SUB NATIONAL HEALTH CLUSTER ONLINE MEETING MINUTES , Hub 28 April 2021

Venue: Virtual Online Sub National Health Cluster Meetings, Using Zoom application.

Date: 28, April 2021.

Facilitator: Dr. Abdullah Zohairy; The Sub-National Health Cluster Coordinator of Al Hudaydah Hub, (SNHCC). Meeting Agenda: 1. Welcome & Introduction & Review and Follow Up the Previous Action Points. 2. Health Cluster Issues: • WHO Fuel Shortage, Urgent Support Gap; May 2021, • HCWs Financial Support Steering Committee (SC), • Averting Famine Taskforce. 3. Outbreaks Updates & GHOs Updates. 4. Partner’s Updates & Challenges.

Previous Meeting Action Points

Meeting Minutes: Agenda Topic Discussion Action Points Introduction of • Sub-National Health Cluster Coordinator (SNHCC), Dr. Abdullah Zohairy welcomed all partners Partners & Review of to the virtual online meeting using teleconference technology (Zoom). the Previous Action Points: • An introduction was done with partners introducing themselves as well as their position within their organization.

• The action points of the last SNHC meeting were discussed, and the meeting minutes were endorsed. Partners interested to • نقص الوقود ، ;Health Cluster Issues 1) WHO Fuel Shortage, Urgent Support Gap; May 2021 & Updates support with fuel to HFs, kindly to share their فجوة اإلحتياج للدعم العاجل • Challenge in Fuel shortage support to 217 HFs (other than World Bank supported HFs), which interest with the Health WHO will not be able to cover any longer with fuel after April 2021 due to lack of funding. Cluster.

ً ً SNHCC to share the list of • • التحدي يف دعم نقص الوقود لـ 217 مرفقا صحيا )بخالف المنشآت الصحية المدعومة من البن ك الدو يل( ، وال يت لن HFs which are no longer تتمكن منظمة الصحة العالمية من اإلستمرار بتغطيتها بالوقود بعد أبريل 2021 بسبب نقص التمويل . supported with fuel. • Fuel shortage will impact the health services provision and functionality in HFs including many of district & inter-district hospitals with the current situation of conflict escalation and COVID- • Ongoing discussion and For more information, please visit the Health Cluster Website: http://yemenhc.org/

19 status in Yemen. updates will be shared on upcoming SNHC meetings.

• حتما سيؤثر هذا النقص يف توف ريالوقود للمرافق الصحية عىل توف ري الخدمات الصحية ع ري تلك المرافق الصحية وابقاء

SNHCC to share the • تلك المرافق عىل قيد الحياة ، بما يف ذلك العديد من المستشفيات المحورية بالنظر للوضع الراهن لألزمة يف اليمن

progress and updates on وحالة وباء كوفيد 19 يف اليمن.

Steering Committee السبيل للم يض قدما ;Way Forward • Health Cluster & WHO started advocacy and discussions with Donors. outcomes. • بدأت الكتلة الصحية ومنظمة الصحة العالمية دعوات المنارصة ومناقشات مع المانح ر ي بهذا الخصوص .

• The National Health Cluster shared a call with all Health Cluster Partners interested to cover this gap. ر • شاركت كتلة الصحة عىل المستوى الوط يت نداء لجميع الشكاء الصحي ري المهتم ري بسد هذه الفجوة.

• Partners interested to support with fuel to HFs, kindly to share their interest with the Health Cluster. • ال رشكاء المهتمون بدعم المنشآت الصحية بالوقود ، ي رج مشاركة اهتم اماتهم مع كتلة الصحة.

• Dr. Iman Nasher UNFPA Representative requested to share with the list of HFs which are no longer supported with fuel.

اللجنة التوجيهية ;(HCWs Financial Support Steering Committee (SC (2

للدعم الما يل للعامل ري يف الرعاية الصحية • Three meetings were held on 16th ,23rd March, 7th April & 20th April. • Three meetings were held on 16th ,23rd March 2021 & 7th April & 20th April 2021.

