HEALTH CLUSTER BULLETIN April-May 2020

All Health Cluster Coordination meetings are conducted virtually

YEMEN Emergency Level: Level 3 Reporting period: 01-04-2020 to 31 -05-2020

15.8M 19.7M Targeted with Health 3.34 627M 1Million PIN of Health Assistance Interventions Million** IDPs Funds required Returnees

HIGHLIGHTS HEALTH SECTOR

 During April and May 2020, Health Cluster 71 HEALTH CLUSTER PARTNERS

Partners supported a total number of 2624 14 M PEOPLE IN ACUTE NEED Health Facilities (16 Governorate Hospitals, 127 KITS DELIVERED TO HEALTH FACILITIES/PARTNERS District Hospitals, 59 General Hospitals, 19 21 IEHK BASIC KITS Specialized Hospitals, 652 Health Centers, and 0 IEHK SUPPLEMENTARY KITS 1751 Health Units). 0 TRAUMA KITS 538 OTHER TYPES OF KITS  The cumulative total number of suspected SUPPORTED HEALTH FACILITIES st st Cholera cases from January 1 to May 31 2020 2,624 HEALTH FACILITIES is 137003 with 36 associated deaths (CFR

0.03%). Children under five represent 2,078,028 OUTPATIENT CONSULTATIONS

23% whilst the elderly above 60 years of age 72,962 SURGERIES accounted for 6.0% of total suspected cases. ASSISTED DELIVERIES (NORMAL & 89,566 The outbreak has so far affected in 2020: 22 of C/S) 23 governorates and 292 of 333 districts in VACCINATION

Yemen. 45,414 PENTA 3

 As of 31st of May 2020, Health Cluster Partners EDEWS supported a total number of 186 DTCs and 770 1,982 SENTINEL SITES ORCs in the 147 Priority districts and 253 DTCs FUNDING US$ and 1015 ORCs at the National Level. 627.2 M REQUESTED FUNDING RECEIVED 0M (0%) BY 31ST MAY 2020(SOURCE FTS)

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Situation Update

Yemen is in the midst of the worst manmade humanitarian crisis in the world. The people in need has increased reaching a whopping 24.1 million people out of 29 million people. Out of the 24.1 million people in need, 19.7 million person require some sort of health assistance and 14 million out of those are in dire need of health assistance. 45 Health cluster partners with ongoing active projects are currently supporting and responding to the health needs of the Yemeni people working in 2624 health facilities all over Yemen. Providing continuous support and health services requires the sustainability of funding for the health operations in Yemen, which supports the most vulnerable groups in the country. Intensified fighting and spread of conflict areas has led to an increasing number of IDPs all over the country. This, in addition to current spread of epidemics such as Cholera and COVID-19 has deteriorated the conditions of these vulnerable groups and increased the needs. Health Cluster partners are responding to their needs by mobile health clinics and service provisions at camps. In addition to the all current epidemics and conflict, the Yemeni people now have to deal with another threat, The Corona virus. The impact of the COVID-19 pandemic on Yemen will be disastrous and will lead to more suffering of the people. More information are detailed in the below COVI-D-19 Highlight. Public Health Risks, Priorities, Needs and Gaps

There are about 51% fully functional Health Facilities (HFs), 36% partially functional and 13% remain non-functional (HeRAMS 2018). The Majority of the Yemeni population have limited access to health services because of the harsh economic conditions, which impacts their ability to seek health services. As a result of transport costs, poor road infrastructure and insecurity, roadblocks and advancing frontlines, access challenges continue to further complicate the already worsened situation. COVID-19 outbreak has been registered in many countries in the region. WHO risk assessment of virus reaching Yemen is still at low, but many preventive and response measures have been taken as per WHO COVID-19 Preparedness and Response Strategy that endorsed by health authorities in Yemen. Those measures include measures at points of entries (PoEs), improve the testing capacity in Public Health Labs in five governorates and reagents, initiated the establishments of Isolation Units identified by MoPHP, provide equipment and medical supplies to operationalize those IUs. Enhancement of the capacities of the CPHL has been supported with training and technical support from WHO. The situation is being monitored closely for any updates or change. COVID-19 Highlights

