WHO EMRO - Yemen site-news

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Sana’a, Aden, 5 December 2022 – Mental health disorders have increased in Yemen over the past 8 years due to the impact of conflict on people’s lives, homes, communities, and livelihoods. Estimates indicate that one in 4 Yemenis, or over 5.5 million people, suffer from mental health disorders and require medical intervention.

Access to care for people with mental health disorders is incredibly challenging in Yemen. There are only 58 psychiatrists and 120 psychologists in the country as of 2020, and there are also severe shortages in other related cadres such as psychiatric nurses, social workers, and psychologists.

Through the Emergency Human Capital Project (EHCP), WHO and the World Bank are working together to provide mental health care in Yemen by expanding capacities. As part of this effort, in August and September 2022, WHO supported the local authorities to train 90 health workers on the training of trainers programme so that they could cascade knowledge and skills in mental health care to their peers.

WHO Representative to Yemen Dr Adham Rashad Ismail Abdel Moneim described the key elements of the training, “The participants learned how to recognize and address stress, trauma, psychological first aid related to humanitarian crises, loss, grief, ways to help vulnerable communities and raise community awareness on the importance of mental health care”.

The 5-day training brought together participants from the authorities and civil society. To enhance equitable access and service acceptance by men and women, 60% of the participants were females. Through presentations, case scenarios, and discussions, the training focused on the provision of primary psychological services by improving diagnostic capacities and knowledge of treatment methods. The pre-and post-test scores showed a dramatic improvement in relevant knowledge, up from 30% before the training to 83% after completing the course.

One of the participants, Dr Mohammed Jumail, a specialist and therapist in Yemen’s Sphere Organization and Al-Tamaninah Clinic in Sana’a, shared his impression of the training saying, “It was an honour to take part in this training among other colleagues from different institutional backgrounds. Theoretically, the course was very effective and came at the right time for us as practitioners. The cognitive enrichment was at a high level due to the professional trainer assigned to us, and we hope that practical sessions are included in the upcoming training. We took the new skills back with us to the field, to use and reflect in our mental health care practices”.

In the upcoming months, WHO is planning to conduct the training of trainers course for more health workers across Yemen, and to guide the trained participants in sharing their skills and knowledge with their peers. Practical sessions and role-play components of the course will be increased in line with participants feedback. Also, there are planned training on psychological first aid, case detection, referral, and psychosocial support as well as mhGAP targeting managers, physicians, and decision-makers in national and international organizations.

Capacity-building is part of a comprehensive approach by WHO to enhance mental health care in Yemen. This work is framed by the National Mental Health Strategy for Yemen, which was launched in October 2022. To take this strategy forward, in addition to capacity-building, under EHCP, WHO is planning to rehabilitate psychiatric facilities in Aden, Taizz, and Saadah, and to establish mental health clinics across 19 EHCP-supported hospitals, as well as carrying out educative and awareness campaigns to reduce stigma around mental health.

Enhancing basic and advanced life support skills among Yemen’s health workforce

Trainees take immediate proactive steps to cascade life-saving skills

Texts from the field: life-saving impacts of basic and advanced life support training in Yemen

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Aden and Sana’a, 22 November 2022 – The COVID-19 pandemic reaffirmed for the world the importance of health systems having strong intensive care capacities in place to save lives.

As part of building back better after the pandemic, WHO and the World Bank, through the Yemen COVID-19 Response Project (YCRP) have trained more than 1200 health workers in recent months to provide life-saving care to COVID-19 patients experiencing severe illness. The training will also help to build critical skills needed to save lives in emergencies.

Some efforts have been made to understand the gaps in emergency and ICU care capacities in Yemen. For example, a study published in 2022, surveyed 200 Yemeni nurses and identified that fewer than 41% had been trained in basic life support and around 75% could not recognize the correct chest compression rate. To address observed shortcomings, WHO launched a nationwide effort to dramatically improve knowledge of basic life support and advanced cardiac life support among health workers in the public sector.

Over the course of 3 months, 18 group training sessions were delivered in Sana’a and 4 week-long sessions in Aden. This resulted in training 230 doctors and 808 nurses in basic life support and advanced cardiac life support and 260 ambulance drivers in basic life support.

