Health in Yemen
From Wikipedia, the free encyclopedia
Much of Yemen's health care developments were undone after the escalation of conflict in 2015, which severely disrupted the delivery of health care.[1][2][3][4] Damage to infrastructure and shortages of personnel and supplies caused a quick deterioration in health indicators as documented by the WBG.[5][6][7][8] United Nations agencies identify the ongoing food crisis as a major cause of poor health outcomes.[9][10] In 2020, WHO and UN estimated that 45% or about 13.5 million people in Yemen required urgent nutritional assistance, including between 540.00 to 98.000 children under five with severe acute malnutrition.[10][11][12]
.jpg)
Assessments indicate that the health system faces severe capacity limitations.[6][12] According to WHO's 2024 HeRAMS survey, which assessed health facilities across 16 governorates, 45% were fully functional, 38% partially functional, and 17% non functional.[6][12][13][14] The same survey calculated inpatient care capacity to be approximately 6.2 hospital beds per 10,000 persons.[13][14] Health Cluster data from 2023 indicate that 21.9 million people required health assistance.[15] Workforce shortages are pronounced; 49 of 276 districts were reported to have no physicians, while about 42% had two or fewer.[16][17][18] Estimates from the World Bank Group and WHO suggest a physician density of roughly 3 per 10,000 population.[16] Maternal and child health services have been particularly affected, with international agencies reporting elevated maternal and infant mortality rates compared to global averages.[19]
Yemen's health system remains constrained by economic collapse and weak financial governance.[20][21] Governance is fragmented, as rival authorities control different parts of the country.[3][22][23][24][25] Humanitarian organizations, including United Nations agencies, now deliver a large share of health services, along with essential support such as food and water.[26][27][28] Noncommunicable diseases account for more than half of all deaths.[29][30][31] At the same time, outbreaks of communicable diseases continue to occur, associated with displacement, reduced vaccination coverage, and inadequate water and sanitation.[32][33][34] Mental health needs are also high.[35][36] In 2025 WBG counted close to 42 million people living in Yemen.[37][38]
History
Early period
Until the mid-20th century, most people in Yemen had almost no contact with formal health services beyond a handful of hospitals and clinics in the main towns, so care for illness usually came from family members, local healers and religious institutions.[39][40][41][42] Early colonial and missionary outposts along the southern coast added a few small facilities that focused on basic treatment, but they reached only a thin strip of the population and rarely the rural highlands.[39][40][42] Because systematic health records were not kept, what is known about patterns of disease and mortality in this period comes mainly from later surveys, mission reports and local testimonies rather than from national statistics.[39][40][43]
Early state era
Yemen joined the World Health Organization in 1953 as its 81st member state, after discussions on how the agency could be of support to the country's emerging public health administration.[39][40][44][45] Early cooperation focused on establishing national health structures, expanding communicable disease surveillance, and providing training and equipment for control campaigns.[39][40][45] By the 1960s and 1970s, the ministry of public health, later the ministry of public health and population, had increased the number of public hospitals and outpatient facilities, although bed capacity and staffing continued to fall short of regional averages.[39][40][46][6] Maternal and child health services were set up primarily in the major urban areas, while rural areas remained underserved due to difficult terrain and limited transport infrastructure.[39][40][47][48]
Health care expansion stage
From the 1980s onward, government planning and donor support increasingly emphasized primary health care and rural outreach, leading to a steady expansion of community health centres and basic units in governorates outside the main cities.[39][40][49][50][51][52] Over the same period, national immunization programmes broadened their reach; WHO reporting links these efforts to marked declines in vaccine‑preventable diseases through a combination of routine coverage and periodic campaigns.[40][45][51][52][53][54] Workforce capacity also grew during the 1990s. World Bank and WHO data suggest that the number of physicians increased by more than 7 percent annually between 1995 and 2000. Despite this growth, overall physician density remained low by regional standards, with estimates of fewer than 3 doctors per 10,000 people in the early 2000s.[39][40][55][52] These expansions in infrastructure and staffing were accompanied by efforts to improve health information systems and management training. However, reporting systems remained incomplete, and data quality was uneven, particularly outside major hospitals.[39][40][6][52]
Reform period
The pre‑war health care system in Yemen was structurally fragile.[5] Government programmes and donor‑funded projects often operated in parallel, with little coordination, which led to fragmentation, confusion, overspending and services.[5][1][56][57] By the mid‑2000s, sector assessments described Yemen's health system as under‑funded and fragmented, and noted that geographic and socioeconomic inequalities further limited access to basic services.[40][46][5] Public spending on health stayed low as a share of gross domestic product, and households covered a large share of total health costs through out‑of‑pocket payments.[40][46][5] In response, the Ministry of Public Health and Population drew up a Health Sector Reform Strategy that set out phased changes in governance, financing and service delivery. The strategy included a learning phase to pilot approaches to decentralization and to strengthen management capacity.[40][46][5] Reviews of the implementation period showed chronic shortages of qualified staff, weaknesses in supply chains, and persistent gaps in health information, with growing pressure from rapid population growth and water scarcity.[40][46][5]