• تم عقد ثالثة اجتماعات للجنة التوجيهية للدعم الما يل للعامل ري يف الرعاية الصحية يف 16 و 23 مارس و 7 أبريل و 20 أبريل. • Steering Committee divided in to 3 Groups; • 2 Groups for Short term approach (Humanitarian & Transitional), • 1 Group for long term approach (developmental). • اللجنة التوجيهية تم تقسيمها إل ثالث مجموعات:

• مجموعتان للنهج قص ري المدى )إنسا ين وانتقا يل(. • مجموعة واحدة للنهج طويل المدى )تنموي( .

• Group 1: Aimed to analyze recent experiences of NGOs that have negotiated lower “grids” and WHO negotiations for “flat” COVID-19 Hazard Pay--both accepted by authorities and enabling continued provision of services -- to inform any change in approach (i.e., identify lessons and articulate pro/cons to applying as a broader cluster approach).

• المجموعة األول: تهدف إل تحليل التجارب األخ رية للمنظمات غ ري الحكومية ال يت تفاوضت عىل "شبكات" أقل ، ومفاوضات منظمة الصحة العالمية بشأن بدل مخاطر " COVID-19 المسطح" – واللذان كالهما تم قبوله من قبل

السلطات المحلية لتمك ري استمرار توف ري الخدمات - لإلبالغ عن أي تغي ري يف النهج )مثال: تحديد الد روس /توضيح اإليجابيات / السلبيات للتطبيق كنهج جما يع أوسع( .

• Group 3: Aimed to reach common understanding on key immediate questions related to salaries that affect the short-term (6-12 months) approach to financial support, recognizing that salary payments are a broader long-term issue.

• المجموعة الثالثة: تهدف إل الوصول إل تفاهم مشيك حول األسئلة الرئيسية العاجلة المتعلقة بالرواتب ال يت تؤثر ً عىل النهج قص ري األج ل للتدخالت الصحية )6-12 شهرا( للدعم الما يل ، مع األخذ بع ري اإلعتبار بأن مدفوعات الرواتب يه قضايا أوسع نطاقا وطويلة األجل .

• Group 1 to feed to Group 3 with lesson learned, analysis & documents for New Grade & Payment framework.

• المجموعة األول ستغذي المجموعة الثالثة من اجل الدروس المستفادة والتحليل والمستندات إلطار عمل التصنيفات الجديدة وطرق الدفع للحوافز للعمال الصحي ر ي.

• Group 3 has identified 2 scenarios which humanitarian will support HCW payment (With salary payment from the Government & With no salary payment) and to suggest the medium grade per category and other characteristics.

• المجموعة الثالثة حددت سيناريوه ري يدعمان العم ل اإلنسا ين لدفع حوافز العامل ري يف مجال الرعاية الصحية )سواء يف For more information, please visit the Health Cluster Website: http://yemenhc.org/

ظل دفع راتب من الحكومة أوبدون دفع رواتب( واق ياح الدرجة المتوسطة لكل فئة وخصائص أخرى .

مجموعة عمل تجنب المجاعة :Averting Famine Taskforce (3

• Multiple technical and strategic consultations held over the past month, noting that the Averting Famine Taskforce has identified three workstreams and defined its roles and responsibilities.

• تم عقد العديد من االستشارات الفنية واالسياتيجية خالل الشهر الما يض ، مع مالحظة أن فريق عمل تجنب المجاعة حدد ثالثة مسارات عمل وحدد أدواره ومسؤولياته.

• OCHA Yemen has been consulting with key clusters and agencies about the most urgent programming and funding areas required to avert famine over a three-to-six-month period.

