This research seeks to enhance the understanding of the multifaceted drivers of food and nutrition insecurity in emergency-affected countries within the Eastern Mediterranean region and investigate the dynamics of food and nutrition security in countries facing emerging emergencies. This is a descriptive aim to determine the key factors and challenges affecting food security and nutrition status in ten countries in the Eastern Mediterranean region (Afghanistan, Djibouti, Iraq, Lebanon, Pakistan, Palestine (Gaza Strip), Somalia, Sudan, Syria, and Yemen). The research reveals that all selected countries experienced severe levels of food insecurity, with many reaching Phase 3 or above according to the IPC classification. In 2020, Afghanistan and Yemen were particularly hard-hit, with food insecurity affecting 42% and 45% of their populations; in 2024 in Gaza and Sudan, the same figures were 93% and 54% of the population, respectively, representing worse food insecurity crises in the region. Somalia, Sudan, and Djibouti also faced significant food insecurity rates. Many key drivers of food security are standard in most countries, and the linkage between food insecurity and malnutrition levels has a similar trend in almost all countries. However, none of the countries achieved all the 2025 global nutrition targets, while some reached one or two targets. Reaching sustainable development goals is still challenging in these countries since nutrition and food security levels, included in many goals, have not yet been reached. Food security and malnutrition in emergency-affected countries are driven by conflict, political instability, natural disasters, and socioeconomic conditions, which disrupt agricultural activities and infrastructure, exacerbating these challenges. To address these issues, we recommend a multisectoral approach, conflict resolution, climate-smart agriculture, integration of emergency responses with long-term strategies, and strengthening health and nutrition information systems.

The evolving availability of health information on social media, regardless of its credibility, raises several questions about its impact on our health decisions and social behaviors, especially during health crises and in conflict settings where compliance with preventive measures and health guidelines is already a challenge due to socioeconomic factors. For these reasons, we assessed compliance with preventive measures and investigated the role of infodemic in people’s non-compliance with COVID-19 containment measures in Yemen. To this purpose and to triangulate our data collection, we executed a mixed method approach in which raw aggregated data were taken and analyzed from multiple sources (COVID-19 Government Response Tracker and Google COVID-19 Community Mobility Reports), then complemented and verified with In-depth interviews. Our results showed that the population in Yemen had relatively complied with the governmental containment measures at the beginning of the pandemic. However, containment measures were not supported by daily COVID-19 reports due to low transparency, which, together with misinformation and lack of access to reliable sources, has caused the population not to believe in COVID-19 and even practice social pressure on those who showed some compliance with the WHO guidelines. Those results indicate the importance of adopting an infodemic management approach in response to future outbreaks, particularly in conflict settings.

Since COVID-19 emerged in China, social media has spread fake news and conspiracy theories faster than the virus, causing the population to take false actions and follow misleading information, which leads to hospitalization, and even deaths, especially in conflict settings. Therefore, efforts to address health misinformation on social media have become urgent. For these reasons, we monitored social media following the vaccine rollout in Yemen and assessed the impact of the infodemic on the population's vaccine hesitancy in Yemen. To triangulate our data, we executed a mixed method approach in which qualitative data via online social listening was gathered using the WHO Early AI-supported Response with Social Listening (EARS) platform, and then complemented and verified with a Knowledge, Attitude and Practices (KAP) survey. Our results showed that social media in Yemen were exhibited contradictory facts and information gaps about the COVID-19 vaccine. The unaddressed questions and concerns on Facebook and Twitter have been filled with all types of misinformation, including rumors and conspiracy theories about the vaccine. Furthermore, the government's weak Risk Communication and Community Engagement (RCCE) have caused an enormous mistrust in its public health actions and stimulated negative behaviours towards the COVID-19 vaccine. The online social listening results were complemented with the survey findings as one third (38%) of the respondents admitted that COVID-19 vaccine misinformation affected their health decisions and almost two-third (61%) showed unwillingness to take the COVID-19 vaccine which clearly demonstrate the Yemenis hesitation in making health decisions including vaccine uptake. Our study highlights the importance of strengthening health communication and infodemic management to mitigate vaccine hesitancy and increase public confidence in the COVID-19 vaccine.

