Health in Yemen: losing ground in war time

Bcheraoui, Charbel El; Jumaan, Aisha O.; Collison, Michael; Daoud, Farah; Mokdad, Ali H.

doi:10.1186/s12992-018-0354-9

Cited by 70 publications

(86 citation statements)

References 16 publications

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“…Another limitation of this analysis is the variability in the waves of MICS and DHS surveys included. Although we captured the most recent available surveys for both regions, for countries such as Syria and Yemen, these data predate ongoing conflicts and are unlikely to represent the current nutritional situation of children, which has been catastrophically affected(El Bcheraoui, Jumaan, Collison, Daoud, & Mokdad, 2018;Eshaq, Fothan, Jensen, Khan, & AlAmodi, 2017;Meiqari, Hoetjes, Baxter, & Lenglet, 2018).…”

mentioning

confidence: 99%

Child‐level double burden of malnutrition in the MENA and LAC regions: Prevalence and social determinants

Ghattas

Acharya

Jamaluddine

et al. 2019

Maternal & Child Nutrition

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Although the prevalence of obesity has rapidly increased in the low‐ and middle‐income countries of the Middle East and North Africa (MENA) and Latin America and the Caribbean (LAC) regions, child undernutrition remains a public‐health challenge. We examined region‐specific sociodemographic determinants of this double burden of malnutrition, specifically, the co‐occurrence of child stunting and overweight, using Demographic and Health Survey and Multiple Indicator Cluster Survey data (2003–2016) from 11 countries in the MENA (n = 118,585) and 13 countries in the LAC (n = 77,824) regions. We used multiple logistic regressions to model region‐specific associations of maternal education and household wealth with child nutritional outcomes (6–59 months). The prevalence of stunting, overweight, and their co‐occurrence was 24%, 10%, and 4.3% in children in the MENA region, respectively, and 19%, 5%, and 0.5% in children in the LAC region, respectively. In both regions, higher maternal education and household wealth were significantly associated with lower odds of stunting and higher odds of overweight. As compared with the poorest wealth quintiles, decreased odds of co‐occurring stunting and overweight were observed among children from the second, third, and fourth wealth quintiles in the LAC region. In the MENA region, this association was only statistically significant for the second wealth quintile. In both regions, double burden was not statistically significantly associated with maternal education. The social patterning of co‐occurring stunting and overweight in children varied across the two regions, indicating potential differences in the underlying aetiology of the double burden across regions and stages of the nutrition transition.

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mentioning

confidence: 99%

Child‐level double burden of malnutrition in the MENA and LAC regions: Prevalence and social determinants

Ghattas

Acharya

Jamaluddine

et al. 2019

Maternal & Child Nutrition

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“…Coupled with the most recent overall mortality rates in the literature from the WHO and an estimated incidence rate for Yemen found in the literature, the transitions rates were created to allow the model's output to match the previously mentioned data. 11,16 The final transition probabilities were as listed in Table 1. An overview of the terms used, as well as their values and meaning are provided below in Table 2.…”

Section: Methodsmentioning

confidence: 99%

“…10 With an under 5 population estimated at 5.16 million, this could translate into 1.60 million cases of diarrheal diseases in this population at any given time. 11 The causes of diarrhea range from viral, bacterial and parasitic with viral causing the largest number of cases and also the most severe ones. 12 Yemen introduced Rotavirus vaccine in 2012 and in line with WHO guidelines the national strategy calls for use of Zn/ORS for all cases and use of antibiotics when specifically indicated.…”

