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HEALTH CLUSTER BULLETIN

October 2019

FIGURE 1 HEALTH CLUSTER COORDINATION MEETING 16TH OCTOBER, 2019

YEMEN Emergency Level: Level 3

Reporting period: 01-10-2019 to 31 -10-2019

HIGHLIGHTS HEALTH SECTOR

A total of 3,073 Health Facilities (17

Governorate Hospitals, 126 District Hospitals,

75 General Hospitals, 19 Specialized Hospitals,

789 Health Centers and 2,047 Health Units) are

supported by Health Cluster Partners.

The cumulative total number of suspected

Cholera cases from the 1st of January to the 31st

of October, 2019 is 767,459 with 997

associated deaths (CFR 0.13%). Out of the

reported cases, 62,159 cases were reported in

October 2019. Children under five represent

26% whilst the elderly above 60 years of age

accounted for 7% of total suspected cases. The

outbreak has so far affected 22 of 23

governorates and 311 of 333 districts in Yemen.

As of the 31 October 2019, the Health Cluster

Partners continue to support a total of 264

DTCs and 578 ORCs in the 147 Priority districts.

During the month of October, the Global Health

Cluster’s RH project conducted an 11-day

BeMONC training for 18 community midwives

71

14 M

HEALTH CLUSTER PARTNERS

PEOPLE IN ACUTE NEED

KITS DELIVERED TO HEALTH FACILITIES/PARTNERS

97 IEHK BASIC KITS

364 IEHK SUPPLEMENTARY KITS

1 TRAUMA KITS

1470 OTHER TYPES OF KITS

SUPPORTED HEALTH FACILITIES

3,073 HEALTH FACILITIES

2,068,299 OUTPATIENT CONSULTATIONS

32,883 SURGERIES

47,333 ASSISTED DELIVERIES (NORMAL &

C/S)

VACCINATION

71,081

PENTA 3

EDEWS

1,982 SENTINEL SITES

FUNDING US$

627.2 M REQUESTED

243.5M

(38.8%)

FUNDING RECEIVED

BY 31ST OCTOBER 2019(SOURCE FTS)

19.7M PIN of Health Assistance

15.8M Targeted with Health Interventions

3.34 Million** IDPs

627M Funds required

1Million Returnees

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Public health risks, priorities, needs and gaps

The Majority of the Yemeni population have limited access to health services as a result of the harsh

economic conditions, which impacts their ability to seek health services. As a result of transport costs,

poor road infrastructure and insecurity, road blocks and advancing frontlines, access challenges

continue to further complicate the already worsened situation. In addition to the fact that there are

about 51% fully functional Health Facilities (HFs), 36% partially functional and 13% remain non-

functional (HeRAMS 2018).

The referral from PHC to the secondary care level, the availability and cost of specialized care alongside

limited resources for the care of non-communicable diseases continue to place a huge burden on the

patients who suffer from chronic illnesses such as diabetes, hypertension, renal failure and cancer.

Communicable Diseases

A continuous and steady decline of Cholera cases has been seen during the month of October 2019.

The 147 cholera priority districts are currently under review by the MoPHP and the Cholera Taskforce.

In the Yemen HIS, there were 408,085 patients treated for various communicable diseases across the

various health facilities supported by health partners in Yemen during the month of October 2019.

During the reporting period, there were 62,159 cholera suspected cases reported, 55 associated

deaths and the outbreak has affected 22 of 23 governorates and 311 of 333 districts in Yemen. The

districts reporting the highest number of suspected cases of cholera during month of October 2019

were, Al Hali 1,776; Hamdan 1,293; Bani Al Harith-1,164; Jihanah 1,043 and Az Zaydiyah-1,020. The

highest reporting governorates of Cholera were Al-Hudaydah 12,590; Sana’a 8,071; Amanat Al Asmah

5,433, Ibb 5,401, and Hajjah 5164.

from Ottomah. Similar training for 18 midw2ives

in Al-Sheikh Othamn started on October 26th.

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 that are

in dire need of health assistance. In October 2019, 47 active Health Cluster partners with ongoing active

projects are currently supporting and responding to the health needs of the Yemeni people through

supporting 3073 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.

The Health Cluster is currently working on preparing the portfolio for the second standard allocation.

This allocation will focus on IDP sites and the defense is scheduled for the 7th of November, 2019.

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FIGURE 2 EPI CURVE: NUMBER OF SUSPECTED CASES AND THE CFR FROM 1 JANUARY TO 31 OCTOBER 2019: SOURCE – EOC

Non-communicable diseases and Mental Health

There were 24,611 new hypertensive and 1,565 individuals with mental health illness who

received medical attention and psychosocial support by health partners during the month of October

2019.

Health Facility Support

In October 2019, 46 Health Cluster Partners have sustained their support to the 3,073 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 continues to

depreciate and the majority of the population are not able to afford transport to and from the health

facilities. In addition, the roads are in poor state and can some of them are no longer usable. 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.

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.

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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. 347,485 Liters of fuel and 28.9 million liters of water

were supplied to the health facilities in addition to 97 IEHK basic Kits, 364 IEHK Supplementary kits,

1470 other types of kits and 1 Trauma kit to support various health facilities across the country.