Health care in Yemen was formally guaranteed as a right in the constitution and organized as a public system at central, governorate and district levels.[39][58][59][2] In practice, the Ministry of Public Health and Population oversaw all major functions, but service delivery was undermined by corruption and limited administrative and technical capacity.[39][48][56] Alongside the public system, a large and mostly unregulated private curative sector grew up in urban centres, including services in military and police facilities as well as private hospitals and clinics. User surveys reported generally low satisfaction with these private services.[60][39][61]
By the early 2010s, assessments by WHO and the World Bank estimated that private facilities outnumbered public ones, with roughly two‑thirds to three‑quarters of all health facilities registered as private and a growing share of curative services delivered outside the public system.[62][63] Survey and national health account data suggest that most care‑seeking for common acute conditions is now in private clinics, pharmacies and laboratories, particularly in urban areas.[62][63]
Conflict and emergency response
Since the escalation of armed conflict in 2015, Yemen's health system suffered extensive damage to facilities, interruptions to supply chains and a sharp decline in routine service coverage, including for immunization, maternal care and non‑communicable diseases.[1][2][3][4] Many facilities, including private ones, had been seriously damaged or closed, but the remaining private pharmacies and clinics were an important source of medicines and basic services, particularly in more secure urban areas.[6][5][7][8] Studies at governorate level during the conflict describe public hospitals and centres functioning with minimal staff and equipment and providing only basic services such as vaccination, reproductive health and nutrition, while more complex care was scarce or absent.[3][64][4] The conflict had a direct impact on health personnel through deaths, injuries having to move due to security concerns, and disruptions to their salary payments.[65][66][67] Facility mapping in 2016 across multiple governorates found that almost half of surveyed districts had no doctors at all, while many others reported only one or two doctors, illustrating both pre‑existing shortages and conflict‑related attrition.[6][60][65]
Humanitarian situation reports and policy notes describe tens of thousands of health professionals going for long periods without regular pay, leading to dual practice, reduced motivation and dependence on external incentives from international agencies to keep basic services running.[5][68][66][65][6] Emergency operations by Yemen's authorities and international organisations worked on keeping key hospitals and primary care services functioning and responding to outbreaks such as cholera and measles, as well as with widespread acute malnutrition among vulnerable groups.[7][69] Given the size of the population and the geography, these interventions were implemented unevenly and remained limited to selected districts.[59][3][4] During the early part of the conflict, more than 7,600 people were reported killed and about 42,000 injured, while weakened health services made the population more vulnerable to preventable and treatable diseases.[9]
Health care system
| Topic | Current figure / status | Notes |
|---|---|---|
| Fully functional health facilities | 45% | WHO HeRAMS 2024, across 3,507 facilities in 16 governorates. |
| Partially functional health facilities | 38% | Indicates widespread reduced service capacity. |
| Non-functional health facilities | 17% | Reflects major infrastructure and service disruption. |
| Health facilities with no doctors in districts | 49 of 276 districts | 42% of districts had two or fewer physicians, World Bank Group Data |
| Hospital beds per 10,000 people | 6.2 | Inpatient care is virtually inaccessible for the majority. |
| People in need of medical care | 19,3 million | 8.4 million people are targeted by UN aid in 2026 |
| People needing humanitarian assistance | 22 million | WASH, water, sanitation, and hygiene. Plus food assistance. |
| Total population | ca 42 million | 41,773,878 people in 2025 by WBG, and UNFPA notes 41,800,000 people in 2025) |
Public health care system
Around 1990, the public health care system was formally divided into three tiers, primary units and centres, district hospitals, and referral hospitals, but some regions lacked a district hospital, and over 30% of rural districts lacked medical personnel.[56][6][3][5] It is estimated that 14.8 million people in Yemen currently lack healthcare and that 22 million people are in need of humanitarian assistance.[9]
Financing
Between 2000 and 2014 the state went from standing for more than half to roughly one fifth of the country's total health cost, while out‑of‑pocket spending rose to more than three quarters, one of the highest in the eastern Mediterranean region.[39][6][70][71] External funding went down simultaneously, leaving households to pay patient fees and transport costs.[39][48][2][72]
Private health care system
Since the early 1990s Yemen has seen a marked expansion of private health care, encouraged by health sector reforms and investment laws that offered tax incentives and customs exemptions to health investors.[62][60][39][6][73] During the mid-2000s Yemen decided to take a market economy approach to their healthcare system due to increased liberalization within the country.[74] However, this market based approach directly affected the poor and those living in rural areas, because of a decrease in Yemen's budget in public healthcare and use of user fees.[74]
Providers
The private sector is composed by solo practices, diagnostic laboratories, specialised hospitals, and large pharmacies[60][39][75] According to WHO mapping exercises and national health accounts, private providers stand for most outpatient care, imaging, and laboratory services.[60][63][76][77][78] Public facilities, in contrast, continue to provide most of the referral‑level care and most of the inpatient beds. Humanitarian and development partners also contract private providers for several different kinds of specialised services, such as emergency obstetric care and caesarean sections, this leaves governorates where public facilities are only partially functional at a severe disadvantage .[6][60][3][79][80]
Geographic distribution