The first confirmed case of COVID-19 in Yemen was declared on April 10th 2020. As of May 30th 2020, 327 positive cases have been reported, 81 deaths, and 16 recoveries (please note that these figures represent the southern part of the country only).The real number of the cases is unknown due to low testing capacity and sharing of information by the authorities. The UN and all of its partners are working under the assumption that the country is in a full-scale community transmission. Aid agencies have scaled up the COVID-19 response; prioritizing suppression of virus transmission through community engagement; procuring and distributing medical supplies and equipment; saving

2 | P a g e lives by supporting COVID-19 clinical readiness; and safeguarding the public health care system1. Add graph As of May 2020, 38 health facilities have been identified by the health authorities to be supported to function and operate as Isolation Units across the country as phase one. Those isolation units were included in WHO Response plan funded by the World Bank, of them 16 IUs are operational so far in North and South. Among the response activities of COVID-19, scale up the capacities of surveillance and RRTs in 333 districts in Yemen, training sessions on case management and IPC were conducted in most of governorates of Yemen. There is ongoing discussion with Health Cluster and WHO as a cluster lead agency to give those health partners who have funding and technical capacity to step in and support few COVID-19 isolation units in governorates where cases are reported high number of cases particularly in the South. Five health partners (IRC, SCI, ADD, QRCS and IRY) have confirmed having financial capacity to support isolation units. MSFs France, Belgium, Spain and Swiss are doing great efforts in COVID-19 response by supporting and running (fully or partially support) 4 isolation units in Aden, Sana’a, Ibb and Al- Hudaydah. As COVID-19 was spreading in neighboring countries, Health Cluster has encouraged health partners to support aspects of COVID-19 response in two folds: Ensure and scale up the support in the health facilities (non COVID) they are currently run in terms of COVID related activities such as Risk communication and engage effectively in community awareness, scale up IPC activities, case definition training, Coordinate with other clusters’ partners such as CCCM and WASH to work together in guidance and vulnerable groups (IDPs, refugees and migrants) are aware of COVID-19 prevention and protection measures Those who could manage to support isolation centers to treat mild and moderate cases so the burden on isolation units can be reduced.

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25 22 21 18 20 17 16 15 13 13 13 15 12 11 10 10 9 9 10 7 7 6 5 5 5 5 4 3 5 2 2 1 1 1 0 10 13 16 19 22 25 28 01 04 07 10 13 16 19 22 25 28 31 Apr Apr Apr Apr Apr Apr Apr May May May May May May May May May May May

FIGURE 1 COVID-19 CASES – DAILY

1 WHO Report for May 2020. 3 | P a g e

Health Facilities Mapping of COVID-19 Activities

Within various COVID- 19 response efforts, Health Cluster team decided to start a monthly mapping for the COVID measures that health partners have supported in NON-COVID health facilities. The mapping of May 2020 which 25 health partners have responded, shows that despite of partners’ efforts to scale up COVID measures, but there are still gaps need to be filled (indicated as planned activities by partners). Those gaps were clearly reflected in Risk communication and community engagement, health staff training on IPC and case management, prepositioning of IPC materials and triage. Communicable Diseases

From the 1st of January to the 31 of May, 2020 there were 137003 cholera suspected cases reported, 36 associated deaths and the outbreak has affected 22 of 23 governorates and 292 of 333 districts in Yemen. Al-Hudaydah, Al-Baydha, Sana’a governorate and Taiz are the highest governorates, which reported highest numbers of suspected cases of cholera during month of May.

