Project Factsheet
Tools for » CHF Som HEALTH/2011-1/OCHA-NGO
Project ID:00078177Description:CHF Som HEALTH/2011-1/OCHA-NGO
Fund:
Somalia Humanitarian Fund
Start Date *: 6 Apr 2011
Theme:
Health
End Date*: 31 Dec 2012
Country: Somalia Project Status: On Going
  Participating Organization:   NGO/OCHA - NGO implementation/OCHA
About

CHF-DMA-0489-087 “Emergency support to the Health Centers of Caliyaalo, Hawadley and Warsheik, serving the most vulnerable drought affected, internally displaced and conflict-affected beneficiaries of Middle Shabelle” – 209,297$                                                                                                                                                 

The increase of communicable disease outbreaks in the area has raised the rates of severe acute malnutrition due to the current drought situation – in a survey during December 2010 and January 2011 Intersos field staff found the SAM rate at 6.7% in Jowhar and Balcad districts.   At the same time due to political obstructions determined by the conflict, immunization rates, particularly for women and children, have dramatically decreased. Additionally the fighting in Mogadishu has been generating a high number of IDPs moving along the Balcad corridor up to Jowhar, among those many are women and girls suffering SGBV, physical and psychological traumas.

The health needs are related to the scarce coverage and quality of essential health care as maternal, neonatal and child care, services addressing HIV, TB, immunization, acute respiratory infections, diarrhea, shortage of life-saving medicine, trauma supplies for primary and secondary health care and lack of trained health workers in place. The displacement has been creating higher needs in terms of adequate sanitation coverage, trauma response and improvement of nutrition.

In the Middle Shabelle Region the only Hospital available for a catchment population of 160,000 people is the Jowhar Regional Hospital.  With the population neighboring the 3 MCHs located inCaliyaalo, Hawadley and Warsheik Intersos reaches to serve 250,000 potential beneficiaries out of which 48,600 are IDPs. The only non-private modern health services in the proposed areas are those currently provided by Intersos in the 3 health centers. 

CHF-DMA-0489-105 “PHC provision for vulnerable IDPs and host communities at Kismayo, Afmadow, Dhobley and Kulbio MCH Centres and their catchments in Lower Juba Region” – 199,992$                                                                                                    

The pastoral, riverine, urban and IDP communities of the Lower Juba region have suffered multiple shocks such as insecurity, recurrent droughts and seasonal floods. Due to poor basic services, the impact on the health situation is adverse. Majority of the population cannot reach the few health facilities whereas the few clinics that exist lack essential supplies.  The number of health care workers is not only insufficient but also not adequately trained. Thus, the minority population that can access these services is often poorly treated. Originally meant to serve only small populations in the vicinity and to complement other bigger hospitals, these clinics must now serve bigger catchment areas with large populations for whom they are the only service providers. The most prevalent cases include diarrhea, malaria, RTI, whooping cough, anemia, STIs, skin infections, typhoid, intestinal parasites and bilharzia.

Kismayo, Afmadow and Badhaadhe Districts in Lower Juba have a combined total population of 256,641. The population faces a pressing need of access to basic health care. In an effort to address the dire health situation, AFREC runs Kismayo, Afmadow, Dhobley and Kulbio (Badade) MCH centres, each with an OPD and outreach component serving more than 100,000 people comprising of IDPs and host populations. With up to 54,000 people being in AFLC/HE and rates of malnutrition at 30.7% GAM  and 7.8% SAM (FSNAU Post Deyr Assessment) there is a rising burden on health services while no corresponding upgrade of facilities, training of staff or provision of supplies. AFREC contributes health staff salaries in an attempt to fill the gap but has no capacity to maintain the required number. There is urgent need to supply medicine and equipment to address the gaps identified in the current and anticipated support and to build capacity of staff to cope with the challenges. This will make health service provision better particularly for girls and women.

