Mapping the resilience capacities and coping mechanisms of health workers and other cadres in hospital emergency departments in Sana’a during protracted conflict and crisis in Yemen

Partners: Al-Sabeen Hospital for Maternity and Children & Al-Thawra General Modern Teaching Hospital, Sana’a, Yemen, and Liverpool School of Tropical Medicine, UK

Background to the study

Conflict has devastating effects on health systems, both directly through attacks and indirectly through insecurity, economic instability, and displacement. Yemen’s ongoing war has devastated the country’s health system, with only 51% of health facilities classified as fully functional, 19.7 million people lacking access to adequate healthcare, and only 10 health workers available per 10,000 people in the country. This situation has been exacerbated by widespread poverty, disease outbreaks (cholera, diphtheria, COVID-19 and dengue fever), and severe shortages of medical supplies, external funding cuts and the closure of borders and aid programmes, hindering the flow of humanitarian assistance.

The health workers and support staff who keep Yemen’s healthcare system functioning, especially at the frontlines, are directly impacted. These impacts include physical attacks, arrests, intimidation, poor working conditions, staff shortages, minimal institutional support, shortages of essential supplies, high workloads and unreliable salaries, leading to economic hardship and deteriorating mental health.

Despite this, health workers’ stories remain largely undocumented.

Research objectives

Previous work by ReBUILD

identified a range of coping mechanisms and adaptations used by health workers in conflict-affected settings to enable them to continue to provide life-saving services during different types of shocks. This new qualitative study will explore the lived experiences, coping mechanisms and resilience capacities of health workers and allied health professionals who are at the frontline of the response during conflict – the staff in Yemen’s emergency departments in Sana’a City in Yemen. The study draws on empirical data from in-depth interviews, focus group discussions and participatory workshops with different cadres of health workers based in the emergency departments of two public hospitals in Sana’a City, Yemen.

The research partners will

• explore the challenges highlighted by health staff relating to the Yemen conflict, and the coping mechanisms adopted,
• co-develop low-cost interventions identified during the participatory workshops which can help health workers respond to shocks, and
• test the impact of those interventions and the lessons which can be drawn.

Outputs will support routine and emergency planning in Yemeni hospitals, and inform approaches both in Yemen and in other conflict-affected settings.

Further information and outputs

• Situational analysis of the health system in war-torn Sana’a City, Yemen: a literature review – download the poster here

Professor Al-Sonboli has spoken at ReBUILD for Resilience events:

• The Tragedy of War: partnerships and strategies to deliver essential health care to vulnerable Yemeni children and babies – watch the lecture here
• No health without peace: Health justice in armed conflict settings – webinar recording here
• A blog post on Professor Najla Al-Sonboli of Al-Sabeen Hospital for Maternity and Children can be read here.

Image: Starvation in Yemen by Felton Davis via Flickr [opens new tab]