‘Better Lives’ programme provides critical health services to women and children
Partnership improving lives in Somaliland
Eighteen-month-old Satham Hassan is among dozens of children being attended to at the Central Maternal and Child Health Centre in Borama town. According to his mother, Hamda Farah, Satham was brought to the centre to have his health checked.
“The reason I brought him here is for us to know how his health is faring, like his weight. We think he is underweight, but I hope he is okay. If he is not healthy, he will receive the treatment and nutritional support he needs,” she says.
Early detection of diseases like pneumonia, diarrhoea and malaria in children and admitting them for treatment is critical to saving their lives. During the treatment, mothers like Hamda are advised on how to care for the children and are supplied with Ready-to-Use Therapeutic Food (RUTF), an energy-dense micronutrient paste comprising peanuts, sugar, milk and other nutrients used to treat children with severe wasting. Children suffering from severe acute malnutrition underpinned by a medical complication are required to be admitted to a stabilization centre where the condition can be treated. In Borama, the stabilization centre is located at the Borama Regional Hospital.
Hodan Nuh, a healthcare worker at the centre, says Satham is underweight and has a persistent cough.
“This can be due to low immunity because of malnutrition. I have given him the bi-weekly ration of RUTF and medication for his cold. He will return in two weeks for a follow-up examination,” she says.
Expectant mothers in rural areas of Somaliland have a higher risk of death arising from antenatal and postnatal complications, particularly during childbirth. The lack of access to optimal maternity services forces many pregnant women to depend on unskilled traditional birth attendants.
The Better Lives Programme, funded by the UK government through the Foreign, Commonwealth and Development Office (FCDO), has been launched to improve the lives of the most vulnerable women and children in Gedo, Galmudug, Mudug, and Benadir regions in Somalia and Awdal and Togdheer regions in Somaliland. The innovative programme is the UK’s flagship health and nutrition programme and supports primary healthcare, especially at the community level, to help achieve universal health coverage. The programme also works with partners to strengthen health systems to deliver integrated and innovative services for Somali children, youths and women of reproductive age.
According to Mohamed Abdi, Awdal Regional Health Coordinator, the programme is supporting 14 maternal and child health facilities in the region as well as two hospitals and seven primary health units. Among the critical services the programme provides is the referral of pregnant mothers from rural areas with birth complications to the regional hospital where they receive specialized services like Caesarean section.
At the Borama Hospital, the neonatal unit cares for babies born prematurely or with complications. According to Hothan Jama, head of the unit, the department has come a long way in newborn lives.
“Since its establishment in December 2021, this unit has continued to provide critical and life-saving services to newborns. Most of the people who come here are poor and vulnerable members of the community. Among those currently admitted is a six-month infant who was born prematurely,” she says.
Hothan says one of the challenges the unit faces is inadequate incubators.
“The numbers of babies needing specialized neonatal care keep increasing and, as a unit, we don’t have enough working incubators to cater for the large numbers of premature births. The one you see here is old and frequently breaks down. We have to improvise for it to continue working.”
Preterm infants are at higher risk of dying because of complications such as respiratory problems, feeding difficulties, poor regulation of body temperature and recurrent infections. Mothers who visit the MCH centre receive counselling and are taken through health education awareness with a special focus on the importance of exclusive breastfeeding for the first six months of a child’s life, as well as the importance of a mother's and child’s hygiene.
Ikran Roble is among the pregnant women receiving services at the health facility.
“I visited this centre to know my health condition as well the health of my unborn child. They check my weight, my blood pressure and, for my unborn child, they use ultrasound. I’m grateful to receive these services.”
Sa’ado Ali, the acting team leader at the Borama central MCH says the centre, in addition to offering antenatal and postnatal services, also provides immunization services to children against tuberculosis, diphtheria, tetanus, hepatitis, and polio.
The centre’s catchment population is 61,400, including people who were displaced by drought in the Awdal region.
“Children are the majority, but we also currently have more than 3,000 pregnant women. They come from within Borama and IDP camps located in Borama municipality,” says Ali.
Working with the government, local authorities and NGO partners, UNICEF is providing integrated health and nutrition services closer to vulnerable communities and the internally displaced, courtesy of ‘Better Lives.’ In the Awdal region, the programme is being implemented in Borama and Zeila districts and the Toghdeer region, in Burao and Odweine districts. The three-year, £38m programme aims to prevent and reduce the high rates of maternal and child deaths, combat cross-border threats of infectious diseases, and create lasting health benefits for some of the world’s most vulnerable women and children.
