Innovative ways to improve access to antimalarial treatment for those living more then 2 km away from health centres such as home management of malaria, especially for infants and young children, should be explored in malaria-endemic areas of Yemen.

No abstract

Background The ripple effects of protracted armed conflicts include: significant gender-specific barriers to accessing essential services such as health, education, water and sanitation and broader macroeconomic challenges such as increased poverty rates, higher debt burdens, and deteriorating employment prospects. These factors influence the wider social and political determinants of health for women and a gendered analysis of the political economy of health in conflict may support strengthening health systems during conflict. This will in turn lead to equality and equity across not only health, but broader sectors and systems, that contribute to sustainable peace building. Methods The methodology employed is a multidisciplinary narrative review of the published and grey literature on women and gender in the political economy of health in conflict. Results The existing literature that contributes to the emerging area on the political economy of health in conflict has overlooked gender and specifically the role of women as a critical component. Gender analysis is incorporated into existing post-conflict health systems research, but this does not extend to countries actively affected by armed conflict and humanitarian crises. The analysis also tends to ignore the socially constructed patriarchal systems, power relations and gender norms that often lead to vastly different health system needs, experiences and health outcomes. Conclusions Detailed case studies on the gendered political economy of health in countries impacted by complex protracted conflict will support efforts to improve health equity and understanding of gender relations that support health systems strengthening.

Objectives: This study assesses the prevalence of and risk factors for child marriage in Yemen, which was experiencing a nationwide conflict at the time of the study. Study Design: We conducted a survey of internally displaced persons (IDPs) and host communities using a stratified multistage cluster sampling design. Each household included an interview with a female adult (n=1210), a household roster (n=8400), and one female adolescent interview (n=1210). We used multivariate logistic regression to assess the association between child marriage and various risk factors. We also used data from focus groups (n=411) and key informant interviews (n=30) to explore community perspectives and understand contextual factors relating to child marriage. Results: Prevalence of child marriage among IDP females aged 10-19 was 18.1% compared to 12.7% among hosts. In the regression model, being older (aOR=1.95), never attending school (aOR=3.94), place of origin of Saada (aOR=4.41), and unemployment of the female adult (aOR=2.84) showed increased odds of child marriage. Head of household unemployment (aOR=0.58) and completed higher education (aOR=0.42) showed decreased odds. Qualitatively, economic factors were cited as central factors in decision-making, both for host communities and even more so for IDPs. Perceptions of marriage readiness and negative consequences of child marriage were dependent on gender normative expectations. Conclusions: Displaced girls experience child marriage more than boys or host girls . Displacement effects economic security and household power dynamics, which affects marriage decision-making and girl s ability to self-advocate. Efforts to address child marriage in Yemen should include livelihood support, with awareness and conflict management components that start in pre-adolescence and include married and unmarried girls.