MdM-France: Integrating Sexual and Reproductive Health Services in Bosaso Basic Health Care System


This 6-year programme aims at improving health service delivery in Bosaso town (Puntland, Somalia) by integrating quality sexual and reproductive health (SRH) services into primary health care delivery packages. This intervention will also contribute to strengthen the emerging public health system by building the capacities of the Bosaso-based Ministry of Health and local health providers to sustain, in the long term, access to quality health services for the most vulnerable, especially women.

Country/region Topic Period Budget
Somalia
Health
Primary health care
Health systems strengthening
Reproductive health & rights
01.04.2019 - 31.12.2021
CHF 2'171'250
Background

Sexual and reproductive health is a key issue for the Somali people. High maternal and perinatal mortality, a very high fertility rate and almost universal female genital mutilation (FGM) show that people (especially women) across Somalia have little access to sexual and reproductive health. This is particularly true among populations on the move (i.e. IDPs, refugees, migrants, returnees), who are at increased risk of sexual and gender-based violence (SGBV) and exploitation due to the erosion of their traditional clannish and ethnic protection systems. Bosaso is one of the most important port towns of Somalia and, as such, is characterised by an extremely high concentration of populations on the move (about 30% of the total population). With about 350,000 inhabitants, it is home to over 70% of the population of the entire Bari Region, the largest in Puntland.

Since July 2011, Médecins du Monde France (MdM-F) is collaborating with both the Integrated Services for the Displaced Population (ISDP), a local NGO, and with the Bari Region’s Ministry of Health (MoH) in order to provide access to basic primary health care services to the most vulnerable people in Bosaso town. It is the most important service-delivery partner of the Somali authorities in Bosaso. Bosaso counts with 9 static health facilities (8 maternal and child clinics and 1 regional hospital) and 1 outreach clinic, all of which are supported by MdM-F with a primary health care package focused on maternal and child health. MdM-F intends to build on the legitimacy and acceptance acquired among Bosaso communities and stakeholders over several years to integrate quality and sustainable SRH and SGBV services into the existing continuum of care, with a strong emphasis on health system strengthening and community empowerment.

The SDC has been engaged in a partnership dialogue with MdM-F since November 2014 and substantial efforts have been put in the joint conception of this intervention. The SDC has conducted a field visit of MdM-F’s Bosaso Programme in January 2016, as well as a partner’s risk assessment in February 2016 – both with positive results. The proposed intervention will start with an Opening Phase (01.05.16 – 31.12.2016) to conduct preparatory work aimed at informing the content of subsequent phases such as a health system diagnosis, community-based organisation mapping, an organisational assessment of MdM-F’s local partner (ISDP) and piloting the integration of the SGBV component in two health facilities. Since the health sector in Somalia is currently facing uncertainties in terms of implementation modalities (and funding) beyond 2016, this Opening Phase will also provide the necessary time to ensure that the Phase 1 is according to the priorities and complementary with other programmes.

Despite the uncertainties currently facing the sector and the highly volatile programmatic environment in Somalia, the proposed intervention has the potential to make a valuable contribution to the Somali health sector and to the health of the Somali people, in line with SDC priorities and approaches. Building on the expertise of a very experienced partner with a large network in Somalia, this intervention intends to capitalize on the potentials of an already existing (even though nascent) health system, to ensure the sustained delivery of essential services for the most vulnerable. In a context where access of international organizations is very limited and remote monitoring the norm, this partnership in an accessible area of Somalia (with the necessary security measures) is also expected to provide evidence-based information to feed into SDC dialogue with the authorities and health stakeholders and further sharpen Switzerland’s profile.

Directorate/federal office responsible SDC
Credit area Development cooperation
Project partners Contract partner
International or foreign Non-Governmental Organization
  • Other international or foreign NGO North


Estimated operational start of intervention

(Phase 1):

01.05.2016

Budget Current phase Swiss budget CHF   2'171'250 Swiss disbursement to date CHF   0
Project phases Phase 99 01.04.2019 - 31.12.2021   (Current phase) Phase 1 01.05.2016 - 31.12.2021   (Current phase)