Galkayo University, in an ongoing partnership with Benadir University and the Karolinska Institutet, reports on the co-creation of a mentorship program for midwifery educators at Galkayo University. This program was initiated in Spring 2023 with the aim of sharing experiences on midwifery education between educators from Sweden and Somalia—both countries with long traditions of midwifery care. By leveraging the expertise of Swedish and Somali midwifery educators, the mentorship program seeks to bridge gaps in knowledge and skills, ultimately contributing to better midwifery education and care in both Somalia and Sweden. This commentary describes the significance of the program and its potential for impact if scaled up after contextualization.
{"title":"A collaborative development initiative to strengthen Midwifery Education in Somalia","authors":"Xabiibo Muxamuud, Fadumo Mohamed, Abdirisak Khalif Adan, Abdikadir Saleiman Tukale, Nina Viberg, Hassan Nor, Rage Adem, Kerstin Erlandsson, Helena Lindgren","doi":"10.36368/shaj.v4i1.459","DOIUrl":"https://doi.org/10.36368/shaj.v4i1.459","url":null,"abstract":"Galkayo University, in an ongoing partnership with Benadir University and the Karolinska Institutet, reports on the co-creation of a mentorship program for midwifery educators at Galkayo University. This program was initiated in Spring 2023 with the aim of sharing experiences on midwifery education between educators from Sweden and Somalia—both countries with long traditions of midwifery care. By leveraging the expertise of Swedish and Somali midwifery educators, the mentorship program seeks to bridge gaps in knowledge and skills, ultimately contributing to better midwifery education and care in both Somalia and Sweden. This commentary describes the significance of the program and its potential for impact if scaled up after contextualization.","PeriodicalId":338064,"journal":{"name":"Somali Health Action Journal","volume":"108 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140079395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In Somaliland, mental health has been a neglected sector since the inception of the country almost 30 years ago. Only two years ago, there was no office, no staff, and no funding for mental health. Public mental health services were confined to five public in-patient facilities within the regional general hospitals, with a total bed capacity of 216 beds for a population of 4 million people. All the facilities experienced severe shortages of human and material resources, and proper supervision or control by the ministry did not exist. Lack of adequate and good quality-public mental health services has encouraged the opening of a plethora of unregulated private mental health facilities with poor records of human rights and services. One of the major impediments to improving mental health in the country was a lack of financial resources. In recognition of the deteriorating situation of mental health in the country and public pressure to do something about the problem. In late 2020, the government decided to scale up mental health services through khat taxation. Tax collection started in January 2021, and the first funds were released for use in July 2021. A five-year national program on mental health was then launched on August 1, 2021 underpinned by four main objectives: 1) establishment of leadership and governance in mental health; 2) strengthening existing mental health services and their integration into primary health care; 3) development of human resources in mental health; and finally 4) setting up a mental health information and research system. In this paper, we present early program achievements and their relevance to public health for other countries with similar settings looking to improve their mental health through effective mobilization of local resources.
{"title":"A National Program to scale up investment and reducing the gap in mental health in Somaliland: first year achievements","authors":"Yakoub Aden Abdi, Liban Ahmed Hersi","doi":"10.36368/shaj.v3i1.342","DOIUrl":"https://doi.org/10.36368/shaj.v3i1.342","url":null,"abstract":"In Somaliland, mental health has been a neglected sector since the inception of the country almost 30 years ago. Only two years ago, there was no office, no staff, and no funding for mental health. Public mental health services were confined to five public in-patient facilities within the regional general hospitals, with a total bed capacity of 216 beds for a population of 4 million people. All the facilities experienced severe shortages of human and material resources, and proper supervision or control by the ministry did not exist. Lack of adequate and good quality-public mental health services has encouraged the opening of a plethora of unregulated private mental health facilities with poor records of human rights and services. One of the major impediments to improving mental health in the country was a lack of financial resources. In recognition of the deteriorating situation of mental health in the country and public pressure to do something about the problem. In late 2020, the government decided to scale up mental health services through khat taxation. Tax collection started in January 2021, and the first funds were released for use in July 2021. A five-year national program on mental health was then launched on August 1, 2021 underpinned by four main objectives: 1) establishment of leadership and governance in mental health; 2) strengthening existing mental health services and their integration into primary health care; 3) development of human resources in mental health; and finally 4) setting up a mental health information and research system. In this paper, we present early program achievements and their relevance to public health for other countries with similar settings looking to improve their mental health through effective mobilization of local resources.","PeriodicalId":338064,"journal":{"name":"Somali Health Action Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127719994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Somalia has one of the highest maternal mortality ratios in the world and an inequitable distribution of maternal health outcomes and service utilisation. Like other