Term Paper

Health Economics
ECON-3503

Yemen’s Health Sector as a war going country

Submitted To: Submitted By:

MD. Emran Hasan Mayaz Al Mahin

Assistant Professor ID:21144881042
Dept. of Economics, BUP Session: 2020-2021
 Abstract

Because of prolonged war and conflict, Yemen is currently facing one of the worst human crises in world’s
history. This conflict created a huge impact over the general people of Yemen. The health sector of Yemen
is nearly collapsed. Over 80% of the population currently has difficulty accessing food, clean water, and
health care services. Only 50% of the health facilities are fully functional. It’s a huge matter of fact that only
50% of the birth of Yemen is done by none specialist. In this paper we will go through the current situation,
the findings, the reason behind Yemen’s this catastrophic health sector and discuss about the what can be
the steps to develop the health sector of Yemen’s sector.

Introduction:
Middle-east is one of the richest regions in this world. But there is a country Yemen which is very poor
comparing with other countries of middle east. There are many reasons behind this situation. But the conflict
between the STC militia, Yemen GPC supported Govt. and the Houthi Movement is the main reason behind
the country’s downfall. This conflict and the war between Houthi militia and the Saudi Arabia affected almost
every sector of Yemen and the general people is the main sufferer at this situation. Health sector of Yemen
is almost collapsed. It is very hard to get any health care service at Yemen. 20.1 million people in Yemen
lacks to get the basic health care at Yemen. Yemen’s maternal mortality ratio is one of the highest in the
region at 164 maternal deaths per 100,000 live births and the infant mortality rate is 45.7 deaths per 1000
children. This on-going war destroyed many healthcare centers and hospitals in the country especially at
Houthi rebels controlled northern and southern area of the Yemen. But there are little dissimilarities we are
going to find at the other part of the Yemen. The working condition for health worker to work there is very
bad right now and we are going to see very little improvements if the necessary measurements not taken
and if the conflict is not solved.

Current condition of Yemen’s health care system:

Not only Covid-19 but also many diseases like cholerae, diarrhea spread out at Yemen in recent times.
These diseases could have been prevented if they had strong health care system. But how it can be
possible to have strong health care system if the country is fighting between militia parties because of
political agenda. Now technically the main source of health care at Yemen is funding from other countries.
From 2014 to 2023, the nine-year conflict has left 22.9 out 31.5 million people in need of humanitarian
health care. 540,000 Yemeni children under age five are currently suffering from severe acute malnutrition
with a direct risk of death. 46 percent of health facilities across the country are only partially functioning or
completely out of service due to shortages of staff, funds, electricity, or medicines.

More than 13,000 new cases of measles, 8,777 instances of dengue fever, and 2,080 probable cholera
cases were reported in the first quarter of 2023. However, because to weaknesses in the surveillance
system, the true numbers are likely substantially higher.

But there are new political talks on-going to bring peace at Yemen. But there is enough damage at the
health care infrastructure of the country which need huge improvement even though there if the conflict is
solved.

While recent data on health indicators and demographic trends in Yemen is scarce, an analysis of pre-crisis
trends already demonstrates a weak health system, particularly in terms of maternal and child health.

While some hospitals in major cities might have a few specialists, many other health facilities, especially in
conflict-affected areas, don’t, said Dr. Edmund Nabena, health coordinator for International Medical
Corps in Yemen. Authorities have not paid many of the health workers, leading them to seek work
elsewhere, including at private facilities, leaving many rural areas without adequate numbers of staff.
Medical equipment had been stolen and ambulanced had been hijacked throughout the period of conflict.
The payment of health worker has been irregular for a long. That gives them lack of motivation. Because
the inflation is quite high and prices of necessary item is also much more comparing with any other country
in the world. A huge number of health service is provided by the INGO’s at Yemen.

