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Every Breath Counts: increasing access to medical oxygen in Somalia
Supervisor General of King Salman Humanitarian Aoid and Relief Centre (KSrelief) His Excellency Abdullah Al Rabeeh address to inaugural ceremony of project in Mogadishu on 28 January 2024. Photo Credit: courtesy KSrelief
29 January 2024, Mogadishu, Somalia – A project to reduce the alarmingly high number of child deaths related to pneumonia and diarrhoea in Somalia has been formally launched by King Salman Humanitarian Aid and Relief Centre (KSrelief) and WHO. The Every Breath Counts project aims to increase access to medical oxygen, set up mother and child health care, establish oral rehydration centres and provide integrated health facilities in the fragile humanitarian setting of Somalia.
Child mortality from all causes in Somalia is among the highest in the world. A child born in Somalia today is about 16.5 times more likely to die before the age of 5 years than a child elsewhere. Every Breath Counts aims to reduce pneumonia- and diarrhoea-related morbidity and mortality among children aged under 5 years in the project’s target districts.
Supervisor General of KSrelief His Excellency Abdullah Al Rabeeah launched the project along with Prime Minister of Somalia His Excellency Hamza Abdi Barre, WHO Representative in Somalia Dr Sindani Ireneaus Sebit and other high-ranking government and United Nations officials.
H.E. Mr Hamza Abdi Barre expressed profound thanks to the visiting dignitaries, to Saudi Arabia and to KSrelief for extending much-needed support to Somalia’s fragile health system: “KSrelief and WHO are helping to set up a sustainable health delivery model which will prove beneficial not only for achieving universal health coverage but also Somalia’s key elements of Essential Package of Health Services.”
The project is set to equip 28 health facilities across 10 select drought- and pneumonia-affected districts with solar-powered oxygen concentrators. The project will also provide 90 oxygen cylinders, 15 baby incubators and 4 ambulances in total to the selected health facilities. In addition, the project will help set up 15 triage centres and oral rehydration centres.
H.E. Dr Abdullah Al Rabeeah said on launching the project: “KSrelief is investing in the future of Somalia by providing self-sustainable and environment-friendly solutions and ensuring that selected health facilities can run various medical procedures especially for children and women without power interruptions.”
An estimated 230 127 children aged under 5 years and more than 3.3 million community members will benefit from the project interventions. Over 700 health workers will be trained on screening, outreach and treatment procedures in the course of the project.
Praising KSrelief for investing in saving the lives of Somalia’s children, acting Head of Mission for WHO Somalia country office, Dr Sindani Ireneaus Sebit said: “Contrary to what this situation in Somalia looks like, WHO has shown that community-based outreach programmes involving visits by community health workers to individual households for the diagnosis, treatment and care of pneumonia and diarrhoea and linking these interventions to primary-level care facilities can be a game-changer.”
Currently, the under-five mortality rate in Somalia is 117 per 1000 live births, which is higher than the sub-Saharan African average of 76 deaths per 1000 per live births. Approximately 21% of these deaths among children aged under 5 years in Somalia are attributed to pneumonia, while 18–20% of the deaths are attributed to diarrhoeal diseases alone.
Project interventions
The KSrelief resources will help WHO to set up cost-effective and evidence-based life-saving interventions in 10 districts of Somalia. The focus will be on strengthening community-based preventive, promotive and curative care and care for sick children with symptoms of child pneumonia and diarrhoeal disease.
The project activities will also help strengthen the capacities of primary health care/maternity and child health centres and district hospitals (referral hospitals) to deliver essential health services for pregnant women and people with disabilities. Across the 10 target districts, 28 health facilities will also be equipped to deliver both ambulatory and acute care for sick children diagnosed with pneumonia or diarrhoeal disease.
The services will be aligned within the overarching framework of the Government of Somalia’s vision for universal health coverage. This is consistent with the Government’s plan for implementing its Essential Package of Health Services (EPHS 2020) at the community and primary levels of care to achieve universal health coverage.
Notes to editors
Somalia’s under-five mortality rate is 117 deaths per 1000 live births – one of the highest rates in the world. Photo credit: WHO Somalia/ I. TaxtaThe integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea set a global target to reduce pneumonia-related deaths in children aged under 5 years to 3 deaths per 1000 live births. Currently, however, there are 39.5 child pneumonia deaths per 1000 live births in Somalia – which shows how far the country is from achieving the global target.