Health Cluster Action

Health Cluster Partners include 4 UN agencies, 19 INGOs, 23 NNGOs in 22 Governorates in Yemen.

In October 2019, 46 Partners reported through the Yemen health information system.

Partners Implementation Status can be accessed at http://yemenhc.org

Health Cluster Partners Updates – September 2019

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 continued providing necessary lifesaving health services in Yemen.

Some of WHO’s services included but were not limited to:

Cholera:

- Water Provision and Monitoring: Continued provision of approximately 18,339 m3 of safe water

to 72 health facilities and 4,017m3 to DTCs. Monitoring visits have been conducted by WHO

field WASH supervisors in 12 Governorates. Reconstruction and rehabilitation of WASH services

in 35 HFs is under process.

- Training: Training session for 222 healthcare workers in 111 DTCs on IPC. Training session for

370 participants from different HFs was conducted on waste management. 5 day training session

for 129 healthcare staff from CPHL, Blood banks and TFCs on waste management.

Diphtheria:

- Diphtheria Antitoxin: 621 vials of DAT arrived at Sana’a Airport as part of urgent support to

MoPHP.

- Integrated Training is planned to start in November 2019 and will cover all districts in the

Northern areas to sensitize the health workers on all five diseases.

Dengue Fever:

- 100,000 NS1 RDTs have been distributed to the Rapid Response Teams in all governorates in

the southern part of Yemen. 60,000 RDTs have also been distributed to the Northern

governorates.

Nutrition:

Establishment of a Surveillance system which supported the targeted detection in 52% of

children 6-59 months. 63 thousand children under five were screened for all forms of

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malnutrition since January 2019. 42 Sentinels sites with an additional 65 being implemented to

cover 100% of priority districts and should be completed by the end of December. -

Trauma:

- 47 Surgical teams were supported with incentives in 17 governorates and 35 primary care teams

were supported with incentives in 13 governorates.

- 181907 consultations were administered by the primary care teams and 10153 were performed

by the surgical teams during October. EMMT performed 1502 consolations.

- 1,116,900 liter of fuel is planned to be distributed to 185 health facilities. 296,800 liters have

been distributed so far to 72 health facilities.

Non-Communicable Diseases:

- WHO supported three cancer centers with incentives in three governorates. Emergence

quantities of cancer medicine has been sent to MoPHP to be distributed to seven cancer centers

covering the needs for three months.

-

International Organization for Migration (IOM)

IOM is supporting the Health System in Yemen by providing support to 86 Health Facilities including 9 mobile

medical clinics providing MSP services.

- Key Highlights for the month of October 2019 include:

123,098 Outpatient Consultations in October 2019

Out of these 123,098 cases, 9034 consultation regarding RH services were conducted.

These included 6475 antenatal sessions, 1292 Normal Deliveries, 64 C-section and 1203

post-natal sessions.

IOM supported 4492 suspected Cholera Cases in 13 DTCs and 25 ORCs.

IOM trained 192 Health Workers and Community Health Volunteers in capacity building.

As the principle recipient for the Global Fund in , IOM supported the National Malaria

Program in the distribution of 213,000 Long Lasting Insecticidal Treated Nets (LLITNs)

providing protection to 426,000 beneficiaries. IOM also supported the distribution of Anti-

Malaria drugs to 1238 Health Facilities in 14 governorates.

IOM supported the National Aids Program in conducting seminars and training on HIV

testing and counselling services for 146 Health Workers.

IOM nutritional support included the distribution of 2479 Food baskets to people living

with HI and Multi Drug Resistance Tuberculosis.

FIGURE 3 WHO’S ACTIVITIES IN DIFFERENT LOCATIONS

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FIGURE 4 IOM SUPPORTED STAFF CONDUCTING CONSULTATIONS

Building for Development (BFD)

BFD is supporting Health Facilities in 8 governorates inside Yemen (Al-Jawf, Dhamar, Al-Mahwit, Al-Hudaydah,

Al-Bayda, Marib, Hajjah, and Sana’a)

- BFD provides a wide range of services including MSP, CEmONC, BEmONC, AND supporting

DTCs and ORCs.

- Key Highlights for the month of October 2019:

Providing equipment to HFs in Snaa’a and Amanat Alasimah supported by WHO.

Rehabilitation and maintenance the operation room in Wa'lan hospital – Sana’a Gov.

Providing and electrical Generator to Humdan Hospital

Providing fuel to multiple hospitals in different districts in Al-Hudaydah.

Activation of seven new health facilities to provide RH services(6 HFs in Al-Bayda

governate-1 HF in Dhamar Governorates)

Distribution of medicines, medical supplies, and cleaning tools to HFs in Multiple

governorates.

Conducting maintenance of equipment and providing new equipment and medicines to

Ad Dhahi Hospital.

Starting the DTC construction in Bajil Hospital supported by UNICEF.

Started rehabilitation of Malaha HC in Al-Jawf Goverorate.

Providing Al-Matoon HC , Malaha HC , and Al-Hazm DHO in Al-Jawf with medicines,

supplies and equipment.