 

CHF-DMA-0489-125 “Enhance the protection and improve basic living conditions for IDPs in Somalia through the provision of emergency/temporary shelter: Puntland  IDPs: Shelter” – 100,000$                                                                                                               

According to OCHA weekly and monthly reports, the provision of primary health services remains a challenge in Benadir and Bakool regions due to humanitarian access restrictions, including suspension of humanitarian agencies. Life threatening gaps continues to widen between essential and life saving health services coverage are compounded by inadequate access to safe water and sanitation, increasingly eroded livelihoods, and mass displacement. The increasing frequency of communicable disease outbreaks, rising rates of severe acute malnutrition, low immunization rates, and other serious health risks for vulnerable groups, particularly women and children, are symptomatic of the poor coverage and quality of essential health care (including maternal, neonatal and child care), and shortages of life saving medicines and trauma supplies. Majority of the medical facilities are overcrowded with insufficient safe water, poor hygiene and sanitation leading to a high risk of communicable disease outbreaks and an increase in avoidable death and disease.

With the expulsion of humanitarian actors, the access to primary health care diminished for the communities in Bakool and specifically in Wajid where there are no primary health services (MCH, OPD and EPI) available at all. The lack of primary health care services, combined with the failed Deyr rains, puts the community of Wajid in a precarious situation.

This project aims to ensure access to primary health care services to women and children < 5 years as they presenting most vulnerable population in Wajid and Hodan.         

                                                                                                                                                                                                                                                                                               

CHF-DMA-0489-132 “Strengthening the delivery and provision of emergency life saving health services to IDPs, urban poor and vulnerable host communities of Lafole and neighbourhood areas of Lower Shabelle and Banadir hospital of Somalia.” – 100,000$                                                       

Due to decades of long civil war in L. Shebelle and Banadir regions, the region is characterized by nascent public health systems and community-based health service delivery is inadequate. There is lack of education on appropriate treatments and thus people self-medicate or use unqualified practitioners. Many essential health products are missing.  Recurring droughts and hyper-inflation have contributed to reduced households’ incomes, hence ability to pay for their own health. The situation is very unstable.Continued fighting in Mogadishu means that increased in IDP’s in the already overcrowded camps along the Afgooye corridor.

WHO statistics show that women have 1 in 10 life-time risk of dying due to pregnancy and childbirth-related causes. HIJRA reports show of the total 679 women who  delivered in Lafole area in the last 6 months, only 115 were attended to by skilled TBAs or qualified mid wives i.e. 17%. 85% of IDPs stated that GBV cases have increased. Only targeting women is insufficient for ensuring improved access to health services.

With this project HIJRA aims to increase access to emergency health services amongst the IDPs and host population, targeting a total of 31,000 Individuals through emergency obstetric neonatal care (EMoNC), sexual reproductive health, child health care and prevention and control of communicable diseases programmes in order to reduce high maternal and neonatal mortality rates in (Lafoole, Jaran, Ris, Garbis) Lower Shebelle and Banadir regions (Wadajir and Hodan districts) that are gender sensitive.

 

CHF-DMA-0489-137 “Provision and support of primary health care in Kismayo General Hospital MCH and Abdale Birole MCH serving urban and peri-urban population” – 119,650$                                                                                                          

Kismayo Town and District peri-urban areas of Lower Juba Region with an estimated population of 90,000 people facing a health provision crisis due to dilapidated health delivery system. Much of the health services provision largely remains with expensive and unaffordable private practitioners and clinics. But both the public and private facilities face huge challenges including poor and inadequate health facilities and are often manned by unqualified health staff. The situation is worsened by the part closure and reduced operations of Kismayo General Hospital, which is the only public hospital offering free medical service.  Its reduced operations has forced many to seek health services in the private medical facilities, which is beyond the reach of the vulnerable population groups consisting of urban poor living in the 5 quarters of Kismayo Town, as well as 24,000 IDPs living in  24 major IDP camps within the Town. The health provision crisis also extends to the vulnerable pastoralist and riverine populations living in the western and Riverine settlements Kismayo District respectively. As a result of the decline of Kismayo General Hospital capacity for health care delivery, vulnerable people from the District have no access to quality health care services.

