National Health Cluster Coordination Meeting - November 18th 2020 Sana'a, Yemen

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National Health Cluster Coordination Meeting - November 18th 2020 Sana'a, Yemen
National Health Cluster
     Coordination
       Meeting

   November 18th 2020
     Sana’a, Yemen
National Health Cluster Coordination Meeting - November 18th 2020 Sana'a, Yemen
Agenda
• Introduction/Action Point follow up
• Updates from various coordination fora,
   • Yemen Humanitarian Senior Official Meeting II SUMMARY
•   [

• Epidemiological updates of Communicable Diseases: MOH
   ❖Cholera, DF and diphtheria, SARI updates
•   [

• Updates on
        • HCWs payment ongoing discussion for HC Payment policy 2021.
        • JIAF- a preparatory step for HPC 2021–HNO 2021,
        • 1st Standard Allocation 2020 & progress

• Updates of TWGs
   ❖MHPSS, Nutrition, EPI/vaccination
• AOB
National Health Cluster Coordination Meeting - November 18th 2020 Sana'a, Yemen
#
    Action Points/ Subjects to Follow Up                                              Responsibility            Status
1   There is need to work together to identify the contributory factors to cholera    Health Cluster, Cholera
    cases decline (agree on type of assessment)                                                                  Pending
                                                                                            Task force
2   Health Cluster Infographics, Central Level and Hubs, to be shared with partners
    on a monthly basis.                                                                   Health Cluster         Ongoing
    Yemen Health Cluster Website: www.Yemenhc.org
3    Keep health partners informed on the updates on HNO 2021                             Health Cluster         Ongoing
4   All selected projects will be recommended to coordinate with MOH for the                                     Ongoing
                                                                                         Health Partners
    assessment before they finalize and submit the proposals
5                                                                                        Health Cluster/         Ongoing/
    Health partners are requested to report any utilization decrease - impact
                                                                                           partners               Critical
National Health Cluster Coordination Meeting - November 18th 2020 Sana'a, Yemen
➢Yemen Humanitarian Senior Official Meeting (SOM) II-Summary
• Participation (online) of the main humanitarian actors/donors active in the country.
• SOM- 2 assessed the deteriorating crisis and expressed their commitment to continue acting collectively
  along the following lines.
• Yemen shows marked deterioration of the humanitarian crisis, including the imminent risk of famine, due
  to increased violence and economic struggles, compounded by shortages of funding, restricted
  humanitarian space, politicization of aid and limited imports of basic commodities.
    • A spiraling economic collapse, exacerbated by the outbreak of COVID-19 (global) is a realistic prospect
• The humanitarian response in 2020 is severely underfunded and additional resources are urgently required
• Humanitarian actors reiterated their firm commitment to continue providing life-saving support to the
  people of Yemen in line with donor accountability regulations and the humanitarian principles of humanity,
  neutrality, independence and impartiality.
• Donors reaffirmed the seven areas, which parties to the conflict must respect in Yemen to enable access and
  allow accountability, efficient, effective and principled delivery of assistance (Avoid taxation of humanitarian
  aid,….,)
• Humanitarian actors agreed that, if and where the operating environment limits or obstructs the flow of
  principled and accountable aid, humanitarian programs will continue to be adapted and recalibrated
National Health Cluster Coordination Meeting - November 18th 2020 Sana'a, Yemen
SOM- 2 SUMMARY
1. Maintain a regular, constructive and consistent dialogue with all parties, assess the situation and its
progress in the next months and reconvene before the 2021 pledging conference for Yemen.
2. Increase urgent advocacy, including at the highest level, with the parties for the respect of International
Law, including International Humanitarian Law and International Human Rights Law, and the protection of
civilians.
3. Intensify engagement with relevant Yemeni parties to facilitate the implementation and monitoring of
progress of the seven areas to ensure principled humanitarian delivery.
4. Continue to adapt and recalibrate their programs to adjust to circumstances on the ground in Yemen,
whenever the operating environment limits or obstructs the flow of principled and accountable aid.
5. Continue to mobilise and increase much needed funding in Yemen to preserve life-saving assistance – such
as food, water, healthcare, nutrition and protection – with focus, on the most pressing and acute needs in the
country. With the aim of avoiding a prospect of further downscaling of programmes by humanitarian actors in
the coming months due to a lack of funding, substantial additional resources, including development funding,
and prompt disbursements are urgently needed before the end of 2020 and in early 2021.
6. Mobilise a support package to prevent the economic collapse, including renewal of proven measures like
foreign-exchange injections, as well as identify concrete modalities allowing a more focused developmental
and financial support to address the drivers of the crisis in order to keep Yemen from the brink of collapse.
7. Follow up by dispatching high-level missions by the UN, NGOs and donors, where appropriate, to pursue
advocacy on humanitarian matters pertaining to the Yemen crisis.
National Health Cluster Coordination Meeting - November 18th 2020 Sana'a, Yemen
Updates on outbreak

