By Iman Morooka

WAJID, Southern Somalia, Apr 01, 2009– For the first time ever in Somalia, a Child Health Days campaign has been implemented nation-wide by UNICEF, the World Health Organization, local authorities, communities and non-governmental partners.

In a country where routine immunization coverage is low and basic health care services are scarce, this large-scale health outreach targets every child under five with immunization against measles, polio, diphtheria, pertusis and tetanus.

The child survival package also includes vitamin A supplements, de-worming tablets, oral rehydration salts to treat diarrhea, and water treatment tablets. And women of child-bearing age are vaccinated against tetanus, which can strike mother and newborn children if birthing conditions are not hygienic.

Families gather for health services

In Wajid district, Southern Somalia, where the first round of Child Health Days kicked off during March, families gathered from early morning to receive the health services.

For Khadija Issac, a widow who has to depend entirely on her relatives to provide for her four children, the free services are crucial. "I brought my four year-old son Ali today to get the vaccines because I want him to live a healthy life. I also got vaccinated against tetanus," she said.

Because malnutrition rates in Somalia remain significantly above the emergency threshold, children's nutritional status is assessed on site and appropriate referral services are provided.

Habiba, a mother of five, came to one of the campaign sites set up inside Wajid town with her children. Her malnourished children, twin one-year-old girls, were immediately referred by the health workers to the nearby therapeutic feeding centre.

Care for nomadic and rural people

Child Health Days are especially important for the nomadic and rural populations of Somalia, whose regular access to health services is extremely limited.

"Seventy per cent of the population are nomadic people who are frequently on the move following the pasture and rain. They are not fixed in one location, so it is hard to reach them with routine services," says Mohamed Ibrahim Mokhtar, a vaccinator in Wajid. "But this campaign ensures maximum coverage through its many teams that reach out to almost every place where there are villages and people."

Still, given the lack of both infrastructure and trained health personnel, reaching all under-five children is challenging.

Logistical and financial obstacles

The logistics are enormous, with more than 1,800 vaccinators, 200 social mobilizers and 1,200 cars involved in Central and Southern Somalia alone.

"Logistically, programmes inside Somalia are very expensive but it is very important that we keep our promises to those communities, and that we come every six months with the Child Health Days," says UNICEF Somalia's Chief of Health and Nutrition, Dr. Suraya Dalil. "We are well funded for the first round that is going on now, but for the subsequent rounds, we are facing financial shortages."

The campaign was launched from Somaliland, the North West Zone of Somalia, in December 2008, and is being implemented in phases to ensure that all children are reached with high-impact, life-saving health interventions.

Source: United Nations Children's Fund (UNICEF)

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