FIGURE 2 EPI CURVE: NUMBER OF SUSPECTED CASES AND THE CFR FROM WEEK 1 2019 TO WEEK 21 2020- SOURCE – EOC

Non-communicable Diseases and Mental Health

There were 19,974 new hypertensive and 4,075 individuals with mental health illness who received medical attention and psychosocial support by health partners during the months of April and May 2020. Health Facility Support

During April and May 2020, 42 Health Cluster Partners have sustained their support to the 2,624 health facilities including operational support, incentives for the health workers, training of health workers and provision of medicines and medical supplies. Availability of Essential Services

The Health Cluster Partners are continuing to support primary and secondary health care services across the country. These services are offered free of charge across all health centers and units, with secondary health care provided in the governorate and district hospitals, as a result of the support of partners with incentives and operational costs. Some of the main challenges that are hindering the delivery of quality health services are insecurity, access impediments and inadequate health workers (capacity and numbers). The economic situation is becoming worst on a daily basis as the Yemeni Rial

4 | P a g e continues to depreciate and the majority of the population are not able to afford transport to and from the health facilities. Displaced people who suffer from chronic diseases are the most vulnerable group who usually face problem accessing the secondary health services. Worth mentioning that mobile teams are not encouraged by health authorities during COVI-19 time for their safety and community safety they serve as well. Taking into account the impact of COVID-19 and movement restrictions, in an effort to counter these challenges, Health Partners are supporting and facilitating patients’ transportation and referral through the voucher system in order to improve acceptance, access and utilization of health services by the patients. Looking at health partners reports of April 2020, it is important to note that there was decline in some health indicators such as medical consultations, RH indicators and child health services which could be attributed to both the violent conflict and the COVID-19 outbreak in Yemen. This could be also referred to the culture of Yemeni people and change in their priorities in the month of Ramadhan. A slight increase was observed in May 2020 data in few indicators but Health Cluster IM team is working to better understand those trends and be able to identify the real causes. Availability of Health Staff

The health workers available in the health facilities are not enough, as the majority have migrated from their locations due to insecurity, access challenges or lack of salaries. Those still in the health facilities are largely dependent on incentives offered by the humanitarian actors to sustain the remaining services offered in these facilities. Availability of Essential Drugs, Vaccines and Supplies

Health Cluster partners supported the health facilities’ operations with medicines and medical supplies as well as payment of incentives to health staff. 166,000 Liters of fuel and 36 million liters of water were supplied to the health facilities in addition to 21 IEHK basic Kits, 0 IEHK Supplementary kits, 538 other types of kits and 0 Trauma kit to support various health facilities across the country. Health Cluster Action

Health Cluster Partners include 4 UN agencies, 18 INGOs, 21 NNGOs in 22 Governorates in Yemen. In April & May 2020, 43 Partners reported through the Yemen health information system. Partners Implementation Status can be accessed at http://yemenhc.org Health Cluster Partners Updates – April and May 2020

Health Cluster Partners continued supporting health service delivery across the country. Below are a few examples of different Health Cluster Partners operating in different governorates inside Yemen. World Health Organization (WHO)

The World Health Organization in Yemen continues to provide life-saving health services in Yemen and supporting and enhancing the existing health system. WHO is also focusing on COVID-19 Preparedness and support. As of May 31st 2020, 327 confirmed COVID-19 cases have been registered, 81 deaths, and 16 recoveries in Yemen.

Key Highlights regarding COVID-19:

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 Suppressing transmission, including through community action and influence: The aim of the first line is to suppress transmission of the virus by mobilizing community volunteers and influencers to explain to millions of people across the country what the virus is, how it is transmitted and what can be done to stop its spread. Aid agencies stepped up awareness raising by activating more than 19,670 community-based volunteers and influencers. This is an increase from 9,000 volunteers in March to 14,000 in April. An additional 6,000 mother-to-mother community volunteers were WHO supports 333 COVID19 rapid response teams. These 5-person teams are also activated. These volunteers have been present in every district in the country, responsible for detecting, assessing & responding to suspected cases. WHO is also equipping hospitals & delivering deployed to explain to communities how the vital supplies. C: Omar Nasr