Cholera, DF, SARI and Diphtheria
      Current situation
         Challenges
        Way forward
        MoPHP – EOC
National Health Cluster Coordination Meeting - November 18th 2020 Sana'a, Yemen
National Health Cluster Coordination Meeting - November 18th 2020 Sana'a, Yemen
Summary of AWD / Cholera indicators
   During 2018 ,2019 and 2020
National Health Cluster Coordination Meeting - November 18th 2020 Sana'a, Yemen
Epidemiological Curve of AWD / Cholera Cases
 (Cumulative from WK1 ,2019 to WK45 ,2020)
National Health Cluster Coordination Meeting - November 18th 2020 Sana'a, Yemen
Top Governorates
(from WK1 to WK45,2020)
Summary of Cholera indicators
During Last 3 Weeks (43,44,45)
Summary of Diphtheria indicators During
        2018 ,2019 and 2020
Epidemiological Curve of Probable Diphtheria Cases
    (Cumulative from WK1 ,2019 to WK45 ,2020)
Summary of Diphtheria indicators
 During Last 3 Weeks (43,44,45)
Distribution of Probable Diphtheria Cases by Governorates
                 (From WK42 – WK45 ,2020)
Summary of DF indicators
During 2018 ,2019 and 2020
EPI-Curve of DF Cases with CFR%
(Cumulative from WK1 ,2019 to WK45 ,2020)
Summary of DF indicators
During Last 3 Weeks (43,44,45)
Distribution of DF Cases by Governorates
        (From WK42 – WK45 ,2020)
Summary of SARI indicators During 2018
           ,2019 and 2020
EPI-Curve of SARI Cases with CFR%
(Cumulative from WK1 ,2019 to WK45 ,2020)
Summary of SARI indicators
During Last 3 Weeks (43,44,45)
Challenges and Recommendations
‫التحديات والتوصيات‬
‫التحديات التي تواجه إدارة الترصد الوبائي‬
‫❑قلة الحاالت المؤكدة مخبريا في نظام الترصد الوبائي بسبب عدم توفر‬
‫مختبرات خاصة بالترصد الوبائي بالمحافظات ماعد المختبر المركزي‬
                     ‫باالمانة باإلضافة الي الحديدة بشكل غير مكتمل‬
   ‫❑شحة اإلمكانيات والموارد الخاصة بنقل العيانات من المديريات الي‬
                   ‫المحافظات ثم الي المختبر المركزي للفحص مثل‪:‬‬
‫❖ عينات الكرونا والحصبة والشلل والكوليرا والدفتيريا والضنك وغيرها‬
               ‫من االمراض في قائمة الترصد الوبائي (‪ 28‬مرض)‬
‫تابع التحديات‪..‬‬
     ‫❑ عدم توفر ثالجات لحفظ العينات المخبرية و وعدم توفر نفقات النقل‬
 ‫❑ ضعف االشراف والمتابعة والتقييم الميداني المركزي علي مواقع الترصد‬
    ‫الوبائي ومراكز معالجة الدفتيريا والكوليرا وفرق االستجابة السريعة‬
    ‫بالمديريات بسبب عدم توفر الميزانيات المخصصه لمثل هذه األنشطة‬
                                                              ‫الهامة‬
  ‫❑ عدم اطالع كتلة الصحة بالوزارة بالمخصصات واألنشطة المتوفرة لدى‬
‫أعضاء الكتلة ليتم التنسيق معهم لالستفادة من هذه المخصصات والموارد‬
                            ‫بالشكل األفضل وفي المناطق ذات األولوية‬
‫توصيات إدارة الترصد الوبائي‬

      ‫❑ بناء مختبرات خاصة بالترصد الوبائي بالمحافظات ودعم هذه‬
                 ‫المختبرات للقيام بعمل فحص العينات او تخزينها‬
 ‫❑ توفير اإلمكانيات والموارد الخاصة بنقل العيانات من المديريات الي‬
   ‫المحافظات ثم الي المختبر المركزي للفحص مثل عينات الكورونا‬
‫والحصبة والشلل والكوليرا والدفتيريا والضنك وغيرها من االمراض‬
         ‫❑ توفير ثالجات لحفظ العينات المخبرية وتوفير نفقات النقل‬
‫تابع التوصيات‪..‬‬

  ‫❑ توفير ميزانيات مخصصه لالشراف والمتابعة والتقييم الميداني‬
   ‫المركزي علي مواقع الترصد الوبائي ومراكز معالجة الدفتيريا‬
                ‫والكوليرا وفرق االستجابة السريعة بالمديريات‬
‫❑ إطالع كتلة الصحة بالوزارة بالمخصصات واألنشطة المتوفرة لدى‬
 ‫أعضاء الكتلة ليتم التنسيق معهم لالستفادة من هذه المخصصات‬
           ‫والموارد بالشكل األفضل وفي المناطق ذات األولوية‬
Updates on the HCWs payment
           (incentives/Top-up/Allowances)

