Drought response
WHO's response
Responding to the drought in Somalia, 2022
Saving lives from cholera in drought-hit districts: WHO steps up vaccination campaign using oral cholera vaccines
31 July 2022
Stepping up humanitarian operations for drought: WHO’s support to the stabilization centres is saving lives
30 May 2022
Information resources
Situation reports
Drought report: January-December 2022, January-August 2023
Drought report: January-December 2022, January-July 2023
Drought report: January-December 2022, January-June 2023
Drought report: January-December 2022, January-May 2023
Drought report: January-December 2022, January-April 2023
Drought report: January-December 2022, January-31 March 2023
Drought report: January-December 2022, 1-31 January 2023
Drought report: January-December 2022
Drought report: January-November 2022
Drought report: January-October 2022
Drought report: January-September 2022
In pictures
The health cluster
Coordinating humanitarian health action
Who we are
What we do
In collaboration with health authorities, we work to ensure a coordinated response to humanitarian health needs, primarily through the following actions:
Coordinate humanitarian response
We coordinate and link national, international and UN partners across the country to ensure all health interventions are coordinated and complementary with the aim of meeting the most urgent national and local health priorities. The Health Cluster team works with other clusters (e.g. Water, Sanitation and Hygiene and Nutrition) as part of the Inter-Cluster Coordination Group (ICCG). A network of state- and regional– level Health Cluster coordination platforms, consisting of six state-level coordinators and nine regional focal point organizations, supports sub- national operational planning and response.
Manage information
We serve as a focal point for the collection, analysis, visualization and dissemination of information on the current humanitarian health situation, and monitoring the Health Cluster response in line with Global Health Cluster guidelines.
Develop the capacity of partners
We organize workshops and training to develop the knowledge and skills of partners on essential topics that address all five stages of the humanitarian programme cycle – humanitarian needs assessments, response planning, resource mobilization, implementation and monitoring, and evaluation and review. These events encourage information-sharing of new ideas, platforms, protocols and techniques, while strengthening and improving service delivery according to established standards and guidelines.
Contribute to the humanitarian programme cycle
We lead the health component of the humanitarian programme cycle each year, contributing health priorities to Somalia’s Humanitarian Needs Overview and the Humanitarian Response Plan. This involves: working with partners to identify people in need of humanitarian assistance in health; prioritizing target populations, those most in need and marginalized people; prioritizing strategic humanitarian health actions; monitoring humanitarian response activities; identifying gaps in health service delivery that can be filled to strengthen delivery, while avoiding overlaps; and organizing the use of scarce resources to ensure communities in great need can access services.
Undertake advocacy and resource mobilization for humanitarian health response
We lead advocacy on behalf of the Cluster partners and affected people through evidence-based needs analysis. We advocate for: equitable and dignified access to health care; safety for patients and health care providers; integrated response actions across health services and multi-cluster response; and building resilience in communities and health services.
Monitor Health Cluster coordination performance
We conduct yearly self-assessments to monitor the Cluster’s performance based on core coordination functions. This results in the development of a yearly workplan for collective action aimed at ensuring effective coordination among partners.
Our impact
What we have achieved
What is next
Neglected tropical diseases
Protecting everyone from preventable tropical diseases
Who we are
What we do
We work with federal and state health authorities and partners to prevent and control NTDs primarily through the following actions:
Identify the NTD burden
We map the prevalence and assess the burden of NTDs across the country.
Increase access to NTD care
We work to extend treatment and care of NTDs to all Somalis who need it.
Conduct mass drug administration campaigns
We help carry out mass drug administration campaigns to treat and prevent schistosomiasis and soil-transmitted helminthiases among high-risk groups.
Build capacity
Through training, we develop the capacity of health workers for case management, surveillance, morbidity management and disability prevention for all NTDs as needed.
Raise community awareness
We work to raise community awareness of NTDs and promote social mobilization to support prevention, control and elimination of these diseases.
Our impact
What we have achieved
What is next
Reproductive, maternal, neonatal, child and adolescent health
Making motherhood and childhood safer
Who we are
What we do
In collaboration with health authorities, we work to improve reproductive, maternal, neonatal, child and adolescent health in the country, primarily through the following actions:
Develop policies and standards of care
We provide evidence to inform and support the development of national policies strategies, plans and service standards and guidelines on reproductive, maternal, neonatal, child and adolescent health based on the best scientific data that ensure better RMNCAH care with the goal of reducing preventable deaths and saving lives of women and children.
Train health care workers and skilled birth attendants
We develop and implement strategies and plans to train, retain and engage health care workers, including skilled birth attendants, in reproductive, maternal, neonatal, child and adolescent health to ensure they are competent to implement RMNCAH interventions.
Work with partners
We engage with relevant United Nations agencies, and national and international partners to harmonize efforts to strengthen and enable health systems to address inequalities and ensure that all women and children have access to respectful and high-quality reproductive, maternity, child and adolescent health care.