virus is transmitted, how people can protect FIGURE 3 WHO ACTIVITIES DURING MAY 2020 themselves and the steps to take if someone falls ill. Together with mass media messaging, these activities reached an estimated 16 million people. Another 2.3 million people have been reached through 410,015 house-to-house visits and Mother-to-Mother sessions.  Supplying – securing, transporting and distributing COVID-19 supplies: The United Nations has procured more than 10,000 metric tons of medical equipment, testing kits and medicine from a highly competitive global market; 4,800 metric tons (181 truckloads) have already arrived in country and another 6,151 metric tons (163 truckloads) are in the pipeline by end of May. Still more is urgently needed, especially oxygen and personal protective equipment.  Saving as many lives as possible, including people who are critically ill by boosting COVID-19 critical capacities: The UN and partners are also rushing to expand hospital capacity in key population centers. Aid agencies scaled up the number of intensive care units (ICUs) in COVID-19 designated hospitals from 38 beginning of May, and are equipping an additional 21 ICUs, bringing the total to 59. In addition, partners are deploying two high capacity mobile field hospitals with nearly 100 beds and providing salaries to 9,000 frontline health care workers.  Safeguarding the public health system at more than 4,300 non-COVID health care facilities to ensure available facilities are not overwhelmed by COVID-19 cases remains a priority for humanitarian partners. These facilities continue to provide non-COVID health care services to prevent deaths from other deadly diseases and causes, including cholera, diphtheria, dengue and malaria, and An emergency campaign to control mosquito, and to raise awareness on mosquito-borne diseases spreading due to stagnant water, as well as on to provide nutrition treatment to pregnant COVID19 pandemic in Aden. C: Nesma Khan women and malnourished children. In May FIGURE 4 WHO ACTIVITIES DURING MAY 2020 2,779 health facilities continued to provide health services for malaria, and 1,257 health facilities provided cholera response services.2

For further information, please refer to WHO’s situation report for the Month of May 2020.

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In addition to the COVID-19 preparedness and response, WHO continues to provide its regular support to hospitals and health facilities to provide essential life-saving services and ensure the continuity of non-Covid19 related health services including Cholera treatment and other type of services. International Organizations for Immigration (IOM)

IOM is a UN Organization supporting more than 86 Health Facilities in 17 governorates in Yemen. Its activities range from Primary Health care, secondary care at hospitals Outbreak Response, Global Fund activities for the Malaria Program, and Mobile teams. IOM continues to work to strengthen the public health system in Yemen through provision of support to 41 health facilities in Al Bayda, Sa'ada, Sana'a, Al Jawf, Marib, Taizz, Al Dhale'e, Abyan, Lahj, Shabwah and Aden. Support to these facilities aims to enhance access to primary health care for migrants, internally displaced persons (IDPs) and host communities in these governorates. These services provide the first line of defense to COVID- 19 ensuring that the most vulnerable populations continue to have access to critical health care - disease prevention, hygiene promotion, case management and treatment, medicines - in addition to screening for COVID-19. IOM is in the process of providing additional screening tools (such as thermal thermometers), additional human resources, specific training for health workers, personal protective equipment (PPE), and information, education and communication (IEC) tools to raise awareness of COVID-19 and its prevention. During April and May 2020, to support COVID-19 prevention and response measures, IOM rapidly further scaled up its support to health facilities and mobile health teams by providing COVID-19 specific personal protective equipment (PPE), medical supplies, triage management support, and information, education and communication (IEC) materials. The Organization provided 10 primary health facilities in April with infrared thermometers and PPE, as well as other medical supplies. Training is ongoing throughout all supported facilities, focusing on COVID-19 triage and case management. In April, IOM provided 80 health workers in Shabwah Governorate with training on COVID-19 case management, case definitions and infection prevention and control measures. Teams consisting of health and protection staff conducted awareness raising sessions in Aden city, specifically reaching 1,732 migrants, host community members and refugees with COVID-19 prevention messages. This was in addition to over 140,000 people reached with health messages conducted through health teams across the country, within which COVID-19 prevention measures have been integrated. IOM has been operating in Marib, providing multi-sectoral assistance to affected populations since March 2019. Assistance was scaled up during the recent displacement crisis, and now, in response to the presence of COVID-19 in the governorate. By 20 May, the first COVID-19 case had been confirmed in Marib. IOM, as lead of the sub-national health cluster, is scaling up preparedness and response activities, including by establishing quarantine and treatment facilities, conducting awareness raising activities and hygiene promotion. In May 2020, IOM established an isolation and treatment facility in Marib city, which has a capacity of 63 beds, including 10 in the intensive care unit (ICU), and is staffed with 68 health professionals. To ensure humanitarian capacity to respond is maintained in Marib during this critical time, IOM is also bolstering clinic capacity and ensuring that the humanitarian hub it manages follows COVID-19 prevention protocols.

