June 18, 2024


Across Yemen today, around 1.3 million pregnant or nursing mothers and 2.2 million children under age five require treatment for acute malnutrition. Health literacy is a critical tool for sustaining and saving their lives, especially when they are conflict-displaced and unable to access basic necessities like food, clean water, and primary healthcare.

The World Health Organization (WHO) in partnership with the King Salman Humanitarian Aid and Relief Centre (KSrelief) is supporting a refresher training for a network of 1,277 community health and nutrition volunteers to equip pregnant and breastfeeding women in 24 priority districts across 8 governorates with the right information to make the best health and nutrition choices they can for themselves and their infants, during and after their pregnancies.

Dhiya Saif, 28, is expecting her first child next month. She and her family were displaced by conflict five years ago, and now live in Aden, Yemen. The unaffordability of food, more than its availability, presents a major challenge for this family.

“There is a community health volunteer who has given me the information I have needed to improve my health awareness, and ensure my baby is well-nourished and in good health,” Dhiya says. “I am so much looking forward to giving birth – I cannot wait to hold my baby for the first time!”

For years, Yemen has ranked among the world’s most acutely food-insecure countries. As the country’s nutrition situation continues to deteriorate in 2023, some 378,000 people – over half of them children and nearly one-quarter women – are projected to become newly displaced, according to the 2023 Yemen Humanitarian Needs Overview (HNO). The same report states that some 86 percent of all children from 6 months to five years of age currently suffer from anemia.

For these and other reasons, personal health literacy is one of the most important influencers of healthy behaviors, perhaps especially in marginalised, impoverished, and food-insecure communities of Yemen. The degree to which Yemenis can find, understand, and use health information and services is a leading determinant of healthy diets, breastfeeding, modification of health-harming behaviors, and reduction of non-communicable diseases.

Knowledge is strength.

Displaced from a rural village in Taiz Governorate, Bilquis Suleiman, 37, has been in Aden for almost five years. Pregnant with her third child, both she and her husband lack steady employment. They share one small room, together with their two daughters, in the house of her husband’s parents.

“Although we have a very modest income, we can still afford food and education for our girls,” Bilquis says. “I want all of my children to be healthy, live a good life, learn, and grow strong.”

Bilquis received potentially life-saving health information from a community volunteer during the first and continuing months of her current pregnancy. She quickly learned that a tetanus vaccination would protect her baby from neonatal tetanus, and that taking vitamins would support her baby’s brain growth. She also came to understand how her first several days of breastfeeding provide nutrient-dense colostrum for building her newborn’s immune system, and why she should practice exclusive breastfeeding thereafter.

“All my questions were answered, and I found her [the community volunteer] so sweet and patient,” says Bilquis. “Both as a woman and a pregnant mother, I understood the importance of the knowledge she gave me. Now I am trying my best to spread the word and provide other mothers with the same information.”

Small acts, big changes

As an experienced community health volunteer, Eshraq Ahmed says that she has found both acceptance and resistance to her science-based messages about pregnancy health, breastfeeding, child nutrition, immunization and health, and adolescent girls’ health, nutrition, and hygiene.

“I have done many one-to-one and group consultation sessions with mothers on these topics. It is challenging to speak convincingly to mothers, then finding resistance, even rejection, among their family members or even their communities.”

“Unfortunately, many people do not believe in the importance of well-planned diets and the difference they can make to their overall health,” adds Eshraq. “They prefer to receive food baskets and money, more than this information.”

According to a 2021 SMART nutrition survey (Standardized Monitoring and Assessment of Relief and Transitions), the diets of between 70 and 90 percent of children up to age five were not meeting minimum acceptable qualitative or quantitative diet standards. This year, with 17.3 million people needing food and agriculture assistance (2023 Yemen HNO), the importance of health literacy can hardly be overstated.

Poor diets, malnutrition and anemia are the most common challenges tackled by community health volunteers like Eshraq. There are also challenges resulting from high levels of health illiteracy and economic and cultural factors that deter women from prioritizing their health, nutrition, and regular pregnancy checkups – by not knowing, for example, that a lack of folic acid and other vitamin deficiencies can cause pregnancy complications and birth defects.

Eshrak knows how important it is that she is both an empathetic listener and teacher in her interactions with every vulnerable woman that she can reach and help.

“The vast majority of mothers I speak to are very appreciative. They want to do all they can to give their children the best nourishment possible. “I can feel for them as they share their burdens, and only then can I persuade them to change their health habits not just for their own good, but for their children’s as well,” Eshrak says.

She adds: “I am very proud to be part of the change of many health misconceptions. Our network of community volunteers is guiding, advising, and referencing mothers with malnourished babies to the nearest health facilities for free checkups, medicines, and nutrition services. We all work with the hope that many more vulnerable women will understand the importance of corrected health and nutrition practices — from exclusive breastfeeding to what foods to avoid, to help their babies grow strong.”

Through the KSrelief-funded Strengthen Essential Nutrition Intervention in Child Health Service for Sustained Mortality Reduction Project, WHO continues to train and support community health volunteers conducting house-to-house visits and group consultation sessions on nutrition, maternal health, and hygiene – to improve health literacy among most-vulnerable women.

Story: Shatha Al-Eryani and Nesma Khan, WHO-Yemen

Photos: © WHO-Yemen / Nesma Khan


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