In Yemen, most people live in rural or peripheral districts, yet these areas have very few private health facilities. Residents therefore depend mainly on primary‑level public units, mobile outreach teams and NGO‑run services.[60][61][39][69] At the same time, public health workers are still concentrated in urban centres. The overlap between scarce rural private services and a already urban‑biased public workforce leads to persistent geographic inequalities in access to care across both sectors.[63][3][81]
Financing
Financing patterns further underline the weight of the private sector.[60][63] National health accounts compiled in the late 2000s and early 2010s indicate that private spending represented around two‑thirds to four‑fifths of total health expenditure, with out‑of‑pocket payments by households accounting for the overwhelming majority of private health financing and formal health insurance covering only a small fraction of the population.[60][63][80] These studies report one of the highest regional shares of out‑of‑pocket spending, and describe how direct payments for consultations, investigations and medicines in both public and private facilities expose poorer households to a high risk of catastrophic health expenditure.[60][63]
Regulations
Regulation of private health care is formally governed by national health legislation, including laws on private medical institutions and on public health, along with licensing procedures for facilities, professionals and pharmacies overseen by the Ministry of Public Health and Population and professional councils.[60][39][82] Nonetheless, WHO and other assessments consistently describe limited regulatory capacity, gaps in by‑laws and weak enforcement, which together make systematic oversight of private providers, fee levels and quality of care difficult.[82][61] The same sources highlight the persistence of informal or unlicensed providers, smuggled or substandard medicines and variable adherence to clinical standards, especially in smaller private facilities.[82][61]
Role and policy debates
The private health sector plays a major role in delivering healthcare in Yemen, especially outpatient services, and most of its financing comes directly from households paying out of pocket.[6][60][63] Assessments by the World Health Organization and the World Bank describe a rapidly growing private sector operating in a context of limited regulation, constrained public funding, and weak financial protection for families. They also highlight ongoing difficulties in coordinating public and private providers across the health system.[6][60][3][63] Policy papers and technical reviews often call for clearer definitions of public and private roles, stronger regulatory systems, and expanded risk‑pooling or other collective financing mechanisms to reduce dependence on direct payments. Taken together, these sources present private sector development as a central challenge, and opportunity, in efforts to make Yemen's health system more coherent, equitable, and financially sustainable.[58][60][63][83]
.jpg)
Facilities
Yemen's health facility network has long been described as widespread, but operates at highly uneven capacities, with rural areas facing poorer access to health care facilities than in urban areas.[6][13][84] A 2021 World Bank policy note said that 80% of the population faced significant challenges in transportation to and from health care services.[6][48]
WHO's HeRAMS survey found in 2024 that 3,507 facilities in 16 governorates were assessed, of which 45% were fully functional, 38% partially functional, and 17% completely non functional.[13][14] This means that 274 facilities were damaged, 69 were totally destroyed and 205 were partially damaged.[13][14] WHO also found in 2024 that hospital bed availability was 6.2 beds per 10,000 population, below the WHO benchmark.[13][14]
Personnel
Yemen's health system faces persistent shortages of health workers, an imbalanced skill mix, and pronounced gender disparities, all of which have been aggravated by years of civil war and war with other countries.[6][60][17] Reviews of service delivery during the conflict report further reductions in staff numbers, including districts with no doctors and large gaps in basic maternal and child health services.[47][60][65] National human resources planning documents, based on Ministry of Public Health and Population data around 2012–2013, estimated roughly 64,000 health care providers and over 10,000 administrative and other support staff; corresponding to a workforce density below the commonly cited threshold of 2.3 health workers per 1,000 population for basic coverage.[6][17] The number of doctors in Yemen rose by an average of more than 7% between 1995 and 2000, as of 2014[update] there were 5.25 doctors per 10,000 people.[16][85][18]
Workforce composition
The health workforce is described as having a skewed skill mix, with about one doctor for a little over one nurse rather than the higher nurse‑to‑doctor ratios recommended in global human resources for health guidance.[6][17][86] A large proportion of medical assistants, pharmacy technicians and laboratory technicians supported a relatively small group of degree‑qualified clinicians, reflecting the reliance on mid‑level and supporting workers in primary care.[6][60][17]
Geographic distribution
About four‑fifths of health care providers were reported to be working in urban areas, even though most of the population lives in rural settings, leaving many rural health units and primary care centres understaffed.[6][47][17] In rural districts, understaffed facilities frequently rely on community health workers and midwives with limited to no support from doctors, laboratory services and referral systems.[17][26][27]
Female health workers
Female health workers play a critical role in reproductive, maternal and newborn health services, but remain under‑represented in key cadres such as doctors and midwives, particularly in remote governorates.[47][87][88] Studies from rural areas report that shortages of female doctors and midwives, combined with social norms favouring female providers, contribute to unmet need for antenatal care and skilled birth attendance.[47][89] Programmes to expand midwifery and nursing education have increased the number of trained female health workers, but many are based in urban facilities or face barriers to working in remote settings, including safety, transport and social constraints.[47][87][88]