Somalia has a high burden and prevalence of risk factors for childhood pneumonia and diarrhoea, including non-exclusive breastfeeding, overcrowding in camps for internally displaced people, high rates of malnutrition and indoor air pollution, poor immunization coverage, and lack of access to quality health care for sick children at the community level. These factors will continue to contribute to a high number of deaths from these preventable causes if the situation cannot be improved.
The current humanitarian situation in Somalia – which results from protracted conflict, civil war, climatic shock and mass displacement – also contributes to poor health service delivery across the country. This has resulted in poor access to health care for vulnerable groups such as disadvantaged children.
Over 7.8 million people in Somalia are adversely affected by climatic shock – of whom more than 1.1 million have been displaced. The Government has declared the current drought situation an “acute humanitarian emergency” and appealed for emergency assistance from international partners and humanitarian agencies.
The drought situation may further aggravate the health conditions of children aged under 5 years because of children’s worsening nutrition condition and the lack of health services in affected areas. This may lead to excess morbidity and mortality from high-burden diseases such as pneumonia and diarrhoeal diseases.
For additional information, please contact:
Fouzia Bano, Communications Officer, WHO Somalia
Email:
Saeed Ahmed, External Relations /Reporting Officer, WHO Somalia
Email:
For more details about WHO’s response across Somalia, see:
WHO and KSrelief helps trains 28 health professionals on basic emergency care
Somalia launches electronic immunization registry in latest leap of innovation
With the launch of an electronic immunization registry in Somalia, WHO Somalia and the Federal Ministry of Health plan to improve the country’s immunization profile. Photo credit: WHO Somalia/I. Taxta
16 January 2024, Mogadishu, Somalia – An electronic immunization registry is set to help increase and streamline immunization coverage in Somalia, with a special focus on children who are new to immunization, defaulters, zero-dose status or underimmunized. WHO Somalia, in collaboration with the United States Agency for International Development, has supported the Federal Ministry of Health to develop and launch the digital platform.
The immunization registry consists of tools that can be used to help monitor individual immunization schedules and store individual immunization histories. As such, using the platform and its tools can help enhance the performance of the Expanded Programme on Immunization (EPI), in terms of both coverage and efficiency.
Somalia is currently managing to reach 720 000 children aged under 1 year through its routine immunization programme. Another 3.6 million children aged under 5 years are reached through special campaigns in hard-to-reach areas or via mobile teams able to help people on the move catch up with missed vaccinations.
Somalia has thus far been using paper-based registration at the individual immunization centres at primary health units, with the data then sent to DHIS2, the open-source digital database. Paper-based data and vaccination cards cannot be used, however, to track and trace children who are missed or overlooked, or whose caregivers fail to bring them for routine vaccination due to financial hardship or any number of other reasons.
“This registry will help develop individual data for each child, with a unique ID, and will be available on the system all across the country. No matter where the family has moved, they can still go to any nearby immunization centre and get their child the required vaccine, without getting a duplicate registry or missing out the previous record of immunization administered to child anywhere in the country,” explained Dr Muhammad Farid, the focal person for WHO Somalia’s Expanded prorgamme on immunization (EPI) programme.
WHO Somalia helped to develop the electronic immunization registry at the request of the Federal Ministry of Health. The country office was able to pursue this latest leap of innovation with the support of its globally recognized partner, the HISP Centre at the University of Oslo, which manages the DHIS2 project.
Previously, from August 2020 to August 2021, WHO Somalia and the HISP Centre had supported the Ministry to review and revise all data elements, indicators and data collection tools for DHIS2. This exercise helped to update Somalia’s DHIS2 platform by adding new indicators, data elements and forms on a government-owned server.
The revised DHIS2 platform has now, finally, helped to unify data relating to EPI; nutrition; the Integrated Diseases Surveillance and Response System; and HIV, tuberculosis and other health conditions.
“We are delighted that after helping us to update the DHIS2 platform, WHO has helped us to conduct training of trainers and, eventually, cascade these trainings to help the Ministry of Health, state, regional and district data officers get hands-on training sessions on the new data collection tools, data entry on the new platform, and get familiarized with the new features such as maps, data visualization and data validation rules,” observed Mohammad Abdullahi, the Federal Ministry of Health focal point for Somalia’s Health Management Information System.