developing countries, Somalia has adopted the global policy goal of attaining universal health coverage of health services and improved health outcomes across all populations. Although United Nations agencies track the progress towards achieving universal health coverage as part of health targets for achieving the Sustainable Development Goals, empirical case studies are rarely documented, especially in developing countries and even more so in post-war contexts such as Somalia. Literature shows the overall progress towards globally agreed-upon targets for maternal health lagging in war-affected countries, with persistent socioeconomic gradients in health outcomes. However, little is known about the mechanisms through which the social determinants of health impact on the distribution of maternal health outcomes. The aim of this study is to examine the mechanisms through which social determinants contribute to inequities in maternal health outcomes in Somalia. Specifically, the study will analyse the policy context and progress towards achieving universal health coverage of maternal health services in Somalia; analyse trends in maternal health outcomes and inequities in Somalia; and examine the mechanisms through which social determinants contribute to inequities in maternal health outcomes. A mixed-methods case study design will be adopted, employing both qualitative and quantitative approaches to data collection and analysis. The findings of this PhD research will contribute to the evidence base on pathways for achieving universal health coverage of maternal health outcomes in post-war countries like Somalia. This will facilitate development of effective health care policies and those addressing the social determinants, which if implemented will improve maternal health outcomes in Somalia and mark progress towards achieving the goal of universal maternal health coverage.
{"title":"Maternal Health Outcomes in a Somalia Post-war Context: a PhD thesis analyzing trends towards universal health coverage","authors":"J. Aden","doi":"10.36368/shaj.v2i1.335","DOIUrl":"https://doi.org/10.36368/shaj.v2i1.335","url":null,"abstract":"Abstract\u0000Somalia has one of the highest maternal mortality ratios in the world and an inequitable distribution of maternal health outcomes and service utilisation. Like other developing countries, Somalia has adopted the global policy goal of attaining universal health coverage of health services and improved health outcomes across all populations. Although United Nations agencies track the progress towards achieving universal health coverage as part of health targets for achieving the Sustainable Development Goals, empirical case studies are rarely documented, especially in developing countries and even more so in post-war contexts such as Somalia. Literature shows the overall progress towards globally agreed-upon targets for maternal health lagging in war-affected countries, with persistent socioeconomic gradients in health outcomes. However, little is known about the mechanisms through which the social determinants of health impact on the distribution of maternal health outcomes.\u0000The aim of this study is to examine the mechanisms through which social determinants contribute to inequities in maternal health outcomes in Somalia. Specifically, the study will analyse the policy context and progress towards achieving universal health coverage of maternal health services in Somalia; analyse trends in maternal health outcomes and inequities in Somalia; and examine the mechanisms through which social determinants contribute to inequities in maternal health outcomes. A mixed-methods case study design will be adopted, employing both qualitative and quantitative approaches to data collection and analysis. \u0000The findings of this PhD research will contribute to the evidence base on pathways for achieving universal health coverage of maternal health outcomes in post-war countries like Somalia. This will facilitate development of effective health care policies and those addressing the social determinants, which if implemented will improve maternal health outcomes in Somalia and mark progress towards achieving the goal of universal maternal health coverage.","PeriodicalId":338064,"journal":{"name":"Somali Health Action Journal","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117009973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Osman, Mohamed Said Egal, A. Abdi, Anisa Abdikarim Mohamud, K. Erlandsson
Background: More than 2.5 million children die yearly due to prematurity and low birthweight. Skin-to-skin care provides a thermal-control environment that offers protection from infection and eases breast milk feeding to the advantage of the new-born. Aim: This study aimed to explore barriers and facilitating factors for introducing skin-to-skin care of premature and low-birthweight infants based on input from mothers and midwives in Puntland, Somalia. Methods: Qualitative semi-structured interviews with four mothers and four midwives were analysed using qualitative content analysis. Results: The findings are presented in four categories: enabled by support and hands-on information to the mother and her family; aided by collaboration with the mother’s family to overcome the mother’s resistance; impeded by limited time, lack of resources and unavailable guidelines; and hindered by traditional and social beliefs. Both mothers and midwives emphasised the importance of information and education concerning skin-to-skin care of premature and low-birthweight infants. Family members and midwives facilitated skin-to-skin contact as the care model. The degree to which the midwives provided information to the mothers and their family members depended on how the two latter groups received and acted on such information and education. Lack of motivation by mothers, their families or midwives were barriers to skin-to-skin contact as a care model. Conclusion: Standardised guidelines, preferably culturally tailored for low socioeconomic groups, for midwives’ use when informing mothers and families on skin-to-skin contact as a care model for premature and low-birthweight infants would empower women, families and midwives to facilitate the practice in Puntland, Somalia.
