“Health Camp” –an alternate model to deliver health and nutrition services, ensuring equity and accessibility, for areas controlled by non-state armed actors in Somalia

Somalia faces significant challenges in providing equitable and accessible health services due to decades of active conflict and political instability, compounded by limited capacity and infrastructural challenges. Somali Demographic and Health Survey (SDHS 2020) revealed that 60% of children received no vaccinations at all, and only 11% of children were fully immunized. “Health Camp” was implemented across 10 conflict-prone, hard- to-reach districts in the Galmudug and Hirshabelle states during October 2022 to June 2024. Considering social and structural gender barriers, this ‘Health Camp’ model functioned as mobile outreach health facilities, providing integrated essential primary health care and nutrition services for women and children.
This innovative approach was specifically aimed to reduce the number of zero-dose children within the project catchment areas. Empirical evidence suggests these health camps as cost-effective service delivery model, as they provide integrated services rather than operating through a vertical, siloed program delivery approach.
The cornerstone of this innovative initiative is clan-mediated access negotiation and community trust-building through informal engagement. Local elders and clan leaders established 30 Community Health Committees (CHCs) for rejuvenating community level health systems. These CHCs facilitated scheduling, organizing and managing health camps across multiple villages. Two local community-based organizations recruited 38 mobile health teams to implement health camps, while another local consultancy firm conducted monthly monitoring and generated quarterly evaluation reports on implementation progress. Within targeted 10 districts, we trained 132 immunization service providers,140 community health workers on a diverse range of topics including immunizations, data management, emergency care and health promotion; additionally, 140 Outpatient nurses also received training on integrated management of childhood illnesses and disease surveillance and 128 received training on the integrated management of acute malnutrition.
During October 2022 – June 2024, following key essential health and nutrition services were delivered through 396 health camp sessions. A total of 67,133 children (6-23 months) were vaccinated; 63,311 pregnant women and 98,039 children (6-59 months) received growth monitoring and nutrition screening: 9,784 had severe acute malnutrition and 37,547 had moderate acute malnutrition. By end of June 2024, the project achieved zero-dose reduction by 56% across the ten districts.
“Health Camp” model as service delivery approach has been built on strong partnerships with local authorities, elderly clan leaders and community members who provided valuable support and insights for addressing complex challenges within target areas controlled by non-state armed actors in Somalia. In addition, innovative use of GIS mapping ensured that the health camps reached the targeted population effectively.