HeRAMS Yemen Baseline Report 2023: Maternal and newborn services

HeRAMSYemen Baselinereport2023 MatErnalandnEwbornSErVICES Acomprehensivemappingofavailabilityofessentialservicesandbarriersto theirprovision July2023 ©WorldHealthOrganization2023 Somerightsreserved.ThisworkisavailableundertheCreativeCommonsAttribution-NonCommercial-ShareAlike3.0IGOlicence(CCBY-NC-SA3.0IGO;https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Underthetermsofthislicence,youmaycopy,redistributeandadapttheworkfornon-commercialpurposes,providedtheworkisappropri-atelycited,asindicatedbelow.Inanyuseofthiswork,thereshouldbenosuggestionthatWHOendorsesanyspecificorganization,productsorservices.TheuseoftheWHOlogoisnotpermitted.Ifyouadaptthework,thenyoumustlicenseyourworkunderthesameorequivalentCreativeCommonslicence.Ifyoucreateatranslationofthiswork,youshouldaddthefollowingdisclaimeralongwiththesuggestedcita-tion:“ThistranslationwasnotcreatedbytheWorldHealthOrganization(WHO).WHOisnotresponsibleforthecontentoraccuracyofthistranslation.TheoriginalEnglisheditionshallbethebindingandauthenticedition”. AnymediationrelatingtodisputesarisingunderthelicenceshallbeconductedinaccordancewiththemediationrulesoftheWorldIntel-lectualPropertyOrganization(http://www.wipo.int/amc/en/mediation/rules). Suggestedcitation.HeRAMSYemenbaselinereport2023-Maternalandnewbornservices:Acomprehensivemappingofavailabilityofessentialservicesandbarrierstotheirprovision;2023 Third-partymaterials.Ifyouwishtoreusematerialfromthisworkthatisattributedtoathirdparty,suchastables,figuresorimages,itisyourresponsibilitytodeterminewhetherpermissionisneededforthatreuseandtoobtainpermissionfromthecopyrightholder.Theriskofclaimsresultingfrominfringementofanythird-party-ownedcomponentintheworkrestssolelywiththeuser. Generaldisclaimers.ThedesignationsemployedandthepresentationofthematerialinthispublicationdonotimplytheexpressionofanyopinionwhatsoeveronthepartofWHOconcerningthelegalstatusofanycountry,territory,cityorareaorofitsauthorities,orconcerningthedelimitationofitsfrontiersorboundaries.Dottedlinesonmapsrepresentapproximateborderlinesforwhichtheremaynotyetbefullagreement. Thementionofspecificcompaniesorofcertainmanufacturers’productsdoesnotimplythattheyareendorsedorrecommendedbyWHOinpreferencetoothersofasimilarnaturethatarenotmentioned.Errorsandomissionsexcepted,thenamesofproprietaryproductsaredistinguishedbyinitialcapitalletters. AllreasonableprecautionshavebeentakenbyWHOtoverifytheinformationcontainedinthispublication.However,thepublishedmaterialisbeingdistributedwithoutwarrantyofanykind,eitherexpressedorimplied.Theresponsibilityfortheinterpretationanduseofthemateriallieswiththereader.InnoeventshallWHObeliablefordamagesarisingfromitsuse. HeRAMSYEMEN BASELINEREPORT2023 Maternalandnewbornservices Acomprehensivemappingofavailabilityofessentialservicesandbarrierstotheirprovision July2023 HeRAMSYemen//Baselinereport2023 CONTENTS Acronymsv Disclaimervi PartI:Overviewoftheavailabilityofmaternalandnewbornservices1 Howtoreadthecharts2 Overviewofhealthfacilitiesassessed3 Availabilityofservicepackageandmainbarriers4 Mainbarriersimpedingavailabilityofservicepackage9 Serviceavailabilitybycatchmentpopulation14 Mainbarriersimpedingservicedelivery16 PartII:In-depthanalysisbyhealthservice20 Howtoreadthechartsandthemaps21 Pregnancytest22 Short-actingreversiblecontraception(SARC)24 Long-actingreversiblecontraception(LARC)26 Antenatalcare28 Cleanhomedeliveries30 Skilledcareduringchildbirth32 Basicemergencyobstetriccare(BEmOC)34 Comprehensiveemergencyobstetriccare(CEmOC)36 Post-partumcare38 Comprehensiveabortioncare40 IEConSTI/HIV42 STI/HIVadvocacy44 SyndromicmanagementofSTIs46 HIVcounsellingandtesting48 Preventionofmother-to-childtransmission(PMTCT)ofHIV50 Antiretroviraltreatment52 Clinicalmanagementofrapesurvivors54 Emergencycontraception56 Post-exposureprophylaxis58 Annexes60 AnnexI:Definitionsofessentialservices61 AnnexII:Populationestimations63 iv Maternalandnewbornservices Acronyms BEmOCBasicemergencyobstetriccare CEmOCComprehensiveemergencyobstetriccare HeRAMSHealthResourcesandServicesAvailabilityMonitoringSystem HFHealthfacility HIVHumanimmunodeficiencyvirus IECInformation,education,andcommunications LARCLong-actingreversiblecontraception PMTCTPreventionofmother-to-childtransmission SARCShort-actingreversiblecontraception STISexuallytransmittedinfection WHOWorldHealthOrganization v DIscLAIMEr Disruptionstohealthsystemscanimpedeprovisionofandaccesstoessentialhealthservices.Communities’vulnerabilitytoincreasedmorbidityandmortalitysubstantiallyincreaseswhenalackofreliableinformationpreventssounddecision-making,especiallyinrapidlychangingenvironmentsrequiringcontinuedassessment.TheHealthResourcesandServicesAvailabilityMonitoringSystem(HeRAMS)aimstoprovidedecision-makersandhealthstakeholdersatlargewithvitalandup-to-dateinformationontheavailabilityofessentialhealthresourcesandservices,helpthemidentifygapsanddetermineprioritiesforintervention. HeRAMSdrawsonthewealthofexperienceandknowledgegatheredbytheWorldHealthOrganization(WHO)andhealthsectoractors,inc