Background: Pandemics, especially in fragile war-torn countries like Yemen, challenge their already strained health systems. Community adherence to pandemic prevention measures is necessary to curb the severity and spread of emerging pandemics – which is influenced by factors, such as people’s knowledge and attitudes toward the pandemic. No studies in Aden have been published on the communities’ knowledge, attitudes, and practices (KAP) toward COVID-19 prevention to date. To understand adherence to pandemic prevention measures in contexts with fragile health systems, this study investigated KAP of Yemeni participants toward the COVID-19 pandemic.Methods: We conducted face-to-face semi-structured questionnaires among 400 eligible participants whom were identified for participation in this study through systematic household sampling from eight districts in Aden, Yemen. Eligible participants were Yemeni community members who were ≥ 18 years, living for more than 10 years in Yemen, and were willing to voluntarily participate in the study. The questionnaire included questions surrounding the participants’ COVID-19 knowledge (e.g., awareness of spread and prevention), attitudes (e.g., willingness to accept the vaccine or other prevention measures), and prevention practices during the pandemic (e.g., mask wearing, social distancing, vaccine uptake). Total KAP scores were calculated. Univariate and bivariate statistical analyses were conducted using STATA 13 software.Results: From January to May 2021 we conducted 400 questionnaires with Yemeni community members. The average age was 41.5 ± 14.5 years (range 18–86 years). The results demonstrated that the participants in this study had an intermediate knowledge (53%) and fair attitude (58%) scores. However, participants reported very poor COVID-19 prevention practices- with only 11% demonstrating these practices. Only 25% (100/400) practiced social distancing, 25% (98/400) wore a mask, and only 6% (27/400) of participants accepted (at least one dose of) the COVID-19 vaccine. Factors associated with increased knowledge were being male, married, and surprisingly those having a primary and middle school education levels (p < 0.05). Also participants who were diagnosed with COVID-19 or had a family member diagnosed with COVID-19 (vs. those not diagnosed OR = 2.08, 95% CI 1.07–3.78, p < 0.05) were more likely to know that the vaccine protects against severe COVID-19 infection and were more likely to apply good practices such as accepting the vaccine (OR = 2.65, 95% CI 1.17–6.00, p < 0.05) compared to those who were not.Conclusion: These findings raise awareness for the need of community-oriented education programs for COVID-19 which considers associated factors to improve the level of public knowledge, attitudes, and practices.

The World Food Conference in 1974 emphasized the significance of establishing global nutrition surveillance to monitor and address nutritional challenges effectively. However, many countries, especially in the EMRO region, continue to encounter substantial difficulties in regularly generating disaggregated data on nutrition. The current study aimed to review the existing nutrition surveillance systems in the region and to identify their strengths and weaknesses, as well as the challenges they face in functioning optimally. Methods: This study focused on the functional nutrition surveillance systems in eight Arab countries; namely Kuwait, Morocco, Oman, Palestine, Saudi Arabia, Sudan, Syria, and Yemen. The study’s analysis involved utilizing primary data collected from both published and unpublished reports. Additionally, a structured checklist was employed to gather information from all countries involved in the study. Furthermore, interviews were conducted with the EMRO offices to gain deeper insights into the challenges, if any, that these nutrition surveillance systems face in functioning optimally. Results: All countries use health facilities as a basic source of data for their nutrition surveillance, some countries triangulate their nutrition surveillance reports with data from other sources of information such as community or school surveys. Identified nutrition surveillance approaches are closely split between those who operate in stable settings and use routine health information systems (Morocco, Saudi Arabia, Oman, and Kuwait) and other countries that operate in fragile settings; for example, Yemen, Syria, Palestine, and Sudan struggle to provide early warning reports for rapid nutritional responses. Conclusions: Nutrition surveillance systems that utilize existing health information systems are the most sustained in the EMRO region. However, by integrating data from multiple sources, such as health facilities, surveys, and population censuses, countries can provide a holistic view of the nutritional situation, enhance their response to any emergency, and can leverage the infrastructure and resources already in place for health data collection and reporting. Collaboration between countries in the region through sharing experiences and success stories is important in order to reach a standardized system that can be implemented in different settings.

Background: This study aims to describe the observable symptoms of children with COVID-19 infection and analyze access to real-time polymerase chain reaction (RT-PCR) testing among children seeking care in Yemen. Method: In the period of March 2020–February 2022, data were obtained from 495 children suspected to have been infected with COVID-19 (from a larger register of 5634 patients) from the Diseases Surveillance and Infection Control Department at the Ministry of Public Health and Population in Aden, Yemen. Results: Overall, 21.4% of the children with confirmed COVID-19 infection were asymptomatic. Fever (71.4%) and cough (67.1%) were the most frequently reported symptoms among children, and children were less likely to have fever (p < 0.001), sore throat (p < 0.001) and cough (p < 0.001) compared to adults. A lower frequency of COVID-19-associated symptoms was reported among children with positive RT-PCR tests compared to children with negative tests. A lower rate of testing was conducted among children (25%) compared to adults (61%). Fewer tests were carried out among children $<5$ years (11%) compared to other age groups (p < 0.001), for children from other nationalities (4%) compared to Yemeni children (p < 0.001) and for girls (21%) compared to boys (30%) (p $<$ 0.031). Conclusion: Understanding and addressing the cause of these disparities and improving guidelines for COVID-19 screening among children will improve access to care and control of the COVID-19 pandemic.