Utilisation of Health and Nutrition Community Interventions to Reach Every Last One of the Most Vulnerable Children: Evidence from A Lifesaving Three-Year Project in Fragile Somalia

Abstract

Objectives: Somalia has some of the worst infant, child and maternal mortality ratios in the world and was unable to achieve its Millennium Development Goals of health and nutrition. This study aimed to examine whether the project achieved its intended outcome in fragile Somalia. Design: The study adopted a quantitative and analysis method. Setting: Data collection involved household surveys and anthropometric measurements. A pre-and post-intervention data collection and analysis was conducted aimed at comparing the performance of the priority indicators, determining if the change was significant with a 95% confidence interval. Participants: It was with caregivers, mainly women of reproductive age (15-49 years) and children 0-59 months as the main participants. Main Outcome Measures: The focus was on Baseline compare to end line, End line Puntland Vs Somaliland and Key indicators to National Targets. Descriptive and inferential statistical analysis of the household questionnaires was conducted using SPSS data analysis software. Cross-tabulation using the McNemar’s Chi-square test was used to compare key outcomes. Results: From baseline to end line, there was statistically significant improvement breastfeeding practices, mothers practice for health timing and spacing of pregnancy, mothers practicing the recommended child birth practices care for children under five when sick and a reduction in the utilization of pregnancy care services and practice of vaccination of children. Comparison of Key indicators to National Targets revealed that the project achieved more in appropriate treatment of childhood illnesses, delivery practices, contractive use, infant and young child feeding, but fell short in the immunization services and ANC services. Conclusions: The health and nutrition care system in Somalia remains weak, poorly resourced and inequitably distributed with the root causes being multipronged. However, the results from this study show that if interventions are appropriately funded, there will always be improvement in the key health and nutrition indicators.