Al-Shifa

Current Health Challenges and Solutions

Challenge #1

Shortage of well-qualified staff in medical and paramedical specialties

  • It is estimated that 3.3 million Yemeni people have been displaced due to the armed conflict.
  • Since the start of the conflict, nearly 400,000 people have been displaced within Ta’iz Governorate alone.
  • The current public and private medical and paramedical institutes recruit a small number of students and residents. For example, in 2020 Taiz University enrolled only 60 students for the Bachelor Degree in Medicine and Surgery, which does not satisfy the community needs.
  • Yemeni professionals and specialists prefer to travel abroad to seek a better work environment and income.
  • Those who travel to study abroad prefer not to return back.

Taiz is one of the largest governorates of Yemen, with an area of 10,008 km2 and a population of 3,059,408 (12.2% of Yemen Population), and Taiz city, the governorate’s capital, is the third-largest city in the country, with about 615,000 resident. Nevertheless, Yemen is already facing a human resource crisis in public healthcare (see figure 3). For example, a report commissioned by the Yemen Ministry of Health and  Population before the conflict revealed serious shortages in skilled staff in maternal, neonatal and child health (MNCH). Nationwide, only 60 percent of the 261 obstetricians and only 5 percent of the 794 neonatal nurses needed to staff government health facilities were available. Taiz is among the governorates suffering the worst shortage of many qualified personnel in many fields.

Challenge #2

Current public health sector provide poor quality health care and medical service

Current Health Service (Public Sector):

  • Most of the public staff has displaced their jobs’ place. ? Human resources
    shortage
  • The current budget for the health sector in Yemen is characterized by a low
    government contribution even before the conflict (Figure 4). Thus public
    hospitals & health sector suffer ? shortage of budget and fund
  • Non-transparent policy and corruption in the public sector. This can be seen
    clearly starting from the government level as seen in the recent UN report
    about Yemen in February 2021, & spreading downward.
  • The current public-university & health-sciences institutes and colleges, are
    based on classic education, and do not own a hospital. Making integration of
    medical services, education and researches difficult. ? No university hospital
  • The employment process in the public health sector does not take the level of
    qualification, skills, knowledge and attitude into consideration. So the current
    staff in this sector incorporate a large proportion of non-efficient,
    non-competent staff that resist development and improvement. And is
    composed of a large proportion of old personnel that lacks youth motivation
    and is not keen on education and research.
  • The lack of coordination, cooperation, and motivation between university,
    public hospitals and GHO.
  • Leading and administrative positions rarely involve young, and females. And is
    almost totally composed of personnel who are not from the medical or
    paramedical field.
  • Political issues in nominating administrative personnel

These led to:

  1. Insufficient fund
  2. No integration between health service, education & research
  3. No development
  4. Non-efficient, non-competent staff
  5. Repellent environment for well-qualified staff.
  6. All these, left these hospitals to act only as an environment that introduce
    medical care that is not evidence-based and widen the gap between medical
    care, education and research
  7. Poor quality of health care & service

These led to:

Challenge #3

Current private health sector provide poor quality health care and medical service with expensive fees

Current Health Service (Public Sector):

  • The current private medical sector is concerned about profits, and gives
    business its utmost priority. ? expensive service not affordable for most of the
    people
  • The least priority is paid for quality of service, education, research or
    community service.
  • The employment process in the private health sector is based on enrolling the
    cheapest staff, & does not take the level of qualification, skills, knowledge and
    attitude into consideration. The lack of coordination, cooperation, and
    motivation between university, public hospitals, GHO and private hospitals
    and educational institutes.
  • Leading and administrative positions involve business men & women. And is
    almost totally composed of personnel who are not from the medical or
    paramedical field.

These led to:

  1. Expensive service, not affordable to most people
  2. Money goes to bank account of investors & business men instead of
    improvement & development
  3. Non-efficient, non-competent staff
  4. Repellent environment
  5. No integration of health service with medical education or research
  6. Poor quality of health care & service

These led to:

Challenge #4

Poor informational system, weak data documentation, and no orientation for research

  • No one health facility provides a computerized data collection system that
    will provide a fertile ground for research conduction
  • Almost no research is conducted at the public and private hospitals of Taiz city
  • Taiz University as a whole specified only ~2,000 USD for all research at the university including those from the Faculty of Medicine.
  • Absence of the concept that health research is important for the decision makers.
  • Difference of patterns used for all data. ƒ
  • Non-system and no-compliance of sending statistical reports in due time. ƒ
  • Pluralism of health information sources. ƒ
  • Rareness of qualified cadres in statistics field.
  • Non-availability of accurate comprehensive statistics of unified concepts. ƒ
  • Non-consideration of the statistics system as part of administrational system.
  • Non-credit of financial allocations for the work of statistics. ƒ
  • Non-existence of legislation to interact with the role of the system of
    information.
  • Non-employment of the computer and health programs of health utilities to
    generalize it on the central level, Governorates, districts and hospitals. ƒ
  • Refusal of using the computer and the appropriate programs in the financial
    system, personnel affairs and dependence on working by hand and intensified
    manpower

Challenge #5

Lack of many specialties, and facilities to provide some medical services, and to manage specific disease

  • Yemenis and Yemen governorate spent a lot of money to send patients to
    receive healthcare outside Yemen.

