While the maternal mortality rate has risen sharply in recent years in Yemen, Première Urgence Internationale supports health centres in the north of the country to ensure safe and institutional deliveries.

Myriam*, midwife in Al Madman Health Center, is checking a young mother, on 14/03/2022 I © Première Urgence Internationale

On the 24th of April, 2022, Al Madman Health Center witnessed its 1,000th birth, a baby boy. This achievement is all the more remarkable as it is a very remote health facility, located within poor communities of northwestern Yemen with no other health infrastructures.


Première Urgence Internationale (PUI) started to work in Al Madman Health Center in February 2020. Before Première Urgence Internationale’s support, the facility was a semi-functional health unit, with little services and outreach. Première Urgence international ensured the rehabilitation of the building, provided it with all the necessary equipment, and financially and technically supported the staff. Initially, the delivery room was a very small space, located behind the consultations’ area, with little privacy and rapidly over-crowded. The local health authority built a separate building, which was then rehabilitated by Première Urgence Internationale. This extension was essential to keep up with the pace of births and to ensure the privacy and comfort of the women:

“It became a good and adapted place with perfect privacy for women. At this moment, I cannot have enough words to express well how I am proud of what we achieved”, assured Bacheer*, the Health Facility Manager.

The new delivery room of Al Madman, on 23/03/2022  I © Première Urgence Internationale

Since then, the center has been able to accommodate an increasing number of institutional and safe deliveries, to the extent that Première Urgence Internationale decided to hire more midwifes – from two to four – in order to ensure a 24/7 service at the facility. Première Urgence Internationale also refers complicated cases to secondary healthcare hospitals, for instance when a cesarean section is needed or when risk factors are noted. Since 2021, observing that pregnant women do not always have the financial capacity to pay for deliveries in other hospitals, Première Urgence Internationale also reimburses the transportation and care costs.


Fatima*, for example, gave birth in Al Madman. Fatima is 22 years old, and was displaced since the beginning of the year 2022 to Hodeidah Governorate, which was then in the midst of the conflicts. She comes from an extremely poor family, and her condition further deteriorated due to war and displacement. Married six years ago, she still had no children due to frequent miscarriages, as she explained:

“I never understood why I was losing my babies. But one day I was visiting my neighbour, she was speaking about Al Madman health center and that there were free health services there. She was pregnant and had her pregnancy followed in this center. As I was pregnant at that time, I went immediately to this facility”.

In Al Madman Health Center, Fatima was received by a Midwife, who collected with benevolence and privacy her medical history. To understand the cause of the recurrent miscarriages, Fatima underwent tests and medical examinations. She was diagnosed with Toxoplasmosis (a parasitic infection), anemia and malnutrition. At the end of her first consultation, Fatima was given guidance on the schedule of ante-natal care consultations and received specific medication and complementary food. Fatima’s pregnancy was followed-up in the health center, until the delivery:

“I was counting the days of pregnancy with happiness, and my nutritional status and blood level improved. On the 17th of April 2022 at midnight, I started feeling abdominal cramps and pain, and I asked my husband to accompany me to the center. The center was opened: actually, we were worried that the center would be closed as it was the night. [The midwife] confirmed that I could deliver normally. […] At a time of severe pain, I heard the voice of my baby, and the midwife said: “The baby is coming!” and she put him on my chest to start lactation. I cannot explain and express my happiness at that time”, Fatima recalled.


Yemen has one of the highest maternal mortality rates in the world, a situation that deteriorated since 2014 because of the war. In 2019, in Yemen, one woman and six newborns die every two hours because of complications during pregnancy or birth, for a mortality rate of 164 for 100,000 livebirths (Unicef data). It can be partly explained by the fact that, in rural areas, most women are delivering at home. Première Urgence Internationale promotes safe and institutional deliveries in its supported health facilities, considering that at-home deliveries are multiplying the risks, especially when there are complications.

Première Urgence Internationale in Yémen : 

In Yemen, Première Urgence Internationale is present and active since 2007, providing assistance to the most vulnerable populations of the conflict-affected areas through a community-based integrated approach combining primary and reproductive health, nutrition, psychosocial support, food security and water, sanitation and hygiene interventions.

Al Madman Health Center and eight other health facilities of North and South Yemen are supported in a project funded by the European Union, implemented from May 2021 to February 2023. Since May 2021, a total of 725 deliveries were ensured in Al Madman Health Center, for a total of 1,000 births since the beginning of Première Urgence Internationale’s support in 2020. Women are also followed up before and after their delivery: since May 2021, 643 women received Ante-Natal Care, and 788 received Post-Natal Care consultations.

*Names were modified to protect the identity and dignity of the respondents.

This publication was produced with the financial support of the European Union. Its contents are the sole responsibility of Première Urgence Internationale and do not necessarily reflect the views of the European Union.

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