ر • يتشاور مكتب األمم المتحدة لتنسيق الشؤون اإلنسانية يف اليمن مع الكتل والمنظمات الرئيسية حول أكي أولويات

ال ريامج وال يت تحتاج التمويل بشكل ملح لتجنب المجاعة عىل مدى فية تياوح من ثالثة إل ستة أشهر.

• Consultations have highlighted the need for multisectoral approach across Food Security, Nutrition, Health, WASH, Protection and Logistics clusters.

• أبرزت المشاورات الحاجة إل نهج متعدد القطاعات ع ري مجموعات األمن الغذا ين والتغذية والصحة والمياه والرصف الص يح والحماية والخدمات اللوجستية.

• Depending on the availability of funds, the taskforce has identified two options for way forward: 1) If funding allows, target all districts classified as IPC 4 (Acute Food Insecurity (IPC AFI) IPC 4 districts (154 districts & 5.1 million people), 2) If limited funding, target combination of IPC Acute Food Insecurity (AFI) and Acute Malnutrition (AMN) IPC 5 districts (84 districts).

ً ً • اعتمادا عىل توفر التمويل ، حدد فريق العمل خيارين للم يض قدما :

1( إذا سمح التمويل : سيتم إستهداف كافة المديريات ذات التصنيف الرابع من انعدام األمن الغذا ين )154 مديرية و 5.1 مليون شخص( . ً 2( إذا كان التمويل محدودا : سيتم استهداف فقط المديريات ذات التصنيف الخامس من انعدام األمن الغذا ين )84 مديرية .( • This is work will fall under the umbrella of the 2021 YHRP. • هذا العمل سوف يندرج تحت مظلة خطة اإلستجابة اإلنسانية لعام 2021 ، و ستتم مشاركتكم بالمناقشات

والتحديثات الجارية يف اجتماعات الكتلة الصحية عىل المستوى الوط يت .

• Ongoing discussion and updates will be shared on upcoming SNHC meetings.

• ستتم مشاركة المناقشات والتحديثات الجارية يف اجتماعات SNHC القادمة .

GHO Updates: Raymah GHO Updates: • Raymah GHO to prepare a list of the Surveillance • Raymah GHO representative highlighted the dire need for providing a support to the WASH department's needs and services in HFs as many of HFs need WASH maintenance as follows; the list of the HFs that 1) Healthcare Facilities are relying on water trucking, need WASH support, to 1) Healthcare Facilities have functional toilets but not sufficient for all three categories (staff, share it with the partners. visitors).

2) Health Facilities are manually disposing off their fecal sludge and not connected to the sewerage network

• SNHCC assured that there is already a working group at the National level for the WASH in Health Facilities Working Group which is responsible for such issues and he request Raymah GHO to prepare a list including the names of the HFs/type of WASH maintenance that need WASH support to share it with the WASH WG.

• Dr. Lisa (Director of the Epidemiological Surveillance Department, Raymah GHO); inquired if there were any support for the surveillance department;

• SNHCC assured her that there is already ongoing support provided by WHO and ask Raymah GHO to prepare a list of the Surveillance department's needs and the list of the HFs that need WASH support, to share it with the partners.

For more information, please visit the Health Cluster Website: http://yemenhc.org/

COVID-19 Updates: • Regarding the numbers of COVID 19 cases, we do not have any epidemiological numbers or • figures, as the Health Cluster has not shared with any epidemiological information in this regard.

• SNHC briefed about the functional Isolation Centers in Al Hudaydah Hub as follows: • There is already 1 Functional Isolation Centers in each governorate of the 4 governorates of Al Hudaydah Hub which is supported by WHO. • In there are 3 Functional Isolation Centers; o 2 Functional Isolation Centers in the main city of Al Hudaydah. o Al Thawrah Isolation Center is supported by Save The Children. o As Sallakhanah Isolation Center is supported by WHO. o 1 Functional Isolation Centers in is supported by Islamic Relief Yemen. o Moreover, there is an isolation center in Bajil district supported by ICRC. However, this information is not confirmed, as ICRC does not share reports with us in this regard.

