By Amgad A. Mohammed, Project Director, MOMENTUM Integrated Health Resilience, Yemen
In the heart of Yemen, where conflict has shattered the health care system and malnutrition casts a long shadow, midwives such as Suaad Hussien Al-Haj stand as beacons of hope. A seasoned practitioner with almost three decades of experience, Suaad operates a home-based clinic for mothers and children seeking essential health care services in Lahj Governorate on Yemen’s southwest coast.
Suaad sees 35-50 clients each month, offering mother and child personalized care. She also serves clients at Ibn Khaldoun Hospital, the largest in the governorate. She offers a wide-range of essential services such as antenatal and postnatal care, reproductive health services, and counseling on breastfeeding and nutrition. This comprehensive approach, which addresses both physical and informational needs, is crucial in a context where misinformation and lack of awareness can have devastating consequences.
Tackling malnutrition in Yemen
Yemen has some of the highest rates of malnutrition in the world. According to UNICEF, “more than 2.7 million children are acutely malnourished and 49 percent of children under the age of five suffer from stunting or chronic malnutrition.” To help address this challenge, USAID’s MOMENTUM Integrated Health Resilience has provided specialized nutrition training to hundreds of health care workers like Suaad, enabling them to offer even more comprehensive care to their communities.
MOMENTUM Integrated Health Resilience is a USAID cooperative agreement led by Corus organization IMA World Health in partnership with five other organizations, including JSI, who also implements USAID’s Strengthening Healthcare Access Project in Yemen. Both current projects build on previous training from a former USAID effort, the Systems Health and Resilience Project, also led by JSI. This laid a crucial foundation by training health care workers, including Suaad, in essential maternal and child health practices. Both MOMENTUM Integrated Health Resilience and the Strengthening Healthcare Access Project work collaboratively through the same community midwives who implement maternal and child health care. For its training, MOMENTUM included a program designed to educate health care providers about optimal feeding practices for infants and young children to promote their healthy growth, development, and well-being.
Promoting social and behavior change for breastfeeding
Recognizing the critical link between maternal health and child nutrition, Suaad embraced the opportunity to participate in MOMENTUM’s comprehensive six-day Infant and Young Child Feeding (IYCF) course, which emphasized quality-of-care and using a person-centered approach, which in turn fosters trust and enables mothers to make informed decisions about their children’s nutrition. Along with the IYCF course, MOMENTUM trained health providers in Community Management of Acute Malnutrition and therapeutic feeding programs to improve the quality of nutritional health services while addressing underlying factors contributing to poor health outcomes.
“The training was eye-opening,” Suaad reflected. “I was able to deepen my understanding of breastfeeding and complementary feeding (the foods and liquids a child should receive starting at 6 months of age) and confidently address the mothers’ questions and concerns, even considering their limited resources and traditional practices.”
The positive effects of Suaad’s enhanced knowledge rippled through her community. She observed decreases in bottle feeding and pacifier use among caregivers visiting her clinic, and mothers reported fewer instances of diarrhea and improved weight gain in their children. Suaad’s counseling sessions also sparked conversations among mothers, leading to greater community awareness about child nutrition. “I noticed that my counseling was spreading among the women in my community,” Suaad observed.
As Nada Ahmed, one of Suaad’s clients, pointed out, “I followed up with Suaad for my previous births. I have seven children, and Jana is the youngest. She gained weight and didn’t suffer from diarrhea. In fact, she’s the healthiest of my kids in terms of gaining weight, and I continue breastfeeding her with complementary feeding in her tenth month of age.”
Suaad’s journey was not without obstacles. She encountered resistance when advocating for immediate breastfeeding and the benefits of colostrum (the initial form of breastmilk after giving birth that is nutrient-dense and high in antibodies and antioxidants)—practices that were often met with doubts by community members who erroneously perceived it as “bad milk” that can cause diseases. “It was a big challenge to change this deeply rooted misconception,” Suaad admitted. Undeterred, she spoke with patients, promoting healthy nutrition practices with grandmothers and mothers alike about the critical role of colostrum in bolstering a baby’s immunity.
Health care providers take post-tests after finishing their IYCF training. Photo credit: Haneen Dayal, MOMENTUM Integrated Health Resilience Yemen Nutrition Assistant
Suaad’s story is a testament to the transformative power of knowledge and the spirit of health care providers in conflict zones. Her dedication to improving child nutrition, even amid the chaos of war, underscores the vital role of midwives in safeguarding the health and future of Yemen’s children.
And Suaad indicates that this is only the beginning: “As a health worker, I look forward to further training to support mothers and children in living healthier lives.”
A version of this blog will appear on the JSI Research & Training Institute, Inc., website. JSI is a partner with IMA World Health for MOMENTUM Integrated Health Resilience and leads the Yemen project office.