Al Waziza Raof, Sheikh Rashad, Ahmed Iman, Al-Masbhi Ghassan, Dureab Fekri
Institute for Research in International Assistance (IRIA), Akkon Hochschule für Humanwissenschaften, Berlin, Germany.
Yemen Public Health Network, Sana'a, Yemen.
Discov Health Syst. 2023;2(1):15. doi: 10.1007/s44250-023-00026-w. Epub 2023 May 10.
Yemen is regarded as one of the Middle East's poorest countries. Decades of political, economic, and social difficulties have culminated in the current protracted conflict. As a result, the globe experienced its worst humanitarian catastrophe. The ongoing war has affected several public services, notably the health sector, which is operating at less than half its capacity. This study aims to examine Yemen's health system at the governorate level (Al Hodeida) amidst the current conflict. It analyzes current challenges and produces suggestions for enhancement.
The study used qualitative research methods such as Key Informant Interviews (KIIs) and document analysis. The study used WHO's health systems framework to measure health system performance. Twelve KIIs were conducted via Skype with several health stakeholders. In addition, documents were analyzed to inform the subject guide, generate themes, and aid in the triangulation of results.
According to the study findings, the governorate health system managed to offer a minimum level of healthcare services while making some advances in outbreak control jointly with other partners. One of the main difficulties confronting the governorate's health system is a severe lack of financial resources forcing it to rely entirely on external aid. Furthermore, other significant deficiencies include inadequate health system organogram, low reporting capacities, insufficient funding, and scarcity of health professionals.
Yemen's frail health system has been weakened by almost eight years of insecurity and conflict. If the current scenario continues, most of Yemen's health system's operations and indicators will likely deteriorate. On the other hand, progress in some areas, such as primary healthcare (PHC) services and disease management, is remarkable. However, for better performance, Yemen's health system leadership and stakeholders should seek a holistic strategy to improve the entire dimensions of the health system.
也门被视为中东最贫穷的国家之一。数十年的政治、经济和社会困境最终导致了当前旷日持久的冲突。结果，全球经历了最严重的人道主义灾难。持续的战争影响了多项公共服务，尤其是卫生部门，其运转能力不到一半。本研究旨在考察当前冲突背景下也门省级（荷台达省）的卫生系统。分析当前面临的挑战并提出改进建议。
本研究采用了定性研究方法，如关键信息人访谈（KIIs）和文件分析。研究使用世界卫生组织的卫生系统框架来衡量卫生系统绩效。通过Skype与若干卫生利益相关者进行了12次关键信息人访谈。此外，对文件进行分析以为主题指南提供信息、生成主题并协助结果的三角验证。
根据研究结果，省级卫生系统设法提供了最低水平的医疗服务，同时与其他伙伴在疫情控制方面取得了一些进展。该省级卫生系统面临的主要困难之一是严重缺乏财政资源，迫使其完全依赖外部援助。此外，其他重大缺陷包括卫生系统组织架构不完善、报告能力低下、资金不足以及卫生专业人员短缺。
近八年的不安全和冲突削弱了也门脆弱的卫生系统。如果当前的情况持续下去，也门卫生系统的大部分运作和指标可能会恶化。另一方面，在一些领域，如初级卫生保健（PHC）服务和疾病管理方面取得的进展是显著的。然而，为了取得更好的绩效，也门卫生系统的领导层和利益相关者应寻求一项全面战略来改善卫生系统的各个方面。