WHO Representative to Yemen Dr Adham Rashad Ismail Abdel Moneim explained the importance of the training, “Basic and advanced life support training is critical knowledge for all frontline health workers serving in emergency rooms and ICUs. By building these foundational skills, WHO and the health authorities, with the World Bank’s support, are ensuring doctors and nurses have the skills to save lives”.

During delivery of the training, participation of female health workers was monitored and advocated for, with the result that by the fourth batch of trainees in Aden, female health workers accounted for 65% of participants. Overall female doctors and nurses accounted for 33% of the trainees. By location, female health workers accounted for 19% of participants in Sana’a and 43% in Aden. To improve on this in future, WHO is working with the authorities to reach 50% female participation in training with the World Bank’s support, and in Aden a focal point has been nominated to help in achieving this target.

In Sana’a, the average pre-test result was 44% and post-test was 80%. Interim results from Aden showed a pre-test average of 57% and post-test increasing to 88%. In feedback forms, 252 participants evaluated the training. Of them, 48% received BLS for the first time, 99% now feel confident to perform CPR and 100% are willing to share their knowledge with their colleagues.

The investments in basic and advanced life support training build on WHO’s 9-week national critical care training, which was also conducted under Yemen's COVID-19 Response Project, for 118 doctors and nurses across Yemen. The basic life support/advanced cardiac life support training is delivered by master trainers who are specialists in emergency and critical care, assisted by selected potential trainers from the national critical care training.

In Aden, academic partners from Amin Nasher Institute, Yemen Medical Specialist Council, and the faculties of dentistry and nursing at Aden University, also participated in the BLS/ACLS towards enhancing institutional capacity-building partnerships and sustainability.

Going forward, the trainers are working on cascading BLS and ACLS skills to more health workers across Yemen’s 22 governorates. This work is planned to continue under the Emergency Human Capital Project (EHCP) with the World Bank’s support.

Learn more

Alkubati, S.A., McClean, C., Yu, R. et al. Basic life support knowledge in a war-torn country: a survey of nurses in Yemen. BMC Nurs 21, 141, 2022 https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-022-00923-0

Texts from the field: life-saving impacts of basic and advanced life support training in Yemen

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Taizz | Sayoun, 22 November 2022 – Participants from WHO’s recent basic and advanced life support trainings in Yemen are taking matters into their own hands to rollout these lifesaving skills to their peers. Among the more than 1200 health workers trained, below are some success stories of health workers playing critical roles in improving delivery of lifesaving care for the Yemeni people. The training was conducted with the World Bank’s support via the Yemen COVID-19 Response Project (YCRP).

Dr Raef is working in the Al-Jamohoury Hospital Cardiac Centre and is a teacher at Taizz Faculty of Medicine and Health Sciences. She successfully completed the 9-week national critical care training and recently got an opportunity to train in basic life support and advanced cardiac life support courses (for the first time), under the supervision of master trainers.

When Dr Raef and her colleague Dr Zahra returned to their governorate, Taizz, they were thinking about how to promote knowledge and skills for a long-term future and sustainability for the next generations. They came up with 4 ways forward:

They convinced the management of Taizz Faculty of Medicine to embed basic life support and advanced cardiac life support into the main curriculum of the ICU and anesthesia module.

Dr Zhara started teaching the theoretical part of basic life support and advanced cardiac life support in Taiz Faculty of Medicine.

Dr Raef delivers the practical part in Al-Jamohoury Hospital Taizz halls and cardiac-ICU for fifth-grade medical students with minimum available tools.

They keep communicating with Taizz governorate health office towards procuring more resources for an effective educational process.

Dr Nabil participated in the basic life support training of trainers in Aden. He passed the exam aligned with international standards to be a basic life support provider and instructor. Dr Nabil used his skills and knowledge to conduct a basic life support provider course at Sayoun University in Hadramaut Governorate targeting medical college students. In doing so, he complied with international standards as much as possible in a low-resource setting. Dr Nabil will have the chance to be a co-facilitator in WHO Yemen’s basic life support rollout plan.

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