Improve family and community health practices
We support the adoption of important family and community practices related to reproductive, maternal and child health and development to improve child survival, growth and development by reducing mortality and morbidity in women.
Support impact measurement, knowledge generation and response
We provide technical support to generate evidence and new knowledge, and measure the coverage and impact of interventions, and encourage accountability and reforms for safer care.
Our impact
What we have achieved
What is next
Essential medicines and pharmaceutical policies
Promoting access to safe, life-saving, affordable medicines
Who we are
What we do
In collaboration with health authorities, we work to promote equitable access to safe, effective and high-quality essential medicines, vaccines and other health products primarily through the following actions:
Establish national supply chain management
We help establish and maintain a safe supply chain of essential medicines in the country.
Support the management of essential medicines
We support the management and safe storage of essential medicines and other pharmaceutical products.
Assess quality problems of medicines
We assess problems related to the quality of medicines and tackle problems related to the availability and accessibility of good-quality medicines for delivery of safe health care.
Our impact
What we have achieved
What is next
Polio eradication
Reaching every last child
Who we are
What we do
Conduct vaccination
In collaboration with health authorities and partners, we work to eradicate polio, primarily through the following actions: Respond to Polio Outbreaks by conducting vaccination campaigns. The last outbreak of wild poliovirus in Somalia was in 2014. However, since December 2017, two concurrent outbreaks of circulating vaccine-derived polio virus (cVDPV) have occurred, resulting in the detection of 19 children with paralysis. In order to interrupt the spread of polio virus and avoid additional infections and disabilities in vulnerable Somali children, we conduct nationwide and smaller, case- response immunization campaigns that aim to reach every child to boost their immunity. Maintaining a high level of immunity in the entire population, including mobile populations and across borders, is essential to prevent future outbreaks.
Detect acute flaccid paralysis
We search for acute flaccid paralysis in children under 15 years to ensure that, if found, no cases of poliovirus spread any further. Polio teams visit health facilities included in the active surveillance network (793 of 1267 health facilities). As part of passive surveillance, polio teams also liaise with focal persons in 413 other health facilities to report (zero reporting) on any suspected cases. Village polio volunteers support house-to-house surveillance in hard-to-reach and insecure areas.
Detect polioviruses in the environment
We complement surveillance of acute flaccid paralysis by searching for polioviruses in the environment. Samples are collected from sewer systems at four sites in Banadir region, and analysed at the Kenya Medical Research Institute in Nairobi. This surveillance helps signal whether people are infected and are shedding virus in their stool.
Build capacity
We develop the capacity of field staff (including WHO, UNICEF and health ministry staff) in the areas of surveillance and outbreak response.
Support routine childhood immunization
We support routine immunization of children by sharing resources, such as staff, systems and infrastructure with country's EPI. We integrate activities during vaccination campaigns and help strengthen the capacity of the Somali EPI.
Raise awareness of immunization
We work with authorities, UNICEF and local media outlets to raise awareness of the benefits of vaccines and vaccination, the campaigns that are being conducted and vaccination schedules, and to encourage caregivers to vaccinate children. Health workers use Somali information, education and communication materials to raise awareness among caregivers. Manage information. We collect data from acute flaccid paralysis and disease surveillance, EPI and vaccination activities, and other work streams, including from partner agencies (such as mapping of internally displaced people from the International Organization for Migration). This information guides decision-making and allows us to assess the quality of work done across the country. We post the information collected and the high-quality maps produced on the website www.somaliapolio.org. Polio teams are progressively using real-time, electronic means of reporting for data management (Open Data Kit software).
Support other health interventions
We provide support to other health interventions by sharing resources and systems established by the polio eradication programme in the past 22 years. For example, our systems are used to improve surveillance for diseases (including measles) and outbreak control (such as cholera).
Our impact
What we have achieved
What is next
EWARN
Early Warning and Response Network (EWARN) is a network of health facilities and public health professionals that support the early detection and timely response to epidemic-prone diseases through collection, reporting, investigation, analysis and dissemination of epidemic-related data.
EWARN was first implemented in Somalia in 2012: following its collapse during the ongoing conflict, it was relaunched in 2017. Information is now collected on mobile devices (tablets) which are preloaded with EWARN software containing the necessary forms and reports for information sharing. The software is designed to auto-generate analytical and epidemiological reports to aid decision-making.
Somalia has 450 designated EWARN sites across the country. The coverage is sufficient to ensure timely alerts to prevent and respond to disease outbreaks.
Communicable diseases
Safeguarding against high-burden endemic diseases:HIV/AIDS, malaria and tuberculosis
Who we are
The HIV programme of the WHO country office supports activities to reduce HIV infection and AIDS, and coinfection of HIV and tuberculosis (TB) in the country. Services are delivered through 16 health facilities that provide antiretroviral therapy and 93 TB treatment facilities.