Conducted on Job training on BLS , Emergency Triage, medical evacuation, IPC and medical

waste management in Al- Hazm DHO, Al-Matoon HC and Malah HC .

Conducted CMAM basic training for 14 HWs.

Conducted on job training of IMCI, EPI and infection Control for health workers in Al-

Hudaydah.

Providing multiple HFs with medical Equipment (Infant Radiant Warmer, and Portable

Ultrasound CBC)

Providing Zabid hospital, Al-Qahra HFs, and Al-Homiat HFs with Solar Power.

Conducting second CHVs refreshment meeting regarding Health and Nutrition services in

Al Hudaydah and Al Mahwit governorates.

FIGURE 5 BFD’S ACTIVITIES IN DIFFERENT LOCATIONS

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Qatar Red Crescent Society (QRCS)

QRCS is supporting eleven health facilities in four governorates in Yemen (Amanat Alasimah – Al-Dhalee – Al-

Hudaydah – Taizz)

- QRCS provides a wide range of services including the provision of medicines, medical supplies

and equipment, water and fuel, payment of incentives, training, health awareness sessions, and

other operational expenses.

- Key Highlights for the month of October 2019:

Total number of outpatient consultations is 38.4 thousand medical consultations.

Total number of consultations for communicable diseases including outbreaks is 6898

cases.

Total number of consultations for hypertensive patients’ is 7466 cases.

Total number of trauma cases that received life support (emergency care) is (1230) cases.

Total number of children under 1 that received Penta3 is (1181) cases.

Total number of beneficiaries that received Reproductive Health care services is 7041 cases:

(antenatal care: 5 K, postnatal care: 1574, C-section: 10, and normal deliveries: 457).

Total number of Dialysis patients' consultations (Kidney Failure consultations) is 1038 cases.

Total number of children benefiting from the provision of cerebrospinal fluid devices is 27

cases.

DEEM for Development

Deep is supporting health services in 28 HFs in three governorates (Taizz, Ibb, and Lahj) with UNFPA support.

Services provided include CEmONC, BEmONC, and EmONC services.

Key Highlights for the month of October:

Conducting the first phase of upgrading and equipping Al-Wehdah HC from HC into

Maternal Hospital.

Providing equipment and incubators for the neonatal department at Hajdah CEmONC

hospital Taiz governorate.

Upgrading Hayfan Health Center into a CEmONC hospital, which included the provision of

all equipment, medicines, medical supplies and all relevant renovations.

FIGURE 6 QRCS’S ACTIVITIES IN DIFFERENT LOCATIONS

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Health Cluster Coordination

The Health Cluster conducted two National Health Cluster coordination meetings and seven 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 11 field visits to various health facilities

in the governorates to support Health Partners during the month of October 2019.

The Health Cluster participated in two ICCM meetings and two HCT meetings at national level and

the Sub-National Health Cluster Coordinators attended two RCT meetings and four ICWG meetings

in all the hubs.

The Health Cluster team conducted twenty-two (22) bilateral meetings with Health Cluster Partners

on arising issues such as implementation challenges, avoiding duplication, covering gaps, capacity

building and reporting challenges.

The Health Cluster conducted six Technical Working Group meetings: - five RH, one MHPSS during

the month of October 2019.

Training of Health Staff

During the month of October 2019, Partners across the country conducted training sessions for: - 274

community health workers on health education, health promotion and infection prevention - 134

midwives on various topics in Reproductive Health. 447 health staff in various health facilities across

the country were oriented on Minimum Service Package (MSP).

FIGURE 7 DEEM’S ACTIVITIES IN DIFFERENT LOCATIONS

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Trauma and Injury Care

With the ongoing conflict in several parts of the country, 12,265 patients were treated for conflict

related trauma injuries in various health facilities across the country in October 2019.

Child Health

71,081 children were immunized for Penta 3, while 28,691 children were treated for SAM with

complications cases and refereed for further follow up care and support.

Reproductive Health

178,127 women attended antenatal care services; 38,433 normal deliveries were conducted;

8,900 mothers had caesarean section, and 29,928 mothers attended postnatal care services.

Plans for Future Response

As part of the preparation steps for HNO 2020, the MCLA will commence at the end of November 2019

and Preliminary data will be ready by the end of January 2020.

A plan for the Partner’s capacity trainings is being prepared and will be finalized for the upcoming year

according to results of the training survey of the partners conducted in 2019.

The Health Cluster will continue to advocate for expedited approval of projects and programs for

partners that have pending agreements with MoPHP and NAMCHA.

The second standard allocation has been launched and the Health Cluster is developing the portfolio

of the projects and the defense will take place at the beginning of November 2019. The second standard

allocation will be targeting support to IDPs only.

The Global Health Cluster RH project will be conducting a BeMONC training for participants from Al-

Odayn District in Ibb in November. Field assessment visits to Ottomah in Dhamar and Al-Odayn in Ibb

will be conducted to assess the health facilities.

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: khanmu@who.int E-mail: nmohammed@who.int E-mail: todrfahad@outlook.com