{"title":"Midwives’ and mothers’ perspectives on skin-to-skin care of premature and low-birthweight infants in Puntland, Somalia","authors":"F. Osman, Mohamed Said Egal, A. Abdi, Anisa Abdikarim Mohamud, K. Erlandsson","doi":"10.36368/shaj.v1i1.260","DOIUrl":"https://doi.org/10.36368/shaj.v1i1.260","url":null,"abstract":"Background: More than 2.5 million children die yearly due to prematurity and low birthweight. Skin-to-skin care provides a thermal-control environment that offers protection from infection and eases breast milk feeding to the advantage of the new-born. Aim: This study aimed to explore barriers and facilitating factors for introducing skin-to-skin care of premature and low-birthweight infants based on input from mothers and midwives in Puntland, Somalia. Methods: Qualitative semi-structured interviews with four mothers and four midwives were analysed using qualitative content analysis. Results: The findings are presented in four categories: enabled by support and hands-on information to the mother and her family; aided by collaboration with the mother’s family to overcome the mother’s resistance; impeded by limited time, lack of resources and unavailable guidelines; and hindered by traditional and social beliefs. Both mothers and midwives emphasised the importance of information and education concerning skin-to-skin care of premature and low-birthweight infants. Family members and midwives facilitated skin-to-skin contact as the care model. The degree to which the midwives provided information to the mothers and their family members depended on how the two latter groups received and acted on such information and education. Lack of motivation by mothers, their families or midwives were barriers to skin-to-skin contact as a care model. Conclusion: Standardised guidelines, preferably culturally tailored for low socioeconomic groups, for midwives’ use when informing mothers and families on skin-to-skin contact as a care model for premature and low-birthweight infants would empower women, families and midwives to facilitate the practice in Puntland, Somalia.","PeriodicalId":338064,"journal":{"name":"Somali Health Action Journal","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126753250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Until the beginning of 1991, Somalia had a reasonable health care system with a good number of tertiary hospitals in Mogadishu and Hargeisa, some regional hospitals, district hospitals, clinics, child and mother health centres (CMH) and out-patient dispensaries. However, the conflict resulting from the civil war has destroyed the public health care system which existed in the country. Somalia was not alone in having conflicts. The total number of conflicts in the world in 2017 was 49, many of them have now entered post-conflict phases, where open warfare has come to an end. There is growing evidence that conflict has a devastating impact on health systems and the health status of the population. In Somalia, the post-conflict phase provides a unique window of opportunity for health sector development and reform. At this juncture, health systems in Somalia face the double burden of a flawed pre-conflict health system, characterised by deficiencies and inequities, and the long-term impact of conflict on the health status of the population and its resultant strain on the health system. This review article analyses the framework for the rehabilitation of health systems in post-conflict countries. Such knowledge can be applied in the rehabilitation and development of health systems in Somalia along the lines of the World Health Organization’s health system building blocks. The impact of conflict on the health status of the population as well as the health system can be catastrophic and be felt for years after the State has entered the post-conflict phase, but also provides an opportunity for reforms of the affected State’s health sector.
