Case Holder:
Rania Bikhazi

Women’s entrepreneurship development programme in the healthcare sector
in Yemen

Promotion of Youth Employment in Fragile Settings

Background & Context

Shattered by continuous state fragility and violent conflict, Yemen is among the poorest countries in the world. By the end of 2014, three months before the beginning of the Saudi-led air strikes, 18% of the population lived on less than 1.25 US$/day and about a third of the population was below the poverty line of 2 US$/day. At the same time 43% of the population was considered food-insecure. During the last two years of war, the situation further deteriorated*.

*  https://www.enterprise-development.org/wp-content/uploads/GIZ-CFAE-PSD-in-Open-Sustained-Violence.pdf

In 2017 the Yemeni women’s participation rate in the labour force is estimated at about 26.2 per cent, thus considerably lower than men’s. Female graduates face serious unemployment challenges in Yemen.

Yemeni universities produce about 30,000 graduates each year, at least half of them women. Yet for government positions, for which 10,000 new graduates are recruited each year, women account for only 40 per cent, while in the private sector working Yemeni women account for only 7 per cent of the total.

In this context, promoting women’s entrepreneurship was crucial to a contribution to alleviation of unemployment challenges and creating an impact on the overall livelihoods situation in Yemen in times of war.

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The Problem

Women-oriented microfinance initiatives in Yemen have allowed some women with low incomes to start their own businesses. According to the Yemen Microfinance Network (2015), the percentage of female microfinance borrowers is considerable but dropped from 50% to 45% (in a sample of six microfinance institutions) owing to the conflict between 2013 and 2015. While small loans have allowed some to enhance their living standards and self-esteem, a number of women still lack any business competence to enable them to flourish because of their weak management and interpersonal skills.

Consequently, encouraging women’s entrepreneurship development (access to finance and business support services) could make a substantial difference in the way women regard themselves.

Using business start-up support as a means to their social and economic empowerment had an impact on the quality of their lives (health and education) as well as their family relations and community life.

Since the beginning of the conflict the healthcare sector became the main target for the Women’s Entrepreneurship Development Programme. Traditionally Yemenis travelled to Jordan for treatment and midwifery services or, if they could not afford that, they relied more or less on the sufficiently functioning public health system and private clinics. Owing to the war travelling to Jordan became difficult and the public health system in Yemen collapsed. Midwives, especially in rural areas, often became the only medical support, with the nearest hospital several hours away, streets being destroyed and movements hindered and slowed down by dozens of checkpoints*.

 https://www.enterprise-development.org/wp-content/uploads/GIZ-CFAE-PSD-in-Open-Sustained-Violence.pdf

Objective

The objective of the intervention was to support potential and existing women entrepreneurs operating in the private healthcare sector, namely nurses, midwives, dentists, doctors, laboratory technicians and pharmacists, under the ILO entrepreneurship development programme “Women Do Business”. This programme aims to:

  • develop the basic business management knowledge and skills of women business owners to enable them to start and manage their businesses;
  • develop the knowledge and skills of trainers to enable them to deliver the programme using effective and participatory methods.

The targeted group includes:

  • women business owners who benefit from micro-finance institutional services, running their own micro-businesses in various sectors;
  • women clients of micro-finance institutions involved in income-generating activities and willing to transform these activities into viable formal micro-businesses;
  • women and men trainers of partner institutions and BDS providers targeting women owners of micro-businesses or involved in income-generating activities.

Value Proposition & Activities

In partnership with the Small and Medium Enterprise Promotion Service (SMEPS), Yemen’s national agency promoting small and micro enterprises and a subsidiary of the Social Fund for Development, the ILO developed an entrepreneurship development training programme in Arabic tailored to women entrepreneurs in Yemen, entitled “Women Do Business” which is based on the existing Get Ahead and SIYB programmes.

A training-of-trainers workshop targeting women trainers from four national training institutes was delivered. This was followed by a number of training workshops targeting existing and potential Yemeni women entrepreneurs to help them access microfinance.

When the conflict erupted it became very difficult to reach women entrepreneurs in many geographical areas of Yemen. To overcome this challenge an online intervention supported by GIZ was launched in support of selected businesswomen who had already taken part of the Women Do Business Programme, to help them develop their own business plans and start or develop their businesses. The services provided relied exclusively on Internet-based means of communication, for example WhatsApp, a popular smartphone App for texting individuals and groups.

WhatsApp group sessions involving 10-14 women were organized to discuss business challenges and receive training from a female consultant, as well as peer-to-peer advice. The BDS were provided over the course of one month and focused on improving financial skills, business continuity capacities, and managerial skills. Since the intervention is implemented via the Internet, each WhatsApp group includes participants from various geographical areas. The majority of beneficiaries in the pilot phase were midwives and some were dentists.

Learning & Results

The intervention targeted 127 private health clinics managed by women, serving IDPs and victims of the war. 30% of the trained women were themeselves IDPs.

Following the WhatsApp-based coaching which complemented the Women Do Business Programme, and as reported by SMEPS, the number of patients handled by the 127 private healthcare clinics grew from 48,000 to 112,000 and income increased by 300%. These results are mainly attributed to simple adjustments to management procedures such as:

  • time management: operating on double shifts to ensure a 24-hour service, which led to improved health coverage and more jobs created (approximately 300 new jobs were created);
  • expansion of ‘client/patient’ coverage to include not only women but also men and children, including those injured by the conflict;
  • overall improvement in daily operations management which included handling of bills, purchase of required medicines, handling a tight cash-flow, and others.

Going beyond the economic impact, the intervention also had a social impact contributing to peace and stability, viz.:

  • each WhatsApp group included women from different and partially-conflicting geographical areas in Yemen; the peer-to-peer advice specifically fostered relationships and confidence-building between participants;
  • trained businesswomen contribute significantly to household income and consequently improve the livelihood of the whole household;
  • the women also serve as role models for younger women in their region.

Complexities of working in a fragile setting

Implementing the women’s entrepreneurship development programme in a country at war entails a number of complexities, namely:

  • restrictions on movement and inability to reach the target beneficiaries;
  • access of international expertise to the country and provision of the required capacity-building;
  • the need to work through local partners and ensure that quality and standards are adhered to;
  • innovative thinking, flexibility and creativity are required in the implementation and management of projects; the use of ICT came as a solution but remains subject to the availability of power and adequate infrastructure.

Conclusion & any future variation

  • Cooperation across conflict lines: the WhatsApp communities provide opportunities for horizontal interaction across conflict lines. It also can serve as a powerful tool for supporting the empowerment of women and the stabilization of households.
  • Implementation through a trusted local partner is even more important for reaching out to marginalized groups such as women in contexts of open and sustained violence.
  • Use of Information and Communications Technology (ICT) for service delivery helps reach out to beneficiaries in conflict areas, complementing the business management training.
  • Similar interventions targeted students in universities with an ILO entrepreneurship course entitled Mubadara that was supported by a coaching service. At the outbreak of the war the latter continued to be provided using the WhatsApp and Skype applications as most coaches fled the country. These coaching services led to preparation of a number of young Yemenis for a business plan competition that distributed US$50,000, provided by two local banks, to ten winners.