Ongoing HC partners’ discussion for HC Payment policy
                        2021.
                          &
                       Survey
Modalities of payment support
• Incentive: A monetary contribution to encourage one to deliver services. This is
  not a replacement for the salary rather a reward offered for increased
  productivity (or to avoid disruption of service and promote lifesaving health
  services).
• Allowance: An amount provided regularly for a defined period for a specified
  purpose within a set of regulations
• Top-up: Addition to an amount to bring it up to a certain level (as a
  compensation).
• Hazard Pay: Means additional pay for performing hazardous duty or work
  involving physical hardships and risk of exposure to hazardous circumstances.
• Per-Diem: The term "per diem" means "daily"; Per diem refers to very short-
  term temporary employment that consists of just a few days of employment
• Extra Duty Allowance: any allowance payable to healthcare staff who are given
  special assignments or perform additional duties in the evening & night shifts
Background
•   Ongoing crisis and deteriorating economic situation
•   Devaluation of the Yemeni riyal and Disproportional Inflation
•   Constrained access to services and commodities
•   Increasing costs of transportation
•   Inability of the government to pay salaries to staff (No salaries to staff in the
    North while nominal salary in the south, volunteerism OR Non-salaried staff)
•   Weak and fragile health system and services due to deficient HR
•   Weak monitoring of the health system and services
•   Inability to meet the demand of health services
•   Difficulty in finding trained HR for projects in remote districts/HTR areas
•   Socio-economic hardships of the health workers
•   Donors willingness/ fatigue and decreased funding
Current Situation and Proposed remedial steps

                        SOUTH                                           NORTH
                                Non employed Staff                              Non employed Staff
  Employed MoPHP staff                               Employed MoPHP staff
                                   (Volunteers)                                    (Volunteers)

                   Current Situation                              Current Situation
Nominal Salary in IRG areas         No Salary             No Salary                 No Salary

                      Proposed                                        Proposed
          Top-up                    Allowance             Allowance                 Allowance
How much and till when (should be paid?)
• According to the level and scale or grade of the health worker
• According to the scope of work
• According to level of difficulty; access; remoteness; risks involved
• Benchmark: Govt. pay scale or Private sector/UN/NGO scale (competitive
  scales)
                                         OR
• Previous Health & Nutrition cluster Incentive standardization exercise (2019)
• For the period of HRP 2021 / Standard Allocation project duration
• Current circumstances points toward non-favorable situation will persist in
  the year 2021 and even may worsen due to which the govt. inability to pay
  salaries
Incentives Paid in 2019

                      Primary Modality of Payment for Incentives                                                                     Monitoring systems for
                                                                                                                                     incentives
            Micro-financing bank (Al Khurami)                                                 22, 52%
Direct payment through local money transfer…                                      15, 36%
                                  Other modality                                                                     # of organizations with a monitoring system
                                                           5, 12%

                      Sources of Funding for Incentives                                                                    No, 21,
                                                                                                                            40%
                                                                      # of organizations
                                                 0     5             10                15        20             25                                       Yes, 31,
                             Yemen Pool Fund                                                                                                              60%
                                         WHO
                                         OFDA
                                         ECHO                                                                         Frequency of post-distribution monitoring
                                        UNFPA
                   Organization own reserves
                       German MOFA (GFFO)
                                       UNICEF                                                                             Monthly, 19, 61%             Quarterly, 9, 29%
King Salman Humanitarian Aid and Relief Centre
                                Canada (GAC)
                                          SIDA
                                          EKFS
                               Belgium (DGD)
                                         Other                                                                                                             Other,
                                                                                                                                                           3, 10%
         Other sources specified: DFID, CDCS Centre de crise et de soutien (France Government), OCHA, WFP, Italy,
         Kuwait, UAE Aid, USAID, Caritas, SV, Japan, Finland, Alawn Foundation For Development - Selah Foundation.
Min, Max and Avg amts (in USD) paid for incentives compared to 2018 harmonized and 2014 MoH scales
                                                                                                   2018 Harmonized
                              Staff Category                            Oct 2019 Survey                              2014 MoH
                                                                                                        Scale
                                                                  Min        Max          Median
            Doctors
                     General Practitioner (GP) / Doctor           317        1,200         715           650           267
                           Specialist (Arab Board)                787        2,125        1,527         1,500
                             Specialist (Master)                  417        2,125        1,416         1,200          288
                             Specialist (Diploma)                 209        2,000        1,048         1,000
            Paramedics
                                Nurse (BSc)                       108         447          298          350            235
                     Nurse (technical nurse / Assistant)          137         400          244          200
                                Pharmacist                        108         511          307          400            228
                              Medical assistant                   137         447          312          350            235
                                   Midwife                        80          450          296          350            191
            Technicians
              Technicians (OT, X-ray, Laboratory , Anesthesia ,
                                                                  160         590          293          250            235
                               physiotherapy)
                               Data Registrar                     108         286          189          200
                               Physiotherapist                    236         336          286
                                Vaccinators                       80          400          251
            Supporting staff
                              Ambulance driver                    78          300          212          200
                                    Driver                        100         300          190          150
                                   Cleaner                        27          303          149          150
                                   Guard                          70          256          147          150
            Coordinators/Managers/Supervisors
                             Central level                        108        2,000         924
                          Governorate level                       54         1,500         551
                             District level                       32         1,000         396
                          Health facility level                   90          709          263
            Community based workers
                       Community Health Worker                    55          250          110
                      Community Health Volunteer                  18          100           58
The need for Sustainable solutions
• Govt resume to pay salaries
• Govt. negotiate with development partners
• Social Security schemes (Insurance….) through developmental partners
• Set up Social Fund for Development
• Cost recovery/cost sharing
Recommendations and Way Forward

