ESD in Yemen:
The Basic Health Services (BHS) Program

Background

In 2005, USAID granted a three-year associate award to the Extending Service Delivery (ESD) Project to work in Yemen. The Basic Health Services Program (BHS) assists the Yemeni government in improving maternal and child health in the five northern and eastern governorates of Amran, Sa’ada, El Jawf, Marib, and Shabwa. BHS works closely with the Yemen Ministry of Health and Population to increase access to quality health care services and to promote the knowledge and awareness of maternal, child, and reproductive health among communities. The Project interventions are taking place in some of Yemen's most isolated and underserved areas where rates of maternal and infant mortality are among the highest in the Arab world.

Increasing Access to Quality Health Care Services

The BHS project works to:

• Renovate and refurbish health facilities in all five governorates, while also ensuring an adequate supply of project-related commodities, including contraceptives;
• Train health facility staff in the delivery of quality FP/MNCH services;
• Establish mobile health care teams to deliver services to remote and underserved populations; and
• Train community midwives to implement outreach services in rural areas, including through private sector schemes. 

Key Projects and Accomplishments to Date

           Construction

• Construction work is now completed in all 24 of planned health facility sites—in most cases expanded by adding housing for health providers and an extension for normal delivery services (basic EmOC).

 Equipment

• Furniture and equipment were supplied to 121 facilities including substantial medical equipment to health centers that were refurbished and basic instruments and equipment to smaller health units which are visited by mobile teams.

 Training

• 1,112 participants in short term in-service training; 123 new midwives graduated; 214 midwives still in a 2 year pre-service training; 16 morshidat from Al Jawf in a 1 year pre-service training to become midwives.
• BHS has also worked with the Yemin Midwives Association (YMA) to build capacity in the development of private midwife practices.

Mobile Medical Teams

• To date, BHS has 12 mobile teams in place in the 5 governorates.
• As of the end of 2008, teams have recorded a total of 183,726 clients.
• An estimated 200 health facilities which otherwise provide very limited services are activated through the mobile teams to provide comprehensive RH/FP and general care services once a month.

Community Mobilization

• One intersectoral Community Mobilization Group was formed in each of the 5 governorates, received training and began conducting awareness activities.
• To date these groups have implemented 2895 activities reaching 118,938 people.

Scaling-Up Best Practices

• 5 best practices scaled introduced at Al-Sabeen Hospital, including:
• Postpartum family planning/HTSP counseling and services
• Providing women after delivery with Vitamin A according to WHO standards for countries with widespread Vitamin A deficiency
• Introducing Kangaroo Mother Care for premature neonates
• Immediate and exclusive breast feeding
• Infection control in neonatal and delivery wards

Mobilizing Religious Leaders

• A cadre of 40 male and female religious leader trainers of training (TOT) on RH/FP is in place. They have trained a further 115 male and 54 female religious leaders to disseminate key RH/FP messages during Friday mosque sermons, lectures in mosques and community group meetings.
• Community outreach from the religious leaders has reached 419,147 clients to date.