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. 2018 Apr 25;14(1):42.
doi: 10.1186/s12992-018-0354-9.

Health in Yemen: losing ground in war time

Charbel El Bcheraoui  1 , Aisha O Jumaan  2 , Michael L Collison  2 , Farah Daoud  2 , Ali H Mokdad  2
Affiliations

Health in Yemen: losing ground in war time

Charbel El Bcheraoui et al. Global Health. .

Abstract

Background: The 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.

Methods: We 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.

Results: Vaccine 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).

Conclusions: The 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.

Keywords: Conflict; Malnutrition; Maternal and child health; Mortality; Vaccine coverage; War.

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Competing interests

The authors declare that they have no competing interest.

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Figures

Fig. 1
Fig. 1
a DTP3 coverage in 2016; (b) percent change in DTP3 coverage from 2013 to 2016; (c) DTP3 coverage in 2013, 2014, 2015, and 2016. In panel (c), the boxes indicate the 25th, 50th, and 75th percentile across all governorates while the lines indicate the full range across governorates and the dots indicate the national-level coverage
Fig. 2
Fig. 2
a Incidence of diarrhea episode per person-year in 2016; (b) percent change in incidence of diarrhea episode per person-year from 2013 to 2016; c Incidence of diarrhea episode per person-year in 2013, 2014, 2015, and 2016. In panel (c), the boxes indicate the 25th, 50th, and 75th percentile across all governorates while the lines indicate the full range across governorates and the dots indicate the national-level coverage
Fig. 3
Fig. 3
a Rate of under-5 mortality per 100,000 under-5 population in 2016; (b) percent change in rate of under-5 mortality from 2013 to 2016; c Rate of under-5 mortality in 2013, 2014, 2015, and 2016. In panel (c), the boxes indicate the 25th, 50th, and 75th percentile across all governorates while the lines indicate the full range across governorates and the dots indicate the national-level coverage
Fig. 4
Fig. 4
a Prevalence of maternal underweight – BMI < 18.5 kg/m2 in 2016; (b) percent change in underweight from 2013 to 2016; c Prevalence of underweight in 2013, 2014, 2015, and 2016. In panel c, the boxes indicate the 25th, 50th, and 75th percentile across all governorates, while the lines indicate the full range across governorates and the dots indicate national-level coverage
Fig. 5
Fig. 5
a Rate of maternal mortality per 100,000 live births in 2016; b percent change in rate of maternal mortality from 2013 to 2016; c Rate of maternal mortality in 2013, 2014, 2015, and 2016. In panel (c), the boxes indicate the 25th, 50th, and 75th percentile across all governorates while the lines indicate the full range across governorates and the dots indicate the national-level coverage
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