• Advocacy document for the CLA and Donors
• Kobo survey sharing with HC partners - (Done)
• Ongoing discussion
• Payments Monitoring
• Clear Exit strategy by December 2021 or later.
18 November 2020

Incentive Survey
Organizations that Participated

              36
Support for Incentives among Organizations

               17%

                     Yes   No

                                83%
Reasons for Supporting the Payment of Incentives

• Without incentives, Health workers will NOT provide services
• Without incentives, Health system will collapse in Yemen
• Government pays nominal salary(only in the south) to health workers; therefore, not
  enough as per the high cost of livings caused by super inflation and the free fall of
  YER
• Incentive is the only motivation for health workers to work in rural and hard to reach
  areas.
• Non employed health workers(Volunteers) are not paid salary by the government.
• Projects cannot be implemented in HF without incentives
Reasons for NOT Supporting the Payment of Incentives

 • Lack of funding
 • Donors are restricting incentives
 • It is the duty of government to pay salary to health workers
Impact of Non-Payment of Incentives

                3%

               Yes     No

                     97%
Impact of non-payment of incentives
• Quality of Healthcare will deteriorate since health workers will not be committed to
  their responsibilities, as they will looking for other source of income(no pay, no
  work)

• The Healthcare system will collapse; the number of non-functional health facilities
  will increase exponentially

• Humanitarian aid organization would not be able to implement projects in health
  facilities without incentives

• The gains made in health and nutrition indicators will be lost.
Government Salaries Adequate for health Workers?

                             8%
                   14%

                         Don't Know
                         No
                         Yes

                           78%
Who should be paid?
• Define Cadres; their scales and their scope of work (Doctors; paramedics;
  Nurses; Midwives; Auxiliary satff; Volunteers)
• Top officials (Central level); GHO/DHO; Managers/coordinators
• Standardization, harmonization of scale
• Address duplications among staff using Common platform – Emergency
  Cash Transfer (ECT)
• Transparency, Utilization
• Top-up for salaried worker
• Incentive/allowance for volunteer OR non-salaried
• Hazard pay for additional responsibility such as outbreak response by RRTs,
  Laboratory workers; Cholera/Covid Treatment centre workers
Who should be paid incentives?

       Employed Staff NOT receiving salary from
                                                                     31                  5
             government(North specific)

Employed Staff receiving salary from government
                                                               20                  16
                (South specific)

Voluntary Staff - NOT on MoPHP payroll list (North
                                                                     32                   4
                   and South)

                    Yes      No                     0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Cadres that are Priority for Incentives
                                  Low Priority                     High Priority
Priorities                               1       2     3     4         5
Specialist                             11%       6%    19%   25%      39%

General Practioner (GP)                 3%       3%    8%    17%      69%

Medical Assistant                       3%       3%    6%    19%      69%

Nurses                                  3%       0%    5%    14%      78%

Pharmacists                             3%       0%    14%   41%      41%

Laboratory Staff                        3%       3%    14%   39%      41%

Midwives                                3%       0%    3%    11%      83%

Others (cleaners, guards etc..)         3%       3%    16%   25%      53%

GHO/DHOs                               33%       11%   33%   17%      6%
Support for Revision of Incentive Scale

                                                36%

                 64%

  No - (maintain current harmonized health cluster scale endorsed by MOPHP)
  Yes
Questions and comments?
Yemen – COVID-19
Main Figures                                            as of 02.11.2020

                   2067              603                                        1376
              Confirmed Cases        Deaths                                    Recovered

                   29%           (11/22) (50%)                   Last reported cases    0
                                Governorates affected                                   0
                   CFR%                                          Last reported deaths
Yemen – COVID-19
 Activity Update
Hazard Pay Program SOUTH:
- Initiation of the program is expected to begin in
  the South within the coming days to cover 21-
  34 hospital staff members directly involved
  with C-19 patient management.

