WHO Representative to Somalia Dr Reinhilde Van de Weerdt (left) met with H.E. Mr OKANIWA Ken, Ambassador of Japan to Somalia, to express appreciation for Japan’s support. Photo credit: WHO Somalia/M. Saydahmat12 June 2024, Mogadishu, Somalia – A critical project led by the WHO Country Office in Somalia aims to reach nearly 900 000 people with life-saving interventions over the course of 2024. The project targeting people in Somalia who are still living with the impacts of extreme climate events is supported by the Government of Japan with a generous grant of over US$ 700 000. 

This new project follows the completion of an earlier project that benefited over 3 million people affected by drought and floods in Somalia with integrated health and nutrition services. This latest funding, allocated under the Japanese Supplementary Budget, thus represents continued support to Somalia from the Government of Japan. 

The project is titled “Ensuring Access to Essential and Emergency Health Care for Drought (and Flood) -affected Communities Living in Hard-to-reach Areas in Somalia” and spans the entirety of 2024. It targets 15 flood- and drought-affected districts across the country. Working with the Ministry of Health and Human Services, WHO aims to mitigate the health impacts of recurrent climate shocks, food insecurity and disease outbreaks, especially cholera, while strengthening health system resilience. 

“Japan’s continuous contribution will enable WHO to enhance our ongoing activities in responding to recurring and escalated cholera outbreaks in Somalia, particularly in areas affected by extreme weather events,” said Dr Reinhilde Van de Weerdt, WHO Representative to Somalia. “We are grateful for Japan’s longstanding support of our efforts to save lives and improve health outcomes in Somalia and the Greater Horn of Africa region, focusing on emergencies from COVID-19 to the drought and floods.” 

Somalia has an ongoing cholera outbreak, which has been made worse since the floods of December 2023, which destroyed sanitation facilities and caused further displacements. Cholera spreads easily amid the poor sanitary conditions and limited access to basic health care. The outbreak is mainly concentrated in the Hirshabelle, Puntland, and South West states. Since January 2024, the country has reported over 9914 cases. Forecasts predict that the outbreak will continue due to anticipated heavy Gu rains expected until the end of June 2024, potentially leading to flash floods. 

“The Government of Japan recognizes the urgent need to address the health challenges exacerbated by extreme weather events in Somalia,” said His Excellency Mr OKANIWA Ken, Ambassador of Japan to Somalia. “We are pleased to continue our partnership with Somalia. Through this project, we aim to support WHO’s efforts in delivering vital health care services, aiming to save lives and enhance resilience against the impacts of droughts and floods.” 

Thanks to Japan’s funding, WHO will be able to improve access to essential health services through community-based interventions in underserved communities across 15 districts. These services will target 866 860 beneficiaries out of the almost 3.2 million people in need in those districts. The effort will focus on providing health and nutrition services, including immunization, for sick children and pregnant and lactating women. 

The project will also strengthen referral linkages between communities and health facilities to improve quality, access and coverage of critical care. This includes in-patient treatment at stabilization centres for children with severe acute malnutrition with medical complications. 

With Japan’s support, WHO will also assist the Ministry of Health and Human Services in strengthening prevention, early detection and prompt response to disease outbreaks, including cholera, at the district level. 

For more information, contact:

Madinur Saydahmat, Partnerships Officer, WHO Somalia
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Fouzia Bano, Communications Officer, WHO Somalia

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WHO and Ministry of Health personnel check for IDSR priority conditions during a joint support supervision visit to a health centre in Beledweyne district, Hirshabelle state, Somalia. Photo credit: WHO/WHO Somalia11 June 2024, Somalia – Amid the complex humanitarian emergency that is ongoing in Somalia, the population is highly vulnerable to disease outbreaks. In such a situation, early detection of disease outbreaks is crucial for an appropriate public health response and interventions.

Somalia has been successfully strengthening its multi-disease surveillance system by implementing the Integrated Disease Surveillance and Response (IDSR) system. These efforts have been made in collaboration with the WHO Regional Office for the Eastern Mediterranean and the WHO Country Office in Somalia.

IDSR improves the efficiency and effectiveness of health information systems. IDSR data are hosted on DHIS2, the open-source software platform used nationally to collate district health information. Health workers use this platform to record, in one place, real-time information on health events and analyse data for early detection and prompt response to disease outbreaks.

IDSR system implementation

“IDSR has enabled the Ministry of Health and Human Services to stay ahead of the public health events and safeguard the health of our communities by detecting outbreaks early,” said Dr Sahro Isse Mohamed, Head of the Integrated Disease Surveillance and Response Unit, Ministry of Health and Human Services, Federal Government of Somalia.

WHO Somalia supported the development of a 3-year, multiphase operational plan. This includes technical guidelines for IDSR implementation, standard operating procedures, and training material tailored to the surveillance needs of health workers.

