Assessing the minimum requirements for a healthy Yemen

Everyone should be able to obtain essential medical care. Yemen's health specialists are reviewing the Minimum Service Package in collaboration with WHO, UNICEF, and the World Bank (MSP).

During a period of rising violence, the first MSP was established in 2017. The package was quickly developed based on the Disease Control Priorities (DCP3) package and sent to around 2,000 Yemeni health facilities as part of the World Bank-funded Emergency Health and Nutrition Project.

Following a successful five-year deployment, the package is being evaluated logically, needs-based, pragmatically, and empirically to define the vital services Yemen's health system requires.

The evaluation will update the service package provided at each level of care (primary, secondary, and tertiary) to ensure that services are based on sickness burden and meet the requirements of the community. The package will focus on high-impact interventions and will provide a continuum of services from prevention through diagnosis, as well as treatment and rehabilitation at all levels of care.

Using a collaborative, evidence-based approach

The evaluation is now underway and will be completed by September 2022. Extensive consultation, collaboration, participation, and an inclusive approach have already been incorporated into the review process.

Meetings with officials in Sana'a and Aden in March and April brought together over a hundred stakeholders to debate each service included in the new package line by line. More than 70 delegates from 30 Health Cluster partners remotely participated in theme lectures on minimal services, complementarity, and referrals in February. To encourage meaningful stakeholder involvement, MSP documentation is being made available in Arabic and English.

Furthermore, to better understand Yemen's disease burden, the review integrates data from government initiatives, the Institute of Health Metrics and Evaluation, as well as professional expertise and validation. This investigation has underlined the importance of continuously enhancing the health information system to ensure the availability of correct data that can impact policy decisions emphasizing Yemen's growing non-communicable disease burden. 

For the first time, the MSP review process indicated that noncommunicable diseases (NCDs) pose a significant burden in Yemen. As a result, a succession of "quick triumphs" against the rising burden of non-communicable diseases have occurred:

Health officials have agreed to create a full-time NCD focal point to improve collaboration.

It is common knowledge that preventing noncommunicable illnesses through primary health care is critical. The draft MSP 2022 includes human papillomavirus immunization for girls, hepatitis B birth-dose vaccine, and screening and early detection of common breast and cervical cancers, in compliance with regional and global WHO objectives and targets.

Improving the healthcare system

The next MSP will necessitate clear action plans, a collaborative atmosphere, increased coordination, and ongoing assistance. Following that, the outputs of the recent workshops will be combined with those of the authorities, lists of quality standards, required laboratory services, equipment, and drugs for each level of care will be created, and the pricing for the package will be finalized.

As the revised package is implemented, efforts will be made to engage district and governorate health offices and field authorities in domain-specific workshops on maternal and neonatal health, child health, noncommunicable diseases (NCDs), and environmental health, as well as to invest in improving the health information system.