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The Minimum Service Package – a lifeline for the vulnerable in remote areas
Safia Ahmed, has been working as a nurse for 20 years now. She currently works at Al Fawaris health centre supported by the Minimum Service Package. Due to the ongoing war in Yemen she has lost her her income.
19 February 2019 – With a health system on the brink of collapse, and ongoing conflict causing one of the largest humanitarian crises in the world, the health needs in Yemen are massive.
The MSP is a health delivery mechanism aiming at strengthening the access and availability of health care services therefore strengthening the health system in YemenThe Minimum Service Package (MSP) is a health delivery mechanism aimed at strengthening the access and availability of health care services therefore strengthening the health system in Yemen. Through the framework of the MSP, WHO in cooperation with health authorities and partners, is able to support the provision of primary health care services at the district level in 135 districts. Providing this access means that access to health care should not be an impediment, especially for vulnerable people in remote areas, where health facilities are either closed or lacking the needed supplies due to the ongoing war. Many people have to travel for hours to reach the closest facility putting them at risk of death.
Dr Hamid Al Hammadi, Director of Al Fawaris hospital, says that the support from WHO has enabled the health centre to provide primary health care for at least 10 000 people residing in the area who do not have access to health care nearby. “This project is critical and timely. Before the support the centre was functional for 5 hours a day only. Now we are able to operate 24 hours a day, 7 days a week,” he adds. The centre is now capable of providing maternal care, emergency care, laboratory tests and medical supplies.
Health workers are not forgotten
Since the beginning of the conflict 4 years ago, health workers in Yemen have struggled greatly to provide essential health care. Across the country, they work tirelessly without being paid and in turn cannot provide for and support their families. Providing incentives within the MSP ensures health workers are not forgotten.
Safia Ahmed works at Al Fawaris health centre supported by the MSP. She has been working as a nurse for 20 years now, and the ongoing war in Yemen has caused her to lose her income, like thousands of civil servants and pensioners who have not been paid salaries and bursaries for years due to the humanitarian situation.
“I now work here and thanks to the incentives paid by WHO, I am able to provide for my family. This support means a lot to us as health workers because it gives us a sense of purpose,” says Safia. Before this support, Safia would work 2 shifts for months on end without getting paid.
WHO expresses thanks to all donors and partners supporting the MSP in Yemen, including Italian Agency for Cooperation and Development, United Nations Central Emergency Response Fund and the Government of Kuwait. In 2019, WHO aims to make health services more accessible and available to 15 million people across Yemen.
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Italian Agency for Development Cooperation
Despite civil unrest, almost half a million Yemenis treated for onchocerciasis
12 February 2019 | Geneva | Cairo | Sanaʽa – Defying logistical challenges and despite ongoing civil unrest and instability, health-care workers in Yemen have been able to distribute medicines through large-scale treatment of people at risk of onchocerciasis in 33 districts of the country’s 8 governorates [1].
The 3-day campaign on 28–31 January 2019 was led by Yemen’s Ministry of Health, the World Health Organization’s country office, with support of the Expanded Special Project for Neglected Tropical Disease (ESPEN) and the World Bank through the Emergency Health and Nutrition Project (EHNP).
“We mobilized 970 teams led by 225 team leaders and more than 1935 health workers to assist in the distribution of ivermectin tablets,” said the National Director of Neglected Tropical Diseases Programme, Yemen. “Preparatory works started in December last year and training workshops were decisive in achieving maximum compliance during the campaign.”
Out of a total of 528 420 people targeted in all 8 governorates, 474 027 people were reached and treated, representing 90% coverage.
A total of 1 177 524 ivermectin tablets from the Mectizan Donation Programme were used during this latest campaign.
Onchocerciasis in Yemen
Unlike Africa, Yemen there are no records of eye complications or blindness due to onchocerciasis.
The disease mainly manifests in a localized form, mainly in lower legs in the form of ‘onchodermatisis’ also known as ‘reactive onchodermatitis’. Intense itching and skin irritation associated with severe manifestations leads to skin abrasion and other dermal infections.
The disease (locally known as ‘Sowda’ or ‘Sowdah’ referring to black pigementation) is endemic in 33 districts of the 8 governorates posing a risk to a total population of 3 million people.
Prevalence of onchocerciasis in Yemen is confined to the valleys running west of the Red Sea with over 60% clinical cases in the worst affected valleys. These areas abound with rapidly flowing water during the country's rainy seasons (usually between April and September) prompting fly breeding to take place. In Yemen, the vector for O.Volvulus is the blackfly, S. rasyani.
Prospects for elimination
Although Yemen started its onchocerciasis and lymphatic filariasis control programme as part of the National Leprosy Programme in 1992, targeting all people at risk of carrying microfilariae and susceptible to maintaining transmission even at a low level. The disease is under control and the national target is to achieve elimination as a public health issue as outlined in WHO’s Regional Office for the Eastern Mediterranean’s roadmap.
It is thanks to the technical support provided by the Regional Office and the dedicated work of local health workers and volunteers that treatment campaigns targeting everyone at risk are being sustained.
[1] Sana’a, Hajja, Ibb, Al-Mahweet, Dhamar, Raimah, Al-Hudaydah and Taiz
Cancer patients face ‘death sentence’ in Yemen
Layan was finally able to sleep after crying from the pain of the cannula that has been attached in her hand for days4 February 2019 – “Mum, it hurts very much.” With tears in her eyes, 4-year-old Layan describes to her mother how she feels about the cannula that has been in her hand for days.
Layan was diagnosed with non-Hodgkin lymphoma – a type of cancer that affects the lymphatic system – in March 2018. “When we admitted Layan to hospital, there were no empty beds and we had to wait for days until she was finally able to receive treatment. My heart aches and no words can describe how I feel seeing my little daughter endure the pain of illness,” says Abeer, Layan’s mother.
Mohammed Ahmed, 3-and-a-half years old, suffers from kidney cancer. With a beautiful, heart-capturing smile, he tells the doctor that he wants to go home. So far, Mohammed has had 6 chemotherapy sessions over 8 months and is scheduled for 2 more in the coming months. Mohammed’s family is trying to move from Ibb to Sana’a to avoid the high cost of transportation.
Providing urgent health care to millions: WHO and the Italian Agency for Development Cooperation work together to reach the most vulnerable
24 January 2019, Sana’a, Yemen — With a generous donation of 2 million euros from the Italian Agency for Development Cooperation, the World Health Organization (WHO) is scaling up efforts to meet health needs in Yemen through the health service delivery mechanism known as the Minimum Service Package. This is the first time since the start of the crisis in Yemen that WHO has partnered with the Agency.
This critical support will allow WHO to reach more than 600 000 of the most vulnerable people in need of essential health services in hard-to-reach areas of Al Hudaydah, Amanat Al-Asimah and Hajjah governorates. The objective is to provide health services through the Minimum Service Package while strengthening the health system with support from health partners across the entire country, ensuring the “right to health” for all Yemenis.