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United Nations Population Fund (UNFPA)

UNFPA is one of the main UN organizations working in Yemen by implementing RH Projects and improving the lives of the people in Yemen. It is one of the frontline responders during the current COVID-19 outbreak and is working very closely with the Ministry of Health and the World Health Organization in the response to COVID-19. Key areas of support during the reporting period of April- May 2020 includes the following:

 UNFPA has distributed 40 ventilators to specialized COVID-19 isolation units in the North and South of Yemen. Additional 40 ventilators have been procured and are in the pipeline.  From March through May, 140 health facilities around the country have been supplied by UNFPA with personal protective equipment and IPC materials procured locally through the Implementing partners, namely DEEM, FMF, CSSW, BFD, and ADRA.  RH services in 40 Health Facilities. Due to funding suspension, UNFPA has been forced to suspend RH services in 140 Health Facilities out of the `80 Health facilities supported. This is endangering the lives of women and children as they lose access to specialized RH services.

FIGURE 5 UNFPA ACTIVITIES DURING MAY 2020

International Medical Corps (IMC)

IMC is a leading International Organization working in Yemen since 2012 providing health services to people in need. It is providing multi-sector humanitarian assistance to the most vulnerable communities in six governorates in Yemen - Sana’a, Ibb, Taiz, Lahj, Aden, and Al Dhale’e. Main Activities:  Support provided by IMC includes incentives for service providers, medical and non-medical commodities which includes pharmaceuticals, medical and laboratory consumables, equipment according to the level of care offered by the health facility, capacity building, WASH support that includes medical and non-medical waste management, water trucking, rehabilitation of WASH and sanitation facilities Key Highlights during April-May 2020:  Triage  General Medical Consultations to include screening for communicable and non-communicable diseases  Provision of Essential Medications  Regular vaccination services for children and pregnant women  Reproductive health care services to include ANC, PNC, childbirth and family planning 8 | P a g e

 Referral to higher level of health services  Disease surveillance through eIDEWS  29,039 consultations  Distribution personal protective equipment to 23 health care facilities  Support training of 256 health care workers on COVID-19.  Participated in contextualizing guidelines for COVID-19. Yemen Family Care Association (YFCA(

YFCA is a leading, independent and neutral non-governmental organization that works nationwide at different levels to promote equitable and sustainable development, humanitarian response, and other relevant interventions for a better life and wellbeing of Yemeni communities and individuals. YFCA is currently working in about 27 hospitals, 24 HC and 15 HU in 44 districts in 8 governorates.

Main Activities:  Obstetric Emergencies to provide maternal, newborn and RH services at health facilities supporting CEmONC & BEmONC services.  Minimum Health Services Package (MSP) interventions  General health services for primary and secondary health care including the CD prevention, RH MISP package, IMCI with focus in increasing immunization coverage

Key Highlights during April and May 2020:  50 Health Facility supported by UNFPA benefited from Cleaning Materials distribution including: hand-Wash cleaning materials plus surface cleaning materials in addition to PPE provision to the health workers (Face Mask plus disposable gloves) and COVID-19 IEC Posters delivery to the HFs.  17 Health Facilities benefited from operational support, minor maintenance and repair including sanitation, latrines and hand washing points.  Integration of COVID-19 awareness session through trainings courses of the community health volunteers & health workers, minding reasonable space between participants, ensure cleaning, mobbing the hall ground & tools by anti-septic, providing face masks, disposable gloves, and hand sanitizers to all participants. Also fixing posters that enhance health awareness messages regarding COVID-19.  9 Health Facilities received Medicines, Laboratory solutions, Medical Equipment and medical supplies and 3 Emergency mobile medical teams. Total of 147,000 people have benefited from the health services supported by YFCA in health facilities and that include 106, 000 medical consolations, 5000 ANC, 450 assisted deliveries and 2,000 children under 1 year received penta vaccine. Also about 33,000 people have been reached with health education messages.

