution.
    [Show full text]
  • Poverty in the Arab Region: a Selective Review*
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Research Papers in Economics Poverty in the Arab Region: A Selective Review* Ali Abdel Gadir Ali, Abstract* The paper provides a stock taking of our current knowledge on poverty in five Arab countries: Egypt, Jordan, Morocco and Tunisia, representing middle income countries; and Yemen, representing low income countries. It draws on the most recent results on poverty based on high quality data. For all countries, except for Jordan, it is noted that the cost of basic needs approach to the estimation of poverty lines is used including the estimation of the non-food component by Engel curves; and except for Jordan, such an approach gave rise to lower and upper poverty lines. The paper also notes that for almost all countries an attempt has been made to decompose observed changes in poverty over time using the conventional Datt-Ravallion method. On the basis of the review tha paper concludes that our knowledge base about poverty in the region is fairly decent, despite conflicting results and sometimes incomplete information. _____________________ * Background paper prepared for the IFPRI / API Collaborative Research Project on: “ Public Policy and Poverty Reduction in the Arab Region”. 1 I. Introduction: This paper is written in the context of a research project on “public policy and poverty reduction in the Arab region”. The recent resurgence of interest in matters relating to poverty reduction is due to the articulation of the Millennium Development Goals (MDGs) by the United Nations in the context of its Millennium Summit held in New York 2000.
    [Show full text]
  • ASSESSING the IMPACT of WAR on Development in Yemen
    ASSESSING THE IMPACT OF WAR on Development in Yemen Jonathan D. Moyer | David Bohl | Taylor Hanna | Brendan R. Mapes | Mickey Rafa DISCLAIMER This report presents the findings of a commissioned study on the impact of war on development in Yemen, through scenarios using the Sustainable Development Goals lens. The views expressed in this study are those of the author(s) and do not necessarily represent those of the United Nations, including UNDP, or the Member States of the United Nations. Furthermore, the designations employed herein, their completeness and presentation of information are the sole responsibility of the author(s) and do not necessarily reflect the opinion of the United Nations Development Programme. Copyright 2019 By United Nations Development Programme (UNDP) 60th Meter Road P.O. Box: 551 Sana’a, Republic of Yemen Website: http://ye.undp.org All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronical, mechanical, photocopying, recording or otherwise, without prior permission of UNDP ACKNOWLEDGMENTS The core team for this report comprised Dr. Jonathan D. Moyer, Assistant Professor and Director of the Frederick S. Pardee Center for International Futures, Josef Korbel School of International Studies, University of Denver; Mr. David Bohl, Senior Research Associate; Ms. Taylor Hanna, Research Fellow; Mr. Brendan Mapes, Research Fellow; and Mr. Mickey Rafa, Assistant Director of Research Operations. From UNDP Yemen Country Office, all discussions were led by Mr. Auke Lootsma, Resident Representative; Ms. Asmaa Shalabi, Strategic Advisor; MS. Leanne Rios, Communication and Advocacy Team Leader; and Mr.
    [Show full text]
  • Multidimensional Poverty in Yemen
    Distr. LIMITED E/ESCWA/EDID/2018/WP.7 October 2018 ORIGINAL: ENGLISH Economic and Social Commission for Western Asia (ESCWA) Multidimensional Poverty in Yemen United Nations Beirut, 2018 _______________________ Note: This document has been reproduced in the form in which it was received, without formal editing. The opinions expressed are those of the authors and do not necessarily reflect the views of ESCWA. 18-00003 Acknowledgments This paper has been prepared by the Multidimensional Poverty Team of the Economic Development and Integration Division (EDID) of ESCWA. The team members are Khalid Abu-Ismail, Bilal Al-Kiswani, Rhea Younes, Dina Armanious, Verena Gantner, Sama El-Haj Sleiman, Ottavia Pesce, and Maya Ramadan. It serves as a country background paper to the Arab Multidimensional Poverty Report, a joint publication by the League of Arab States, ESCWA, UNICEF and Oxford Poverty and Human Development Initiative. The team members are grateful to Sabina Alkire and Bilal Malaeb from OPHI for their technical advice and collaboration on the construction of the regional Arab Multidimensional Poverty Index, which we apply in this paper using the household level data from the Yemen DHS (2013). Contents Page Abbreviations .............................................................................................................. iv I.CONTEXT............................................................................................................... 1 II.METHODOLOGY AND DATA ..........................................................................
    [Show full text]
  • Poverty Dymanics in Yemen As a Representative Arab
    Arab Development Challenges Background Paper 2011/13 The ADCR 2011: Poverty Dymanics in Yemen as a Representative Arab LDC Mohammad Pournik and Khalid Abu-Ismail i United Nations Development Programme Arab Development Challenges Report Background Paper 2011/13 The ADCR 2011: Poverty Dynamics in Yemen as a Representative Arab LDC Mohammad Pournik and Khalid Abu-Ismail* Mohammad Pournik is Poverty Practice Leader at United Nations Development Programme- Regional Centre in Cairo (UNDP-RCC). E-mail: [email protected] Khalid Abu-Ismail is Poverty and Macroeconomics Adviser at UNDP-RCC. E-mail: [email protected] Comments should be addressed by email to the author(s) i Acronyms and Abbreviations GCC Gulf Cooperation Council GDP Gross Domestic Product HDI Human Development Index HPI Human Poverty Index IMF International Monetary Fund LDCs Least Developed Countries LSI Living Standard Index MDGs Millennium Development Goals NPS National Poverty Survey P0 Headcount Poverty PAPFAM Pan Arab Project for Family Health UBN Unsatisfied Basic Needs UNDP United Nations Development Programme ii Introduction Socio-economic development in Arab LDCs has been shaped in the context of the political economy of rentier states and a delayed demographic transition. The tribal identity that defines these countries has been reinforced and mal-formed through patron-client relationships promoted by states using revenues from resource-based activities to accentuate tribal differences. Thus undermining a rule and merit based system for making decisions about the use of public assets and policy choices thus breaking traditional symbiotic relationships amongst different population groups, and rendering public investments ineffective, by using them as tools in the patron-client relationship.