As of January 2024, the country has been implementing the second phase of the plan, which aims to:

improve the quality of data that health workers report to the IDSR system

link surveillance data with laboratory information

strengthen the capacity for data use at the subnational level

monitor and evaluate the implementation of the IDSR system through supportive supervision

monitor indicators

conduct review meetings with all stakeholders.

A WHO team member and Jubaland public health laboratory technicians discuss how to increase the testing capacity of IDSR priority conditions in Kismayo district, Jubaland state, Somalia. Photo credit: WHO/ WHO Somalia

Phase one was completed in 2023, with health workers from 371 out of 620 (59.8%) health facilities trained, surpassing the target coverage for the training. State-, regional- and district-level managers also took part in the training.  

Thanks to these training efforts, by the end of 2023, these health facilities had submitted reports on 42 priority conditions. From epidemiological week 3 to week 13 of 2024, this number increased to 409. Of the health facilites that have received the training, 80% have been regularly submitting surveillance data.

The IDSR system has been instrumental in detecting cholera, diphtheria and pertussis alerts in Somalia since April 2023. Also, the capacity of health workers at different administrative levels has been enhanced to develop weekly epidemiological bulletins with analysis and trends of various conditions reported by health facilities. The weekly bulletins are shared with a wide range of stakeholders for decision-making and resource coordination and to the health workers as a form of feedback.

Transforming plans into actions

Planning for IDSR began in 2020, when Somalia made a strategic decision to implement such a system. In 2021, the country established a functioning IDSR system for the first time. In 2022, guidelines and training materials were developed to build health workers’ capacities to successfully use and implement the IDSR system. All these efforts have contributed to reduce morbidity and mortality associated with disease outbreaks.

The final phase of the operational plan will complete in 2024. The IDSR system will then provide a holistic approach to public surveillance of priority diseases and conditions, as well as address response needs.

Somalia has also initiated steps to implement event-based surveillance, especially at the community level, to complement the IDSR system. The country is also strengthening its public health laboratory capacity to ensure that priority diseases reported through the IDSR system are diagnosed in good time.

Rapid response teams will be trained to respond to emergencies within the community. There are also plans to establish surveillance and response systems for antimicrobial resistance, and maternal and perinatal deaths.

WHO is committed to support Somalia as it continues to develop and refine its IDSR system. This support is vital for strengthening Somalia’s surveillance system to improve the country’s preparedness and response plan to disease outbreaks.

Mrs Abdia Adan and her son Mohamed at Garasbaley Health Centre, Kahda district, during his final follow-up appointment to check on his condition. Photo credit: Action Against Hunger/Ahmed Issack11 June 2024, Mogadishu, Somalia – Abdia Adan returns to Garasbaley Health Centre, in the heart of Kahda district, Banadir Region, for her 8-month-old son’s final follow-up at the facility. This visit proves different from her previous encounters as young Mohamed Hussein is now healthier. Abdia visited the health centre with Mohamed in November 2023 when he had a fever and was vomiting. His condition has significantly improved since the doctors diagnosed him with pneumonia and malnutrition, thanks to Abdia’s love and the attentive quality medical care received at the facility.

Living in the Sodonka camp in Kahda, a district in Mogadishu inhabited mainly by people affected by Somalia’s prolonged drought crisis of 2022–2023, Abdia’s family has faced numerous challenges. Her husband’s meagre earnings as a teacher are barely enough to sustain their family of 7. There are more than one million people sharing the fate of being displaced from their areas of origin into internally displaced camps in Mogadishu due to conflict, drought and floods. The living conditions in the camps are harsh, and limited access to basic services, such as water, sanitation, food and health services, increases the risks of disease outbreaks and malnutrition.

To address the critical issue of disease outbreaks, severe acute malnutrition and improve access to health and nutrition services, the WHO in Somalia initiated an emergency response, working with Action Against Hunger, an international NGO, and as well as the Juba Foundation, a local partner in Lower Shabelle Region. The joint venture was made possible thanks to generous and timely support provided by the Central Emergency Response Fund (CERF).

The emergency response was successfully implemented. Disease surveillance teams, community health workers, and health centres played crucial roles in delivering life-saving health and nutrition interventions. Working together enabled WHO and Action Against Hunger to avoid service duplication and smooth referral between community and facility-based care. More vulnerable people were reached in the targeted districts through complementary interventions, leverage of resources and knowledge sharing.

Garasbaley Health Centre, where Abdia had brought her ailing son, is one of the facilities that was supported by the project. Over her 4 years of living in the camp, Abdia knew the community health workers serving her neighborhood and had seen them refer sick children to nearby facilities like Garasbaley Health Centre, giving hope to families.

Young Mohamed is now better following treatment for fever and vomiting made possible by CERF-funded primary health care in Kahda, implemented jointly by WHO and Action Against Hunger. Photo credit: Action Against Hunger/Ahmed IssackThe project supported dedicated disease surveillance teams and community health workers and improved the availability of services at Garasbaley Health Centre, as well as other facilities. As a result, young Mohamed received the necessary medical attention and care, including amoxicillin, paracetamol, vitamin A, and ready-to-use therapeutic food, leading to his improved health and well-being.

