Objectives To identify the risk factors associated with patient non‐compliance to anti‐tuberculosis treatment among Yemini tuberculosis (TB) patients. Methods A prospective nested case‐control study was conducted. Non‐compliant cases were recruited from a cohort of TB patients registered between July 2007 and June 2008 in 10 governorates. Three forms were used for data collection that covered interviewing the participants and reviewing their medical cards and TB registers. Independent variables extracted from univariate logistic regression were analysed in multivariate regression to identify independent risk factors for non‐compliance. Results Descriptive statistics showed that approximately 90% of the respondents were at their most economically productive age (15–54 years; with mean (standard deviation) of 32.1 (± 13.6)). The response rate for the study was 87.8%. By the end of the follow‐up period a total of 133 cases were identified. A non‐compliance rate of 16.3% has been found. In the multivariate logistic regression analysis, factors that remained independently associated with non‐compliance were: place of residence, literacy, travelling time, waiting time, employment, living status, family support, stigma, khat chewing and patients' knowledge of TB. Conclusion Results, imply existence of human resource gaps and TB staff inadequately prepared to deal with complex issues of TB patients. This study suggests that reducing travelling and waiting times for TB patients may improve compliance rates. This may be achieved by expansion of directly observed treatment short‐course near to patients' homes and involving additional staff. Improved education for patients and offering free services for unemployed may also improve compliance.

Objective: The Yemen is a signatory of the Millennium Development Goals (MDGs) and one of 10 countries chosen for the UN Millennium Project. However, recent MDG progress reviews show that it is unlikely that the maternal health goal will be reached by 2015 and Yemen still has an unacceptably high maternal mortality of 365 per 100 000 live births. Because 82% of deaths happen intrapartum, the purpose of this needs assessment was to identify and prioritize constraints in delivery of emergency obstetric care (EmOC). Methods: Four district hospitals and 16 health centers in 8 districts were assessed for functional capacity in terms of infrastructure; availability of essential equipment and drugs; EmOC technical competency and training needs; and Health Management Information System. Results: We found poor obstetric services in terms of structure (staffing pattern, equipment, and supplies) and process (knowledge and management skills). Conclusion: The data argue for strengthening the 4 interlinked health system elements-human resources, and access to, use, and quality of services. The Government must address each of these elements to meet the Safe Motherhood MDG.

high relative relapse rate (RRR) of 6-11% between 1995 and 2009, exceeding the acceptable norm (<5%). [3][4][5] The present study was designed to measure the actual relapse rate and to identify associated risk factors. METHODS Study designA prospective nested case-control study was conducted to identify risk factors for relapse among TB patients. At the end of the follow-up period (28 February 2010), all those who relapsed within 12 months after completion of treatment were identifi ed from the tuberculosis registry. For each confi rmed relapse case, four control subjects were randomly selected from among patients who had successfully completed the initial phase of treatment and had not relapsed. Sampling was performed using the Statistical Package for the Social Sciences sampling procedure (Base 7.4 for Windows, SPSS Inc, Chicago, IL, USA). Study area and populationThe study was conducted at health centres with TB units throughout the 10 governorates of Yemen: Metropolitan, Amran, Aden, Taiz, Al-Hodeida, Hajjah, Ibb, Dhamar, Hadramout and Mareb. The study population was a cohort of smear-positive pulmonary TB (PTB) patients registered for DOTS-based treatment between July 2007 and June 2008. Patients who had completed treatment, were considered cured and were aged ⩾15 years were included as subjects, while all patients with smearnegative PTB and extra-pulmonary TB (EPTB), children aged <15 years and adult patients receiving other treatment regimens were excluded. SamplingThe calculation of the sample size for determining factors contributing to relapse was based on a balanced design for simple logistic regression with a binary covariate (X ). 6 In this method, the proportion (B) of the sample (X = 1) was assumed to be 0.5. The event rates P 1 and P 2 are 0.05 (X = 0) and 0.1 (X = 1), respectively. The power of the study was set at 80%, while the two-tailed type I error was assumed to be 5%. The sample size required to detect a change in probability (Y = 1) from a baseline value of 0.05 to 0.1 was 862 patients. Adjusting for the variance infl ation factor, a total sample size of 880 was needed for multiple logistic regression. Based on the required sample size and the number of patients available according to the previous years' statistics, it was decided that recruitment of all patients within the timeframe July 2007 to June 2008 would provide an adequate sample size. Results: A relapse rate of 5.7% was found. Multivariate logistic regression analysis showed that unemployment, smoking, presence of cavitations, weight gain, weight loss, non-adherence during the continuation phase and diabetes were significantly associated with relapse (P < 0.05). Interna onal Union Against Tuberculosis and Lung Disease Conclusion:Relapse rates can be reduced by ensuring that patients take their treatment regularly and are counselled effectively to stop smoking. Reinforcing the implementation of the DOTS strategy and strengthening the anti-smoking campaigns are important actions. Action to help unemployed patients, including free...

By subjecting a number of household attributes to factor analysis, we derived three SES indices (wealth, educational, and housing quality) that are useful for maternal and child health research in rural Yemen. The indices were worthwhile in predicting a number of maternal and child health outcomes. In low-income settings, failure to account for the multidimensionality of SES may underestimate the influence of SES on maternal and child health.

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