Table 4 Recommendations for policy and research

Relevance:

The Health Cluster objectives, although they were relevant (to some extent) to the context in Yemen, they had short-term and emergency perspective.

Some vulnerable groups and illnesses need specific activities to address them.

- Cluster objectives can undergo a review process by all Cluster members to review their relevance and update them according to the gaps and needs.

- Include specific objectives to emphasise health system strengthening and recovery outcomes.

- Inclusion of objectives (or sub-objectives) to support people with special needs and mental health interventions.

- Further research on the best approach to identify relevant objectives and to measure their effectiveness and efficiency is needed.

Health Cluster, WHO as a CLA

Effectiveness:

The Health Cluster was effective in delivering its activities according to objectives, but not on a timely basis.

Neutrality and independence of the Health Cluster were not protected on some occasions.

- There should be a mechanism to provide a rapid response within the authority and budget of the Health Cluster to provide a swift response to emergencies.

- Equal representation and delegation of decision-making power to leaders of subnational hubs.

- Strengthening the Health Cluster leadership and financial independence.

- Clarifying the role of the Health Cluster in all operational areas.

- Cost-effectiveness analysis of the health sector response coordinated by the Health Cluster would provide evidence to invest in the most effective interventions.

Health Cluster, WHO as CLA, OCHA, IASC

Efficiency (funding):

The Cluster funds were enough to cover its basic coordination tasks, but not to respond to emerging outbreaks or displacement needs.

- The Health Cluster would benefit from having an independent financial mechanism to rapidly respond to emergencies at early stages.

Health Cluster, WHO, OCHA, donors

Effects:

The Health Cluster gave suboptimal attention to MoPHP senior staff’ capacity, persons with disabilities, senior people, mental health, and chronic disease.

- Finding an approach to “second” MoPHP senior staff while maintaining their salaries and benefits.

- Establishing and expanding activities to tackle chronic diseases, geriatric, and mental health and to prioritise enough assistance to people with disabilities.

- Impact evaluation research, which could include the perspective of the affected population within its design.

IASC, Health Cluster, WHO, UNICEF and OCHA, MoPHP

Connectedness:

- The inclusion of exit strategies to sustain health services after the end of donors’ support was not included in the Health Cluster’ partners responses.

- The Health Cluster should encourage donors to include specific sections on exit strategies in health project proposals.

- The Health Cluster shall work with MoPHP and all health stakeholders to draft and implement a health system recovery plan.

- Research to evaluate projects and to document successful stories (good practices) in sustaining the health services after concluding aid funds.

Health Cluster, SAG, UNFPA, OCHA, donors

Participation:

- Participation and equitable representation of all partners in the Health Cluster’ decision-making process was unsatisfactory.

- The composition of SAG should be reviewed to ensure fair representation of all partners.

- The process of decision-making within the Cluster should be clarified, standardised, agreed upon, and circulated to all partners upon their final collective consensus.

- Regular partner surveys, with action points to follow the outcomes.

- Research on the role of observers (e.g. MSF) and the private sector in the Health Cluster.

Health Cluster, WHO, OCHA, MoPHP