Community Health Provision in Somalia

Project completed

This intervention contributes to improve access of the Somali population to quality, affordable and equitable health services in South Central Somalia and Puntland. In a context of still very low health services coverage, high level of vulnerabilities and protracted conflict, this intervention will ensure the delivery of essential primarily health care services, focusing on women and children, while at the same time contributing to progressively build the health system at both district and regional levels.

Country/region Topic Period Budget
Primary health care
Health systems strengthening
Health education
15.06.2017 - 30.04.2021
CHF  7’000’000

The combination of conflict, insecurity, large displacement, recurrent droughts, flooding and extreme poverty, coupled with very low basic social services coverage, has a direct impact on the population’s vulnerability to disease and malnutrition. The highest rates of maternal mortality in the world are found in Somalia, with a maternal mortality ratio of 732 per 100’000 and an under-five mortality rate of 137 per 1’000 live births. Access to skilled birth attendant is low, which puts women at high risk of mortality and morbidity in and around child birth. The health system in Somalia remains weak, poorly resourced and inequitably distributed. The current severe drought situation in Somalia puts heavy pressure on the existing facilities, with health providers in the forefront in trying to address the increasing numbers of malnutrition and acute watery diarrhea cases.

The intervention will take place in several underserved districts: in Adado District (located in the newly established Federal member State of Galmudug with an estimated population of 61’000 people); in Kismayo and Afmadow districts (located in the nascent Jubaland Federal member State and home to an estimated population of 346’300); and in Bari region (located in Puntland, with a total population estimated at 719’512).


To increase the utilisation of quality Reproductive, Maternal, New-born, Child Health (RMNCH) services which are accessible, acceptable, affordable and equitable, through the provision of EPHS (Essential Package of Health Services).

Target groups
  • Women and children under 5 years. This is due to the specific focus on reproductive, maternal and child health(estimated 184’000 women and 237’500 under 5 children).
  • Health staff in the target facilities benefitting from capacity building to provide better health services (total of  1’338; 575 are female).
  • Health authorities at district and regional levels will be targeted for capacity building.
  • Local community.
Medium-term outcomes
  • Essential Package of Health Services, including nutrition, family planning and reproductive health, delivered to women and children.
  • Health governance and management structures strengthened.
  • Evidence base of innovative solutions to inform replication and advocacy established.
  • Community ownership, accountability and demand for health services enhanced.

Expected results:  

  • Delivery of health and nutrition services at the facility and community level.
  • Capacity of the staff in the health facilities enhanced to provide proper health services.
  • Capacities of local authorities/communities enhanced to cater for the health needs of the population.
  • Research data of successful interventions shared for potential replication or scale up.
  • Community events organized to promote nutrition and   hygiene practice.

Results from previous phases:  

No previous phase supported by the SDC. However this intervention is understood as a follow-up phase to the Joint Health and Nutrition Programme (JHNP) supported by the SDC and other donors (DfID, Sweden, Finland) from 2013 until April 2017. The intervention will support the EPHS delivery in areas previously covered by the JHNP (Adado, Afmadow and Bari region).

Directorate/federal office responsible SDC
Credit area Development cooperation
Project partners Contract partner
International or foreign NGO
  • Other international or foreign NGO North

Coordination with other projects and actors

Save the Children (SC) will build on achievements, gains and lessons learnt from the JHNP, as SC was the major implementing partner for the UN programme. As the health co-cluster lead in Somalia, SC is well positioned to coordinate with other partners within the sector. Support to SC complements other SDC engagement in the health sector, both in terms of service delivery and system building. These are support to Swisso Kalmo in Merka (SK), Médecins du Monde  (MdM) in Bosaso, the International Committee of the Red Cross (ICRC) and the Global Fund. This intervention will also complement other EPHS service delivery programmes currently implemented by the UNFPA, the UNICEF and INGOs in Somalia (funded by various donors i.e  DFID, Germany, Sweden and Finland).

Budget Current phase Swiss budget CHF    7’000’000 Swiss disbursement to date CHF    7’000’000
Project phases Phase 3 01.05.2024 - 30.04.2027   (Current phase) Phase 2 01.08.2021 - 30.04.2024   (Completed)

Phase 1 15.06.2017 - 30.04.2021   (Completed)