The Middle East presents many challenges for health systems and women's health.  Many gender issues create barriers to improving health, such as a large gap in literacy rates, early marriage, and cultural restrictions on women's participation, decision making, and movement. (Source: World Bank)   Most of Options work in the region has concentrated on reproductive health services and modernising health care systems.   See below for illustrations of our work:

Technical Assistance to Egypt's Health Sector Reform Programme
When the Government of Egypt embarked on a five year pilot phase of health sector reform to restructure family health services to deliver an essential package of basic health services, a number of donors, including the European Commission, the World Bank and USAID provided financial support to a total value of £350 million. Options was part of a consortium, that provided technical assistance to the programme. The TA team assisted the Government's Technical Support Office to define the essential health package and develop a national health sector reform implementation plan. Options provided long-term consultants to assist with the development of the implementation plan, a health financing expert to assist with overall budgeting and a nursing specialist to review and improve the quality of Egypt's nursing profession.

Yemen Health Sector Reform Support Programme
Yemen is a poor country with a life expectancy at birth of 56 years, and 25% of the population living below the poverty line.  In order to meet the Millennium Development Goals, deliveries attended by trained staff need to increase from 22% in 2000 to 43.7% in 2015, and the use of contraceptive from 10% to 19.5%. To support increased access to reproductive health services and commodities, the Royal Netherlands Embassy supported a new programme of training of Community Midwife Workers and provide pooled funding for reproductive health.  Options was contracted to provide a Reproductive Health Specialist to assess Government of Yemen, bilateral and multilateral donors inputs in the field of reproductive health since the start of the Health Sector Reform Programme.  We also reviewed achievements over this period.  The work involved drafting a health seeking behaviour questionnaire for the household survey, including questions on the determinants of demand for reproductive health services.  We reviewed institutional weaknesses in the field of reproductive health in Yemen, and provided specialist inputs in reproductive health to the Programme Formulation Mission and drafting of the programme document.

Syria Health Sector Modernisation Programme
Options is working in collaboration with international organizations to implement a five-year European Commission funded Health Sector Modernisation Programme in Syria.  The objective of the programme is to improve the health status of the Syrian population by increasing the equity, efficiency and quality of the health system. The programme supports reform initiatives instigated by the Ministry of Health, including strengthening policy, planning and regulatory capacity; improving the health care delivery system; and enhancing management capacity at the facility level.  The programme is working to establish quality assurance and accreditation processes and will develop a framework for sustainable financing of the health sector.  Options is providing long-term international expertise in human resource development and quality assurance.  We also provide expertise in primary health care, health management training, health financing and insurance, public expenditure, accreditation processes and the legal environment.

Technical Assistance to the Programme of Reproductive Health in Turkey
This £55 million programme is aimed at improving the sexual and reproductive health status of the Turkish population - especially women - by increasing the availability and utilisation of services and strengthening the policy environment to better support sexual and reproductive rights and choices.  This is to be achieved through the implementation of two strands: direct support to the Ministry of Health in the implementation of the National Strategy for Women's Health and Family Planning (though training of service providers, infrastructure improvement and knowledge generation) and strengthening civil society organisations that implement advocacy and behaviour change activities. The activities funded by this grant will primarily focus on neo-natal health, family planning, safe abortion and STD/HIV/AIDS. Options is part of the managing consortium and provides technical assistance through two long-term advisers in civil society capacity building and financial management and procurement and short-term expertise in various areas.