{"title":"Strategies for post-conflict development of the Health Systems in Somalia: lessons from selected countries","authors":"Mayeh Omar","doi":"10.36368/shaj.v1i1.250","DOIUrl":"https://doi.org/10.36368/shaj.v1i1.250","url":null,"abstract":"Until the beginning of 1991, Somalia had a reasonable health care system with a good number of tertiary hospitals in Mogadishu and Hargeisa, some regional hospitals, district hospitals, clinics, child and mother health centres (CMH) and out-patient dispensaries. However, the conflict resulting from the civil war has destroyed the public health care system which existed in the country.\u0000Somalia was not alone in having conflicts. The total number of conflicts in the world in 2017 was 49, many of them have now entered post-conflict phases, where open warfare has come to an end. There is growing evidence that conflict has a devastating impact on health systems and the health status of the population.\u0000In Somalia, the post-conflict phase provides a unique window of opportunity for health sector development and reform. At this juncture, health systems in Somalia face the double burden of a flawed pre-conflict health system, characterised by deficiencies and inequities, and the long-term impact of conflict on the health status of the population and its resultant strain on the health system.\u0000This review article analyses the framework for the rehabilitation of health systems in post-conflict countries. Such knowledge can be applied in the rehabilitation and development of health systems in Somalia along the lines of the World Health Organization’s health system building blocks.\u0000The impact of conflict on the health status of the population as well as the health system can be catastrophic and be felt for years after the State has entered the post-conflict phase, but also provides an opportunity for reforms of the affected State’s health sector.","PeriodicalId":338064,"journal":{"name":"Somali Health Action Journal","volume":"183 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133355161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mari-Cristin Malm, F. Osman, A. A. Ibrahim, Hussein Ghanim Hasan, K. Erlandsson, J. Kiruja, Sara Kalucza
Background: Somali women, not only those living in Somaliland but also those living abroad as asylum seekers and refugees, are highly vulnerable in terms of perinatal health outcomes. Respectful and supportive care is critical for all women when stillbirth occurs and improving bereavement care and reducing the stigma that surrounds stillbirth are global priorities. Culturally- and context-specific approaches that build on an understanding of the needs of women giving birth to a stillborn baby, no matter where or why, are required. Objective: This study aims to investigate and analyze Somali women’s experiences of stillbirth, including their perceived reasons for losing their unborn baby, the premonitions they had before giving birth and their experiences of psychosocial support from healthcare professionals and relatives. Methods: A descriptive retrospective study was conducted at the Borama regional hospital in Somaliland. A study-specific questionnaire was developed that gathered personal information and data on topics related to women’s experiences of stillbirth. Women who had either experienced a stillbirth at the hospital or had been referred there after a stillbirth 2015 were approached and 75 women agreed to participate in the study. Results: Most of the women were multiparas and had experienced a previous stillbirth. Before having it confirmed that their baby was no longer alive most of the woman reported that they had felt no fetal movements and had a premonition that something was wrong. The most common perceived cause of stillbirth that the women reported was prolonged labour followed by a ‘big baby’. Thirty-three women (44%) felt it was important to know the cause of the stillbirth and eight reported feeling angry or disappointed (11 %) with the health care providers who assisted them during labour, birth, or post-partum, although 41 women (55%) were satisfied with their treatment. A third of the women blamed themselves for their stillbirth and a majority spoke to others about it. Conclusions: Our results show that women in Somaliland share similar perceptions of stillbirth as women in high income countries. This raises important implications for antenatal care and preventive interventions and stressed the need to respond to women’s concerns regardless of background, context or setting. A maternal healthcare approach that is equal in its global application must be established to enable health care providers to give relevant information and care both in the cultural setting of Somaliland and elsewhere in the world where Somali-born women live and give birth.
{"title":"Somaliland women’s perception of stillbirth - a descriptive survey study","authors":"Mari-Cristin Malm, F. Osman, A. A. Ibrahim, Hussein Ghanim Hasan, K. Erlandsson, J. Kiruja, Sara Kalucza","doi":"10.36368/shaj.v1i1.259","DOIUrl":"https://doi.org/10.36368/shaj.v1i1.259","url":null,"abstract":"Background: Somali women, not only those living in Somaliland but also those living abroad as asylum seekers and refugees, are highly vulnerable in terms of perinatal health outcomes. Respectful and supportive care is critical for all women when stillbirth occurs and improving bereavement care and reducing the stigma that surrounds stillbirth are global priorities. Culturally- and context-specific approaches that build on an understanding of the needs of women giving birth to a stillborn baby, no matter where or why, are required. Objective: This study aims to investigate and analyze Somali women’s experiences of stillbirth, including their perceived reasons for losing their unborn baby, the premonitions they had before giving birth and their experiences of psychosocial support from healthcare professionals and relatives. Methods: A descriptive retrospective study was conducted at the Borama regional hospital in Somaliland. A study-specific questionnaire was developed that gathered personal