With minor support, the hospital has the potential to ease access in the provision of health services. Past conflicts and lack of local capacity in health services delivery has also adversely affected community driven health provision that used to be supported from the hospital which needs to be reinstated.  These includes support to provision of MCH services, OPD and revival of the Community Hygiene Committees and training of Community Health Workers to improve access to health. There is also need to ensure community sensitization and reactivate structures to contain and manage disease outbreaks especially Cholera and Acute Watery Diarheoa within Kismayo Town and its Periphery.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                

CHF-DMA-0489-142 “Improve Health Services through Primary Health Care in Banadir, Lower Shabelle, Lower Jubba, and Hiran,” – 299,200$                                                                                                            

Over the last years, the lives of millions of people in Somalia had been negatively affected by civil war, especially in the South-Central zone. Mogadishu, the capital city is the worst hit area, and millions of men, women and children have been displaced due to continuous fighting and due to recent severe droughts in Jubas, Shabelles and several other regions of the country. Since December 2010, UNHCR estimates that some 14, 100 people have been displaced from Mogadishu and 8, 500 have fled the city. There is poor availability and quality of essential health care (including, maternal, neo-natal and child health care) and shortage of life-saving interventions for both primary and secondary health care.

Muslim Aid (MA) proposal addresses vast needs of emergency health services which have been prioritized by IDPs and other affected communities. The project targets these emergency and essential health needs in South and Central regions with main focus on drought affected and IDP populations. Health facilities in these areas lack basic equipments and drugs to provide primary curative and preventive services, especially reproductive health and MCH services.

CHF-DMA-0489-143 “Reviving of Balanbale MCH with medicines, medical tools and nutritional supplies” – 57,737$

Balanbale district has more than twenty locations besides this there are also three IDP camps in the town which host people who fled from Mogadishu, Balatweyne, Dhusamareb and other parts of Galgadud region where conflict is relatively high. These IDPs prefered the relative stability in Balanbale town which is controlled by the Ahlusunna Waljama. High level of malnutrition, food and water shortages as a result of the rains failure and the ongoing La nina drought has exacerbated the critical and the ailing health services in the area. A total population of 39,370 women, men and children under five years in  Balanbale and its immediate villages which are supposed to be served by the Balanbale MCH do not get proper health care due to insufficient provision of medicines and nutrition supply. there also exists lack of necessary medical tools and  inadequacy in the number of trained staffs hence the MCH only provides a meager services for the large number of mothers and children and other patients seeking medical help in the district.     

Balanble MCH was established in 2005. Since then, HOPEL, Diaspora and local community have been supporting it. The MCH used to be in a rental house but has now been given a room by the Administration of Balanbale Hospital. It has no enough Medical supplies, tools and equipment in order to meet its role of providing quality health services, The MCH receives irregular medical supplies from UNICEF in the last 3 years, the latest medical supplies received by the MCH was in December 2010, and this was mainly immunization and MCH health kits. Although without a valid PCA now but HOPEL and UNICEF had advance discussions and are currently working towards having a PCA aimed at regular support for the MCH, and that is the reason we are requesting for one month medical supply cash assistance to keep the MCH going while we wait for HOPEL to finalise agreement with UNICEF. Therefore UNICEF will cover subsequent medical supplies.

The MCH will serve a target population of 11418 composed of 7874 U5 children - 4,000 girls and 3,874 boys - (20% of the total population of 39,370), and 3544 of Pregnant and Lactating mothers (9% of the total population of 39,370), the Balanbale local authority estimated that 19% of the total population in Balanbale are IDPs living in Four Camps in Balanbale town. 

