Sa'ada governorate is located in north-western Yemen and is estimated to have a population of 934,000 people. It is one of the governorates most affected by both the current conflict and previous conflicts in Yemen, with the current conflict originating in the mountainous Houthi strongholds of Sa’ada governorate. According to the 2021 Humanitarian Needs Overview (HNO), Sa’ada governorate is home to an estimated 691,000 people in need of humanitarian assistance, with 20% of those people classified as facing a “catastrophic” severity of need. Sa’ada governorate hosts one of the largest populations of internally displaced persons (IDPs) out of all governorates in Yemen, with an estimated 104,000 people displaced (11% of the total population).
Despite these evident humanitarian needs, Sa’ada governorate is isolated by both mountainous terrain and protracted bureaucratic processes, making it difficult for humanitarian actors to deliver aid or carry out assessments. Until the 2021 HNO, there had been no large-scale water, sanitation and hygiene (WASH) needs assessment at the household level in Sa’ada governorate since 2018. Although sporadic WASH needs assessments have been conducted in support of humanitarian programming, the geographical and political isolation of the governorate makes consistent, systematic WASH needs assessments nearly impossible.
Household data from 2018 likely underestimates the current WASH needs in Sa’ada governorate, due to escalating crisis in the country over the past three years. Funding for the humanitarian response in Yemen has been significantly reduced since 2018; only 56.5% of the $3.38 billion humanitarian response plan (HRP) budget was funded in 2020, and only 54% of the budget for WASH aid was funded. Furthermore, the 2020 COVID-19 pandemic has increased demand for health and WASH services to serve those affected by COVID-19, displaced people from areas where the disease is spreading, and has created new logistical challenges when delivering services. Unprecedented floods in 2020 have also affected an estimated 500,000 people in Yemen, washing contaminated waste into water systems in some areas. Finally, WASH and other infrastructure has most likely been further damaged since the 2018 household assessment, as airstrikes have increased by 140% compared to 2019.
Poliovirus has re-emerged in Yemen, with an outbreak declared in August 2020 following the identification of multiple cases in the Sa’ada governorate. Since January 2020, 33 circulating vaccine-derived poliovirus (cVDPV) cases have been reported, spreading among a few select districts in Sa’ada governorate (Table 1). Surveillance of acute flaccid paralysis (AFP) is the gold standard for detecting cases of poliovirus. However, with the temporary closure of Sana’a airport (September 9 – October 26, 2020), authorities have been unable to test new samples for poliovirus since June 2020. Due to the inability to properly monitor the spread of poliovirus, the most up-to-date information on the outbreak in Sa’ada governorate comes from surveillance data from January to June 2020.
Along with vaccine coverage, poor sanitation and hygiene are major risk factors related to transmission of poliovirus, due to the importance of the faecal-oral transmission route. The objective of this report is to provide an updated WASH needs overview in Sa’ada governorate to inform the cVDPV outbreak response in Yemen. WASH needs data from the 2018 Household WASH Assessment will provide a detailed baseline, and WASH data from the 2021 HNO will provide insight into the current WASH needs in Sa’ada governorate. Other factors related to cVDPV will be summarized to provide context and identify priority districts for the response to the cVDPV outbreak in Sa’ada governorate.