Setting
The Taiz Houbane MCH Hospital is located in the Taiz suburb of Houbane
in Yemen. Since the outbreak of the war, Taiz city has harboured one of
the most active Yemeni frontlines. The Hospital serves citizens
inhabiting or displaced to the Taiz Governorate (pre-war population of
3.1 million). It is the only facility in the governorate providing
comprehensive emergency obstetric and neonatal care (CEmONC) services
free of charge, including basic obstetric care, blood transfusions,
caesarean sections and other surgical management.12The facility also provides antenatal care (ANC), family planning
services, paediatric care and malnutrition treatment for children under
five years of age. The maternity department is divided into a unit for
intrapartum care and clinics for ANC and family planning. The
intrapartum care unit is split in two wings and is staffed at daytime
with a total of two gynaecological specialist doctors, two
non-specialized medical doctors, three nurses and eight midwives. During
weekends and nights (17-08 hours), the staff composition is identical to
daytime, except for only one specialist doctor on duty. All staff are
nationals recruited from Yemen, and supervised by an expatriate
specialist in obstetrics and gynaecology. The total bed capacity is 45,
with 12 low-risk pre-labour/labour beds, six high-risk pre-labour beds
for women with severe complications and 27 post-labour beds. Midwives
attend to the labouring women, nurses primarily care for the post-partum
women, and doctors have responsibilities for both. Hence, if one woman
in each labour bed, the birth-attendant-to-labouring-women ratio is
approximately 1:1.5 in daytime and 1:1.6 at nights and in weekends
(birth attendants include both doctors and midwives).