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Improved reproductive health services: The difference between life and death

A building with a ladder in front of it

Khillah health centre before rehabilitation

Khillah health centre before rehabilitation

On a quiet afternoon in Khillah area of Al Dhale governorate in Yemen, Saeeda was at home when she began to feel labour pains. At the 38th week of pregnancy, Saeeda realized that she was in serious trouble as she started to bleed. Saeeda was strong enough to make the decision to walk to the nearest health centre on foot, which was a decision that saved her life and the life of her baby.

In obstetric emergencies, timely access to reproductive health services can mean the difference between life and death for mothers and babies. For many Yemeni women in rural areas like Saeeda, harsh terrain, as well as the lack of paved roads and funds, makes it difficult to access clinics, depriving them of life-saving reproductive health care.

Yemen records the highest maternal mortality ratio in the region and has been placed among the high alert countries for maternal mortality in the Fragile Countries Index.  As often in crisis, women and children pay the heaviest price. An estimated 5 million women and girls of childbearing age, 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. Decades of underdevelopment and years of intense fighting have left only half of all health facilities fully functional. Moreover, the COVID-19 pandemic has aggravated the situation, with roughly 15 percent of the functioning health systems repurposed for COVID-19 treatment.

Hospital Beds in a hospital room
Women used to give birth in an unequipped delivery room at Khillah health centre

In many areas of Al Dhale governorate, health facilities that still operate can’t meet the growing need for reproductive health services due to the lack of female doctors and essential medical supplies and equipment.

“We didn’t know how to deal with the huge need,” says Dr Mohamed Muthanna, Khillah health centre manager. “Women weren’t delivering their babies in a good environment because there was no labour ward in the centre.”

Women wearing black outfits sitting and waiting in a hospital room
More women visit the centre after the employment of the female doctor

“Women delivered their babies on the floor because there were no beds,” says another staff member. “We used to use flashlights during deliveries due to the frequent power cuts and a lack of fuel to operate the standby generator.”

To reduce the neonatal and maternal mortality rate, with funding from the Dutch Relief Alliance, CARE intervened to rehabilitate Khillah health facility. CARE provided essential equipment for safe delivery, solar panels and water tanks to ensure power and water supply, and renovated the toilets in the delivery room; in addition to training 40 midwives to deliver  much-needed reproductive health services for women in their homes.

A woman in a white coat holding a small child
A nurse performs a medical examination for a child in Khillah centre

“Before this intervention the lack of tools was catastrophic,” says a staff member in the centre. “We used to use the same set of delivery tools when we had many women giving birth at the same time, which was very unsafe for the patients. But now we have enough tools that can be sterilized after each usage and used again.”

“Our female patients are spreading the good news about the new services provided by the centre to other women in remote areas, and with the newly-employed female doctor, we expect more women to visit the centre soon,” says Dr Mohamed. CARE’s reproductive health officer says: “This centre offers a one-stop-shop that provides a wide range of much-needed reproductive health services for women in need.”

“I feel grateful for all the useful things that the midwife in my area taught me,” says Saeeda.  “She educated me about breastfeeding and nutrition and helped me make a plan to deliver at the health facility. I’m no longer scared of delivering a new life into this world.”

A new red and white building
Khillah health centre after rehabilitation
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