Background Yemen that has been devastated by war is facing various challenges to respond to the recent potential outbreaks and other public health emergencies due to lack of proper strategies and regulations, which are essential to public health security. The aim of this study is to assess the implementation of the International Health Regulations (IHR 2005) core capacities under the current ongoing conflict in Yemen. Methods The study simulated the World Health Organization (WHO) Joint External Evaluation (JEE) tool to assess the IHR core capacities in Yemen. Qualitative research methods were used, including desk reviews, in-depth interviews with key informants and analysis of the pooled data. Result Based on the assessment of the three main functions of the IHR framework (prevention, detection, and response), Yemen showed a demonstrated or developed capacity to detect outbreaks, but nevertheless limited or no capacity to prevent and respond to outbreaks. Conclusion This study shows that there has been poor implementation of IHR in Yemen. Therefore, urgent interventions are needed to strengthen the implementation of the IHR core capacities in Yemen. The study recommends 1) raising awareness among national and international health staff on the importance of IHR; 2) improving alignment of INGO programs with government health programs and aligning both towards better implementation of the IHR; 3) improving programmatic coordination, planning and implementation among health stakeholders; 4) increasing funding of the global health security agenda at country level; 5) using innovative approaches to analyze and address gaps in the disrupted health system, and; 6) addressing the root cause of the collapse of the health services and overall health system in Yemen by ending the protracted conflict situation.

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Background: there are several states which are unable to implement the International Health Regulations’ core capacities to face the urgent public health threats. Yemen is fronting various challenges to response to the recent potential outbreaks and other public health emergencies due to lack of proper strategies and regulations, which are essential to public health security. It has lived under the turmoil of several rounds of internal armed conflict and political instability since 2011. The overall impact of war and conflict on the health system is vividly observable. The aim of this study is to assess the International Health Regulations’ core capacities to respond to outbreaks during the conflict in Yemen. Methods: The study used qualitative data analysis, including desk reviews and in-depth interviews with key informants. This study simulated the World Health Organization's Joint External Evaluation tool to assess the IHR core capacities in Yemen Result: Based on the result of the assessment (with its three core functions of: Prevention, Detection, and Response), the country showed limited or no capacity to prevent and respond to outbreaks, however, it presented demonstrated or developed capacity to detect outbreaks. This signifies an overall poor IHR implementation in Yemen.Conclusion: This study shows that there has been poor implementation of IHR in Yemen, therefore, an urgent intervention is highly need to strengthen the implementation of the IHR core capacities in Yemen.

The on-going humanitarian crisis in Yemen is one of the worst in the world, with more than14 million people in acute need. The conflict in Yemen deteriorated the already fragile health system and lead to the collapse of more than half of the health facilities. Health system fragmentation is also a problem in Yemen, which is complicated by the existence of two health ministries with different strategies. The aim of this study is to evaluate the effect of health system fragmentation on the implementation of health policies in Yemen across the global agendas of Universal Health Coverage (UHC), Health Security (GHS) and Health Promotion (HP) in the context of WHO priorities achieving universal health coverage, addressing health emergencies and promoting healthier populations. Methods The study is qualitative research using key informant in-depth interviews and documents analysis. Results There are many health stakeholders in Yemen, including the public, private, and NGO sectors - each with different priorities and interests, which did not always align with national policies and strategies. The WHO and Ministry of Public Health and Population (MoPHP) are the main supporters to implement all policies related to the UHC, GHS and HP agendas. Interestingly, initiatives initially pursuing a health security approach to control the cholera epidemic realigned with the UHC concept and moved from an initial focus on health security, to propose a minimum health service package, a classical UHC intervention. Overall, Universal Health Coverage is the most adapted agenda, health security agendas were highly disrupted due to conflicts and health staffs were caught unprepared for emerging outbreaks. The health promotion agenda was largely ignored. Conclusion Restoring peace, building on synergies between the three health agendas through joint planning between the MoPHP and other health actors are highly recommended.