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FIGURE 6 YFCA ACTIVITIES DURING APRIL-MAY 2020

Save the Children International (SCI)

SCI is an International Organization supporting the Health System in Yemen by providing support to 150 Primary Health Care facilities and hospitals in 9 governorates in Yemen. It is also one of the organizations at the forefront of the COVID-19 preparedness and response in Yemen.

 SCI has support health facilities with PPE and 1,037 total of health workers have been trained on IPC, COVID-19 standard case definition, triage and screening, and how to deal with COVID- 19 suspected cases. In addition, SCI established triage and screening units in targeted health facilities in order to minimize COVID-19 transmission in health facilities and ensure continuity of PHC services.  During April and May 2020, 223,779 people have utilized the health services supported by SCI in the supported health facilities. That include 136,352 medical consolations (OPD), provided treatment for 73,214 communicable diseases cases (malaria, diphtheria, DF and TB treatment), 80, 10 ANC, 2,522 PNC and 3,681 doses of measles to children. Also about 94,918 people have been reached with health education messages.

Addition for Disasters assistances and Development (ADD)

ADD was established in May 2016 with the aim of providing humanitarian services and is working in multiple sectors including Health and Nutrition. It began operations in Yemen in December 2018 working in 4 governorates. It is currently supporting 18 Health facilities in Yemen providing Health and Nutrition services. ADD is also responding to the COVID-19 pandemic spread in Yemen.

 ADD, and in collaboration with WHO & Alhudydaha GHO, equipped and operated Alwa`raa isolation center in Alkhowkha district Al-hudydaha gov. with has a current capacity of 2 ICU beds and 4 inpatient beds. WHO support:  Equipped the Alwa`raa isolation center by 2 ICU bed, 4 non ICU beds and basic lab devices  Through GHO basic drugs and basic PPE  Seconded staff training in case management  WHO committed to pay risk allowances for seconded staff GHO:  Identified seconded staff for isolation center ( 6 doctors, 6 nurses , 3 lab person and 6 cleaners)

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 Support the Alwa`raa isolation center by one ambulance ADD support:  Procured and provided one generator for isolation center with good capacity  Completed the basic rehabilitation of the isolation center  In partnership with GHO finalized sample transfer to Aden strategy and ADD support role  In partnership with WHO completed ICU devices installation  In partnership with GHO competed staff training on ICU devices operation and management  Provided IPC supply and basic PPE  Monthly incentive  In May ADD Distributed IPC/PPE supply to 9 health facilities in western coast as part from COVID -19 preparndess and response.

FIGURE 7 ADD ACTIVITIES DURING APRIL AND MAY 2020 Qatar Red Crescent Society (QRCS) QRCS is an International Organization working in Yemen and providing support to a number of health facilities in Taizz, Sana’a and Sad’ad governorates. It is also one of the organizations responding to the COVID19 pandemic in Yemen. In addition to its normal health activities in the specified locations, QRCS has provided PPE materials and Hygiene items to all its facilities, thus protecting well over 280 health workers on the front lines. List of items provided:  Medical Disposable Gloves  Facemask  Insulation Suits  Liquid hand sanitizer  Liquid hand soap  Clorox  Dettol

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 Other protective items.

