Mid-Year Review of the Humanitarian Response Plan for Yemen 2012

3.2.4 HEALTH

Summary of updated cluster response plan

Cluster lead agency	WORLD HEALTH ORGANIZATION
Cluster member organizations	ADRA, CSSW, IMC, IOM, MDM, Merlin, MoPHP, MSF France, MSF Spain, MSI, RI, Save the Children, UNFPA, UNHCR, UNICEF, USAID, WHO, YFCA.
Number of projects	23
Cluster objectives	To ensure coordinated response to the humanitarian health needs of the crisis-affected and other vulnerable populations, especially the women and children. To ensure access to a standardized package of quality life-saving, essential health care services (preventive and curative). To monitor and respond to potential outbreaks (including environmental health interventions).
Funds required	Original: $56,180,512 Revised at mid-year: $66,406,674
Funds required per priority level	Life Saving: $61,735,098 Support Services: $1,337,500 Time Critical: $3,334,076
Funding to date	$11,894,181 (18% of revised requirements)
Contact information	Dr. Ghulam Popal (WHO Representative): [e-mail] and Dr.Dauod Altaf (HCC): [e-mail]

Categories and disaggregated numbers of affected population and beneficiaries

Category of people in need	Number of people in need			Number of targeted beneficiaries			Number of people covered
	Total*__Female'>Female	Male	Total*	Female	Male	Total*	Female	Male	Total*
Total population in need	2,584,810	2,715,190	5,300,000	1,292,405	1,357,595	2,650,000	622,663	598,244	1,220,907**
Population aged (aged 5 and above)	2,000,000	1,300,000	3,300,000	700,000	600,000	1,300,000	386,051	370,911	756,962
Women of child-bearing age	1,300,000	N/A	1,300,000	450,000	N/A	450,000	299,122	N/A	299,122
Pregnant women	200,000	N/A	200,000	80,000	N/A	80,000	48,836	N/A	48,836
Children under five	980,000	1,020,000	1,020,000	661,500	688,500	1,350,000	110,834	106,487	217,321

* Cannot be added owing to overlapping categories. ** Will be reduced down to 229,576 beneficiaries if vaccination campaign not included

The total number of children vaccinated by 3 nationwide campaigns for polio and measles is 7,796,000 children aged 0 - 15 years

In light of the deteriorating security situation and further disruption of basic social services, the need for humanitarian interventions has increased in the relatively unstable and insecure governorates of Sa’ada, Al-Hudaydah, Hajjah, Abyan, Lahj and Aden, as the host governorate for many IDPs. The current conflict in Abyan has led to further displacements also in the neighbouring governorates while basic services, including healthcare, have been further disrupted in the affected areas.

The Health Cluster was able to achieve most of its objectives on the basis of the proposed indicators, particularly in providing basic health care services to the IDPs residing in the camps where 95% could be covered. Also, 40% of IDPs outside the camps could be assisted with basic health care services. The immunization coverage for measles was more than 95% nationwide and in IDP camps.

As result of delays and lack of funding for critical Health Cluster projects, a number of activities had to be discontinued in Sa'ada, Haradh and Al-Jawf. Other activities have been downsized and populations will not have access to basic health care services. As a consequence, the capacity to detect and respond to disease alerts and outbreaks, as well as the vaccination coverage for vaccine-preventable diseases (VPD) has been minimized, creating the risk of re-emergence of the polio virus. Moreover, the low capacity and lack of access of Government partners has further disrupted the delivery of quality and comprehensive health care packages to the affected populations. The lack of access and effective monitoring and evaluation of activities are important implementation challenges, which are further compounded by the low health awareness level of communities.

Health indicators are reaching alarming dimensions. Only 35.7% of deliveries are assisted either by a midwife or a skilled birth attendant, the caesarean section rate is below 1% (the target is a rate between 5-15%) and the subsequent maternal mortality rate stands at 365/100,000 live births. UNFPA aims to deliver coordinated humanitarian response to ensure that women and girls can access basic emergency obstetric and neonatal care (BEmONC) and comprehensive emergency obstetric and neonatal care (CEmONC) to prevent a rise in maternal and infant mortality and morbidity rates as well as the spread of HIV.

The total number of target beneficiaries for health services stayed approximately the same, with the exception of priority health interventions and geographical prioritizations for the control of communicable diseases and reproductive health needs. In these areas, existing PHC services and specific reproductive healthcare (RH) services and family planning interventions will have to be strengthened. Such programmes include the training of health personnel and midwives, as well as the supply of RH kits and safe delivery kits, with the ultimate goal of increasing the number of deliveries assisted by trained health personnel.

Priority interventions of the Health Cluster for the second half of 2012 include: PHC packages; outbreak detection and response; mass casualty management; integrated outreach, expanded programme on immunization, reproductive health and integrated management of childhood illness (EPI, RH & IMCI) and mass vaccination. The Health Cluster is working closely with non-Cluster partners, such as MSF-France, to share information and coordinate health activities.

Table of mid-year monitoring vs. objectives

Outcomes with corresponding targets	Outputs with corresponding targets	Indicators with corresponding targets and baseline	Achieved as mid-year
Cluster objective 1: To ensure coordinated response to the humanitarian health needs of the crisis-affected and other vulnerable populations, especially the women and children.
Improve access to essential health care services for IDPs, host communities and affected populations and access to emergency obstetric care services.	Quality essential healthcare services to target population and minimum initial services package (MISP) for RH in crisis situation.	100% coverage of IDPs living inside camps, 45% coverage of IDPs living outside camps. Provision of life saving BEmONC and CEmONC services.	100% coverage of IDPs living inside camps and over 40% coverage of IDPs living outside camps. 50%.
Cluster objective 2: To ensure access to a standardized package of quality life-saving, essential health care services (preventive and curative).
Maximize coverage of immunization against childhood VPDs.	More children vaccinated against VPDs and related morbidity and mortality prevented.	Measles vaccination coverage > 95% in camps/urban areas and 90% in rural areas.	100%. 93%.
Cluster objective 3: To monitor and respond to potential outbreaks (including environmental health interventions).
Mitigating, preparing for and responding to public health threats, with a focus on prevention and control of communicable diseases among the vulnerable populations.	Early detection of disease alerts and timely investigation and response to communicable diseases outbreaks.	90% of alerts investigated within 24 hours. 100% of investigated outbreaks are responded to within 24-36 hours.	90% of alerts have been investigated with 24 hours. 100% of investigated outbreaks are responded within 24-36 hours.