Partner’s Update: ACF Updates: • Raymah GHO to prepare a list of the Surveillance Dr. Taher from (ACF): department's needs and • Commented that he calls the concerned authorities to facilitate and speed up obtaining permits the list of the HFs that for the implementation of the health activities and permits for field visits to evaluate and need WASH support, to monitor these activities share it with the partners.

• SNHCC replied that he had contacted with the concerned authorities (Al Hudaydah GHO & SCMCHA) in this regard to cooperate with them and if any difficulties persist in this area, please feel free to reach out the HC to try to facilitate and take the necessary advocacy actions.

Dr. Taher (ACF) gave a brief overview of ACF current support as follows: • ACF continue supporting HFs with a full package of health and nutrition activities that included: 1) Training HWs and raising their efficiency (170 HWs) 2) Pay workersꞌ incentives (190 HWs) 3) Developing a training plan for HWs in epidemic diseases, nutrition, reproductive health, and widespread disease like covid-19. • Finally, he added that ACF aspires to work together with all partners and HC to achieve best results.

SCI Updates: Dr Mohammed Dowbalah, SCI Representative gave a brief overview of SCI current support to Al Thawrah Isolation Center as follows; 1) Pay Health workersꞌ incentives on monthly basis. 2) Purchase of medical equipment and supplies 3) Rehabilitation of the Isolation Center. 4) Preparing a plan to extend the support for the Isolation Center during the next 3 months after May 2021. 5) Starting today, HWs at the isolation center will be provided with meals.

WHO Update: Dr Mohammed Abkar WHO Epidemiological Officer gave a brief overview of WHO current support of COVID 19 as follows; • From the beginning of 2021, WHO planned to confront the spread of COVID-19 by; 1) WHO has conducted many Training sessions for all HWs in isolation centers and HFs. 2) WHO has carried out rehabilitation for all the 4 isolation centers in the Hub, 3) WHO is providing all the 4 isolation centers with the required medical equipment such as: Ventilators, Monitors, Suction Pumps, WASH Materials and PPE. 4) WHO is paying hazard payment for all the HWs in all the 4 isolation centers in the Hub. 5) Providing all the 4 isolation centers with a daily quantity of Re-filling O2 Cylinder/Day.

SNHCC inquired whether WHO support was with providing new oxygen cylinders or only filling cylinders that are already in the isolation centers;

• Dr Mohammed Abkar answered that WHO is supporting all the isolation units with re-filling the oxygen cylinders as follows;

• Based on the attached oxygen refilling table, all Isolation Units is receiving daily the following

For more information, please visit the Health Cluster Website: http://yemenhc.org/

quantities of Re-filling O2 Cylinder/Day;

IU Name Re-filling O2 Cylinder/Day As Sallakhanah Isolation Unit/Al Hudaydah 25/Day Al Thawrah Isolation Unit/ Al Hudaydah 100/Day Abs Isolation Unit/ Hajjah 50/Day Al Jomhorri Isolation Unit/ Hajjah 50/day Al Jomhorri Isolation Unit/ Al Mahweet 100/Day Raymah Isolation Unit 25/day

• Those quantities were requested by the MoPHP. If the needs are increasing, GHOs are kindly requested to raise their request to the MoPHP who in turn will agree with WHO at country office to increase ASAP the quantity based on the needs.

WHO Cholera Support: • WHO has recently supported GHOs/DHOs with quantities of Cholera Kits, IV Fluids and WASH Materials.

IRY Update: Dr. Ayman Heba Islamic Relief Representative gave a brief overview of IRY current support as follows: • Upon the request of Al Hudaydah GHO, an intervention was made in the isolation center in Zabid district by; 1) Paying incentives to 31 HWs from March 2021. 2) Purchasing medical equipment according to the center's needs. 3) In addition to interventions in environmental sanitation.