The project’s impact extended beyond Abdia’s family and reached almost 15,000 people affected by drought in the Banadir, Bay and Lower Shabelle regions, with the provision of essential health and nutrition services in health facilities, such as outpatient consultations, safe delivery services, vaccination, antenatal care (ANC) and postnatal care (PNC), nutrition support, as well as mental health and psychosocial support.

The story of Mohamed and his family shows the importance of collaborative efforts among partners, community engagement, and access to quality health care and nutrition services in crisis-affected regions. It highlights the positive outcomes that can be achieved when organizations like WHO and Action Against Hunger work in partnership with local communities and stakeholders to address the urgent needs of vulnerable populations.

For more information, please contact: 

Madinur Saydahmat, Partnerships Officer,
WHO Somalia
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Ahmed Issack Hussein, Communication and Advocacy Coordinator, Action Against Hunger
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A mother and her child at a Public Health Centre of one of the drought-affected districts in Kismayo, Somalia. Photo credit: WHO Somalia/I. Taxta1 May 2024, Mogadishu, Somalia – A 12-month project led by the WHO Country Office in Somalia over the course of 2023 reached 3 137 217 people affected by drought or flood. The project was made possible thanks to the generous support of the Government of Japan.

Initially intended to address drought, Japan’s support swiftly adapted to the evolving situation in Somalia. Starting in October 2023, the country was hit by El Niño-related heavy rainfall. This resulted in severe flooding that affected more than 2.4 million people and led to the destruction of 31 health facilities. The surge in demand for emergency health services prompted the reallocation of Japan’s available funds to also facilitate WHO’s flood response.

With the critical support of donors, including Japan, humanitarian and development actors worked with the Government of Somalia on the drought response. This successfully prevented a nationwide famine arising from the 2022–2023 drought crisis. There is still much work to be done, however, as the same communities continue to be affected by the impacts of other extreme climate events.

“The support from Japan played an important role in enabling WHO to reach millions of vulnerable individuals in Somalia who were affected by extreme climate events,” said Dr Ifeanyi Okudo, Incident Manager at WHO Somalia. “We are pleased to deliver the project objective of averting preventable loss of life by strengthening the outbreak detection and implementing an integrated health and nutrition package for the most affected.”

With over US$ 700 000 in financial support received from Japan, WHO was able to deploy 369 community health workers and 121 mobile outreach teams in drought-affected areas. These provided essential health and immunization services to local population with a special focus on children and pregnant and lactating women.

Through this project, basic health and nutrition services were delivered to more than 1.5 million people, including nearly 480 000 children aged under 5 years and more than 250 000 women of childbearing age. Through routine immunization efforts, close to 410 000 children received the pentavalent 3 and measles-containing vaccines.

This surge capacity to provide essential services effectively complemented the routine activities of the local health system, mitigating severe service disruption caused by climate events and consequent mass population displacement. The project also supported health facilities: for example, 369 primary health care units were provided with essential medicines and supplies, benefiting over 3 million people who receive their health services in these health facilities.

Japan’s funding also enabled WHO Somalia to support the treatment of children with severe acute malnutrition, by providing 29 stabilization centres with supplies and supervision support. A stabilization centre is a fixed health care unit where children with severe acute malnutrition with medical complications are referred, admitted, and treated. These WHO-supported stabilization centres maintain a cure rate of above 90%.

“The support from Japan and WHO has been vital in responding to drought and floods, and providing treatment to children suffering from severe acute malnutrition with medical complications [SAM/MC] at our stabilization centres,” said Mr Farhan Mohamed, Head of Nutrition, Federal Ministry of Health.

“Thanks to the comprehensive training sessions provided to health care providers, we have been able to enhance the capacity of our health care workers and provide high-quality services, resulting in a high cure rate for SAM/MC,” he added. “In addition, the funding made it possible for us to deploy critical resources and personnel to the most severely affected areas, where they had a significant impact on saving lives and averting famine.”

Finally, the project allowed WHO to help the Federal Ministry of Health enhance its epidemic surveillance and response mechanism through community-based surveillance. Now, community health workers send alerts based on danger signs they see in the communities they serve, and rapid response teams verify the alerts. As a result, 84.2% of all outbreak alerts raised in 2023 were addressed within 48 hours, and 92.1% of all cases were confirmed. WHO has also been assisting the Federal Ministry of Health to produce weekly epidemiological situation reports.

For more information, contact:

Madinur Saydahmat, Partnerships Officer, WHO Somalia
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Fouzia Bano, Communications Officer, WHO Somalia
Email: هذا البريد محمى من المتطفلين. تحتاج إلى تشغيل الجافا سكريبت لمشاهدته.