FIGURE 8 QRCS ACTIVITIES DURING MAY 2020 Intersos Intersos is an International Organization operating in Yemen since 2008. It mainly targets IDPs, people with special needs, women, children, migrant and asylum seekers and refugees. It works across all sectors such as Health, WASH, Protection and other sectors. It is currently supporting 20 health facilities in 3 governorates in Yemen. Main Activities MSP- primary health care including OPD/IMCI consultation, EPI, nutrition (SAM/MAM), health awareness (ANC,PNC, natal, family planning)

 Secondary health care including surgical emergencies, CEmONC, referral system  Capacity building and infrastructure  Outreach activities by CHW and CHVs  COVID-19 preparedness and preventive measures

Key highlights and achievements during the month of May  225 Health workers and 65 CHVs have been trained on EPHC package including new training on COVID-19 protocol.  By May 7,608 people accessed OPD consulations,807 women accessed reproductive health care,457 accessed surgical and non-surgical emergencies,96 CU5 enrolled in CMAM program and 4786 people received health and nutrition awareness.  In addition, 20 Health facilities have been supported by drugs, medical and non-medical equipment, running cost and rehabilitation.

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Relief International Relief International is an international organization established in 1990. RI is supporting 15 health facilities in 3 governorates in Yemen. Main Activities  Basic Emergency Obstetric and Newborn Care (BEmoNC)- in 5 Hospitals in Sana’a and Amran (2 in Sana’a and 3 in Amran)  Comprehensive Emergency Obstetric and Newborn Care (CEmoNC) in 5 Health Centers In Sana’a and Amran (2 in Sana’a and 3 in Amran)  Integrated Multi-Sector Interventions in 1 District hospital, 3 health centers and 1 health unit in 3 districts in Dhamar governorate.

Key highlights and achievements during the month of April and May 2020:  A Total of 11,994 female beneficiaries in 10 HFs within the 7 targeted districts in Sana’a and Amran benefited from one or more RH services during April and May 2020  A Total of 2,364 female beneficiaries in 10 HFs within the 7 targeted districts in Sana’a and Amran attended IYCF awareness sessions during April and May 2020  715 deliveries (647 Normal and 68 C/S) were conducted by skilled birth attendants in Sana’a and Amran 10 targeted HFs in 7 districts during April and May 2020  A total of 61 emergency cases in 10 HFs within the 7 targeted districts in Sana’a and Amran targeted were referred from the community level to PHC level and from PHC level to secondary/tertiary hospitals through the RI’s referral system.  A Total of 10,575 beneficiaries in 3 targeted districts in Dhamar benefited from one or more health and nutrition services during April and May 2020  A Total of 2,298 beneficiaries in 3 targeted districts in Dhamar attended health and nutrition awareness sessions during April and May 2020  96 normal deliveries were conducted by skilled birth attendants in 5 targeted HFs in 3 districts in Dhamar during April and May 2020

Nutrition

The Yemen Nutrition Surveillance System (YNSS) Infographic – May 2020 can be accessed at: http://www.emro.who.int/yem/yemen-news/nutrition-surveillance-dashboard.html

Highlights – May 2020  9191 children under five screened for all forms of malnutrition in May ; 31% of them under 6 months of age  95,856 children screened, since January 2020, across the 81 reporting NSS sites  114 sites established in 21 Governorates, with a geographical coverage of 95% of all governorates of Yemen and 42% of priority districts  Acute Malnutrition detected in 22% of the total children 6-59 months screened in May, with highest rates of both moderate and severe acute malnutrition recorded in Al-Hudaydah and Taizz (WHZ). Children found with acute malnutrition are referred to appropriate nutrition services.

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 The proportion of children with Severe Acute Malnutrition (SAM) is 6%, on average. The highest proportion of children affected by SAM (WHZ < -3 z-score) was found in Al- Hudaydah (13%). and Taizz (9%).  Chronic malnutrition remains of high concern, with 55 districts reporting a very high proportion of stunting.  Exclusive breastfeeding, only 22% of infants under 6 months of age. The indicator still lagging behind the WHO global targets 2025, which aims to increase the rate of exclusive breastfeeding in the first 6 months up to at least 50% by 2025.  Further (representative) assessments are recommended to verify these alerts, targeting locations that presented high rates of acute malnutrition

