Abstract
BackgroundThe effect of the ongoing war in Yemen on maternal and child health (MCH) has not been comprehensively assessed. Providing a situational analysis at the governorate level is critical to assist in planning a response and allocating resources.MethodsWe used multiple national- and governorate-level data sources to provide estimates of 12 relevant MCH indicators in 2016 around child vaccination, and child and maternal nutritional status, and the change in these estimates for the period 2013–2016 based on shock variables including change in gross domestic product, burden of airstrikes per 1000 population, change in access to untreated water sources and unimproved toilets, and change in wheat flour prices. We also used findings from the Global Burden of Disease 2016 study.ResultsVaccine coverage decreased for all antigens between 2013 and 2016 among children 12–23 months. The largest decrease, 36·4% for first-dose measles vaccine, was in Aden. Among children under the age of five, incidence of diarrhea was at 7·0 (5·5–8·9) episodes per person-year. The prevalence of moderate and severe child anemia ranged from 50·9% (24·9–73·1) in Sana’a City to 97·8% (94·1–99·2) in Shabwah in 2016. Prevalence of underweight among women of reproductive age ranged from 15·3% (8·1–24·6) in Sana’a city to 32·1% (24·1–39·7) in Hajjah, with a national average of 24·6% (18·7–31·5).ConclusionsThe war and siege on Yemen has had a devastating impact on the health of women and children. Urgent efforts to secure food, essential medicines, antibiotics, deworming medicine, and hygiene kits, and cold chains for immunization are needed. Yemen is in dire need of clean water and proper sanitation to reduce the spread of disease, especially diarrhea.
Highlights
The effect of the ongoing war in Yemen on maternal and child health (MCH) has not been comprehensively assessed
Yemen is divided into 21 governorates – Abyan, Aden, Al-Baidha, Aldhalae, Al-Hodeida, Al-Jawf, Al-Mahrah, Al-Mahwit, Amran, Dhamar, Hadramout, Hajjah, Ibb, Lahj, Mareb, Reimah, Sadah, Sana’a, Sana’a City, Shabwah, and Taiz – with their own local health departments that report to the central Ministry of Public Health and Population (MOPHP)
We focused our analyses on maternal and child health to estimate the following indicators: For children, we focused on 1) vaccine coverage, including third-dose polio vaccine (Polio 3); third-dose diphtheria, tetanus, and pertussis (DTP3); third-dose pneumococcal vaccine; and first-dose measles vaccines among children 12–23 months old, 2) global acute malnutrition (GAM) stunting among children under 5 years old, 3) anemia among children 6– 59 months old, and 4) under-5 mortality (U5MR)
Summary
The effect of the ongoing war in Yemen on maternal and child health (MCH) has not been comprehensively assessed. Yemen is one of the poorest countries in the Middle East. It ranked as the 160th country (of 188) based on the Human Development Index in 2014 [1]. Yemen has experienced multiple conflicts that intensified around 2010 [4], with large protests taking place in 2011, internal fighting in 2012–2014, and a war and siege that started in 2015 and continue to date [5]. The war and siege have had a devastating impact on every vital sector in Yemen including agriculture, service, and industry, which faced large-scale destruction and significant cost increases [6, 7]. Water supply, sanitation, irrigation, and agricultural services were all hindered, leading to the deterioration of population health, especially women’s and children’s health [8, 9]
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