Reducing maternal mortality in Yemen: challenges and lessons learned from baseline assessment.
OBJECTIVE
The Yemen is a signatory of the Millennium Development Goals (MDGs) and one of 10 countries chosen for the UN Millennium Project. However, recent MDG progress reviews show that it is unlikely that the maternal health goal will be reached by 2015 and Yemen still has an unacceptably high maternal mortality of 365 per 100000 live births. Because 82% of deaths happen intrapartum, the purpose of this needs assessment was to identify and prioritize constraints in delivery of emergency obstetric care (EmOC).


METHODS
Four district hospitals and 16 health centers in 8 districts were assessed for functional capacity in terms of infrastructure; availability of essential equipment and drugs; EmOC technical competency and training needs; and Health Management Information System.


RESULTS
We found poor obstetric services in terms of structure (staffing pattern, equipment, and supplies) and process (knowledge and management skills).


CONCLUSIONS
The data argue for strengthening the 4 interlinked health system elements-human resources, and access to, use, and quality of services. The Government must address each of these elements to meet the Safe Motherhood MDG.
Al Serouri
Abdul Wahed
AW
Community Health Department, Faculty of Medicine and Health Sciences, Sana'a University, Yemen. A_alserouri@yahoo.com
Al Rabee
Arwa
A
Bin Afif
Mohammed
M
Al Rukeimi
Abdullah
A
D003625:Data Collection; D036861:Delivery, Obstetric / Q000592:standards; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000592:standards; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration / Q000592:standards*; D008428:Maternal Mortality; D008429:Maternal Welfare; D009775:Obstetrics and Gynecology Department, Hospital / Q000458:organization & administration / Q000592:standards; D010865:Pilot Projects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality* / Q000517:prevention & control; D011787:Quality of Health Care; D015006:Yemen / Q000453:epidemiology