W O R L D H E A L T H O R G A N I Z A T I O N ORGANISATION MONDIALE DE LA SANTE
INTERCOUNTRY GROUP MEETING ON THE DEVELOPMENT
OF THE MENTAL HEALTH PROGRAMME EM/INT.GRP.MTG.DEV.MHP./lQ
Amman, 24 - 28 September 1983
NATIONAL REPORT ON MENTAL HEALTH PROGRAMME
IN
.YEMEN ARAB REPUBLIC
ENTERCOUNTRY GROUP MEETING ON DEVELOPMENT OF MENTAL HEALTH
PROGRAM
NATIONAL REPORT ON MENTAL HEALTH PROGRAM IN YEMEN ARAB REPUBLIC
Yemen since evacuation of Turkish 1918, was rulled by Immam
and his family. The country lived in isolation away from the twentetk
century era, and modern life, poverty in all aspects of life, lack
of physical structure, communication, difficiency among others
ig sanitation and health.
Health services were neglected and only reserved for prhvilged.
where citizins were left to practices of reli ous, local healers
and quacks. Until 1962 revolution announc
following settlement of the civil war, genuin efforts were made to
repair the inherited damage, ambitious programs for a broad
sociocultural and economic development were planned against
immense difficulties and short comings.
Sociodemographic data:
Yemen according to 1981 cens. was populated with 8.783.084
persons. Out of these 4.752.890 were males, 3.783.084 were females.
29.2% were between 5-15 yrs. 2Q.19t over 65 ~ r s 49.99 under 69 yrs. U X U \ ~ Q ~ \ ~
Population destributed as 22% in towns - 88% in rural areas (villagers) with 35% density. Illetracy was 74.4% above 10 yrs. 9% - o u with total 87%.-Ministry of health budget encreased to four
falds between 1976-1980 with average of 3.73% of the total national
budget (1980) equal to 6.93 ~i~als/~a*ita. Total hospital beds 4067 out of these no hospital psychiatric
beds were available but only few beds were left for neurology in
medieal wards.
Total Yemeny doctors 1981 were 300+333 expatriates. This number
may doubled now. Medical assistants = 24 Yemenies + 7 non Yemenies. ,&v&&g&t.L
physicians = 16 Y. plus 5 non Y. also this number has
been increased due to flow of qualif~ed Y. doctors graduated during
the last few years together with the inflow of expatriates.
Currenent Health Services:
The overall socio economic development of Y.A.R. during the
past decade has been accampanied by a shift away from traditional
indigenous medicine towards modern western sdyle medic&& practjces,
and by broad national concern for improvement of existing medical
and health services with special attention to primary health care
in terms of preventive and social sanitations integrated with
curative medicine. 9
Hospitals were formerly unevenly distributed and concentrated
in the major governorates, but resently more services were extended
to other governorats and rural ereas.
The total number of hospital beds was 4067 (1982 sen.) but has
increased since 1983 and plans were drawn for further additions
of hospital beds,as there is a numberof governorates still suffers
inaquality.
Public health plans were raised to solve the inherited in-
adequacy of health services, preventive and curative. This is
intended to be solved through primary health care extended throughout
the country aiming to lead the population towards the karget of
health for all by the year 2000.
With these activities going on it is generally agreed that
there is a great need for psychiatric services. But no surveys
has been made to identify the true magnitude of the problem.
Unfortunately mental health services remained laging behind, and
were ignored in the 1st. and 2nd 5 years plan. But we can assure that there is regahkey high percentage of mentally handicaps in
Yemen compare$ to other Arab World due to rapid socio-economical
change during the past twenty years aad-dse,to xcaserbation in the
hqbbit of Quat chewing of high abitious desire for catching up the / 3
style of modern life and due to immigration of millions Cemfny
men for earning in other countries.
Early in 1982 the services were initiated in the governorates
of Sana, a and Taiz with special care for custodial patients in
prisons and improvement of the bad situation there. The units has
access to impatient facilities and beds. Efforts were not reserved
to expand the services to the governorate of Hodiada. Late on 1982
it became possible to establish a temporary unit of 60 beds capacity
in Taiz. In a building donated by catholics four miles away from
the centre of the town and is ment to face the increasing pressure
by patients in need for hospital care. Meanwhile a 20 bed unit is r A
planned at the Thawa hospital in Sana, a and for a unit in Hodaida.
Within these units the care is &ven allowing participation of the
patients relatives.
Rehabilitation care is introduced in simple activities due to
lack of premisses and qualified personnel. No facilities are avail-
able at the time for day centres and the like.
Manpower: Before these services were initiated there was
only one neurologist (Yemeny) interested in the field, was
practicing in the old hospital of Sana,a. It became possible
ko recrute three medical officers now prepared for further
study abroad. Another neurologist jionede the service, early
this year a qualified Yemeny Psy. took work in the unit
of Taiz. And another Yemeny psychologist.
Difficiency still exist inauxillary staff due to reluctancy
to work in the field for low wages, and concern about future
prospect. Only 11 nurses joined and are under training locally.
Services are introduce freely except for nominal donations
giving by patients relatives.
Organization and Administration:
Mental health is in theory falling under the directory of
curative medicine. It is proposed that a central organization
body to be formed to shoulder responsibility of planning
excuction, implimentation and follow up of the programme. It
is suggest to involve relavant ministries of social wellfair,
education, and ministry of information and interior.
Drugs :
Psychiatric drugs were not available before except for some
of diazepines, chloropromazines and miner tranquilizers. After
initiation of the service important psychotropic drugs were
registered in the suprem board of drugs and allowed for
impartation and sale under regulations of the supremeboard.
Ministry of Health provides only minor tranquilizers and
anxyletic drugs. Prescription of these drugs is under
restrictions and only prescribed by general paactitioners.
Objectives:
Objective were drawn as:
a) Short term to meet tho pressing presant needs.
b) Long term objectives:
1) Prevention and treatment of mental illness and neurological
disorders.
2) Development of implimentation of mental health service
with proper utilization of the available local facilities,
approprate skills and knowledage.
3) To involve the community to enhance the programme. Strategy and policy:
That mental health should be incorporated with the country
wide programme with the least burden over national finance and
proper utilization of available resources.
Mental health services to be integrated with M.O.H. system
involving health programme and primary health care at district
and subdistrict level.
Development of man power, training and research.
Approprate knowledge and techology
The target is based on the pressing priorities:
a) Immediate care for the psycholocially disturb in prisons and
custodial centres.
b) Strengthening the present facilities
c) Development of man power
d) Secure supply of drugs and equipments
e) Inforcement and extention of M.H. services in Sana'a,
Taiz and Hodeidah
f) Initiation of central organization body in the M.O.H.
g) Extention of service to other governorates integrated with
mental health and primary health care.
The future target is graded to re-inforce the present
services and extent the programme to other areas to meet the
growing needs.