SANA'A, Yemen – More than four years of armed conflict have brought Yemen’s essential public services to the brink of total collapse. The first to feel the effects are, invariably, the nation’s most vulnerable: mothers and babies.
Access to quality health services during and after pregnancy can be the difference between life and death for mothers and their unborn babies. Yet the conflict in Yemen has severely curtailed access to skilled care.
Every two hours, one mother and six newborns die because of complications during pregnancy or birth.
Even when mothers do make it to facilities with functional maternity wards, there’s no guarantee that they will actually be able to receive care. Health providers report that they are understaffed and under resourced, sometimes lacking even essential equipment like incubators. Pregnant women, new mothers and babies, meanwhile, are often forced to share beds; infection control is poor.
A future in the balance
Ali lost his mother the day he was born.
With little money and no means of transportation, Ali’s father didn’t have any way of getting his wife, Khaizaran, to a hospital or health centre when she went into labour last December. It’s an all too common story in Yemen, where less than a third of babies are born in health facilities.
Khaizaran died from severe bleeding within five hours of Ali’s birth. Had his father been able to get Khaizaran to a hospital, she might have had a chance. Instead, she died in his arms.
Ali’s future now hangs in the balance. He is living with this aunt, who is trying to nurse both Ali and her own 3-year-old child.
Maternal and child survival are closely linked. Babies who lose their mothers often stand little chance of survival: 1 in 37 die during their first month of life. Infants who lose their mothers – and are therefore not exclusively breastfed – are also at heightened risk of death, directly through malnutrition, and indirectly through increased susceptibility to infections.
Yemen’s conflict-torn economy leaves those already barely scraping by even deeper in debt.
Most maternal deaths are associated with conditions that could have been prevented if the woman had access to family planning and quality healthcare before and during pregnancy, and when she is giving birth. But even when families can access health care, the country’s conflict-torn economy leaves those already barely scraping by even deeper in debt.
The cost of a future
Intense fighting forced Suad and her family to flee their home in the southern Yemeni city of Taiz. She now lives with her family in a camp for internally displaced persons (IDPs) in the neighbouring Lahij governorate. When the time came to give birth to her youngest child, Saeed, her husband, Mansur, was determined that she should do so at the nearest hospital. The problem? The nearest hospital was several hours from their home.
Mansur took out a loan to cover the costs of travel and medical treatment for a hospital delivery. But Suad experienced complications during the delivery and needed a Caesarean section. As the family’s medical expenses mounted, Mansur was forced to exhaust his family’s entire savings – US$90 – to settle the bill.
Only able to find work as a casual labourer, and without a secure income, Mansur can now barely earn enough to feed his children.
Only half of health facilities in Yemen are fully functional, and even these face severe shortages in medicines, equipment, and staff. As part of its efforts to reduce the high level of newborn deaths in the country, UNICEF is supporting 13 hospitals – including by providing neonatal intensive care units – across five Governorates.
In addition, UNICEF and partners this year launched the Healthy Start Voucher Scheme to improve access to life-saving healthcare. The initiative includes coupons for poor and vulnerable pregnant and lactating women to help them cover the cost of traveling to a hospital for a delivery, as well as for accessing emergency obstetric and new born care in case of complications. Families can also use the scheme to access treatment for malnutrition and contraception.