The Saudi German Yemen Hospital (SGH), an existing IFC client in Sana’a, Yemen, initiated this program based on its interest in providing antenatal and maternal care services to women from poorer and underserved communities in Sana’a. The Saudi German Hospitals Group began its operations in 1998 and is one of the largest private for profit healthcare providers in the Middle East. It currently operates five hospitals in the MENA region and is about to establish a new hospital in Cairo, Egypt.

University of Science and Technology Hospital (USTH) joined SGH in this program. USTH is a 144 bed private teaching hospital. It includes a full service hospital and a medical residence for students at the UST medical school. It was established in March 2005 to improve access to quality healthcare services and health professionals in Sana’a. It is the second largest private hospital in Sana’a in terms of number of beds available. It is the first private hospital which is affiliated to a university medical school.

The total project cost is estimated at $7.6million and GPOBA will subsidize approximately 89% of the total cost.

The program will commence in two underserved districts in Sana’a, Yemen in the first year. Primary care services will be provided at the level of the community by midwives at satellite clinics within these districts. In year 1, two satellite clinics will be established by renovating existing facilities in each of the two districts. The clinics will be owned and managed by private service providers. Patients with complications will be referred to in-house specialists based at the satellite clinics. Those patients requiring more tertiary or emergency care would be referred to two private hospitals for management using the emergency transportation systems of these private hospitals.

Yemen has one of the highest maternal mortality ratios at 570/100,000 live births (2000 estimates) with only 27% of births attended by skilled birth attendants (2003). The project seeks to improve access and quality of services to women from poorer districts in Sana’a, Yemen and also aims to relieve some of the strain experienced by the overburdened public sector. The main expected estimated output will be to achieve approximately 40,800 safe child birth deliveries attended by skilled birth attendants amongst the target population over the project period.

IFC is one of the partners and funders of GPOBA. The project provides an opportunity to assess private sector health provision and opportunities/lessons for public private partnership in health service delivery especially to poorer communities. A joint World Bank and IFC team have collaborated to design and implement a program that provides key lessons and serves as a demonstration effect of use of innovative models of care that integrate Yemeni public policy on maternal and child care and private healthcare provision in Yemen.

IFC''s initial review of this project has identified the following environmental, social, health and safety issues for the proposed safe motherhood clinics:

- potable water supply, waste management in particular medical waste, worker health and safety including training and housekeeping;
- disinfection, sterilization, hygiene and implementation of good hospital management practices required to prevent infections among patients and employees and integration with the main hospital''s (USTH and SGH) corporate-wide, integrated environmental and health and safety management system.

While all Performance Standards are applicable to this investment, IFC’s environmental and social due diligence indicates that the investment will have impacts that must be managed in a manner consistent with the following Performance Standards:

- PS1: Social and Environmental Assessment and Management Systems
- PS2: Labor and Working Conditions
- PS3: Pollution Prevention and Abatement
- PS4: Community Health, Safety and Security

Based on this early review, it is anticipated that this project will require 30 days disclosure by IFC prior to Board and has been provisionally categorized as B.