Hazard Pay Program North:
- list of eligible staff to receive payment expected
  to be received in the coming days from MoPHP
  in the North

Triage Program of training:
- to be available next month
- To support non-COVID-19 facilities and
   provided essential connections to Case
   Management and IPC
Yemen – COVID-19
 Activity Update

Global Partnership:
- to make available 120 million affordable, COVID-19
  rapid diagnostic test for low- and moderate-income
  countries (Announced Sept 28)

- A full access package includes WHO policy guidance on
  the use of antigen based RDT, manufacturer volume
  guarantees for low and middle-income countries,
  catalytic funding to assist governments to deploy the
  tests and an initial US$50 million procurement fund

- The Global Fund commits an initial US$50 million to
  enable countries to purchase the new tests, with the
  first orders expected to be placed this week
Yemen – COVID-19
 Activity Update
COVAX :
- A Pillar of the Access to COVID-19 Tools (ACT)
  Accelerator launched in early April by WHO, Euro
  Commission, and France to bring together key
  stakeholders to facilitate the expedited turnaround
  for access to COVID-19 diagnostics, treatments, and
  vaccines.

- COVAX focus is on the making COVID-19 Vaccines
  readily available to low resources fragile states.

- Recent talks with WB it was proposed that 12 billion
  will required to fund the COVID-19 vaccines among
  low income and fragile states, Yemen would be
  earmarked to receive a share yet to be determined to
  support it COVID-19 Vaccination campaign.
Yemen – COVID-19
 Activity Update
Sero-Prevalence :
-   South in high priority governates , pending issue remains the
    delivery of reagents ( are planned to be flown into Aden from
    Dubai ASAP. Approval from MoPHP to begin has been
    granted.

-   To measure the sero-prevalence of antibodies to COVID-19 in
    the general population by sex and age group, in order to
    ascertain the cumulative population immunity.

-   To estimate the fraction of asymptomatic, pre-symptomatic or
    subclinical infections in the population and by sex and age
    group.

-   To determine risk factors for infection by comparing the
    exposures of infected and non-infected individuals

-   To contribute to an improved understanding of antibody
    kinetics following COVID-19 infection.
-   Total sample size 2000 divvied in 4 districts according to
    population size of each district
COVID-19 Response Needs
Trust
- Rebuild of Public Trust in the Health Services
- Community Acceptance and Awareness of the Risks Posed by C-19
Train
- Develop, Maintain, and Improve Clinical and Technical Expertise
Test
- Extend Testing Capabilities, Capacities, and Targeted Reach
- Access to Data to Drive Response Program Delivery & Monitoring
Treat
- Case management with proven up to date methods based on Global          Photo Retivied from: https://www.infomigrants.net/en/post/25129/coronavirus-in-yemen-a-country-on-
   Experience and Technology                                              the-brink

- Clinical Care for all C-19 symptomatic levels in addition to existing
   medical conditions and emergencies
- Maintain access to specialities, medications, supplies and support
   structures

        11/21/2020                                                                                                                                    61
Updates on HNO-HRP 2021
HNO 2021
• Cluster specific PIN and Severity   • Joint Inter-Sectoral Analysis Framework
  Analysis                              (JIAF)
• Proposed health indicators to       • Scoping of the HNO:
                                      ➢Context
  inform the severity,
                                      ➢Shock/ events
➢Impact on exposed population
                                      ➢Impact
➢Access Score
                                      ➢Risks
➢Health System Capacity:
                                      • JIAf indicators , based on Global clusters
➢Morbidity
                                      • Final List of indicators for all clusters (Below)
• Severity scale is changed 1-
  5(instead 0-7)
HC JIAF list of Indicators
                                                                 SEVERITY SCALE                                    Data         Status
                                                                                                                   collection
                                                                                                                   frequency

                         Source          None/Minimal   Stress (2)     Severe (3)   Extreme (4)    Catastrophic
                                         (1)                                                       (5)

Coverage of DTC3
(DPT3 / PENTA3) in < 1 EPI data (VCE)     >= 95%        90% - < 95% 85% - < 89%     80% - < 84%      < = 80%      Monthly       Available
year old/")

Percentage of children
aged six months to 15
years who have         EPI data (VCE)     >= 95%        90% - < 95%   85% -< 89%    80% - < 84%      < = 80%      Monthly       Available
received measles
vaccination")

Number of cases or
                                                        < 0.25% - >= < 0.75% - >=   < 1.0 % - >=
incidence rates (attack eDEWS            < = 0.25%                                                   >= 1.0%      monthly       Available
rate) for (cholera)                                        0.75%        0.50%          0.75 %