For more information, please contact:
Fouzia Bano, Communications Officer, WHO Somalia
Email:
Saeed Ahmed, Reporting/External Relations Officer, WHO Somalia
Email:
Notes to editors:
For more details about WHO’s response across Somalia, see:
USAID support leads to 47% of eligible Somalis being vaccinated against COVID-19
USAID’s BHA supports WHO to continue the health emergency response to Somalia’s drought
Participants from the Federal Ministry of Health, USAID/BHA and WHO Somalia pose for a group photo after a review meeting of the USAID-funded project in Mogadishu. Photo credit: WHO/Fouzia Bhatti
18 December 2023, Mogadishu, Somalia – The WHO country office for Somalia, along with the Federal Ministry of Health, and the United States Agency for International Development’s (USAID) Bureau of Humanitarian Assistance (BHA), convened a meeting to review the progress achieved through a collaborative project for scaling up the health response to drought in Somalia.
This project is being implemented by the Ministry of Health with the technical support of WHO Somalia and is being funded by USAID’s BHA with a US$ 2 million contribution. The project is instrumental in strengthening 2 critical areas of drought response: national and subnational health cluster coordination, and community-based surveillance. The new collaboration between BHA and WHO demonstrates a global commitment to humanitarian relief.
Five consecutive failed rainy seasons in the Horn of Africa since 2022 have led to an unprecedented drought crisis. In Somalia, the drought has affected 8.7 million people, with over 1.9 million displaced and 6.7 million facing critical health needs. In May 2022, WHO declared the drought a Grade 3 public health emergency, indicating the highest level of concern. In February 2023, Somalia’s Federal Ministry of Health, WHO, and the United Nations Children’s Fund (UNICEF) estimated that the drought in Somalia may have caused 43,000 excess deaths in 2022. Shockingly, children aged under 5 years may account for half of these deaths.
Dr Ali Hadji Adan Abubakar, Minister of Health and Human Services said “We express our gratitude to WHO and USAID for their continued support to our fragile health system. This project will help build on the great strides made during the COVID-19 pandemic to strengthen national and sub-national capacity to prepare for, respond to, and recover from public health crises.”
WHO Somalia is delivering a range of life-saving health and nutrition interventions in 28 Somali districts in response to the dire health needs arising from the drought. The activities target nearly 6 million people, including 2 million internally displaced people, and span the 5 strategic pillars of WHO’s Food Insecurity and Health Readiness and Response Strategic Framework: (1) coordination and collaboration; (2) surveillance and information; (3) outbreak prevention and response; (4) essential nutrition actions; and (5) essential health service actions.
BHA’s support comes at a critical time: more resources are urgently needed to bridge the resource gap for pillars 1 and 3 of the Framework and so continue the health emergency response. The project will help strengthen coordination, at the subnational level especially, through the recruitment and deployment of key roles at the state level. This will help decentralize the drought response, increase state-level capacity to manage crises and strengthen collaboration with other stakeholders, including the Ministry of Health, Health Cluster partners, and other clusters such as the Food Security, Nutrition, and WASH (water, sanitation, and hygiene) clusters.
BHA will also support WHO to deploy community health workers to conduct risk communication for disease prevention, and disease surveillance and alerts, to contribute to early detection and response to epidemics in communities. Such efforts can contribute to reducing excess deaths.
Dr Ireneaus Sebit Sindani, WHO Representative a.i. in Somalia, stressed the importance of the collaboration: “This new partnership with USAID’s Bureau for Humanitarian Assistance marks a significant stride in counteracting the devastating health impacts of Somalia’s protracted drought. WHO remains unwavering in its duty towards the people of Somalia and is working to strengthen coordination and disease surveillance. Our activities across the 5 strategic pillars of the Framework ensure a life-saving response in these critical times and conditions.
“The Somali drought crisis necessitates a unified, global response and we encourage other international entities, agencies, and governments to partake in similar efforts,” Dr Sindani added. “The gravity of this predicament sounds a call to action – to deliver aid to those most in need, and to strive towards a future where such extensive suffering is only a historical footnote.”
“USAID’s Bureau for Humanitarian Assistance is honoured to partner with the World Health Organization to address some of the devastating health impacts from climate-related challenges in Somalia,” said Ms. Sheri-Nouane Duncan-Jones, USAID Somalia Mission Director.