Health Cluster Coordination

COVID-19 Updates: Among the efforts of COVID-19 response in Yemen, Health Cluster is effectively contributed to the coordination of COVID-19 (Pillar one) in Yemen. About six COVID-19 meetings in weekly basis were conducted with partners during April and May of 2020. The Health Cluster also conducted five National Virtual Health Cluster meetings and ten Sub-National Health Cluster coordination meetings conducted in the five functional hubs (Aden, Al Hudaydah, Ibb/Taizz, Sa’ada and Sana’a). The Sub-National Cluster Coordinators at Hub level conducted five field visits to various health facilities in the governorates to support Health Partners during the month of April 2020. Taking into account the work from home modality and the restriction of staff movement as COVID cases started to be reported also the Eid vacation. The Health Cluster participated in six ICCM meetings and three HCT meetings at national level and the Sub-National Health Cluster Coordinators attended eight RCT meetings, three ICWG meetings in all the hubs in addition to 34 bilateral meetings (rely on virtual solutions).

As all efforts were directed on COVID- 19 Preparedness and Response, only four Technical Working Group meetings during the months of April and May 2020 were convened. Five trainings were conducted to IDPs focal points on COVID-19 surveillance.

Links to the 4Ws are as follows: http://yemenhc.org/?wpdmpro=health-cluster-4w-april-2020-draft http://yemenhc.org/?wpdmpro=health-cluster-4w-may-2020-draft

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Health Cluster in Marib:

Health Cluster had initiated many consultations and discussions in order to ensure coordinating the health humanitarian interventions in few locations / governorates, which are difficult to access such as Marib, west coast districts and Al-Turbah. For this and since IOM is leading the hub coordination efforts in Marib, so the Health Cluster has agreed with IOM support as focal point in Marib. Following this arrangements, IOM has immediately coordinated with GHO in Marib and agreed to convene weekly cluster meetings to make sure collective efforts is well mapped at the governorate. Weekly coordination meetings were agreed upon and 4 meetings were conducted during April – May 2020 in Marib. In light with COVID-19 Preparedness and Response, IOM is working hard to ensure functionality of one isolation unit in Marib (Saba University) with rehabilitation, equipment, medical supplies, staff training, IPC, operational cost and incentives. This IU is operational effectively since early May 2020 with 63 beds, of them 4 beds used for triage and 59 for admission including 10 ICU beds with ventilators and monitors provided by WHO. As the GHO in Marib has requested support to the IDPs sites quarantine centers (alternative for home quarantine for IDPs in sites with poor setups), Al Rhoda school site is prepared and Al Jufaina is underway shortly, yet, non is operational – IOM supported sites (Al Jufaina and AL Marda’) are expected to be operational by mid and end of June respectively. Testing capacity in Marib is the major challenges in COVID response as no PCR machine are available for testing and samples are sent to Say’un or Mukalla in Hadramout and those samples are declined as no enough testing kits even in Hadramout lab. In addition, GHO is keep requesting to expand the isolation units to another two different districts. Training of Health Staff

During the months of April and May 2020, Partners across the country conducted training sessions for: - 357 community health workers on health education, health promotion and infection prevention - 100 midwives on various topics in Reproductive Health and 365 Nurses. Trauma and Injury Care

With the ongoing conflict in several parts of the country, 15986 patients were treated for conflict related trauma injuries in various health facilities across the country during April and May 2020. Child Health

52,597 children were immunized for Penta-3, while 45,693 children were treated for SAM with complications cases and refereed for further follow up care and support.

For Further Information, Please Contact:

Dr. Fawad Khan Dr. Nasr Mohammed Dr. Fahad Al-Fadhel

Health Cluster Coordinator-Yemen Sub-National Health Cluster Coordinator – Sana’a Hub Health Cluster Coordinator (MoPHP)

World Health Organization World Health Organization Ministry of Public Health and Population

Mobile: +967-738335599 Mobile: +967 – 739888428 Mobile: +967 - 776120800

E-mail: [email protected] E-mail: [email protected] E-mail: [email protected]

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