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Improving access to health care services for pastoral nomads in Somalia

Research project
Active research
Project size
666 000 SEK
Project period
2021 - 2022
Project owner
Institute of Medicine

Short description

Access to good quality health care is largely problematic in Somalia due to prolonged war and political instability. About 26% of Somalia's population live a nomadic life, and this significant group of about 4 million people is believed to have even less access to modern health care and health promotion than the rest of the population. This project aims to build up a network of knowledgeable researchers in Somalia, Kenya and Sweden to, together with representatives of the nomadic population and the Ministry of Health, build up a knowledge bank on nomadic health and health care access.

The project will also develop a research application for deeper analysis of:

  1. Central health problems to the nomad population
  2. Obstacles to access health care
  3. Design and test interventions to create better access to both emergency care and elective care under the special living conditions of the nomadic population

The University of Gothenburg, KEMRI (Wellcome Trust funded health research program in Kenya) and Benadir University in Somalia are initiating this work but intend to join more partners over the next two years. During the project, three major workshops will be conducted in the relatively safe Hargeisa, Somaliland, and the databasewill be built by Benadir University.

Background

Pastoralism is practiced throughout rural areas of Somalia. It can be exclusive pastoralism (everyone moves with the animal), transhumant (some people move while others stay behind) and agro-pastoralism (people practice farming, but still priorities rearing animals). Exclusive pastoralism is predominantly practiced in the arid lands of northern and central Somalia while agro-pastoralism is found in the riverine regions in Southern Somalia as well as in Awdal and Western Galbeed in the north-west (Somaliland).

More than a quarter (26%) of the Somali population are pastoral nomads (exclusive pastoralism) who move with animals in search for water sources and grazing. In addition, to the pastoral nomads, some communities the in South Somalia and the North practice also agro-pastoralism with some farming, but still rely more heavily on rearing livestock for their livelihood. Pastoral nomads play a critical role in the economy of the country. The livestock trade remains the backbone of the country‘s economy contributing to 40% of the GDP and 80% of the foreign currency earnings.

The current Somali public health service delivery points are designed for more stable and sedentary populations in urban and rural areas ignoring pastoralists. Establishing health service delivery points for pastoral nomads is challenging mainly due to their lifestyle, often on the move. However, such challenges should not discourage to look for innovative solutions for improving access of pastoral nomads to essential health interventions. Suitable health services for pastoralists should respond to geographical, social and cultural context. Understanding health problems, socio-demographic and socio-cultural factors influencing the access to the health service delivery by pastoralists is critical.

Goals

This project aims to build a consortium of knowledgeable researchers and stake holders (national and international) who, together with representatives of the nomadic population and the Ministry of Health:

  1. Build up a knowledge bank on nomadic health and health care access
  2. Develop a research application for deeper analysis of health needs of pastoral community, available health care services for pastoral community, obstacles to access health care

This will generate evidence to inform the development of health service delivery approach tailored to pastoralists needs. Furthermore, the network will explore approaches to strength the research capacity of the national partner universities through PhD training of staff members.

The University of Gothenburg, the KEMRI-Wellcome Trust program in Kenya and Benadir University in Somalia are initiating this work but intend to join more partners over the next two years. During the project, three major workshops will be conducted and the database will be built by Benadir University.

Project activities

Project activities include:

  1. Identification of key players in nomadic health issues in Somalia
  2. Virtual scoping meeting with the Key players and invite them to share their experience – successes and challenges
  3. Systematic review on access nomadic populations to healthcare services in the greater Somali region
  4. Collection and presentation of complementary information with key partners (EPI, UNICEF, WHO etc)
  5. Initiate a repository of geo-spatial data on nomadic pastoralist migration routes and services in Somalia
  6. Consensus building workshop on the research theme and refine the research questions, select study areas and agree on timeline of the research proposal development, assign task between the collaborating institutions to work on a final research proposal
  7. Workshop to finalize the research proposal and identification of PhD students