                                                                                               

CHF-DMA-0489-144 “Improve health services to IDPs and Host communities in Mudug” - 399,005$

Somalia has been in chaos for two decades since the collapse of the central government 1991 leaving the country’s social infrastructure shattered & making the country a nation in humanitarian crisis.  Since the collapse of government, the production of new carders of health workforce has since dropped to almost zero level & as a result, Somalia has the worst health indicators in the world. South central Somalia remains the epicenter of the ongoing conflict in Somalia hence originating mass exodus of people & because of the relative peace, Puntland remains an ideal destination for the displaced people. Galkacyo district houses the largest IDP settlement in the entire Puntland state. Despite having hundreds of thousands of IDPs in more than 21 IDP camps, the region lags behind in both health infrastructures and health services. For the 3 years, IRS has been engaged in providing free and accessible health services to the IDPs through mobile clinic. The current drought in the region has aggravated the already dire situation of the people & many pastoral communities are losing their livelihoods & forced to join the IDP camps. IDP communities were also the hardest hit in the drought and due to shortage of water and a drop in nutritional status, malnutrition and water-borne diseases are expected to surge unless mitigation intervention is put in place now. List of sources: MOH Puntland, Health needs assessment by Islamic Relief, Field health staff, MIS from the field, OCHA & WHO   .

The project aims to respond to emergency health service needs of 45,000 IDPs and host community in Mudug region by (i) improving access to emergency and life-saving health services to 45,000 people including 30,000 IDPs, (ii) improving access to primary and secondary health service with improved local capacity for better provision of health services to 1500 pregnant women and 6750 children under the age of 5 years and (iii) strengthening disease surveillance and outbreak control system in the area.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                          

CHF-DMA-0489-145 “Provision of strengthened primary health services to both IDPs and host communities in Middle Shabelle region” – 92,210$

More than 2.4 million people in Somalia, 1.46 million of whom are displaced including 52000 IDPs in Middle Shabelle, are in currently in need of humanitarian assistance. South Central Somalia is the area most affected. The availability of health services is severely limited, relying almost exclusively on NGOs for delivery. Service delivery is hampered by the weak public health system and the lack of infrastructure, health facilities and skilled health workers.

In Middle Shabelle access to health care services is very limited due to the poor health facilities and limited humanitarian space to support. As result, the region experiences explosion of AWD, malaria, measles and other preventable diseases that claims the lives of many children and women (FSNAU,2011. Humanitarian access and spaces is very poor. In addressing the needs, the Zamzam foundation is implementing many health activities in the region. The Health facilities, we are targeting in this project is built by Zamzam foundation and runs from its own resources with collaboration with the community and currently the health facilities in need for sustainable source to benefit the community.                

                                                                                               

CHF-DMA-0489-146 “Provision of Emergency Primary Health Care with Referral at Xamar Jabjab, Mogadishu” – 109,650$

Banadir region is the most affected region in South and Central Somalia for humanitarian crisis. The region experiences chronic crisis, civil conflict, repeated fighting, droughts, flooding, inadequate or absent health services and is affected by high influx of IDPs. In Mogadishu there are high demands and challenges of access to quality basic health care services, shortage of life-saving essential medicine; recurrent disease outbreaks including cholera; malnutrition and low coverage of immunization.

WARDI has been supporting health facilities in Mogadishu including Xamar Jabjab where there are no any other health care providers. WARDI is proposing the continuation of supporting the functioning health centers in Banadir region (i.e. Xamar Jabjab health centre). The objective of the project is to provide quality life saving service, emergency health care services and access to sanitation programme for conflict- and drought-affected women and children IDPs and members of the host community in Xamar Jabjab of Banadir region.  

CHF-DMA-0489-148 “Strengthening access to primary health care services in Lower Shabelle Region” – 331,869$

Lower Shabelle is facing a severe and increasingly acute drought which is indeed exacerbating an already dire humanitarian situation whereas civil insecurity, political instability and confrontations between armed groups continue to drive human rights abuses, violence, killings, and population displacement. The population remains in a state of Acute Food and Livelihood Crisis and Humanitarian Emergency, currently made worse by severe drought. Infant, child and maternal mortality rates are among the highest in the country.

The health situation in the area reflects the critical situation of most of South Central Somalia where the delivery of health services has been deeply affected by the long crisis. IDPs are among the most vulnerable groups since the displacement has disrupted their access to social services. Main health problems are the maternal and neonatal health, which remain precarious since 80% of the deliveries are still attended by unskilled staff. In addition, the region has a high incidence rate of communicable diseases whose transmission is facilitated by the mass movement of the IDPs, the scarcity of safe water,  poor sanitation  and lack of access to health services.