Human resources management
Reviews of human resources for health management highlight weaknesses in workforce planning, incomplete or fragmented human resources information systems.[6][17][86] Decentralization and cost‑sharing reforms have delegated responsibilities for staffing and supervision to governorate and district health offices, but these levels often lack the resources needed to implement HR policies effectively.[6][39][17]
NGO supported health workforce
Case studies of services during the conflict describe the use of midwives, and other NGO‑supported staff to sustain basic services where public facilities lack personnel.[47][26][28] Humanitarian mission often include training for locals in emergency obstetric care, pediatrics, and in good health practises.[47][26][27] Recent community health worker programmes, supported by UNICEF and other partners, aim to build networks of trained workers in rural districts, strengthen supervision and integrate community‑level reporting into district health management.[26][27][28] Yemen's health workforce remains below international density targets, unevenly distributed and vulnerable to further disruption.[6][17][18]
Financing
Oxford University Press and World Bank Group report that before unification in 1990, the Yemen Arab Republic and the People's Democratic Republic of Yemen both had state run‑health systems where government health spending was under 3% of total public expenditure, and households covered more than 50% of total health costs out‑of‑pocket.[56][39] It continued between 2005 and early 2015 when more than 50% health spending came from households.[56][6]
Total expenditures on health care in 2014 constituted 5.64% of gross domestic product.[90] In the same year, the per capita cost for health care was US$202 per capita.[91] The national budget for health has declined, and there are many public facilities relying heavily on external funding.[6][60][92][63]
Governance
Historically, the Ministry of Public Health and Population (MoPHP) has been the main steward of Yemen's health system, responsible for making policy, policy enforcement across the health care sector, and coordination of public services.[6][39][60][92][22] Before the escalation of conflict in 2015, national policy set out a model in which regional health offices were expected to plan and manage primary care and basic referral services.[39][92][80][22][93] In practice, implementation of this model was uneven, and many local units lacked personnel and budget needed to carry out their mandates.[6][39][22][92][80][63]
Since the start of the current conflict, Yemen's health governance has been increasingly fragmented.[3][22][23][24][25] Two completely separate health authorities rule in the north and south, making their own policies in parallel systems, both national and local levels.[6][3][48][22][94] This division has made coordinating emergency relief more difficult and led to uneven service priorities across different regions.[3][22][25][95][12]
International partners and the national Health Cluster now play a central role in coordination health services.[24][25][12][22][96] The Health Cluster, led by the World Health Organization and national health authorities brings together more than 40 United Nations agencies and non-governmental organizations to plan the humanitarian health response.[22][24][25][12] In 2022, the cluster reported that around 46 percent of health facilities were only partially functioning or completely out of service, and that about 12.9 million people had urgent humanitarian health needs.[22][24][25][12] By early 2023, the Health Cluster had reportedly received around 16 percent of the funds required under the humanitarian response plan.[22][24][25][12]
Health status
Over the last two decades, Yemen's health indicators have worsened, with long‑standing weaknesses intensified by the current conflict.[33][32][34] Earlier gains in life expectancy have stalled, and under‑five and maternal mortality remain among the highest in the region.[32][33][34] Coverage of childhood vaccination, prenatal care and skilled birth attendants has fallen in many regions as routine services have been disrupted by violence and economic collapse.[47][32][34][97] Damage to facilities, reduced health workers and irregular supplies worsen the country's health status notably.[2][34][98][84] Child malnutrition, repeated outbreaks of infectious disease and unmet medical service needs are also adding to the strain.[33][32][34][84] The combined effects has deepened existing inequalities for minorities, women, children, and individuals living in hard‑to‑reach areas.[47][3][34]
Fertility rate
Yemen's total population size is around 42 million people (41,773,878 people in 2025 by WBG, and UNFPA notes 41,800,000 people in 2025).[37][38]
Historical levels and long-term trends
Yemen's fertility rate has remained among the highest in the world, but it has declined markedly from around eight to nine births per woman in the 1970s and 1980s to just under five births per woman in recent years according to United Nations and World Bank estimates.[99][100][101] Historical reconstructions suggest that fertility in the territory of present‑day Yemen was already high in the early and mid‑20th century, increasing to nearly nine births per woman in the late 1970s and 1980s before the onset of sustained decline.[99][100][102] Estimates from United Nations and World Bank series indicate that Yemen's total fertility rate peaked at around 8.8–8.9 births per woman in the mid‑1980s, one of the highest recorded levels globally at the time.[101][100][102] According to World Bank data, the total fertility rate fell from around 7.9 births per woman in 1960 to about 5.6 in 2005 and approximately 4.6 by the early 2020s, reflecting a gradual but persistent reduction over six decades.[99][100][101]
Post-unification decline and comparisons
Since unification, fertility has fallen steadily, reaching about 4.6 births per woman by 2020–2023, while remaining well above the global average of roughly 2.4 births per woman.[99][100][101] Despite the long-term decline, Yemen's fertility remains high in comparative perspective.[99][100][101] Recent estimates place the country well above many other states in the region, and well above the global mean, with an average of about 4.6 births per woman in 2022–2023 and a historical mean of just over seven births per woman since 1960.[99][100][101] This sustained high fertility, combined with reductions in child mortality, underlies Yemen's very young age structure and rapid population growth, with implications for health services, education systems and broader efforts to improve maternal and child health in a context of protracted crisis.[99][103][104]