Presumed Solution: Establishment of Yemen Academic Hospital (YAH), a non-profit based project at Taiz city

Yemen, one of the Arab world’s poorest countries, has been devastated by a civil war. Yemen currently has the greatest level of humanitarian needs in the world with 16 million Yemenis food insecure,  10,000 have been killed by the conflict, and two million people have been displaced. Furthermore, the situation in Taiz city is considered special, as it is divided into two territories by the frontline between the fighting parties. This has resulted in damage to hospitals, severe shortage of essential medical supplies, university education deterioration, virtual collapse of health service, migration and displacement of brains and manpower, insufficient water and food supply, and spread of diseases. From our perspective, providing medical education, post-graduate programs, training and research are as essential as providing medical supplies and equipment. This will not only optimize medical care, additionally it will ensure a constant out-flow of human resources in a country where 53% of health facilities lack general practitioners (GPs), 45% of functioning hospitals lack specialists, and with ten health workers per 10,000 people.

 

Additionally, the constant attacks on public hospitals and staff jeopardizes healthcare in Taiz. Between 2018 and 2020, MSF recorded at least 40 incidents of violence against the MSF-supported Al-Thawra General hospital, its personnel and patients, including shootings inside or near hospital premises. Hospital buildings and structures were hit more than 15 times by small arms fire and shelling during this period, and there were nearly 10 incidents of medical staff being harassed and attacked.

In order to overcome these challenges, there is an urgent and essential need to bring to life our dream project of a non-profit, community-based educational hospital aimed at providing a safe, high quality health and medical education, training and research.  It will be professionally managed, productive, and open to all sponsors, sectors and organizations that meet its mission locally and globally. Moreover, this corporation will aim to open cooperative channels with national and global charities, foundations, and medical experts in order to receive expert missions in multiple specialties. In addition to providing unique medical service to patients, it will enhance the skills and knowledge of its staff, trainees and students. We may even be able to send our staff abroad to participate in educational courses and acquire skills through advanced training. And of course all of our transactions, partnerships and service delivery will uphold our mission and respect human rights as a priority, regardless of race, sex, political preferences, religions convictions, nationalities, sectarian or tribal distinctions.     

To achieve an environment that fosters medical education and research in combination with the best quality of medical and surgical service, we established a non-profit hospital away from the corruption of public sectors and political conflicts . Named Yemen Academic Hospital (YAH). A project proposal was  prepared.  A board trustee for the hospital was chosen. A five floor building and another floor beside it was hired. We designated the building to be a hospital including sectioning, epoxy made floor and steel doors for the operation room and ICU, decoration ..etc.  Additionally we installed an elevator for the building.

In cooperation with Pure Hand Organization we brought some equipment and supplies. Additionally, we received some support from Mercy Without Limits Organization,  currently we are sending one of our members to China to purchase more equipment and supplies that allows the launching of our dream project YAH.

1- In Yemen Academic Hospital (YAH)

  • Enrollment will be based on an individual's efficiency. Therefore, we look to enroll the best national qualified staff & efficient students.
  • We aim to communicate and coordinate at local, national and international level, to open post-graduate programs in many specialties.
  • A hospital that integrate medical service with education & research

These  will  lead to:

  • Fueling our community with qualified medical and paramedical professional staff
  • Providing work vacancies for our local qualified staff.
  • All these factors will provide an attractive environment for our national qualified staff and graduates.
  • Suffice our community health requirement
  • Decrease morbidity and mortality of injuries and diseases.

2- Yemen Academic Hospital (YAH)

  • Non-profit project will sustain its operations.
  • Transparency: Income and expenses will be apt to frequent monitoring, reviewing, and evaluation by a third party will be permitted in a transparent mechanism.
  • Enrollment to our hospital staff will be based on individual's efficiency and competency
  • Young, and females will be encouraged and given a fixed proportion in the administrative and leading positions. Giving them the chance to acquire experience in leadership and administration.
  • Leadership is a principle that we believe in
  • We aim to communicate, cooperate, coordinate and open our hands to all national and international sectors, institutes, universities, NGOs, donors, and authorities that share our mission and vision
  • Administration staff will be chosen according to efficiency, competency and qualification.

This will lead to:

 

  • An academic hospital equipped with the basic minimal prerequisites. After the project’s launching, a proportion of the income will go for further development and equipping.
  • Fostering an academic environment that keen on education and research and integrate them with medical service

3- Yemen Academic Hospital (YAH)

  • Our project is a non-profit one. Thus, resources and income will go for operating budget, self-replenishing, development and manpower investment, education, research and expansion.
  • As our project is not for profit, our services will not be expensive.
  • Free services will be possible for pre-specified classes of individuals.
  • Enrollment to our hospital staff will be based on individual's efficiency and competency
  • Administration staff will be chosen according to efficiency, competency and qualification.
  • All these factors will provide an attractive environment for our national qualified staff and graduates.

These will lead to:

 

  • Medical service with affordable fees.
  • Part of the project's income will go for development, education, and research.
  • Being a hospital, an educational institute and research center, will facilitate integrating medical services, education and research to provide the best quality of care.

4- Yemen Academic Hospital (YAH)

  • We will maintain electronic medical records to facilitate data collection and management.
  • Enrolling statisticians to our staff.
  • We aim to establish an academic environment and a research center that foster research culture.
  • We will specify a proportion of our income for research and development.

5- Yemen Academic Hospital (YAH)

  • Facilitating the provision of unique healthcare and hence saving the population the cost and effort of travelling

Final Expected Outcome

  • Best quality healthcare and service
  • Decrease the morbidity and mortality rates among the Yemeni population.