title: Findings from a needs assessment of public sector emergency obstetric and neonatal care in four governorates in Yemen: a human resources crisis.
abstract: Recent reviews suggest that it is unlikely Yemen will reach Millennium Development Goal 5 on maternal health by 2015. We conducted a needs assessment in 2010 to identify the human resources constraints in delivery of emergency obstetric and neonatal care (EmONC), in one urban and three under-served rural governorates. The assessment tools were adapted from the UN Guidelines for Monitoring Availability and Use of EmONC. Findings showed that while the urban governorate (total population 666,210 with 26,648 expectant mothers yearly) had 54 obstetricians, 10 anaesthetists and 72 paediatricians, the three rural governorates (total population 1,885,371 with 75,414 expectant mothers yearly) together had only three obstetricians, three anaesthetists, and eight paediatricians. Furthermore, in the rural governorates, with an 0.5% caesarean section rate, which is far below the 5% minimum for this UN indicator, no district hospital had an operating surgeon or an anaesthetist. There was also a marked scarcity of female general physicians and a large disparity in the proportion of births with a skilled attendant between the rural (12%) and urban (34%) governorates. Findings emphasize the need for increasing the coverage of EmONC nationally, but especially in rural areas, through more equitable staff distribution and promotion of task shifting. Developing a national human resources plan and ensuring an enabling policy are prerequisites.
authors.affiliation: Community Health Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen. A_alserouri@yahoo.com
authors.forename: Abdul Wahed
authors.initials: AW
authors.lastname: Al Serouri
authors.forename: Abdulla
authors.initials: A
authors.lastname: Al Rukeimi
authors.forename: Mohammed
authors.initials: M
authors.lastname: Bin Afif
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Al Zoberi
authors.forename: Jamela
authors.initials: J
authors.lastname: Al Raeby
authors.forename: Catherine
authors.initials: C
authors.lastname: Briggs
authors.forename: Hamouda
authors.initials: H
authors.lastname: Hanafi
mesh_terms: D004636:Emergency Service, Hospital; D005260:Female; D006040:Goals; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006786:Hospitals, Urban; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008428:Maternal Mortality; D008507:Medically Underserved Area; D020380:Needs Assessment / Q000706:statistics & numerical data; D009775:Obstetrics and Gynecology Department, Hospital; D011247:Pregnancy; D011248:Pregnancy Complications; D017150:Public Sector; D014480:United Nations; D000078329:Workforce; D015006:Yemen