The malaria and vector control team supports actions to reduce malaria and improve vector control across the country. Our activities span all levels of the health systems. The whole population of Somalia is considered at risk of malaria. However, in 2019, 51% of the country’s population was living in a high-risk transmission zone for malaria (> 1 case per 1000 population).
The TB programme implements the national TB programme jointly with national TB programme managers and other partners implementing TB control activities.
What we do
In collaboration with health authorities and partners, we work to tackle HIV/AIDS, malaria and TB in Somalia, primarily through the following activities:
» HIV/AIDS
Developing capacity of health workers
We provide formal and on-the-job training on HIV/AIDS testing and counselling, which is the gateway to HIV/AIDS treatment, as well as training on anti-retroviral therapy.
Enhancing laboratory services
We conduct external quality assurance of HIV testing to validate the accuracy of HIV testing.
Supporting people living with HIV/AIDS
We train staff at HIV treatment facilities on monitoring the health of HIV/AIDS patients, offering supportive counselling and following up on adherence to instructions on taking the medication.
Collecting and analysing data on HIV
We conduct HIV sentinel surveys every 2–3 years to measure the prevalence of HIV and generate national estimates for various population groups. We collect data from 20 antenatal clinics and five clinics for patients with sexually transmitted infections.
Advocating to guide appropriate responses
We use the data collected on the HIV/AIDS situation in the country to advocate for policy responses and decisions.
» Malaria and vector control
Enhancing diagnosis and treatment
We distribute rapid diagnostic tests for prompt diagnosis of malaria and provide medicines to improve access to malaria treatment anywhere at any time.
Supporting vector control
We distribute insecticide-treated nets and carry out indoor residual spraying in high-risk areas, supplemented by management of larval sources.
Monitoring
We monitor malaria drug efficacy and resistance to inform treatment policies and to ensure early detection of, and response to, drug resistance.
Collecting and analysing data on malaria
We collect surveillance data on malaria in a standardized way to estimate the malaria burden and map risk to guide control interventions.
Developing capacity of health workers
We train health workers on laboratory diagnosis, case management, vector control and malaria surveillance.
What we have achieved
» HIV/AIDS
- Established 16 treatment centres for antiretroviral therapy: at the end of 2019, 3472 patients (32.5% of all people estimated to be living with HIV/ AIDS) were alive and on treatment.
- Supported 79.8% of patients with TB coinfected with HIV to begin antiretroviral therapy, thus very nearly attaining the target of 80%.
- Screened 75% of people living with HIV to check for TB during clinic visits, more than the target of 72%.
- Supported 89 of 93 (96%) TB centres in providing HIV testing and counselling; as a result, 91.2% of TB patients learnt of their HIV status in 2019.
- Provided technical assistance for transition planning to the new dolutegravir-based regimens for antiretroviral therapy.
- Completed analysis of data for the 2018 round of HIV sentinel surveillance. We also provided support to the country to update the national estimate of HIV prevalence, beyond pregnant women and people with symptoms of sexually transmitted infections.
» Malaria and vector control
- Malaria case finding substantially increased from 2014 to 2019, a 188% increase.
- Use of rapid diagnostic tests for case detection substantially increased from 2014 to 2019, a 322% increase.
- Use of long-lasting insecticidal net substantially increased from 2014 to 2019: 1.36 million people protected (18% of people living in high malaria transmission zone) in 2019 compared with 697 089 in 2014, an overall increase in coverage of 95%.
- Indoor residual spray to prevent malaria outbreaks after flooding in several parts in the country in 2019 protected 183 629 people.
- Detected Anopleles stephensi, which was suspected of being responsible for recurrent and prolonged malaria transmission in several regions, such as Bossaso, Bari and Berbera.
- Conducted two therapeutic efficacy studies in 2019, in line with plans to conduct at least two studies on an annual basis.
- Systematically monitored the efficacy of insecticides used for vector control and developed national guidelines for insecticide use.
- Introduced new vector control management, such management of larval sources through distribution of larvivorous fish and rehabilitation of berkit (reservoirs).
- Conducted capacity-building for health workers at selected health facilities supported by the private sector.
- Conducted a programme review for the malaria programme towards the development of the National Strategic Plan (2021–2025) for Malaria Control and Elimination.
What is next
In collaboration with health authorities and partners, we work to tackle HIV/AIDS, malaria and TB in Somalia, primarily through the following activities:
» HIV/AIDS programme
From 2021 to 2023, the HIV/AIDS programme aims to undertake the following actions:
- Provide technical support to the programme with the aim of: having 5026 people living with HIV/AIDS on antiretroviral therapy by 2023; and decreasing the proportion of patients dying and being lost to follow-up in the first 12 months of receiving treatment from 24.5% in 2019 to 15.0% by 2023. In addition, the programme aims to increase the proportion of people starting treatment following diagnosis to 93% by 2023.
