Yemen: Research Terms of Reference: Situation Overview of Polio Outbreak and WASH Needs YEM2103 (March 2021, Version 1)

Manual and Guideline
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2. Rationale

2.1 Background

Poliovirus has reemerged in Yemen, with the first cases identified in June and July 2020. Since January 2020, 30 circulating vaccine-derived poliovirus (cVDPV) cases have been reported, spreading among a few select districts in Sa’ada governorate. Sa'ada governorate is located in north-western Yemen and was estimated to have a population of 934,000 as of the 2021 Humaniatian Needs Overview (HNO). It is one of the governorates most affected by both current and previous conflicts in Yemen, with the current conflict originating in the mountainous Houthi strongholds in Sa’ada governorate. According to the 2021 HNO4, Sa’ada governorate is home to an estimated 691,000 people in need of humanitarian assistance, with 20% of those people classified as being in catastrophic need. Sa’ada governorate also has one of the largest populations of internally displaced persons (IDPs) out of all governorates in Yemen, with an estimated 306,000 people displaced (33% of total population). Since January 2020, 30 cVDPV cases have been reported, spreading among a few select districts in Sa’ada governorate. Since January 2020, 73 cases of Acute Flaccid Paralysis (AFP) have been identified in Sa’ada governorate, making the governorate’s AFP rate four times higher (0.16 cases/100,000 children under 15) than Yemen’s national average (0.04 cases/100,000).

2.2 Intended impact

The World Health Organization (WHO) and United Nations International Children’s Emergency Fund (UNICEF) have proposed an integrated response to the poliovirus outbreak. The integrated response will address advocacy, communication and social mobilization and robust immunization (as per global polio response SOPs). The response will consist of a poliovirus vaccination campaign integrated with: measles vaccination in Sa’ada, Hajja and Amran districts; as well as WASH (hygiene items and water treatment), and micronutrient interventions and maternal health services in Sa’ada, Amran, Al Jawf and Hajjah districts. Communication and community engagement will also be an integral component of the interventions. The objective of this report is to provide an updated needs overview in Sa’ada governorate in order to inform the WASH component of the first round of the integrated cVDPV outbreak response in Yemen. Along with vaccine coverage, poor sanitation and hygiene are major risk factors related to transmission of poliovirus, due to the importance of the fecal-oral transmission route. Until the recent Integrated Food Security Phase Classification (IPC) data collection was conducted in October-December 2020, there have been no representative, household-level WASH assessments carried out in Sa’ada governorate since 2018. This assessment will provide critical information to the polio response to ensure that the most vulnerable are targeted for the proper WASH and polio interventions.