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SUMMARY
The conflict in Yemen is entering its tenth year in 2024. Since the initial UN-brokered truce between the warring parties expired in October 2022 the humanitarian needs have remained alarmingly high. As the conflict persists, access to essential services such as clean water and healthcare is, at the time of writing, severely limited, leading to outbreaks of water-borne diseases. According to the 2024 Humanitarian Needs Overview, 1 an estimated 2.7 million pregnant and lactating women, as well as children under five, require treatment for acute malnutrition. Furthermore, approximately 70% of children three years old have not received a full course of basic vaccinations as recommended in the national immunization schedule.
The economic crisis has deepened, exacerbating food insecurity and livelihood limitations for many Yemenis. As of 2024, 17.6 million people, or half of the total population, are likely to be severely food insecure. Disruptions in public services, including education and sanitation, have further complicated the situation. Furthermore, mental health has emerged as a critical issue, affecting Yemenis in various sectors, including integration, livelihood, and trauma recovery. The United Nations Population Fund reports that 7 million Yemenis require mental health treatment and support, yet only 120,000 individuals have uninterrupted access to these crucial services.
This settlement-based assessment (SBA) was carried out in Khanfar district, Abyan governorate, in the Internationally Recognised Government (IRG) territory, in February 2024 with a public health focus. This focus included the humanitarian sectors of food security and livelihoods (FSL), water, sanitation, and hygiene (WASH), health, nutrition, with analysis supported by indicators on cash and markets as well as accountability to affected populations (AAP) as well as climate and remote sensing, gender, and resilience to shocks dimensions. The assessment aims to fill the gap of limited, localised information by holistically assessing population needs related to public health both at the household (HH) and community level by understanding the availability and accessibility of services related to FSL, WASH, health, and nutrition.
REACH have partnered with ACAPS, CARE Yemen, Abyan Youth Foundation (AYF), and Yemen Family Care Association (YFCA) through the implementation of three data collection tools, including mapping focus group discussions (MFGD), semi-structured HH interviews, and a structured HH structured survey. The data was collected all through February 2024, and included 6 MFGD sessions, 60 semistructured HH interviews, and 281 HH structured surveys. Using a probability sample based on population data received by the Yemen Food Security and Agriculture Cluster (FSAC) a 95% confidence level, 7% margin of error, and a 5% buffer means that the structured survey data collected is representative at the district level as well as for two internally displaced persons (IDP) sites. Al Noabah, a managed site, and Baer Al Sheikh, an unmanaged site, were selected due to reported high intersectoral needs, as captured by the Yemen Camp Coordination and Camp Management (CCCM). Collecting data representative at both the IDP site level and district level allow for findings to be compared between these categories.
The analysis of data collected reveals several limitations that need to be considered. Firstly, the MFGD data analysis was based on summaries of discussions rather than direct quotes or transcripts, potentially leading to generalizations and overlooking specific nuances. Moreover, the translation of these summaries from Arabic to English might have resulted in loss of context and detail. Additionally, conducting sessions with 10 or more participants posed challenges in capturing detailed input from each participant.
Similarly, the semi-structured data collection encountered limitations, particularly regarding the coherence and consistency of responses. While efforts were made to transcribe interviews directly, the sensitivity of recording interviews in Yemen prevented us from achieving high levels of detail and consistency. Some topics, such as access to food and markets, were not consistently addressed across interviews, potentially skewing the analysis. Furthermore, certain questions were not directly answered by respondents, leading to repetitive or fragmented data that required synthesis for a comprehensive understanding.
In terms of the structured household surveys, the absence of GPS coordinates during household data collection limits the certainty regarding the exact locations where data were collected, despite meeting sampling requirements. Moreover, fluctuations in the Household Hunger Scale (HHS) results may occur due to seasonal changes and shocks, such as peak water prices and land preparation activities, affecting data collected one month before Ramadan, a period of significant agricultural activity and water scarcity in Yemen.