Adult mortality before and during the COVID-19 pandemic in nine communities of Yemen: a key informant study

IntroductionWidespread armed conflict has affected Yemen since 2014. To date, the mortality toll of seven years of crisis, and any excess due to the COVID-19 pandemic, are not well quantified. We attempted to estimate population mortality during the pre-pandemic and pandemic periods in nine purposively selected urban and rural communities of southern and central Yemen (Aden and Taiz governorates), totalling > 100,000 people. MethodsWithin each study site, we collected lists of decedents between January 2014-March 2021 by interviewing different categories of key community informants, including community leaders, imams, healthcare workers, senior citizens and others. After linking records across lists based on key variables, we applied two-, three- or four-list capture-recapture analysis to estimate total death tolls. We also computed death rates by combining these estimates with population denominators, themselves subject to estimation. ResultsAfter interviewing 138 disproportionately (74.6%) male informants, we identified 2445 unique decedents. While informants recalled deaths throughout the study period, reported deaths among children were sparse: we thus restricted analysis to persons aged [≥]15 years old. We noted a peak in reported deaths during May-July 2020, plausibly coinciding with the first COVID-19 wave. Death rate estimates featured uninformatively large confidence intervals, but appeared elevated compared to the non-crisis baseline, particularly in two sites where a large proportion of deaths were attributed to war injuries. There was no clear-cut evidence of excess mortality during the pandemic period. ConclusionsWe found some evidence of a peak in mortality during the early phase of the pandemic, but death rate estimates were otherwise too imprecise to enable strong inference on trends. Estimates suggested substantial mortality elevations from baseline during the crisis period, but are subject to serious potential biases. The study highlighted challenges of data collection in this insecure, politically contested environment.

Are Married and Unmarried People Differ in their Perception and Attitude about Family Functioning and Wellbeing in Selected Governorates in Yemen?

Globally, there is a scale of views about family functioning and wellbeing with a great deal of conflicting evidence. In Yemen, conservative social traditions are the norms. Yemen has one of the highest population growth rate and the highest rate of unmet need for FP in the world. This study aimed to explore the perception and attitude about family functioning and attitude among married and unmarried people in selected Yemeni Governorates. The study was conducted in April–May 2014 through house to house community-based cross-sectional survey with a purposively selected sample in 21 districts in 3 Yemeni governorates. The target population was Yemeni citizens aged 15+ years present in households in the targeted districts at the time of data collection. Married and un married respondents were approached equally with a pre-tested questionnaire and only consented respondents were enrolled. Analysis was done using the statistical package for Social Sciences version 22. Differences between married and unmarried respondents was tested by Chi squared test (χ²). Statistical significance was set at p˂0.05. The study involved 2217 respondents. Married and unmarried respondents were not different in their perception and attitude regarding family size, the negative influence of large family size, the relation of family size to children education and age at marriage, and some economic aspects in relation to large family size. However, they differently perceive the meaning of the family; reasons for establishing not different the family and for having children; decision makers for continuation of children education; reasons for postponing marriage, the influence of having too male children on increasing family income and on boosting father’s prestige amongst others. In conclusion; married and unmarried were not different in most of the addressed issues. The few differently perceived issues reflect differences in life experience, reality and social responsibilities. There is a need for further studies to monitor practices related to demographic changes over time in the Yemeni society.