Yemen - What is GIS - World Health Organization

Health Systems Profile- Yemen Regional Health Systems Observatory- EMRO
Public/private distribution of hospital beds
The total number of public hospitals in 2004 was 172 (43 governmental, and 129 rural).
There are 93 private hospitals (in 2004) three of them are not for profit. The total
numbers of beds (including private police and military hospitals) are 23350 beds, 12734
are in the public sector.
As hospitals are located mainly in urban areas and receive much more budgetary support
from the government than the PHC system. They are therefore better equipped and
staffed than PHC facilities. Not surprisingly, patients who are within reach of a hospital
prefer to go directly to it without first consulting a PHC facility. As a result, the majority of
hospital patients are self-referred and most of them require only routine care. This has
led to serve over-crowding of hospitals, stretching their resources and eroding the quality
of their services.
The role of the private sector in providing health care services has grown dramatically in
recent years. From 1991 to 1996, the number of private health centers with beds has
risen from 60 to 348, and that of private hospitals from 4 to 43. This rapid expansion was
driven by market forces and by legislation encouraging domestic and foreign investment
in the health sector. If distance and cost would not play a role 64% of the respondents
prefer to be treated in private sector health facilities, while 32% prefer government
health facilities. When asked to provide reasons the respondents said that private health
facilities had a better-perceived quality, faster treatment and better equipment. Most
respondents go to a government health facility for reasons of convenience such as that
the facility is “nearby” or that they “know the staff”. Most respondents go to private
health facilities due to the better perceived-quality. In particular there is a large
difference concerning the perceived respectful attitude of health workers. Only 41% of
the respondents think that government health workers are respectful against 85% in the
private sector. The perception of the availability of drugs in both public and private health
facilities is below 50%, but particularly low in government health facilities with only 16%.
Long waiting time is another quality issue with only 16% of respondents thinking that the
waiting time in government health facilities is reasonable.
The private sector provides a full range of diagnostic and curative services in offices,
clinics, hospitals and laboratories. Preventive and promotive health care, on the other
hand, is mostly left to the public sector. Private health services are generally of
acceptable quality, and few are of poor quality. Some offices and inpatient facilities are
equipped with modern diagnostic tools and patients are treated with up-to-date
procedures. The private sector operates on a commercial basis, and is therefore much
more expensive to the patient than public health care. A recent UNICEF study covering
four governorates found that the cost of private health services is about five to ten times
higher than the cost of similar services in public facilities.
Key issues and concerns in Secondary/Tertiary care
Primary health care is being supported by secondary and tertiary health care facilities.
They include rural, district and governorate hospitals (secondary level) and specialized
hospitals located in major urban centers (tertiary level). These referral facilities employ
more highly trained staff capable of dealing with a progressively wider range of
specialized medical interventions that require more sophisticated technology than can be
provided at the PHC level.
Secondary Health Care: In 1992, Yemen had more than 80 rural, district and
governorate hospitals. Although they differ in size, with a capacity ranging from 20 to 100
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