Healthcare Utilization among Internally Displaced Persons in Camps and Hosting Communities after a Decade of the Yemeni Conflict
A cross-sectional survey conducted in August 2025 reveals that while internally displaced persons in Yemen's camps and hosting communities maintain high healthcare utilization rates despite severe financial barriers, they face significant economic hardships and require urgent, targeted financial protection and pediatric-focused interventions to sustain health outcomes.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
In the wake of prolonged conflict, the movement of people is often the most visible scar on a nation, but the invisible injury is the disruption of how those people stay healthy. When families are forced to leave their homes, they face a critical question: can they still reach a doctor when they are sick? This question lies at the heart of public health research in crisis zones. To understand the answer, scientists look at two main things: whether services are physically reachable and whether people can actually afford to use them. They also examine who is most vulnerable, such as young children and pregnant women, and whether the system treats everyone fairly. In Yemen, a decade of war has uprooted millions, creating a complex landscape where some displaced families live in crowded, temporary camps, while others have found shelter within existing towns and villages. Understanding the difference in how these two groups access care is not just a matter of statistics; it is a matter of life and death for the most fragile members of society.
A team of researchers set out to map this reality in Yemen, focusing on two distinct groups of displaced people ten years into the conflict. They traveled to the Marib governorate to visit families living in large, designated camps, and to the Taiz governorate to visit families who had integrated into local communities. The goal was to see if the place where a displaced person lives changes their ability to get medical help. The team surveyed nearly a thousand households, speaking with parents and guardians about the health of their families over the previous six months. They asked specific questions about who got sick, where they went for help, how they paid for it, and how long it took to get there. By comparing the camp dwellers with those living among neighbors, the researchers hoped to uncover whether the camp environment offered better protection or created new barriers.
The picture that emerged from the data revealed a stark difference in the composition of these families. The households living in the Marib camps were significantly larger and contained a much higher concentration of the most vulnerable members. Nearly four out of five families in the camps had a child under the age of five, and one in five households included a pregnant woman. In contrast, while the families in the Taiz communities also faced hardship, they were smaller on average and had fewer young children and expectant mothers. This concentration of high-risk groups in the camps meant that the demand for medical care was intense and focused heavily on the needs of children and mothers.
Despite these differences in family size and vulnerability, the drive to seek help was remarkably strong in both groups. Almost every family surveyed reported that someone in their household had been sick enough to need medical attention in the last six months. When illness struck, the vast majority of families did not stay home; they sought care. However, the path to that care looked different depending on where they lived. Families in the camps often had to walk to reach a clinic, with many covering the distance on foot. Those living in the host communities in Taiz were more likely to use motorized transport to reach facilities. While the physical distance to the nearest clinic was similar for both groups, the journey to a hospital was slightly longer for those in the camps.
The most significant barrier, however, was not distance but money. The study found that very few people received free medical care; only a tiny fraction of the families surveyed managed to get treatment without paying. For the overwhelming majority, the cost of seeing a doctor, buying medicine, or getting a lab test was a heavy burden. To cover these costs, more than half of the families had to borrow money. This financial strain was a universal challenge, affecting both the camp residents and those in the communities, though the specific ways they paid varied slightly. Despite the high cost, the families did not give up. They continued to seek out formal medical services rather than relying solely on self-medication, showing a deep commitment to health even when it was financially difficult.
When the researchers looked at what kind of care people were seeking, the needs were clear and consistent. The most common reason for visiting a clinic was the health of children, particularly for treating common childhood illnesses. This was followed by care for chronic conditions and general checkups. Interestingly, families in the camps were more likely to seek care for children than those in the communities, reflecting the higher number of young children in their midst. They also used public health facilities more frequently than private ones, turning to government-run hospitals and health centers as their primary source of care. The data showed that while the system was strained and expensive, it remained the main lifeline for these displaced populations.
The study concludes that while the camps in Marib house a higher density of vulnerable people, the residents there have managed to maintain a high level of engagement with the healthcare system, similar to those living in host communities. The physical access to clinics is reasonable, and the willingness to seek care is high. However, the financial wall remains a critical obstacle. The researchers emphasize that the current system is surviving on the resilience of the families themselves, who are borrowing money to keep their children and pregnant women healthy. As the conflict in Yemen shows signs of de-escalation, the findings suggest that future health plans must focus on protecting these families from financial ruin. The priority is to ensure that the healthcare system can continue to serve these vulnerable groups without forcing them into debt, ensuring that the progress made in keeping people alive during the war is not lost in the transition to peace.
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