information and data on topics related to women’s experiences of stillbirth. Women who had either experienced a stillbirth at the hospital or had been referred there after a stillbirth 2015 were approached and 75 women agreed to participate in the study. Results: Most of the women were multiparas and had experienced a previous stillbirth. Before having it confirmed that their baby was no longer alive most of the woman reported that they had felt no fetal movements and had a premonition that something was wrong. The most common perceived cause of stillbirth that the women reported was prolonged labour followed by a ‘big baby’. Thirty-three women (44%) felt it was important to know the cause of the stillbirth and eight reported feeling angry or disappointed (11 %) with the health care providers who assisted them during labour, birth, or post-partum, although 41 women (55%) were satisfied with their treatment. A third of the women blamed themselves for their stillbirth and a majority spoke to others about it. Conclusions: Our results show that women in Somaliland share similar perceptions of stillbirth as women in high income countries. This raises important implications for antenatal care and preventive interventions and stressed the need to respond to women’s concerns regardless of background, context or setting. A maternal healthcare approach that is equal in its global application must be established to enable health care providers to give relevant information and care both in the cultural setting of Somaliland and elsewhere in the world where Somali-born women live and give birth.","PeriodicalId":338064,"journal":{"name":"Somali Health Action Journal","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115469020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Handuleh, Abdirahman A. Sulleiman, Yusuf S. Yusuf, Hayat Mohamed, D. Wolde-Giorgis
Evidence based public health is one of the basic training tools of public health students and young officers in decision making. The training tools for early career specialists and trainees in public health is journal clubs (JC). It keeps the knowledge of professionals up to date and assist them in receiving information to design, plan, implement health care services, policies and strategies. The intention of the JC team was to raise awareness of methods for public health literature search, appraising it and applying this knowledge in their daily practices. A senior public health practitioner in Somaliland (the corresponding author) invited medical students and residents to have JCs as a part of their training. They did not accept the offer so the organizer invited practicing junior public health professionals instead. The JC team members were a general practitioner and 3 public health workers from Ministry of Health, public hospital physician, public health school and field public health officer. A weekly or twice weekly journal club took place to train them in critical appraisal. This continued for 15 months in a hybrid mentorship for the health care professionals. The team mentor selected a paper for discussion. Mentees choose a study design appraisal tool from the Critical Appraisal Skills Program (CASP) that matched the study to present. In the process of appraisal, a team member led the discussion using the checklist. The mentees presented their critical appraisal either orally or via a presentation. The checklist and paper were compared for assessing the study design and structure of the paper of the week. This approach of empowering junior public health officers in Somalia is a way forward for encouraging the professionals to use evidence based practice in their daily practices. This will improve their selection of research tools and translating the scientific work into their practice and services.
{"title":"Introducing evidence based public health practice through a journal club for public health officers in Somaliland","authors":"J. Handuleh, Abdirahman A. Sulleiman, Yusuf S. Yusuf, Hayat Mohamed, D. Wolde-Giorgis","doi":"10.36368/shaj.v1i1.256","DOIUrl":"https://doi.org/10.36368/shaj.v1i1.256","url":null,"abstract":"Evidence based public health is one of the basic training tools of public health students and young officers in decision making. The training tools for early career specialists and trainees in public health is journal clubs (JC). It keeps the knowledge of professionals up to date and assist them in receiving information to design, plan, implement health care services, policies and strategies. The intention of the JC team was to raise awareness of methods for public health literature search, appraising it and applying this knowledge in their daily practices. A senior public health practitioner in Somaliland (the corresponding author) invited medical students and residents to have JCs as a part of their training. They did not accept the offer so the organizer invited practicing junior public health professionals instead. The JC team members were a general practitioner and 3 public health workers from Ministry of Health, public hospital physician, public health school and field public health officer. A weekly or twice weekly journal club took place to train them in critical appraisal. This continued for 15 months in a hybrid mentorship for the health care professionals. The team mentor selected a paper for discussion. Mentees choose a study design appraisal tool from the Critical Appraisal Skills Program (CASP) that matched the study to present. In the process of appraisal, a team member led the discussion using the checklist. The mentees presented their critical appraisal either orally or via a presentation. The checklist and paper were compared for assessing the study design and structure of the paper of the week. This approach of empowering junior public health officers in Somalia is a way forward for encouraging the professionals to use evidence based practice in their daily practices. This will improve their selection of research tools and translating the scientific work into their practice and services.","PeriodicalId":338064,"journal":{"name":"Somali Health Action Journal","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129362885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Somali Health Action Journal - A Collaborative Venture for Health Research and Development","authors":"K. B. Mohamud","doi":"10.36368/shaj.v1i1.262","DOIUrl":"https://doi.org/10.36368/shaj.v1i1.262","url":null,"abstract":"","PeriodicalId":338064,"journal":{"name":"Somali Health Action Journal","volume":"284 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115423234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Abdi, N. Said, Yusuf Abdi Hared, Ismail Ayeh, S. A. Walhad
