As the sun rises, 442 enthusiastic teams of vaccinators, supervisors, monitors, record-takers and social mobilizers converge at different health facilities for the morning briefing and to fill their vaccine carriers with vials and icepacks that keep the vaccines alive throughout the day.
They then disperse to ensure all eligible children and mothers receive a package of healthcare that includes immunization.
Critical health interventions
This effort is the second phase of the 2012 Child Health Days (CHDs) that are being carried out in the northeast zone of Somalia. Some 275,000 children under 5 years old and 394,000 women of childbearing age (15–49) in 26 districts and in camps for displaced persons are expected to receive a bundle of critical health and nutrition interventions.
“The CHDs are now being regularly implemented across Somalia twice yearly by the Ministries of Health, UNICEF and the World Health Organization. Through a concerted support, staff are deployed to health centres to gear up for big crowds and long days, while outreach is made by whatever means necessary to the most remote communities, where face-to-face contact with health professionals has often been non-existent,” says Accelerated Child Survival and Development Specialist in Bossaso Dr. Nasir Ahmad Dadgar.
The CHDs were introduced as a health-promoting strategy to reach even the most underserved areas and target every child in a community.
The CHD package in Somalia includes measles, polio, DPT (diphtheria, pertussis, tetanus) vaccines for under-5 children, Albendazole de-worming drug, vitamin A supplementation, oral rehydration salts, water purification aquatabs and malnutrition screening. Women of child-bearing age also receive tetanus toxoid vaccination.
“As a ‘one stop shop’, children receive vitamin A supplements to boost immunity and prevent blindness; de-worming medication to treat intestinal worms and the iron-deficiency anaemia they can cause; routine immunization; and monitoring for their nutritional status,” says Supervisor at the Horsed mother and child health clinic in Bossaso Nawal Saeed.
By November, the first round of CHDs had been completed across all accessible areas of the country, including the four districts of Badade, Afmadow, Balad and Afgoy in south-central Somalia that had been recovered from the Al-Shabaab militant group earlier this year. The second phase of the 2012 CHDs in both the northeast and northwest zones of Somalia has been completed. The CHDs are due to start in Mogadishu shortly.
Shams, 32, has brought her 6-month-old baby Ayan to the CHD at Ugas Yasin maternal and child health centre in Bossaso. “The happiest moment in my life is when I see Ayan growing up healthy and not getting sick like most children in the neighbourhood,” she says. ”I will do my best to complete Ayan’s immunization schedule.”
The child and maternal mortality rates for Somalia are among the highest in the world; one in every ten Somali children dies before seeing her or his first birthday. It is also ranked one of the world’s lowest, in terms of immunization coverage rates.
Since starting CHDs in Somalia in 2009, UNICEF has been supported by the Canadian International Development Agency, Swedish International Development Cooperation Agency, United Kingdom Department for International Development, the Governments of Denmark, Germany, Japan and Norway, United Nations Foundation, USAID Office for Foreign Disaster Assistance, the U.S. Fund for UNICEF, the National Danish, Italian, Japanese, Netherlands and Spanish Committees for UNICEF, the GAVI Alliance, various donors through the Common Humanitarian Fund for Somalia, the Measles Initiative, the Saudi Fund, the Micronutrient Initiative and World Concern.
Investing in child and maternal health in Somalia has long-term dividends. The generous donor support has enabled UNICEF provide all vaccines and cold chain supplies, technical assistance, supervision, monitoring, training, social mobilization and communication support to the CHDs across the country.