Drivers of fertility decline
Several factors have contributed to this decline.[105][103] The expansion of basic education, especially for girls, and the gradual uptake of family planning have been associated with delayed marriage and smaller completed family sizes, particularly in urban areas.[105][103][106] Demographic surveys prior to the current conflict already documented differences in fertility between women with no schooling and those with secondary or higher education, as well as between rural and urban governorates.[105][103] This long-term decline has unfolded unevenly, shaped by differences between regions and by the cumulative impact of conflict, delayed marriage, and gradual changes in women's education and access to reproductive health services.[105][102][103]
Conflict, inequality and recent dynamics
Conflict has shaped fertility trends in Yemen in uneven and sometimes contradictory ways.[47][105][103][107] National data indicate that the earlier decline in fertility slowed during the 2010s, with estimates remaining around 4.6–4.7 births per woman.[105][108][109] This plateau has been linked to displacement, economic strain, and disruptions in health services, all of which have affected both marriage patterns and access to contraception.[47][99][102][103][107][110] The effects have not been uniform. In areas most directly exposed to violence, early marriage and short birth intervals appear to have continued, and in some cases intensified. Elsewhere, prolonged family separation, migration, and deteriorating living conditions have been associated with delays in childbearing.[47][103][105][110]
Life expectancy
Over recent decades, Yemen has seen modest gains in average life expectancy alongside persistent and often severe health burdens.[33][85][58][111][112] Life expectancy at birth increased from about 59 years in 1990 to roughly 65 years in 2021, and health‑adjusted life expectancy rose by around six years over the same period, reflecting some improvement in survival despite ongoing poverty and instability.[39][33][5] At the same time, age‑standardised mortality from all causes fell only slightly (by an estimated 8–9% between 1990 and 2021), and the country remains among the lowest in the world for healthy life expectancy and among the highest for premature death in conflict‑affected settings.[33][5]
Non‑communicable diseases now account for roughly half of all deaths, with coronary heart disease, stroke and hypertensive heart disease among the leading causes of mortality and years of life lost.[33][113] Communicable, maternal, neonatal and nutritional conditions still contribute about one‑third of all deaths, and injuries, including those related to conflict and road traffic, make up the remaining share.[33][114] The burden of disability has shifted over time, with increases in years lived with disability from musculoskeletal disorders, mental health disorders and diabetes, even as fatal outcomes from some infectious diseases have declined.[33][5]
Maternal mortality rate
The United Nations inter agency group on maternal mortality estimate that Yemen's maternal mortality rate remained very high in the early 21st century, with only modest improvement compared with the marked global declines over the same period.[115][116][117] In regional terms, Yemen has one of the highest maternal mortality levels in the Middle East and North Africa, a pattern commonly linked in the literature to prolonged war and economic collapse.[118][119][120][121][122] Before the current conflict, national surveys and international estimates reported maternal mortality rates generally between 300 and 500 maternal deaths per 100,000 live births, depending on the year and estimation method.[116][123][124][125] Hospital‑based and regional reports from the conflict period describe continued high maternal mortality, with many women arriving late in labour, in critical condition, and with severe obstetric complications.[47][125][126][127]
The leading causes of maternal death in Yemen are postpartum haemorrhage, hypertensive disorders including eclampsia, and sepsis, similar to those seen globally.[128][125][129][130] Conflict has damaged Yemen's health system, cutting both the availability and the quality of emergency obstetric care.[118][119][123][129][131] Fewer than half of health facilities are functional, and few of the ones that work offer specialist maternal and newborn services such as surgery and blood transfusion.[123][131][119][128]
Infant mortality rate
In 1950, the child mortality rate in Yemen was 370 children per 1000 births.[132] Yemen then made significant progress, with the rate falling to 58.6 children per 1000 births in 2015.[132]
Malnutrition is one of the leading causes of child mortality. By 2018, about two million Yemeni children suffered from acute malnutrition, as a result of the civil war consuming their nation's economy. Geographically, Yemen also has the world's most depleted water sources. According to UNICEF, nearly 462,000 children are suffering from severe acute malnutrition. By November 2018, an estimated 85,000 children under the age of five had died due to acute malnutrition over the three years of the war.[133]
Under 5 child mortality rate
.jpg)
Yemen's under‑five mortality rate has fallen substantially since the 1960s, but levels remain high compared with most other countries, with recent estimates at around 39 deaths per 1,000 live births in 2023.[19][134][135][136][137]
In 1990, the under‑five mortality rate in Yemen was estimated at about 102 deaths per 1,000 live births, compared with roughly 45 deaths per 1,000 live births for the Eastern Mediterranean Region as a whole.[134][136][137][138]
By around 2018, data from UN and WHO suggest that Yemen's under‑five mortality rate had declined to approximately 45–55 deaths per 1,000 live births, which is close to half the estimated level in 1990.[134][136][137][139]