Background: The situation of mental health globally is alarming particularly in developing countries. In Somaliland/Somalia, every third person may be suffering from some sort of mental illness according to the World Health Organization. Major barriers to improve mental health include stigma and lack of skilled human resources. Objectives: The aim was to explore the feasibility of organizing integrated community-based mental, epilepsy and mother and child health services delivered by trained female community health workers (FCHWs) in three urban sites (Borama, Baki and Dila) in the Awdal Region, Somaliland. Methods: After selection of the 3 project sites and recruitment and training of project staff, a baseline survey was carried out. First, the sites were properly mapped based on existing geographical administrative sectors and sub-sectors of the sites. Then a representative sample of 2,722 households was randomly selected from all the 3 sites. The female head of each of those households were then interviewed using a questionnaire containing 22 questions on the target groups. The questionnaire responses were coded, and data analysed using Statistical software program, SPSS. After the baseline survey, the FCHWs were deployed in the sites assigning a specified area to each female worker. The FCHWs worked 6 hours per day 6 days per week and were required to visit 6 families each day including follow-ups. Their activities included identification of patients with severe mental illness (SMI) or with epilepsy, counselling, distribution of medications, follow-up of patients already on medication, referral, stigma reduction and documentation of their daily activities in logbooks. Results: The baseline study showed that 12% of the households were taking care of at least one person with SMI each, while 7% had one person with epilepsy each. Of the patients with SMI, 18% were on chains. During the project period (2015-2019), the number of people with SMI or with epilepsy who benefited from the project was 2.225 and 738 respectively and their families empowered through increased mental health awareness. Among the patients with SMI, 237 were on chains before intervention and 85% of them were successfully released from their shackles. Conclusions: This project has shown that deployment of trained and supported FCHWs can be used to reduce the mental health care gap in Somaliland. It is suggested as a model project which could, hopefully, be replicated and tested in other similar settings.
{"title":"Mental health care delivery in poor settings through trained female community health workers: A five-year intervention program in Somaliland","authors":"Y. Abdi, N. Said, Yusuf Abdi Hared, Ismail Ayeh, S. A. Walhad","doi":"10.36368/shaj.v1i1.246","DOIUrl":"https://doi.org/10.36368/shaj.v1i1.246","url":null,"abstract":"Background: The situation of mental health globally is alarming particularly in developing countries. In Somaliland/Somalia, every third person may be suffering from some sort of mental illness according to the World Health Organization. Major barriers to improve mental health include stigma and lack of skilled human resources. Objectives: The aim was to explore the feasibility of organizing integrated community-based mental, epilepsy and mother and child health services delivered by trained female community health workers (FCHWs) in three urban sites (Borama, Baki and Dila) in the Awdal Region, Somaliland. Methods: After selection of the 3 project sites and recruitment and training of project staff, a baseline survey was carried out. First, the sites were properly mapped based on existing geographical administrative sectors and sub-sectors of the sites. Then a representative sample of 2,722 households was randomly selected from all the 3 sites. The female head of each of those households were then interviewed using a questionnaire containing 22 questions on the target groups. The questionnaire responses were coded, and data analysed using Statistical software program, SPSS. After the baseline survey, the FCHWs were deployed in the sites assigning a specified area to each female worker. The FCHWs worked 6 hours per day 6 days per week and were required to visit 6 families each day including follow-ups. Their activities included identification of patients with severe mental illness (SMI) or with epilepsy, counselling, distribution of medications, follow-up of patients already on medication, referral, stigma reduction and documentation of their daily activities in logbooks. Results: The baseline study showed that 12% of the households were taking care of at least one person with SMI each, while 7% had one person with epilepsy each. Of the patients with SMI, 18% were on chains. During the project period (2015-2019), the number of people with SMI or with epilepsy who benefited from the project was 2.225 and 738 respectively and their families empowered through increased mental health awareness. Among the patients with SMI, 237 were on chains before intervention and 85% of them were successfully released from their shackles. Conclusions: This project has shown that deployment of trained and supported FCHWs can be used to reduce the mental health care gap in Somaliland. It is suggested as a model project which could, hopefully, be replicated and tested in other similar settings.","PeriodicalId":338064,"journal":{"name":"Somali Health Action Journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132369617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}