- Update the operations and training manual for Integrated Management of Adolescent and Adult Illness in light of the transition to dolutegravir-based regimens.
- Increase testing among key vulnerable populations through a mix of testing approaches (e.g. facility-based outreach testing and self-testing) and integrate testing and counselling within existing targeted service settings.
- Work to increase the coverage of testing for viral load, which indicates amount of HIV in a person’s blood, and testing for CD4 (a type of white blood cell), which indicates immune function in patients living with HIV.
- Scale up further HIV diagnostics and treatment for TB patients.
- Design integrated social and behaviour change communications for key vulnerable populations.
- Contribute to health systems strengthening through integrating services into the Essential Package of Health Services.
» Malaria and vector control programme
Enhancing diagnosis and treatment
As part of the national strategic plan for 2021– 2025, the programme aims to implement the following activities between 2021 and 2023:
Case management
- Test at least 278 654 of an estimated 292 334 suspected malaria cases (95%) for parasitological confirmation.
- Provide at least 17 888 of an estimated 18 252 confirmed malaria cases (98%) with first-line treatment.
- Test at least 383 835 of an estimated 417 406 suspected malaria cases (92%) for parasitological confirmation, which confirms malaria and guides treatment.
- Vector control: through mass campaigns, distribute at least 2 399 488 long-lasting insecticidal nets, covering an at-risk population of 4.319 million.
- Carry out indoor residual spraying to respond to any early signs of a malaria outbreak.
- Prioritize six districts for malaria elimination.
- Specific prevention interventions: provide intermittent preventive treatment in pregnancy in 13 districts where malaria endemicity is more than 10%.
- Contribute to health systems strengthening through integrating services into the Essential Package of Health Services.
Expanded programme on immunization
Making every child count
Who we are
What we do
In collaboration with health authorities, we support routine childhood vaccination primarily through the following actions:
Maximize the reach of and sustained access to childhood vaccination
We support health facilities to vaccinate children younger than 1 year of age against common, preventable diseases. We team up with partners, such as the polio eradication programme, to roll out vaccination campaigns to reach children living in hard-to-reach areas. This work also includes developing and implementing district microplans for accessible regions that allow teams to search for and vaccinate every eligible child.
Monitor prevalence of diseases
We carry out surveillance of diseases such as measles, to be able to tackle any outbreaks in a timely manner and prevent further spread.capacity. We help build the capacity of staff from the health authorities at all levels and the polio teams in immunization practices and measles surveillance.
Build strong health systems
We deliver vaccines to children, which also contributes to delivering essential health services. Delivering vaccines to households establishes a point of contact between families and primary health care services at least five times during the first year of a child’s life. Thus, by improving immunization services, we also contribute to building strong health systems.
Monitor progress
We carry out monitoring and supervision activities, such as regular EPI reviews and field visits, including during immunization campaigns, to maintain high standards of service delivery. We update the EPI policy regularly to meet the needs of Somali children. We manage and analyse information, hold review meetings and disseminate updates to partners through weekly polio technical updates.
Our impact
What we have achieved
What is next
Promoting healthier populations
Health and well-being for every individual is an essential component of Sustainable Development Goal (SDG) 3. WHO provides technical, policy, and advisory support to enhance the scope and functionality of Somalia’s primary health care (PHC) systems in order to support better health and well-being for all. (PHC refers to health care provided in the community through local health facilities, community health workers, and local medical professionals.
One out of 12 women die from pregnancy-related causes and 1 out of 7 children die before their fifth birthday.
Midwifery is the cornerstone of Somalia’s reproductive, maternal, newborn, child, and adolescent health provision. WHO is working closely with national health authorities to implement Somalia’s Integrated Reproductive, Maternal, Neonatal, Child and Adolescent Health Strategy 2019‒2023, and National Midwifery Strategy 2018–2023.
WHO also supports implementation of the Political Declaration of the United Nations General Assembly on the Prevention and Control of Noncommunicable Diseases (NCDs). NCDs include cardiovascular disease, stroke, cancer, diabetes, chronic respiratory diseases, and mental health disorders.
Mental health and substance abuse care in Somalia is neglected and underfunded, and poor understanding results in the isolation and stigmatization of the mentally ill and the use of dangerous and humiliating treatment practices. A mental health strategy has been developed that will incorporate mental health care into primary health care services in order to treat, rehabilitate, and care for people with mental illnesses using sound medical practices. A national action plan is also being developed to combat antimicrobial resistance, a global cause of concern.
WHO is working to promote collective, multisectoral and integrated efforts to treat and prevent malnutrition. To improve health and well-being and reduce health risks in the community WHO encourages health promotion and rights literacy, people participation and community empowerment.