World Bank series based on UN IGME estimates place Yemen's under‑five mortality rate at about 39 deaths per 1,000 live births in 2023, and in these data the pace of improvement appears slower after the mid‑2010s than in earlier decades.[136][137]
According to reports from the WHO Regional Committee for the Eastern Mediterranean, this loss of momentum is linked to the effects of the conflict and displacement in Yemen, as well as interruptions in health, nutrition, and water and sanitation services.[140][141][142]
A large share of deaths among children under five are attributed to infectious diseases and other conditions that are preventable or treatable with existing interventions, including vaccination.[134][137][143]
Health conditions and risk factors
Communicable diseases
Communicable diseases is an enlarged factor in the health of Yemen as preventive healthcare is unevenly accessible.[25][144]
Cholera
Currently, according to WHO, Yemen is suffering the worst cholera outbreak in history with an estimated more than 10,000 cases a week in 2018.[145]
Cholera has broken out within Yemen because of its poor infrastructure that deteriorated due widespread war in the country. Yemen faces issues in control and provisions of fresh, clean water as Yemen does not have the capacity to create the infrastructure needed to provide it; thus, people are forced to obtain unsanitary water from rivers, lakes, and wells. Cholera is prominently found in contaminated drinking water, making the Yemeni people, especially children, the most prone to such a disease. There have been more than 815,000 suspected cases of cholera in Yemen over the past three years, 60% percent of them being children.[146] Cholera can be found throughout a majority of Yemen, mostly concentrated in the cities closest to water. Cholera currently kills an estimated 95,000 people per year and infects upwards of 2.9 million people.[147]
International response
UNICEF has made efforts in fighting the war against the cholera epidemic by providing vaccines to immunize the Yemeni people, there has been 900,000 suspected cholera cases. They've launched various campaigns to help combat diseases such as whooping cough, pneumonia, tetanus, tuberculosis, diphtheria, and meningitis, and they continue to send vaccines to the Yemeni people[148]
Diphtheria
Since October 2017, a diphtheria outbreak in Yemen has been reported in 176 districts across 20 governorates.[149][150] By 17 March 2018, surveillance data documented 1,368 probable cases, including 17 laboratory‑confirmed infections and 76 deaths, corresponding to a case‑fatality rate of about 5.6%.[150]
HIV/AIDS and sexually transmitted infections
Yemen is officially classified as a country with a low HIV burden but the data point to an expanding concentrated epidemic and services and testing of sexually transmitted infections (STIs) are limited to patients showing serious symptom and to autopsies.[151][152][153][154][155] Based on the available date, WHO and UNAIDS estimate that HIV prevalence in the general adult population (15–49 years) is below 0.1%, roughly 11,000 people were living with HIV in 2020.[152][154][156][157] There is a rise in AIDS‑related deaths, suggesting gradual growth of a small epidemic in the context of prolonged conflict and a weak health system.[151][153][158][159] Most documented infections occur among men who have sex with men, sex workers and their clients, and other people with higher‑risk sexual behaviours, rather than in the general population.[151][152][154][160]
WHO report ongoing transmission of syphilis.,[161][34][162] based on detection of congenital syphilis in persons aged 15 to 49 years, and syphilis positivity among women attending obstetrics and gynaecology services, though numbers are incomplete,[34][70][163]Condom use is low, and female patients receive little to no testing[154][34][162][164] Many adolescents have little knowledge of HIV transmission and prevention and express high levels of stigma towards people living with HIV and STIs.[154][164][165][166] A school‑based peer‑education programme implemented in 27 high schools raised the proportion of students with "good" HIV knowledge scores from about 43% among non‑participants to nearly 68% among those reached by the intervention, and improved awareness of condom use as well as willingness to support people living with HIV.[154][164][166][167] UNFPA and others continue to describe HIV and STI knowledge among adolescents as persistent misconceptions with risk-behaviours in a socially conservative environment.[154][161][162][168]
Malaria
Malaria remains one of the main endemic communicable diseases in Yemen and contributes substantially to morbidity, particularly in coastal and lowland governorates.[169][170][171] Transmission is predominantly due to Plasmodium falciparum, with Plasmodium vivax and other species reported only sporadically.[170][172] Yemen accounts for a notable share of the population at high risk of malaria within the WHO Eastern Mediterranean Region, and large rural populations in the Red Sea coastal plain, Tihama, and certain highland fringes regularly experience seasonal transmission.[169][171][173]
Epidemiology and burden
WHO and regional programme data show that the majority of Yemen's population live in areas with some level of malaria transmission, with several million people in high‑transmission zones,[174][175][171][176] with higher rates in certain occupational groups.[170][172][177][178] Ministry of Health surveillance recorded more than 600,000 malaria cases nationwide, and coastal governorates such as Hudaydah, Hajjah and Taiz were among the most affected, underscoring both the magnitude of the burden and its concentration in particular ecological settings.[169][171][179][180]
More recent WHO reports continue to register confirmed case numbers in the hundreds of thousands per year, including 210,022 confirmed cases and 18 reported malaria‑related deaths in 2024, although mortality is probably under‑ascertained because of limited diagnostic capacity and incomplete reporting in many districts.[180][181][182][183] Community based studies consistently highlight the particular vulnerability of children under five years of age; one 2019 survey in rural Al Mahweet, for example, found malaria in roughly one in ten children and identified sleeping outdoors and non‑use of mosquito nets as important risk factors.[171][178][184] Entomological surveys from both highland and coastal areas generally identify Anopheles arabiensis as the predominant malaria vector in Yemen.[170][171][177]