Section: Introductionmentioning

confidence: 99%

A Model for the Creation of a Predictive Healthcare Coverage Map in Yemen

Suprenant

Gopaluni

Dyson

et al. 2020

Preprint

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IntroductionThe ongoing war in Yemen continues to pose challenges for health care workers in the country. The fighting has destroyed public infrastructure including primary and secondary health care facilities, hindered the movement of people, food, fuel, medical supplies, and information, and restricted access to and availability of social services including safe drinking water and sanitation. This has led to the increase in the spread of diarrheal diseases, including cholera, which, despite the efficacy of zinc and oral rehydration salt solutions to treat the resulting dehydration, remains one of greatest sources of mortality in children under five years old. In contexts such as Yemen, Health Management Information Systems and Surveillance Systems are weak and unreliable to begin with, with conflict and linked disruption of social services these systems are further weakened making monitoring of the situation and evidence-based planning and implementation even more difficult. Without information on the total number of children suffering from these diseases, it is difficult for health officials and aid organizations to make policy level decisions, inform annual and humanitarian response plans, set targets, mobilize resources, order supplies, deploy resources (human and supplies) and monitor based on needs, leading to poor quality decisions. These reasons, coupled with lack of access, security, and financial and human resources make it even more important in conflict settings, than in non-conflict settings, to know where it is best to invest. This manuscript looks at the development of a computational model designed to draw upon available health data and supplement it with additional sources and acceptable assumptions to provide some of the missing data via health access chart to better inform decision making on the above-mentioned policies. This chart is designed to show what percentage of the total estimated sick population is receiving medical assistance without the need for health workers to place themselves in the way of any additional harm.MethodsA Markov model, which is a probabilistic model that shows how a population moves between different states overtime, was created based on an analysis of Yemen clinical register data from the Ministry of Public Health collected through a third party hired for monitoring purposes covering the period of May through September of 2018. The model was designed with four states for children to transition between over a weekly basis. The probability that a child transitioned from the Sick state to the In-treatment state during any given week was a time varying function based on the average precipitation recorded monthly for 115 years and the state of the roads and bridges during that week as assessed by the World Food Program. The model examined the number of children treated, incidence rate, mortality rate, treatment efficacy and treatment mortality. Once validated, the model was run for 2019 to provide the weekly estimated coverage of children being treated for diarrheal diseases throughout all of Yemen. ResultsThe model was able to recreate the observed trends in treatment on the ground with no significant difference between model output and provided validation data for all metrics. When combined with infrastructure data, the curve of best fit created for the precipitation values depicted a seasonal increase in the number of estimated new diarrheal cases in children under five and a resulting decreasing in the number receiving treatment. This combination has led predictions for the percent coverage to range between an average weekly minimum of 1.73% around the 28th week of the year to a weekly maximum weekly coverage of just over 5% around the new year. ConclusionThe model created and presented in this manuscript shows a seasonal trend in the spread of diarrheal disease in children under five living in Yemen. Despite the assistance of aid organizations in attending to those in need, during the mid-year rains up to 98% are unable to receive medical aid. The coverage map indicates that community outreach or other types of assistance where aid proactively goes out to those in need should be scaled up during and just prior to these periods. This would serve to offset the decrease in the number receiving treatment by lessening the prohibitive travel burden on families during these times.

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“…Further, war-and conflict-associated destruction often precedes extreme economic hardship which may act as another moderating risk factor towards the development of psychiatric illnesses. Food insecurity and clean water inaccessibility may ensue following both physical and economic structural damage (Alfadhli, & Drury, 2018;Bojicic-Dzelilovic, & Turkmani, 2018;El Bcheraoui, Jumaan, Collison, Daoud, & Mokdad, 2018). Children in conflicted regions may be unable to continue their educational preparation, another factor that can have long-range psychosocial implications for those affected.…”

Section: Premigrationmentioning

confidence: 99%

“…Bojicic-Dzelilovic, & Turkmani, 2018;El Bcheraoui, Jumaan, Collison, Daoud, & Mokdad, 2018). Children in conflicted regions may be unable to continue their educational preparation, another factor that can have long-range psychosocial implications for those affected.Alternatively, premigration trauma may include interpersonal trauma or generational trauma with particular culturally relevant implications.…”

mentioning

confidence: 99%

Management of mental health conditions in refugee youth: An overview for the psychiatric‐mental health nurse practitioner

Kameg

2019

Child Adoles Psych Nursing

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Topic In 2017, there were a total of 70 million forcibly displaced individuals or refugees, worldwide. Unfortunately, over 50% of refugees are under the age of 18 years. Refugee youth are at‐risk for a variety of mental health conditions. Purpose The purpose of this report is to provide psychiatric‐mental health nurse practitioners (PMHNPs) with an understanding of unique cultural implications in refugee youth, risk factors towards the development of psychiatric illness, and means to identify those at‐risk for sequelae or those meeting diagnostic criteria. Also presented are foundational treatment and management implications to ensure the provision of culturally sensitive and efficacious care to this unique population. Sources used Utilizing PubMed, CINAHL, and PsycINFO, a literature review was conducted to identify relevant publications pertaining to mental health issues in refugee youth spanning from 2013 to present. Reference lists of identified articles were also searched. Conclusions A variety of risk and protective factors are discussed, spanning from premigration, during flight, and postsettling periods. PMHNPs must be proficient in screening and diagnosis of mental health conditions in refugee youth and implementation of pharmacological and psychotherapeutic interventions. PMHNPs must also be well versed in community‐based resources that can be utilized to promote optimal outcomes.

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Health in Yemen: losing ground in war time

Cited by 70 publications

References 16 publications

Child‐level double burden of malnutrition in the MENA and LAC regions: Prevalence and social determinants

Child‐level double burden of malnutrition in the MENA and LAC regions: Prevalence and social determinants

A Model for the Creation of a Predictive Healthcare Coverage Map in Yemen

Management of mental health conditions in refugee youth: An overview for the psychiatric‐mental health nurse practitioner

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