The project aims to increase access to primary health care services for drought affected communities and  IDPs in Lower Shabelle by (i) improving the access to primary health care services, and (ii) improving the prevention and control of communicable diseases in collaboration with WHO.                                                                                                                                                                                                                                                                                                                        

CHF-DMA-0489-152 “Provision of Emergency Primary Health Care and Nutrition services targeting women, men and children in Galgaduud region, Somalia” – 183,226$

The nutrition situation in Galgadud region is critical with the humanitarian crises continuing due to ongoing drought and civil unrest. Recent conflict has exacerbated an already acute humanitarian crisis by putting more pressure on the already weak coping mechanisms of the population and on scarce available resources.

The locations under the proposed programme are in a critical nutritional situation with little or no access to health facilities. Additionally, immunisation services have been very poorly supported due to the recent past insecurity and access difficulties. Need for greater emphasis on EPI is vital, and every effort to ensure safe passage for EPI outreach support will be made, as will strengthening of IMCI in the community and in the facilities.

Merlin is currently implementing activities to address critical health and nutrition needs. Under the proposed programme, Merlin proposes to continue with these same services, but greatly increase and emphasize EPI in additional to the nutritional, general child and maternal health, and provision of basic PHC to the total population.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             

CHF-DMA-0489-153 “Provision of Emergency Primary Health Care and Nutrition services targeting women, men and children in Mudug region, Somalia.” – 117,068$                                                                                                              

Assessment and external data show the Mudug and Nugal population face acute health threats while having little access to services. Most at risk to the combination of food insecurity, poor water/sanitation and inadequate health care are women and children and those people displaced by civil insecurity, ethnic tension or drought. Data on health status of the target population is largely inadequate; what exists illustrates a very serious situation in terms of health and vulnerability. The burden of disease is particularly high among children under five, as reflected by a mortality rate of 180 per 1,000 (UNICEF 2009). Main causes of morbidity and mortality are acute respiratory infections, diarrhea, malaria and malnutrition. With over a quarter estimated to be underweight, malnutrition is clearly a major factor to poor health in children under five (GAM rate 19% - FAO/FSNAU Post-Gu 2009). Women of reproductive age are critically vulnerable; the majority has little or no access to other primary maternal health care services and the rate of maternal mortality of 1,400 per 100,000 (WHO, 2009) illustrates inadequacy of maternal health services.

Merlin seeks to address these needs by providing outpatient consultation, integrated management of childhood illness, immunization, maternal health services, health education and nutrition programmes.

 

CHF-DMA-0489-154 “Support of Primary Health Care Services at MCH-level in the Emergency-Affected Areas of Galgaduud and South Mudug Region of Central Somalia” – 262,925$

Because of the failure of the Gu and Deyr seasons of rainfalls in 2010, preceded by low and infrequent rainfalls in 2008 and 2009, most parts of South Mudug and Galgaduud regions face harsh drought that threatens the lives of the communities. In the area of intervention identified by this action (catchment population of 9 MCHs), 200,000 people, almost all of them agro-pastoralists, are under lethal risk of starvation and/or of outbreak of water borne disease due to the ongoing drought.

There is an urgent need to strengthen the capacity of the MCHs in South Mudug and Galgaduud regions, since only 9 MCHs services provide health support to almost 200,000 people.

The health service delivered by the 9 MCHs that the action intends to support is overstretched by the current situation and severely hampered by lack of adequate structures and skilled male and female health personnel, as well as insufficient drugs and equipments. Furthermore community members, especially women, are not sufficiently informed and aware of MCH services and their crucial role, which results in high morbidity rates of children and mother during motherhood.

To face the drought crisis and to guarantee the basic package of health services to the 9 MCH, CISP proposes in this project to provide: kits for emergency preparedness (EHK), Diarrhoeal Diseases Kit (DDK), drugs to guarantee the functioning of the MCH, training and incentives for the health staff, outreach activities to address the health needs in the field, support to PHC services, and health facility rehabilitation/renovation.

 

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