Risk factors, control efforts and impact of conflict
Malaria risk in Yemen depends strongly on household's proximity to mosquito breeding sites, such as streams, marshes and water collection points. An other big factor is sanitation conditions and the consistent good use of mosquito control measures.[170][184][177][185] Occupational exposures, including fishing and small‑scale agriculture in endemic districts, are also associated with increased prevalence.[170][172][177] Studies of community knowledge and practices point to gendered differences in treatment‑seeking behaviour and prevention, suggesting that health education and control strategies need to account for local social norms.[170][171][186]
Since the mid‑2000s, the National Malaria Control Programme, supported by WHO and other partners, has introduced a package of interventions, including distribution of long‑lasting insecticide‑treated nets, indoor residual spraying, expansion of diagnostic services and community‑based surveillance.[171][187][188] Coverage of these measures has remained uneven and has been severely constrained by the protracted conflict, which has damaged health infrastructure, disrupted supply chains and complicated access to high‑risk districts.[169][171][183] Recent WHO reports emphasize that, despite ongoing scale up of good mosquito net use, diagnostics and community health workers, progress towards significant reduction of malaria transmission and eventual elimination will depend on sustained political commitment, stable funding and strengthened local health systems.[169][189][190]
Injuries and risk factors
Alcohol use
The World Health Organisation have over time reported that alcohol use in Yemen is difficult to measure so figures should be treated cautiously.[191][192][193] WHO evidence however suggests that alcohol use in the Eastern Mediterranean region is lower than the global average, but Yemen specific data are sparse and largely based on modeled estimates.[191][192][194]
Nutrition
Yemen's nutrition crisis reflects both acute and long-term malnutrition, particularly among children under five and pregnant or lactating women, rather than a temporary shortage of food alone.[195][196] Even prior to the current phase of conflict, widespread poverty, limited access to basic services, and chronic food insecurity had already contributed to high rates of stunting and wasting.[197][198] Since 2014, the escalation of war and economic collapse has deepened these conditions.[199][200] Recent assessments classify large parts of Yemen as facing crisis or emergency levels of food insecurity, with some areas considered at risk of famine.[201][202] Child nutrition indicators, including rates of wasting and stunting, are well above global averages and exceed thresholds commonly used to define a public health emergency.[203][204] Acute malnutrition among children under five has reached unprecedented levels, with estimates for 2021 suggesting that roughly 2.25–2.3 million children aged 0–59 months and more than one million pregnant and lactating women were acutely malnourished.[205][206]
Child undernutrition
Data from health facilities and national surveys consistently indicate very high levels of stunting among Yemeni children, a pattern that points to long‑term deficits in diet quality, recurrent illness and constrained care practice.[207][208] In 2023, nutrition surveillance activities found that about 44% of screened childrIen under five were stunted, and documented high‑prevalence stunting in more than half of Yemen's 333 districts.[208][209] Acute malnutrition analyses of 2020–2021 classified most assessed zones at serious or critical levels, with several areas periodically reaching IPC Acute Malnutrition Phase 4.[205][210]
Infant and young child feeding and breastfeeding
Inadequate infant and young child feeding practices are major contributors to malnutrition related diseases in Yemen, exclusive breastfeeding is far below international targets.[211][212][213][214][215] Eating habits of young children fails to meet recommended standards for dietary diversity, and many households report that it's difficult to obtain nutritious foods such as animal products, fruits and vegetables.[213][216][217][218][15] Poor access to micronutrient foods contribute directly to both acute and chronic undernutrition and to high levels of anaemia among young children.[208][211][213][214][219]
Food insecurity, disease and structural drivers
In facility‑based surveillance carried out in 2025, anaemia was observed in roughly one fifth to one quarter of children aged 6–59 months who were screened for haemoglobin.[207][212] High and persistent levels of food insecurity, driven by disrupted markets, dependence on food imports, declining incomes and repeated displacement, form an important structural backdrop to the nutrition crisis and limit households' ability to adapt and secure adequate diets.[220][221] Recent acute food insecurity assessments have classified most analysed zones of the country in crisis (IPC Phase 3) or worse, with some areas at times reaching emergency levels.[210][221] Inadequate water, sanitation and hygiene, together with recurrent outbreaks of diarrhoeal diseases, cholera and other infectious diseases, further heighten the risk of wasting and stunting by increasing illness and nutrient losses in children.[216][220] In several northern governorates, surveys and reviews have reported that around two in five children experience diarrhoea, and that many are also affected by malaria or fever illnesses that may aggravate malnutrition.[216][221]
Response and nutrition services
In response to these conditions, the Ministry of Public Health and Population, in collaboration with WHO, UNICEF, the World Bank and other partners, has expanded nutrition surveillance and therapeutic feeding services in different parts of the country.[208][222] The World Health Organization has provided huge efforts by creating its humanitarian response plan in 2017. Their plan consisted of a US$219.2 million WHO budget and a US$430.4 million Health Sector budget that targeted support for 2.6 million women and 5.8 million children in Yemen.[223]