• In addition, a set of medical supplies was distributed to 20 HFs including oxygen cylinders in the districts of Az Zuhrah and Al Luhayiah.

NFDHR Update: Dr. Abdulwahab NFDHR Representative gave a brief overview of NFDHR current support as follows: • In Hajjah; The coordination for NFDHR Project with GHO has been completed, and work has been started in 4 HUs in Aslem district & 2 Caravans in Khayran Al Muharraq district will be provided with medicines as soon as possible.

• In Al Hudaydah; The meeting took place with GHO, and it was agreed to support Al Garrahi hospital, Mai Health unit, Beit Al-Faqih district.

• Regarding the support to Al Hussayiniah HC, there was a duplication. Therefore, another meeting took place to solve this problem.

• Regarding Al Garrahi Hospital, two bilateral meeting at Sana’a & Al Hudaydah has been conducted with QRCS representative Dr Wafa based on a coordination with the SNHCC Dr Abdullah Zohairy to coordinate for our interventions in this Hf and avoid any space of duplication.

The SNHCC briefed about what has been done by the HC Regarding the duplication in Al Hussayiniah Health Center, Bayt Al Faqih District; • During the Sub National Health Cluster Meeting that held on 24 February 2021, NFDHR updated the Health Cluster about their coming project which is funded by OCHA in some HFs at Al Hudaydah Governorate. This project will target Al Garrahi Hospital & Al-Hussayiniah Health Center, Bayt Al Faqih district.

• Mrs. Helen from ICRC was participating in the meeting and informed us that ICRC is also planning to intervene in Al-Hussayiniah Health Center, Bayt Al Faqih district, which would considered as a duplication, taking into consideration that ICRC is not sharing with the Health Cluster.

• As a Health Cluster, we take this into our consideration and agreed as an action point to organize a bilateral meeting between NFDHR & ICRC which has been already held on 21 March

For more information, please visit the Health Cluster Website: http://yemenhc.org/

2021, and the main action points of this bilateral meeting were as follows: - ICRC will continue to support Al-Hussayiniah Health Center. - NFDHR will shift their support to another HF which will be nominated by Al Hudaydah GHO. - Additionally, the Sub National Health Cluster Coordinator coordinated with Al Hudaydah GHO to nominate another Health Center to be supported by NFDHR; which was Al Tahrir HC in Al Mina district. - All this coordination steps have been carried out by the Health Cluster to avoid duplication, whether during the SNHC meetings or through the bilateral meeting or through the bilateral phone calls with NFDHR & ICRC representatives.

• The SNHCC clarified that it is difficult to add new district and YHF will not accept as we had experienced a lot before,

• The HC suggested to avoid any loss of the support and to remain in Al Hudaydah governorate/same district, to continue in the same district with nomination for other HF (prefer for Health Center) and to provide justification from SNHCC/GHO and NFDHR for replacement approval ASAP.

UNICEF Updates: Dr. Sharif UNICEF Representative gave a brief overview of UNICEF current Updates/Support as follows: • Upon the request we received last year to rehabilitate a HF in Az Zuhrah, and we are starting soon. Moreover, regular communications with partners to support what they can.

BFD Updates: Dr. Abdullah BFD Representative gave a brief overview of BFD current Updates/Support as follows: • During this week, obstetric emergency facilities in Hodeida governorate were provided with medicines, medical supplies, hygiene materials and protective equipment against covid-19. Moreover, providing fuel to Bajil, Zabid, Al Lawiyah HFs.

RH Working Group Dr Iman Nasher gave the updates on the Reproductive Health in Al Hudaydah Hub as follows; Update: • In Al Hudaydah; all HFs received PPE.

• In Hajjah and Al Mahweet; support will be in the coming days (Dealing with papers permission).

• ADO expressed the enormous need to fund Al Hudaydah & Al Mahweet HFs, duo to the suspension of support from the beginning of this year. AOB

For more information, please visit the Health Cluster Website: http://yemenhc.org/