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Bridging the gap: Health volunteers improve community access to reproductive health services

Three women in black burqas standing looking at the camera

Nour, Omnia, and Heba are volunteers who work to deliver awareness messages in Lahj Gov. Photo: Bassam CARE

Nour, Omnia, and Heba are volunteers who work to deliver awareness messages in Lahj Gov. Photo: Bassam CARE

Improving access to reproductive health services is vital in a context like war-torn Yemen which has the highest maternal mortality ratio in the Arab region. According to the Fragile Countries Index, Yemen is one of the “high alert” countries for maternal mortality.

The health of women and their newborns directly affects the wellbeing of communities. Health issues among mothers and babies can be passed down  from one generation to the next.

a high angle view of a mountain range
The rugged terrain and the difficulty of obtaining services weaken the resilience of the villagers in the Yemeni countryside. Lahj Gov. Photo: Bassam Saleh/CARE

Years of armed conflict, food insecurity, epidemic outbreaks, economic decline and deterioration of public services has meant that Yemen’s population face significant threat to their  health and wellbeing. A staggering 20.7 million Yemeni people – 66 percent of the population –  require some form of humanitarian assistance. As often in crises, women and children pay the heaviest price. An estimated 73 percent  of the over four million people displaced in Yemen are women and children, while approximately 30 percent of displaced households are headed by women.

a woman in a black robe talking to another woman
Nour, a volunteer, explains awareness messages to beneficiaries during a home to home field visit, Tuban district, Lahj Gov. Photo: Bassam Saleh/CARE

The lack of nearby health facilities, paved roads,  transportation and medication funds affect maternal health-seeking behavior, particularly for the 75% of Yemeni women in rural areas. An estimated five million women and girls of childbearing age in Yemen, and 1.7 million pregnant and breastfeeding women, have limited or no access to reproductive health services, including antenatal care, safe delivery, postnatal care, and emergency obstetric and new-born care.

Three women walking in a sandy field
Nour, Omnia, and Heba during their field trip to rise the awareness messages in Lahj Gov. Photo: Bassam Saleh/CARE

Only half of all health facilities across Yemen are fully functional – with as litte as 20percent of these providing maternal and child health services. The COVID-19 pandemic has further exacerbated the already fragile situation as nearly 15percent of the functioning health system has been repurposed for the treatment of COVID-19, further complicating the delivery of reproductive health services.

A woman wearing a black head covering
Heba is describing her pregnancy experience and suffering. Photo: Bassam Saleh/CARE

For many Yemeni women in rural areas like Heba, timely access to reproductive health services can mean the difference between life and death. Heba is a mother from Tuban, a district in Lahj governorate in southern Yemen. Speaking about her motivation to work as a Community Health Volunteer, Heba says: “A year ago, I suffered from complications during the delivery of my baby. My family was late in deciding to take me to the hospital because they didn’t know that reproductive health services were available. When I arrived at the hospital, the doctor told me that I had anemia and that’s why I couldn’t deliver the baby. I received a blood transfusion then I was able to safely deliver my baby. Later on, the doctor told me that I could have died. From that day, I made a promise to help other women by educating them about reproductive health services.”

a group of women wearing black clothes sitting at a table
Volunteers are being trained on awareness messaging in Aden Gov. before conducting field visits. Photo: Bassam Saleh/CARE

Midwives and community health volunteers play a vital role in improving pregnancy and neonatal outcomes in Yemen’s hard-to-reach areas. In 2021, CARE trained 15 midwives and 40 community health volunteers in remote rural areas of the Radfan and Tuban districts in Lahj governorate.

Three women in burqas sitting at a table, reviewing papers and engaging in a discussion.
Volunteers are being trained on awareness messaging in Aden Gov. before conducting field visits. Photo: Bassam Saleh/CARE

The women volunteers were trained on educating women in the community about maternal health and referring cases with complications to nearest health facilities.

Two women in white coats holding up bags
5882 Clean Birth Kits are being checked to be distributed to help pregnant women deliver their babies safely at home. Photo: Bassam Saleh/CARE

Moreover, CARE provided 5,882 clean delivery kits to help pregnant women safely deliver their babies at home.

Three women sitting down listening to a woman in a white coat standing addressing them
Heba, a volunteer, delivers awareness messages to beneficiaries during home to home field visit. Photo: Bassam Saleh/CARE

After the training, Heba and other volunteers started to conduct house-to-house visits to educate women in their communities about antenatal care, safe delivery, post-natal care, family planning services, and best nutrition and hygiene practices. “The training didn’t only provide us with new knowledge, but it changed our behaviors too,” says Heba.

Two women wearing black headscarves and white vests standing facing each other
Volunteers are exchanging experience and lessons learned during a field visit. Photo: Bassam Saleh/CARE

Nour and Omina are two of the 40 health volunteers who are working hard to raise community awareness about the importance of reproductive healthcare. In addition to home-to-home visits, Nour conducts awareness sessions in her home and on social media to counter misinformation and stereotypes about reproductive health issues.

“Poor practices can cause dangerous complications for pregnant women and their babies,” adds Omina. “I recall how Aisha, a mother from Al-Roeat village in Lahj, suffered from a heavy hemorrhage while delivering at home and sadly lost her baby. After I met Aisha and her husband, the couple’s understanding  of reproductive healthcare changed. Now, they periodically visit the hospital to follow up on Aisha’s new pregnancy so she can deliver her baby safely this time.”

Nour, Omnia, and Heba hope all women and babies can receive adequate care to enjoy good health with dignity.

With support from EuropeAid CARE works in partnership with five relief agencies to enhance the resilience and social cohesion of conflict-affected communities in Lahj and Dhamar governorates As part of this partnership, CARE provides a package of integrated health, livelihood, and empowerment interventions.

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