Number of health
workers per 10,000    HeRAMS                                                                                      Biannual      Available
population                                 ➢ 22         19 - < = 22   15 - < =19     11 - < =15       < = 11
Number of HF with
Basic Emergency
Obstetric Care/        HeRAMS                                                                                     Biannual      Available
500,000 population, by
administrative unit")
                                           ➢5                4             3              2
Updates on the 1st SA 2020
SA Strategy – 2 Priorities

 • Priority 1                              • Priority 2
 • Hardest of the hard to reach (HTR)      2.1- underfunding protection
   areas 34 districts                      programmes
 • Based on access analysis                2.2- IDPs response
 • Some districts observed remain as       2.3- Pre-Positioning of items for CP
   inaccessible                               - The CCCM and Health Cluster priorities
 • Sub-districts need also to be              - Health need in districts with Vulnerability
                                                score(4, 5) + IDPs, 33 district
   considered
 • OCHA approved for 4 districts in Taiz
   (Maqbanah, Hayfan, As Selow, Al
   Mukha) , as an integrated Response
   with other clusters
1st SA, 2020 - Health cluster

• P1 = 4 Districts ($3 million TBC)                  • P2 = 33 Districts ($9.6million TBC)

                               Total projects =12
                       Hospital      Health centre    Health Unit   Mobile/ Outreach
       Parameter 1         4              13              12               9
       Parameter 2        18              37              29              32
       Total              22              50              41              41
68
List of Health Cluster Activities for 1st SA, 2020:
• Provide Minimum Service Package (MSP) including; Basic and Emergency health services , child care &
  vaccination (Penta/DPT, measles & Polio), Mental Health Services, management of Communicable disease,
  early diagnosis & management non-communicable disease, through fixed HFs & outreach activities
• Provide Minimal Initial Service Package for Reproductive Health through Basic Emergency obstetric
  care(BEmONC) & Comprehensive Emergency Obstetric Care(CEmONC) in the selected HFs
• Support secondary health care provision in the selected supported hospitals
• Capacity building of health care workers(Doctor, Nurses, Midwives) , community health workers,
  community health volunteers
• Support IDPs & critical cases referral between health care level
• Operationalization / continuation of health services through operational support( HCW payment support
  (Allowance/Top-Up), water, electricity, and IPC materials, medicines and supplies.
List of Health Cluster Indicators for                                    1st   SA, 2020:
•   - # of medical consultations (Out-patient/ communicable disease) for host community and IDPS separately
•   -# of children under 18 mo. provided with measles vaccination
•   -# of children under 1year provided with Penta/DPT vaccination
•   -# health care workers (Doctors, Nurses, Midwife, Lab Tech, Pharmacist) receive top up
•   -# of HFs supported with operational support (Water L/mo., fuel L/mo., Solar power support), IPC & waste
    management support
•   -# of HFs supported with medicines / medical supplies
•   - # of women receive ANC ,post-natal care, tetanus vaccine
•   - # of deliveries by skilled birth attendants
•   -# of assisted delivery (with Caesarian /Section
•   -# child Children < 5 Years with SAM & complication supported/referred
•   -# of health workers receive training on MSP & other trainings.
•   -# of referrals cases (Host community/IDPs)
•   -# of people reached with health education sessions
•   -# of outreach visits
Assessment tools used by Health Cluster to identify gaps:
  In addition to HTR and IDPs sites priorities shared by OCHA and CCCM cluster, Health cluster priorities were
informed/guided by:

❑   Partners presence 4W - gap analysis 2020
❑   Health Cluster severity matrix September 2020,
❑   Current project status (projects that ended in March – October 2020)
❑   Cholera prioritization mapping 2020,
❑   HeRAMS 2019/ 2020 ,
❑   Utilization of health services analysis – impact of COVID-19
❑   Consultation with Sub-National cluster coordinators, partners and GHOs offices
❑   Gaps in health services to the IDPs- Health, Nutrition, WASH, CCCM and Protection cluster partners assessments and
    reports

                                                                                                                71
Steps and timeline
Once OCHA launched the SA call, all clusters sent full guidance to partners

As usual, the SA is with very tight timeline –
• Health Cluster has submitted the cluster priorities based on two priorities with funding estimated
• Discussion and mapping with hubs is ongoing 3 -4 Nov
• Updated partners 30 Oct & 4th Nov
• Inter-Cluster matching done 4th Nov
• SAG 5 Nov - OCHA
• Submission of dossier on 5th November to YHF Advisory Board
• Defense by Cluster 8 Nov and 9 Nov
• Based on defense, selected projects notified , Proposals 12 – 27th Nov
• Inter-cluster meeting discussing the opportunity of converging to maximize the effect on 16th Nov.
• List of activities & indicators share by cluster by 16th Nov.
• GSM open on Thursday 19th Nov.
Questions and comments?
Partner Presence September
                    2020
                 Yemen Health Cluster

