28 March 2023, Aden | Sana’a – In a context of increasing restrictions on women in Yemen, WHO is advocating for gender equality and to address gender-based violence. Through the Emergency Human Capital Project (EHCP) supported by the World Bank, WHO is negotiating and succeeding in increasing the participation of female health workers in capacity-building and field work activities. 

WHO Representative to Yemen, Dr Adham Rashad Ismail Abdel Moneim, explains the importance of this approach: 

“Empowering female health workers has immediate benefits for the women involved, as they are given learning opportunities and financial allowances. It also contributes to Yemeni women more broadly, having better access to essential health services”. 

In 2022, reports of restrictions on the movement of women in Yemen started to be increasingly reported. For example, in many governorates, women should not travel without a male escort (e.g. father, brother or husband) (known as mahram). This meant that female health workers could not participate in multi-day WHO training activities far from their place of residence. In some cases, social norms restrict women from being treated or physically examined by male doctors. One female health worker explained, “The lack of female health workers in Yemen has exacerbated the humanitarian emergency, as it forces Yemeni women to go without the care they need.” 

The impact of such restrictions is reflected in estimates of maternal mortality in Yemen. Before the humanitarian emergency, in 2015, Yemen was estimated to have 164 maternal deaths per 100 000 live births. Last month, WHO, the World Bank, UNICEF, UNFPA and UNDESA released new estimates indicating Yemen’s maternal mortality ratio had increased to 183 as of 2020. 

In response to this challenging situation, WHO conducted a rapid gender analysis assessment of EHCP activities, which showed that women account for only around 18% of participants in EHCP training, workshops, field visits and other activities linked to per diem payments. 

WHO communicated these findings by official letter to the authorities in Aden and Sana’a and requested support to achieve 50% female participation in all World-Bank-funded activities going forward. The Ministry of Public Health and Population replied to WHO the next day in concurrence and nominated a focal point for gender in Aden. 

To enhance gender equality in activities, WHO is investing significant time in negotiation with the authorities, as demonstrated by a recent training of trainers in infection prevention and control. When the Ministry first requested the training, 3 female participants were nominated among 40 participants. After 4 follow-up meetings with different stakeholders, the proportion of female participants increased to 30%. The decision was also reached to decentralize the training so that female participants would not need to travel. A fifth consultative meeting led to WHO receiving a proposed participant list with 41 attendees, of which 56% were women, with 2 training locations agreed as part of a decentralized approach. 

In parallel, a series of consultative meetings have been held with the Ministry's gender-based violence (GBV) focal point in Aden and a joint operational plan was developed to establish protection units in EHCP hospitals. A grievance redress mechanism is also in place in all EHCP hospitals to report any case related to violence, sexual exploitation or harassment. In addition, WHO has conducted orientation sessions to increase awareness and staff of the Organization have consulted and sought feedback from 500 female health workers on issues related to gender-based violence. 

As part of these efforts, WHO also provided survivor-centred care and psychological first aid training to 129 nurses, midwives and doctors towards improving the services available to people experiencing gender-based violence. One of the participants provided feedback that “since the eruption of war in Yemen there are increased cases of women experiencing sexual violence and GBV, making prevention and response efforts even more important. One doctor added “I appreciate this initiative by WHO on making a commitment to supporting health staff in addressing GBV as an urgent public health matter and ensuring that those experiencing violence receive high-quality care.” 

Related links

Women at the forefront of the COVID-19 response in Yemen, 31 August 2022 

Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division