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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

Challenge

Current coping mechanisms

RMNCAH+N services affecteda

Scale and urgency of needs

Prioritization of nutrition and disease control

Integrated famine risk reduction strategy

Performance-based incentives

All

Insecurity and humanitarian access constraints

Use 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 workers

Humanitarian 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 supplies

Humanitarian 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 affordability

Selective 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 demand

Advocacy 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