The reason behind Yemen’s poor health sector

 Yemen's territory is divided into two halves. The de facto authority in the north is the Houthi
movement, commonly known as Ansar Allah. The south, on the other hand, is divided between the
internationally recognized administration and the secessionist Southern Transitional Council.
Moving between regions of control is difficult and risky, according to health workers. The harsh hilly
terrain in some parts of Yemen also hampers health workers' access to populations.
 Because of Covid-19 the external funding at Yemen’s healthcare sector has been low comparing
with other years after the start of conflict. So, it really impacted really bad. Because of that many
Non-Government organization that used to work in small area with less group of people either
stopped their work or shift to the other area where they can connect with more people.
 Geographical situation is also a reason. The population is scattered in Yemen. There is more time
need to move one place to another for better treatment. That’s create more cost to people of
Yemen.
 Houthi Rebels has not only conflict with the govt. of Yemen but also with the KSA, because they
support the govt. of Yemen. That’s why the parts occupied by The Houthi Rebels don’t get that
much funds and donation comparing with other part of Yemen.
 Because Yemen’s govt. is one-party ruled for long time. There is not that much reform not only in
health but also in many sectors of Yemen. That’s why there is lack of knowledge towards any work
and plan related with health. For example, children under age 5 are not vaccinated for many
diseases.
 There is low immunity in the country for vaccine-preventable diseases, which makes the population
vulnerable to childhood diseases. Increased vaccine hesitancy among parents and adults, in
general, is a challenge. Outbreaks of whooping cough, diphtheria, measles, and vaccine-derived
polio, a kind of polio that spreads in regions with poor vaccination rates, are examples of this.
Positive Sides of Yemen’s Health-Sector
Strategic health plan of the Ministry of Public Health and Population 2011–2025 includes health system
strengthening as a priority. Well established immunization, and control of the communicable disease
programs prior to internationalization of crisis. Fully functional ‘Health Cluster’ mechanism that is
coordinating the emergency response. Commitment of development partners and their engagement to fulfil
the urgent emergency needs. UN organizations, including WHO, have maintained their commitment to
providing technical and financial assistance to the Ministry of Public Health and Population. The Yemen
Minimum Service Package will be adopted by the government and its partners as the foundation for a
service delivery recovery strategy that will be funded in large part by a partnership between the World Bank,
the World Health Organization, UNICEF, and World Food Program. Consistently updating HeRAMS (Health
Resources Availability Mapping System) data and analysis for use in resource mobilization, allocation, and
response planning. Applying vertical equity concepts, vulnerability analysis is used to focus service delivery
assistance on the districts that need it the most.

Steps that can change the current situation of Yemen’s health sector
Restoring the functionality of health services and public health programs through the ongoing
implementation of Yemen Minimum Service. Implementation of packages (reproductive health, maternal,
neonatal, and child health, communicable and noncommunicable diseases). Advocate for funding pledges
for the Yemen humanitarian response plan's urgent health needs. Development of a medium-term MSP
implementation strategy that includes rehabilitating the health system so that it can function properly and
will serve as the foundation for ultimate transition to the recovery phase. Ensure continuous payment of
salary to Yemeni health workers at the level required to retain employees in facilities through government,
donor, implementing humanitarian, and development partner commitment and action. Increasing the
capacity of the health system to respond to public health emergencies and epidemics.

Conclusion
The main purpose of the paper is to show the impact of internal conflict or regional war at any country on
health sector. At Social media it’s easy to find Yemen’s malnourished child pictures. That shows usually
how bad the impact is at Yemen. The health sector is suffered most for this situation. But now there are
talks of peace between the militia groups of Yemen. So it’s possible to see good results in near future. But
for that, The Govt., international organizations and NGO’s must work to together to create a better blueprint
for the health sector. Otherwise, the general people of Yemen will not be able to have the good facilities
that should have been provided with new and better Govt. that has huge possibility to establish.
References
 https://www.devex.com/news/yemen-s-health-system-is-hanging-on-a-cliff-102543
 https://www.sciencedirect.com/science/article/pii/S0277953621000836
 https://www.worldbank.org/en/country/yemen/publication/health-sector-in-yemen-policy-note
 https://news.un.org/en/story/2017/02/552032
 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10169293/