    [Show full text]
  • Support to Rural Water Supply and Sanitation in Republic Of
    IOB Impact Evaluation | no. 315 | October 2008 Support to Rural Water Supply and Sanitation in Dhamar and Hodeidah Governorates, Republic of Yemen IOB Impact Evaluation | no. 315 | October 2008 | Rural Water Supply and Sanitation in Dhamar and Hodeidah, Yemen 1990-2007 OSDR6635/E www.minbuza.nl The Hague eb October 2008 ISBN 978-90-5328-368-4 www.minbuza.nl/iob-en Ministry of Foreign Affairs P.O. Box 20061 2500 The Netherlands evaluation studies published by the policy and operations evaluation department (IOB) 2000-2008 Evaluation studies published before 2000 can be found on the IOB-website: www.minbuza.nl/iob-en 284 2000 InstitutionalDevelopmentNetherlands support to the 301 2006 FromProjectAidtowardsSectorSupport water sector. An evaluation of the sector-wide approach in Dutch bilateral aid isbn 90-5328-274-2 1998–2005. isbn 90-5146-000-7 285 2000 OnderzoeknaardesamenwerkingtussenMalien 302 2006 EvaluatievanhetNederlandsemensenrechtenbeleid Nederland1994-1998 indeexternebetrekkingen isbn 90-5328-278-5 isbn 90-5328-350-1 286 2001 SmallholderDairySupportProgramme(SDSP)Tanzania 303 2006 DutchHumanitarianAssistance Inspection of its identification, formulation and tendering process An Evaluation isbn 90-5328-298-x isbn 90-5328-352-8 287 2001 DekunstvanhetInternationaalcultuurbeleid1997-2000 304 2007 EvaluatievandevernieuwingvanhetNederlandse isbn 90-5328-300-5 onderzoeksbeleid1992-2005 288 2002 Health,nutritionandpopulation isbn 978-90-5328-353-0 Burkina Faso Mozambique Yemen 304 2007 EvaluationoftheNetherlands'ResearchPolicy1992-2005
    [Show full text]
  • Comprehensive Food Security Survey in 2009 Highlighted a Deteriorating State of Food Security
    The State of Food Security and Nutrition in Yemen Comprehensive Food Security Survey 2012 Page | 1 The State of Food Security and Nutrition in Yemen Contents Key messages 3 Foreword 4 Summary 7 1 The Yemen context 9 2 Methodology 14 3 The food security situation 18 4 The nutrition situation 31 5 Causes of deterioration 42 6 How people try to cope 55 7 Conclusion 61 Selected references 63 Photos: With courtesy from WFP photo library Page | 2 Key messages . The number of severely food insecure people nearly doubled between 2009 and 2011 . The poorest people are the most vulnerable . Food prices have risen dramatically . The quality of diet has fallen sharply . Coping strategies have become more widespread and more severe . Families have limited the quantity and quality of their diet, and are accumulating debt to do so . One-quarter of all food is bought using borrowed money . Malnutrition rates are soaring . Civil unrest is exacerbating food insecurity . Water shortages and qat cultivation and consumption are limiting agricultural potential Page | 3 Foreword This publication is the product of extensive, wide-ranging research and consultation. It offers a picture of the state of food security and nutrition in Yemen. It assesses the causes of food and nutrition insecurity and highlights the major issues that will expose Yemenis to further risk, revealing the vulnerabilities and identifying areas where targeted assistance may be required. The picture is one of a country on the brink of a disastrous and rapid decline into humanitarian crisis. Yemen, once prosperous and home to successful and innovative systems of agriculture, now faces a troubled economic outlook, with dwindling oil reserves.
    [Show full text]
  • The Human Development Approach to Women's Health in Yemen
    THE HUMAN DEVELOPMENT APPROACH TO WOMEN’S HEALTH IN YEMEN Simone Wahnschafft Yemen, a nation that has been classified by the United Nations as one of the Least Developed Countries (LDCs) since the 1970s, has long been characterized by inaccessible healthcare for the majority of its population. Although Yemen has a largely rural population – roughly 65% in 2015 – most healthcare facilities have historically been concentrated in urban areas (2-3). An overdependence on these fixed healthcare sites in urban centers has resulted in an inefficient allocation of healthcare workers (HCWs), where many HCWs will see as few as one to three patients in a single day despite millions of people in need of healthcare (4). Yemen has had very poor health outcomes as a result of such deficiencies in healthcare infrastructure, including a very high prevalence of malnutrition and under five child mortality rate (5). These factors are heavily entwined, where the cause of many of Yemen’s health problems ties back to one population – women. The most recent Millenium Development Goals (MDG) progress report on Yemen explains that while developmental support for reducing child mortality was “fair,” the persistent lack of improvement in the under five child mortality rate was primarily due to undernourished and overall unhealthy mothers. Yemen’s Maternal Mortality Rate (MMR) has historically been very high: approximately 1 in 39 Yemeni women die during childbirth (7). The MDG progress report indicated that the Yemeni MMR had not been improved since 1997 (5). Besides structural inefficiencies in the health care system itself, the poor health outcomes for both women and children in Yemen are rooted in the lack of opportunities that are afforded to women by Yemeni social structure.
    [Show full text]