By 2023, more than one million children had been screened through surveillance sites, and about a quarter of those screened were identified as undernourished and referred for treatment.[208][209] The finding that 44% of screened children were stunted in 2023, with high‑prevalence stunting recorded in a large share of districts, underscores the persistence of chronic undernutrition despite the scale‑up of services.[207][209] Admissions for severe acute malnutrition with medical complications to WHO‑supported therapeutic feeding centres increased from around 32,000 in 2020 to about 62,000 in 2023, while reported treatment success rates remained above 95% and mortality and default rates were low.[208][212] National and international actors have also worked to integrate nutrition surveillance into routine child and maternal health services and to strengthen Yemen's nutrition information systems, including through the use of electronic platforms such as DHIS2 for data reporting.[216][222]
Tobacco use
Tobacco use remains common in Yemen. The WHO reported tobacco use to be at 21.4% of adults in 2022.[224]
Water and sanitation
Water and sanitation are major health risk factors in Yemen. Conflict damage and underinvestment have left large parts of the population without access to safe drinking water or adequate sanitation.[225][226][227][228] These conditions facilitate repeated outbreaks of cholera and other waterborne diseases.[226][229][230][231] Scarcity does not only reduce quantity, it changes behavior, driving families toward longer collection routes and more use of unsafe water storage.[225][226][232] Current humanitarian and public health responses continue to prioritize chlorination, water trucking, rehabilitation of water and sewage systems, and hygiene support. However, these efforts remain but temporary solutions without sustained infrastructure recovery.[69][225][233][234]
Mental health
Burden of mental disorders
Years of conflict, economic collapse and repeated epidemics have contributed to a substantial burden of mental disorders in Yemen.[35][36] A widely cited analysis of the right to mental health in Yemen estimated that about 19.5% of the population lives with a mental disorder, a figure echoed by United Nations reporting that roughly one in five Yemenis have conditions such as depression, anxiety or post‑traumatic stress disorder.[35][235] Humanitarian assessments coordinated by the World Health Organization have found that around 7 million people, close to one quarter of the population are in need of mental health care and psychosocial support.[236][237] WHO also found high levels of post-traumatic stress disorder symptoms, and a substantial amount of people screening positive for mood disorder and anxiety disorder.[36][237]
Children and adolescents
The mental health impact on children and adolescents has been a particular concern, with school based studies in urban areas such as Sana'a indicating that a majority of pupils report symptoms compatible with post traumatic stress disorder.[238][239] Yemeni mental health professionals and advocacy organisations have reported rising numbers of suicide cases and suicide attempts in major cities, alongside increases in people seeking psychiatric care in the years following the escalation of the conflict.[238][239]
Services and access
Mental health services in Yemen are unevenly distributed and have historically not been well integrated into primary health care.[238][240] Before the escalation of the current conflict, Yemen reportedly had only a small number of psychiatrists and a handful of specialised psychiatric hospitals serving a population of over 40 million people leaving large areas without specialist coverage.[238][240] People in need of care often have to travel long distances to reach one of the few functioning mental health units, and reports from both national authorities and international organisations that there are frequent shortages on medicines and trained staff.[238][241]
Policy and responses
A national mental health strategy developed for 2011–2015 planned to strengthen services, but its implementation was limited by conflict and financial limitations.[36][238] In 2022 the Ministry of Public Health and Population, with technical support from WHO, began a new strategy for 2022–2026 aimed at integrating mental health into primary care.[237][242] WHO reported that by the mid‑2020s hospital‑based mental health facilities where being set up accompanied by training programmes for non‑specialist workers.[237][242] International organisations such as Médecins Sans Frontières and UNFPA have also scaled up mental health services with a focus on survivors of sexual violence and those affected by displacement.[235][243][241]
Non-communicable diseases
Non‑communicable diseases (NCDs) are the most common causes of death and disease in Yemen. That's a pattern seen across the eastern Mediterranean region.[29][30][31] Cardiovascular diseases, cancers, chronic respiratory diseases and diabetes dominate, yet these estimates carry a high degree of uncertainty in the absence of comprehensive national mortality data.[29][30][144] Global Burden of Disease data and other international assessments show that the contribution of NCDs to years of life lost and disability has grown in recent decades.[48][29][244]
Cardiovascular diseases
Cardiovascular diseases stand for most NCD deaths in Yemen with hypertension and coronary artery disease often cited as the main contributors of premature death.[29][30]
Chronic respiratory diseases
Chronic respiratory diseases account for about 4% of all deaths in Yemen.[195][30] Asthma is reported from Sanaa based in surveys in 2017,to have a prevalence of around 0.4–0.5%, being slightly higher among women than among men.[70][30][245] Data on COPD in Yemen are limited, but regional studies from the Eastern Mediterranean World Health Organisation indicate that COPD is a major cause of adult disability and premature death, often linked to tobacco use and exposure to indoor air pollution.[246][247][248] The current conflict in Yemen directly causes shortages in medicines, such as inhalers, contributing to avoidable inpatient care and deaths.[6][24][249][250]
Diabetes
Diabetes is a growing problem, WHO country profiles and regional studies show increased prevalence, however, there is uneven access to services, insulin, and other related medications.[29][30][251]
See also
External links
- State of the World's Midwifery - Yemen Country Profile Archived 2012-10-05 at the Wayback Machine