Child Survival and Development

Polio Eradication

Somalia has achieved and maintained a polio free status since March 2007 (for more than 2 and ½ years) and a well-established surveillance system with national key indicators exceeding polio-free certification standards.

Despite the challenges that face the country mainly insecurity, the polio eradication program has successfully supported implementation of all the planned polio supplementary immunisation activities (SIAs). The two rounds of polio national immunisation days (NIDs) planned for 2009 in all regions of Somalia were implemented in June and July. Due to persistent insecurity, NIDs could not be conducted in the districts of Lower Shabelle region (excluding Afgoye district) and in Kismayo district (Lower Jubba region). Distribution of Vitamin A and deworming medication was successfully integrated in the campaign activities.
Acute Flaccid Paralysis (AFP) surveillance training and awareness-raising workshops are ongoing in the north-west and north-east zones of Somalia for health care providers from AFP reporting sites.
                                       ©WHO/Somalia

The program has successfully supported the implementation of CHDs, efforts to strengthen routine EPI activities, other disease surveillance activities like measles surveillance, CSR and EWARS and other public health interventions like emergency response and outbreak investigations.

Polio Monthly Bulletin
- November 2009
- October 2009
- September 2009
- August 2009
- July 2009
- May 2009

Child Health Days

Child Health Days (CHDs), is a component of the joint WHO/UNICEF Accelerated Young Child Survival (AYCS) initiative to address the high under-five morbidity and mortality in Somalia. CHDs are planned to be delivered twice a year; the objective being to reach all targeted children in every district of Somalia by offering an integrated package of key child survival interventions in order to contribute to the achievement of MDG 4 (reduction of under-five morbidity and mortality).
The CHD package includes: Measles for 9-59 months, DPT for <12 months, polio for <5 yrs, Tetanus toxoid for women of child bearing age (15-49 yrs), Vitamin A for 6-59 months, de-worming (albendazole tabs) for 12-59 months, nutrition screening (MUAC) for <5 yrs, ORS & Aqua tabs for <5 yrs, and IEC/health promotion.
CHDs use teams in multiple fixed sites in urban areas and mobile teams traveling from village to village in rural areas. Given resource constraints and challenges such as the limited number of trained health workers to give injectable vaccines, and the large number of cold boxes required for vaccine delivery and distribution, the implementation is done progressively and in phases.

In the light of the urgent need to scale up access to life-saving interventions and based on the experience of the successful measles catch-up campaigns, implementation of Child Health Days (CHD) is being prioritized. Since the launch of the first round in 2008, CHDs were successfully implemented in all Somalia except Banadir and Lower Shabelle regions, and Kismayo district in Lower Jubba region.
In mid-2009, the second round of CHDs was completed in Somaliland and preparations are underway for Puntland, South and Central zones. For the first time, CHDs were implemented in six districts of Banadir region. The remaining ten districts will be covered in the next phase. Afgoye district was also covered in recent campaigns. Afgoye currently hosts over 524,000 internally displaced persons, driven out of their homes by the conflict in Mogadishu and the south, and facing humanitarian health challenges including disease, limited access to health care and safe water and sanitation.

Special issue on Child Health Days in Somalia
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Routine Immunisation

WHO’s role in Somalia is to improve children’s health by decreasing mortality and morbidity levels from vaccine preventable diseases by providing the six primary antigens to all eligible target populations.


                                             ©WHO/Somalia

WHO Somalia alongside partners of its Expanded Programme of Immunization (EPI) are supporting immunization service delivery in fixed centres and outreach vaccination sites in all Somalia. The Reaching Every District (RED) strategy has been initiated in 20 districts to improve immunization coverage. In 2008, the distribution of supplies, disease monitoring and capacity-building of health sector partners were the main activities undertaken. In addition, the Programme provided technical and financial support to 2 EPI units in Puntland and Somaliland.
The 2005 - 2007 measles campaigns that were conducted by WHO and its partners were successful in preventing outbreaks of measles and widespread deaths in Somalia.
With an increase of measles cases in 2008 with reported 105 cases in Somaliland, laboratory investigations were carried out for 17 suspected cases of which 9 were confirmed as measles. A follow-up immunization campaign was initiated in late 2008 in Somaliland, along with other interventions as part of the new Child Health Days (CHD) Initiative, with the support of Eastern Mediterranean Regional office and Measles Partnership. Based on the findings, the outbreak was successfully controlled. Also in 2008, WHO initiated a measles monitoring system in Somaliland and Puntland and trained health workers on its use and laboratory technicians on measles diagnosis.

Currently the RED strategy is being expanded to cover more districts in Puntland, and South and Central Somalia.