Helping the Helpers: Skills Training and Mental Health Support for PAC Providers in Yemen
THE CHALLENGE
Quality post-abortion care (PAC) in Yemen is severely lacking due to several factors including inadequate PAC training and a lack of mental health support for those providing the service. A 2019 BMC Public Health study found that 63.2% of doctors surveyed in Yemen are experiencing a high degree of burnout. This percentage is likely to be higher for PAC providers, who face significant social stigma for the services they perform. Beyond this, providers are mostly trained to offer dilatation and curettage, an outdated and less effective method of PAC provision, as opposed to the safer manual vacuum aspiration (MVA) method. This further increases the already high risk of maternal death in Yemen.
THE SOLUTION
To improve PAC care in Yemen, Marie Stopes International (MSI) Yemen developed a new programme which provided healthcare workers in the South of Yemen with critical mental health and training on high-quality, modern methods for providing life-saving healthcare to women. In total, 90 healthcare providers received clinical training on MVA, mental health awareness, and stress management. They were also provided with counselling sessions with a mental health specialist focused on handling the strain of delivering highly stigmatized PAC services during active conflict. Throughout the CHIC funding period, the service providers delivered 1,190 post-abortion care cases and received ongoing supportive clinical supervision. A total of 617 counselling sessions were successfully conducted and all of the service providers who received them subsequently reported stress relief and improvement in their overall confidence levels. Most importantly, discussions were initiated with the governorate health office (GHO) manager around the highly stigmatized PAC services, with the ultimate goal of establishing a referral division in the main hospital in Taiz governorate for gender-based violence survivors to receive proper support. MSI Yemen has also sought to integrate the mental health awareness module developed under this program into all of its clinical training, recognizing the immense psychological challenges that all healthcare providers in Yemen face in the current operational context.