YEMEN
45 Partners reporting status by Months
         # of Partners    %    # of Partners   %     # of Partners    %    # of Partners % # of Partners    %    # of Partners    %
Sr.No
            (Apr20)    (Apr20)   (May20)     (May20)    (Jun20)    (Jun20)    (Jul20)   (Jul20) (Aug20)  (Aug20)    (Sep20)    (Sep20)
  1             0       0%         1          2%         1          2%        1         2%        1         2%         0          0%
  2             3       7%         3          7%         3          7%        1         2%        1         2%         1          2%
  3             11      24%        5         11%         8         18%        7        16%        6         13%        7         16%
  4             31      69%        36        80%         33        73%        36       80%        37        82%        37        82%

      Legend
         100% to 80%
          79% to 65%
          64% to 50%
        Less than 50%
Partners Reporting Status
                Average of Reporting by Governorate
S    Partner            Type                Status       Sep-20        S    Partner   Type   Status      Sep-20
 1       ACF            INGO                 Active       100%         24   NFDHR     NNGO   Active   100%(Finished)
 2      ADD             INGO                 Active       100%         25     PAC     INGO   Active        50%
 3      ADO             NNGO                 Active        94%         26   PU-AMI    INGO   Active        96%
 4     ADRA             INGO                 Active        94%         27    QRCS     INGO   Active        92%
 5      AGF             NNGO                 Active       100%         28     RDP     NNGO   Active       100%
 6     Alatta           NNGO                 Active        80%         29       RI    INGO   Active        95%
 7       BFD            NNGO                 Active        86%         30     RRD     NNGO   Active       100%
 8     CSSW             NNGO                 Active        89%         31    SAWT     NNGO   Active       100%
 9     DEEM             NNGO                 Active        74%         32      SCI    INGO   Active        88%
10     FHI360           INGO                 Active       100%         33     SDF     NNGO   Active   80%(Finished)
11      FMF             NNGO                 Active        90%         34     SHS     NNGO   Active   65%(Finished)
12        HA            INGO                 Active   75%(Finished)    35    SOUL     NNGO   Active       100%
13     HAND             NNGO                 Active   100%(Finished)   36     TFD     NNGO   Active       100%
14         HI           INGO                 Active        78%         37      TYF    NNGO   Active        83%
15       IMC            INGO                 Active        85%         38   UNFPA      UN    Active        85%
16   INTERSOS           INGO                 Active        89%         39   UNICEF     UN    Active        85%
17      IOM              UN                  Active        76%         40      VHI    INGO   Active   90%(Finished)
18         IR           INGO                 Active        75%         41    WHO       UN    Active       100%
19        IRC           INGO                 Active       100%         42   Yamaan    NNGO   Active        63%
20      IYCY            NNGO                 Active       100%         43     YDN     NNGO   Active       100%
21      MdM             INGO                 Active       100%         44     YFCA    NNGO   Active        88%
22      MMF             NNGO                 Active   100%(Finished)   45     ZOA     INGO   Active       100%
23        MS            INGO                 Active        96%                                            Legend
                                                                                                             100% to 80%
                                                                                                              79% to 65%
                                                                                                              64% to 50%
                                                                                                            Less than 50%
Services Utilization
Jan to Sep 2020 (2019 vs 2020)
Services Utilization
Jan to Sep 2020 (2019 vs 2020)
Services Utilization
                                  2020 Vs 2019
      Services           Difference              Services        Difference

Medical Consultations      -11%                    NCD             -27%

                                            Medical Support        17%
 Reproductive Health       13%

                                           Operational Support     59%

Mental Health Services      -1%
                                            Capacity Building      -51%

 Child Health Services     -19%
Working groups and Taskforce - Updates
• Mental Health & Psychosocial Service Support (MHPSS)
• WASH in Health Facilities
• Nutrition Surveillance System –WHO
MHPSS Technical Working Group
           Yemen

