The fragility of Somalia over the past 27 years has resulted in weakening of the health sector, its systems and its personnel, with a subsequent focus on emergency response interventions to recurrent crises.
For the last 20 years INTERSOS has been implementing evidence based intervention in Middle Shebelle working with the high risk groups of target beneficiaries: children under 5, women of childbearing age and pregnant and lactating women.
Rape, early marriage, forced marriage and female genital mutilation are the main risks faced by women in Middle Shebelle. 63% still deliver at home and a significant part of them does not know the importance of delivery in a health facility. Lack of proper transfer system and poor road network can potentially lead to loss of lives.
The story of Aamaal is quite significant in this regard
The Shanlow neighbourhood is a poor shanty village on the banks of river Shebelle, 35 km north of Jowhar town. It is in Shanlow that Aamaal Osman Mohamed, a 20-year-old pregnant woman with labour pain was admitted to Hawadley MCH, a primary health center managed by INTERSOS through a DG-ECHO funded project. The midwife in the MCH referred Aamaal via boat, as emergency case due to obstructed labour and a previous caesarean section done.
In 2015, Aamaal had lost her baby due to a similar delayed obstructed labour. While in Jowhar Regional and Referral hospital, the only secondary health facility of the entire region serving more than half a million of persons, that is functioning thanks to the partnership between DG ECHO and INTERSOS, Aamaal had previously undergone an emergency caesarean section in which she gave birth to a live baby.
During this last year INTERSOS has slightly changed the approach of implementation ceasing to be directly involved but rather providing technical support to health authorities, signing a MoU with the Ministry of Health and a partnership with a local NGO, WOCCA, to ensure sustainability of the activities.
Although the capacities of public institutions in Somalia have significantly improved, the health system is still facing serious challenges regarding inequities in access to quality health care services and health issues related to poor sanitation