PHRplus was requested by USAID/Yemen to support its Strategic Plan, which focuses on providing assistance that will lead to visible, high impact results in five underserved governorates Al Jawf, Amran, Marib, Saada, and Shabwa. In all sectors, USAID's programs focus on improving services and opportunities for women and girls, encouraging community participation and enhancing the quality of health data for planning and management. USAID's Strategic Objective in health is to increase the use of reproductive, maternal, and child health services. Intermediate results leading to the achievement of this objective include:
- Increased access to quality health services
- Increased knowledge and improved health behaviors at the community level
- Improved physical and policy environment for health
USAID/Yemen's strategy is designed to support the Republic of Yemen's Ministry of Public Health and Population's (MOPHP) Health Sector Reform Strategy, which focuses on improving management systems, decentralizing to the district level, cost-sharing, and redefining the role of the MOPHP.
PHRplus expects to achieve results in the following areas:
- Strengthened decentralized service delivery systems through improved planning, budgeting, and management interventions at the governorate and district levels
- Strengthened health planning, management, and financing at the national and subnational levels through use of National Health Accounts (NHA), Geographic Information Systems (GIS), Health Information Systems (HIS), and manpower planning and training
- Pilot interventions that focus on environmental issues that impact health
- Strengthened skills and role of midwives through improved curriculum and establishment of a national association of midwives
National Health Accounts – collaboration with Health Policy & Technical Support Unit (HP& TSU) at the MOPHP, WHO and the World Bank
Objective: institutionalize NHA framework for measuring total public, private, and donor national health expenditures, providing information that decision makers need for funding priorities and allocation.
- Provide ongoing assistance in development of workplan and data collection with the NHA team
- NHA team is working on finalizing the health expenditures through 2003
- Supported the World Bank public expenditure review
- Donor Survey – developed survey in collaboration with HPSR Unit and the EC. Results should provide information on where donors are working, major categories of assistance (rehabilitation, construction, equipment, training, etc.) and other information about donor investments
Geographic Information Systems collaboration with the Yemeni Health Statistics & Health Information Unit (HS & HIU)
Objective: enhance Geographic Information Systems (GIS) and Health Information Systems (HIS) capabilities to move beyond mapping towards sophisticated, evidence-based spatial analyses to improve health care, increase health facility utilization, and decision-making.
- Conduct ongoing collection of data from various sources to populate the GIS database
- Provide support to HP & TSU with donor mapping
- National Health Facility Survey – cleaned base maps and developed survey instrument and reference manuals for the national survey and conducted the survey of public and private facilities in the five USAID target governorates. The survey teams consist of MOPHP team leaders and governorate/district level surveyors. Results will provide the baseline for an improved HIS and GIS
- Facility Level Information System – testing the development and implementation of a simple, one-page patient encounter form to collect facility level data on patient visits to hospitals and health centers in 3 districts in Amran, including the Amran Hospital
- Immunization Management Information System – an improved immunization MIS model piloted in Amran. The plan is to provide a system that will improve the use of information for planning and disease prevention and control, and result in an increase in immunization coverage, reduction of vaccine wastage, enhanced capacity of local managers, and optimized immunization policies and practices. This activity will also link immunization data to the GIS
- Support to the new Population Sector in the MOPHP – assistance in team building, establishing roles and responsibilities, job descriptions
- MOPHP website developed and supported to house data, GIS, and other types of health information and documentation. Launched in Arabic and English
Environmental Health (EH)/Disease Prevention
Objective: incorporate environmental considerations into health care service planning and delivery for better information, education and community action, in order to improve conditions that most directly affect children and women’s health (the following are proposed topics).
- Thula Pilot/Environmental Health –program will involve communities in the design of environmental health interventions, including awareness campaigns, health education, issues of clean water, management of village cisterns, sanitation and solid waste management.
- Amran Cement Factory/Environmental Impact Assessment – a team of environmental experts has worked with the EPA, Ministry of Environment, and the Cement Factory to assess the current environmental impact of the old and newly designed plants. The study results were presented in February 2005 at the Amran Cement Factory
Support to Midwives
Objective: support strategies for improving the skills and services provided by midwives to enhance/promote the role of midwives
- National Midwife Association – assisted the establishment of this important association. Additional support includes training in fund-raising, advocacy, planning and budgeting, proposal writing, drafting a business plan, developing a brochure, logo, newsletter and website
- Discuss possible interventions to be included in training curriculum
Support to Governorate Health Teams
Objective: enhance the capacity in health planning, budgeting, management and financing, and in collecting and using reliable data
- Statistics Training – a short course in the importance and use of health statistics conducted for governorate and district health teams. Provided computers, printers and additional training to the governorate statistics offices. Will train a cadre of trainers to continue support to DHOs.
- Management Training – a short course to build management capacity within the governorate and district health teams.
- English Language Training – an English course was offered to the Governorate Health Office in Marib. The course will be given to staff of the Amran Governorate Health team.
- Computer Equipment and Training – providing DGs of Health with computer equipment and training in an effort to connect them with other governorates, districts and with the Central Ministry. The DGs will receive basic training once computer equipment has been installed.
- Hababa Health Facility in Amran – the project was able to assist this well-functioning facility in getting connected with electricity and phone lines. Catalyst has now supplied the facility with an X-Ray machine and ultrasound and will train staff in the use of this equipment.
Objective: provide support for observation tours to other countries to gain firsthand knowledge of the experiences related to health reform and strengthening of health systems
- Thailand sponsored five midwives to attend Postpartum Hemorrhage Conference, resulting in a review of current curriculum and practices
- Morocco supported a tour to Morocco to look at experience of decentralization, the role of the Ministry of Health, institutionalization of NHA, and Morocco's long and successful experience in family planning