     October - November 2020
             Updates
October-November 2020 Updates
▪ Increasing coordination capacity:
   ▪ MHPSS TWG coordinator will be travelling to Aden end of this week or beginning
      of next week.
   ▪ UNICEF is considering the possibility to support the MHPSS TWG co-chair in
      Sana’a.
▪ Establishment of National Mental Health Programme (NMHP) – Aden: An official
  letter was shared regarding the establishment of national mental health
  programme. The head of the NMHP was selected and appointed officially in Aden.
▪ Capacity Building: WHO is launching training on mHGAP and PFA to support MoPHP
  which will start hopefully during the month of November 2020 in the southern
  governorates. For the north it still pending the provision of training participants.
▪ Technical Capacity: WHO YCO is currently working to establish a small technical
  group that sits under the TWG to support in addressing some of the gaps related to
  the delivery of MHPSS services. Still in consultation phase.
EPI/Vaccination Updates
General updates
• 16 governorates implemented the 1st round of Integrated outreach rounds & 7 completed the 2nd round. Third
  round integrated outreach to start in governorates that have completed the second round to reach additional
  children
• 41 high-risk district implemented MNTE campaign in October.
• Nationwide polio campaign to be conducted through Yemen except Sa’adah in response to the cVDPV1 outbreak
  in Sa’adah. Another round will be conducted in Northern governorates with the 3rd in 3 governorates around Sa’adah
    – Sa’adah will be conducting multiple fixed site strategy offering bOPV, MR, Diphtheria and all EPI
      antigens along with IMCI, Nutrition and WASH interventions. This will be followed by two more
      rounds in Sa’adah offering bOPV and routine EPI antigens
• Operational cost, vaccine and non vaccine supplies being arranged with some distributed while other in process
• PPEs (masks, sanitizers & gloves) arranged and being distributed as well all vaccinators and supervisors will be
  trained on infection control (IPC) measures in th elight of COVID19 pandemic
• Polio campaign planned for 21 Nov, postponed by the MoPHP to unknown date with 1.3 Million doses already in
  Aden and 5.1 million doses of polio vaccine arriving Sanaa on 17 Nov and other preparation ongoing
• Mid Level Management (MLM) : TOT training for central and governorates supervisors completed in Sana’a and
  Aden. Training of district supervisors completed in Northern Governorates while it will start in Dec for Southern
  governorates.
Coverage comparison all antigens for Period Jan - Sep
                                          2019 & 2020
            85%                           85%               84%             83%
              79%                           79%               79%             78%                 2019    2020
                      75%                          75%              75%             77%
                                71%                                                   70%
                        68%                          68%              68%
  64%                             66%                                                       66%
                                                                                              62%
    60%

                                                                                                         48%
                                                                                                           44%

   BCG      OPV1      OPV3       IPV      Penta1   Penta3   PCV1    PCV3    Rota1   Rota2   MR1          MR2
Data of Sep 2020 only from 14 North governorates
Coverage by Months for Period Jan - Sep 2019 & 2020
                                        BCG                                                                               IPV
                                                           81,463                                                                                                 81,406
                                                                             79,263
                                                                             77,669
                                                                                                                                                73,217            74,387
                                                                                      68,054
                                                  65,575   63,647                              63,172   64,872
                     62,458                                         60,755                                         61,166              61,756
57,889     59,235              58,285                                                                                                           57,546   55,595
                                                                    54,856            63,373                                                             54,052
           48,902                                                                                       62,849
57,517               58,352                                                                    56,318            56,835     46,028
                          52,581        37,602    63,801                                                                               55,643
                                                                                                                            34,876

            2019        2020                 23,327                                            2019      2020

   Jan      Feb      Mar        Apr     May       Jun       Jul     Aug      Sep       Jan      Feb     Mar         Apr     May        Jun       Jul     Aug      Sep
                                        Penta 3                                                                           MR1
                                                                             81,406                                                                               81,406
                                                                             74,387                                                             77,692
                                                           73,217                                                                                                 71,461
  68,054
           63,172    64,872
                     62,849                                                                                                            65,054   62,185
                               61,166             61,756                              59,821                       61,369
                                                           57,546   55,595                     54,713   57,070
                                                                    54,052            53,772
63,373                                                                                                                                                   50,556
                                                                                                                                                         48,885
           56,318             56,835    46,028
                                                                                                               54,719       41,215     61,140
                                                  55,643                                                 58,625
                                        34,876
                                                                                               28,167                       29,735

                    2019         2020                                                                              2019         2020

   Jan      Feb      Mar        Apr     May       Jun       Jul     Aug      Sep       Jan      Feb     Mar         Apr     May        Jun       Jul     Aug      Sep

         Data of Sep 2020 only from 14 North governorates
Monthly vaccinated children by Penta3 by Fixed activities Jan - Sep
                                             2019 & 2020

         52,976

                                                                                                                 52,171
                                      52,073

                                               51,300
60,000

                                                                                        49,071
                      51,083 47,860

                                                                        47,462 45,790

                                                                                                 46,398 43,105
                                      52,822
50,000
         52,333

                                               48,923

                                                               37,035

                                                                                        48,792

                                                                                                                 45,152
40,000

30,000

                                                               27,924
20,000

10,000

    -
         Jan         Feb              Mar      Apr             May      Jun             Jul      Aug             Sep

                                                        2019   2020
AOB
• Data Sharing – MoPHP/Partners
THANK YOU

Next Health Cluster meeting → 2nd December 2020
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