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Table 2 RMNCAH+N service delivery challenges and coping mechanisms

From: Reproductive, maternal, newborn and child health service delivery during conflict in Yemen: a case study

ChallengeCurrent coping mechanismsRMNCAH+N services affecteda
Scale and urgency of needsPrioritization of nutrition and disease control
Integrated famine risk reduction strategy
Performance-based incentives
All
Insecurity and humanitarian access constraintsUse of mobile teams, community midwife and volunteer networks, outreach campaigns to reach specific populations when access permits
Reliance on local NGO implementers and third party monitoring
Short-term project cycles
Coordination of implementation plans
Health education
Immunization
Sick child care
Nutrition screening
Family planning
Availability, retention and motivation of qualified health workersHumanitarian agencies contracting staff for specific facilities/projects or providing either individual or facility-level performance-based incentive payments
Task shifting
In-service and on-the-job trainings
Maternal and newborn care
Treatment of acute malnutrition
Lack of infrastructure and irregularity of suppliesHumanitarian agencies providing in-kind resources (e.g. fuel) and/or facility-level performance-based incentive payments
Payment of a lump sum to HF in charge for meeting water, electricity, security and cleaning needs of the facilities
Charging informal user fees and/or requiring patients to purchase supplies
Delay or interruption of services
Antenatal care
Routine labor and delivery care
Emergency obstetric and newborn care
Immunization
Sick child care
Family planning
Access and affordabilitySelective and delayed care seeking
Reliance on community-based care providers
Maternal and newborn care
Sick child care
Treatment of acute malnutrition
Distrust and lack of demandAdvocacy with authorities
Awareness campaigns
Relocation of services
Immunization
Family planning
  1. aChallenges affect all RMNCAH + N services: those listed are the areas key informants highlighted as particularly affected