“This new project with WHO is critical to USAID’s humanitarian response and will allow Somali government partners to manage, monitor, and treat disease outbreaks, especially in communities suffering from multiple and complex crises,” she added. “By focusing on community-based initiatives, this critical project will also build a more resilient health system, better prepared for future health emergencies.”
For more information, please contact:
Danielle Botti, Senior Development Outreach Communications Specialist, USAID Somalia
Email:
Fouzia Bano, Communications Officer, WHO Somalia
Email:
Saeed Ahmed, Reporting Officer/EXR
Email:
Related links
For more details about WHO Somalia’s drought response and results in 2022, you can view: Drought report 2022: managing an unprecedented health crisis.
WHO and KSrelief helps trains 28 health professionals on basic emergency care
Participants received hands-on training sessions during basic emergency care training in Hargeisa on 5–9 November 2023. Photo credit: WHO Somalia/S. Farah08 December 2023, Hargeisa, Somalia – Nearly half of the deaths and one-third of disabilities in fragile settings like Somalia are estimated to result from conditions that timely emergency care could prevent. To address this critical need, the WHO country office in Somalia with support from the King Salman Humanitarian Aid and Relief Centre (KSrelief), has helped the Ministry of Health Development in Somaliland to train 28 health professionals on basic emergency care (BEC).
WHO, in collaboration with its partners and the International Federation for Emergency Medicine, has developed the BEC course for front-line health providers which enables them to manage acute, life-threatening conditions with limited resources. The BEC training on 5–9 November 2023 in Somaliland was attended by 6 doctors, 15 nurses, and 7 midwives from 7 regional health facilities – including 21 women from the Awdal and Gailey regions. The Deputy Minister of Somaliland’s Ministry of Health Development, Honourable Liban Gahnuug inaugurated the event by thanking the KSrelief and WHO for helping the ministry with such an important training. “This initiative will help provide hands-on training to health professionals and help them learn a systematic approach for the initial assessment and management of time-sensitive health conditions, where early intervention saves lives,” added the deputy minister.
The BEC course introduces a systematic approach to managing acute, potentially life-threatening conditions even before a diagnosis is known. It includes modules on airways, breathing, circulation, diaphragm, trauma, shock, burns, altered mental status, and extras (ABCDE assessment). The practical skills section covers the essential time-sensitive interventions for these key acute conditions.
“The course is designed for front-line physicians and nurses and focuses on life-saving interventions for acutely ill patients suffering trauma, difficulty in breathing, shock, and altered mental status,” explained the trainer, Mr Mohamud Salah. The course package includes a participant workbook and electronic slide decks for each module. The course is based on WHO guidance, including for the emergency triage assessment and treatment for children, and the integrated management of adult/adolescent illness.
“Specifically, the BEC-trained health workers are capacitated to minimize further harm to the patients, reduce pain, prevent potential complications, and save lives,” observed Dr. Mohamed Abdi Hergeye, Director-General of the Ministry of Health Development, while presiding over the concluding session of the training.
After completing the training sessions, one of the trainees, Dr Haniya Majur observed that: “Such a course is very relevant to a resource-constrained place like Somalia because today we have managed to learn that health emergencies happen every day, everywhere. They affect adults and children and include injuries and infections, heart attacks and strokes, and acute complications of pregnancy and of chronic disease. While specialized care may never be available at all times in all places, a systematic approach to emergency conditions can save lives.”
One of the nurse participants, Ms Sufiya Wasfi, who has been serving in the field for over 6 years, said: “This is the first time I have attended such a useful training. It has helped me to learn that emergency care providers must respond to undifferentiated patients – those with acute symptoms for which the cause may immediately not be known.”
The course is based on the WHO clinical recommendations set out in its “Integrated Management of Adult/adolescent illness district clinician manual”, “Pocketbook of hospital care for Children”, “Paediatric emergency triage assessment and Treatment” guidelines, and “Integrated Management of pregnancy and childbirth” paper.
For more information, please contact:
Fouzia Bano, Communications Officer
Email:
Saeed Ahmed, Reporting/EXR Officer
Email:
Note to editors:
For more details about WHO’s response across Somalia, see:
https://www.who.int/publications/i/item/9789241510219
1 Names of trainees have been changed for security reasons.
