Revolutionizing Maternal Health: The Damal Caafimaad Project Saves Lives in Somalia

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Somalia‘s Fight for Maternal Health: A Lifeline for Mothers and Newborns

October 6, 2025

The World Health Organization Reports that Somalia contends with one of the highest maternal mortality rates globally, with 563 deaths per 100,000 births-nearly three times the worldwide average of 197.A concerted effort spearheaded by initiatives like the Damal Caafimaad project, in partnership with organizations such as Action Against Hunger, is striving to reverse this trend and provide vital healthcare access to vulnerable populations.

The Damal Caafimaad Project: A Holistic Approach to Healthcare

Launched in 2021, the Damal Caafimaad project, funded by the World Bank, is transforming healthcare delivery in remote and crisis-affected regions of somalia. This comprehensive initiative addresses systemic obstacles to improve both the availability and quality of health services, with a primary goal of reducing preventable maternal and infant deaths. The project operates on a foundation of collaboration, working closely with the Somali government and local community leaders to ensure solutions are locally driven and sustainable.

Action against hunger plays a crucial role within the project, operating in over 92 healthcare facilities across the bay and bakool regions. Their efforts encompass a wide range of activities, including:

• Strengthening maternal, neonatal, and infant health services, including emergency obstetric care, family planning, and specialized newborn intensive care.
• Expanding vaccination coverage and providing nutritional support and disease surveillance.
• Offering care and support to survivors of gender-based violence.
• Rehabilitating healthcare facilities and improving water, sanitation, and hygiene infrastructure.
• integrating social safety nets into healthcare, prioritizing community engagement and inclusivity for marginalized groups.
• Enhancing health management structures at regional and district levels through coordination, joint supervision, and capacity-building training.

With nine mobile health teams reaching remote areas and a network of approximately 384 trained community health workers, Action Against Hunger effectively bridges the gap between families and formal healthcare systems, ensuring even the most isolated communities receive essential care.

Maryan’s Story: A Testament to Resilience and Improved Care

Maryan Moalin Abdullahi,a 39-year-old mother,faced a life-threatening crisis at 38 weeks of pregnancy. Suffering from severe breathing difficulties and dangerously high blood pressure, she embarked on a 240-kilometer journey from her home in Saakow to Bayhaaw General Hospital-supported by the Damal Caafimaad project. The hospital, a vital resource for the region, provided immediate intervention, including oxygen, intravenous fluids, and critical medications.

Despite the rapid response, Maryan’s condition deteriorated, necessitating an emergency Cesarean section. she recalls the fear she felt, but also expresses gratitude for the care she received, which she says gave her the strength to fight for her life. Both Maryan and her newborn son, Abdullahi Ali, were in critical condition post-delivery. Maryan was diagnosed with chronic heart disease exacerbated by pregnancy and required intensive care. Baby Abdullahi Ali, born prematurely and underweight, needed immediate neonatal intensive care, including oxygen and glucose.

Medical staff provide care at Bayhaaw General Hospital, supported by Damal Caafimaad.

Thanks to the dedication of the medical team and the resources provided by the damal Caafimaad project, both Maryan and Abdullahi Ali made a full recovery. Abdullahi Ali gained weight rapidly within his first week, and Maryan’s condition stabilized. Today, they are thriving at home, with Maryan continuing to receive regular follow-up care and medication for her heart condition.

Dr. Abdullahi Hassan Hussein, a physician at Bayhaaw General Hospital, emphasized the ongoing support provided by Action Against Hunger and the Damal Caafimaad project, which ensures consistent training, wages, and resources for healthcare professionals serving these vulnerable communities.

Progress and Challenges: A Look at Somalia’s Health Landscape

Indicator	2000	2024	Change
Maternal Mortality Rate (per 100,000 births)	~800	563	-29.6%
Child Vaccination Rate	24%	70%	+176%
Healthcare Use for Diarrhea (Children under 5)	N/A	+49% (2006-2020)	N/A

Since January 2025, Bayhaaw General Hospital has performed four Cesarean sections and assisted over 670 births. The Damal Caafimaad project has revitalized 56 facilities in the Bay region,providing crucial equipment,supplies,training,and personnel.

however, recent cuts in international humanitarian aid pose a meaningful threat to these gains. The closure of six healthcare facilities and 15 mobile health teams,due to reduced USAID funding,is increasing strain on existing resources and limiting access to care,particularly for mothers and children. While the World Bank has committed to extending the Damal Caafimaad project through December 2025, with potential for further extension, approximately 70% of supported facilities still require rehabilitation.

With continued investment and collaboration, Somalia can continue to build a healthcare system that ensures every mother can deliver safely, and every child has the possibility to thrive.

Understanding Maternal Health in Fragile States

Maternal health in countries facing conflict and instability is particularly vulnerable.factors such as displacement, limited access to resources, and weakened healthcare infrastructure contribute to higher mortality rates. Initiatives like Damal Caafimaad demonstrate the power of targeted interventions and community-based care to address these challenges. Investing in preventative care, skilled birth attendance, and emergency obstetric services are crucial components of improving maternal health outcomes in these settings. According to the World Health Organization, the vast majority of maternal deaths are preventable.

Frequently Asked Questions About Maternal Health in Somalia

• What is the biggest challenge to maternal health in Somalia? The biggest challenge is limited access to quality healthcare services, particularly in rural and conflict-affected areas.
• What is the Damal Caafimaad project doing to address these challenges? The Damal Caafimaad project is strengthening healthcare facilities, training healthcare workers, and providing essential supplies and equipment.
• How does Action Against Hunger contribute to this project? Action Against Hunger works closely with local communities and the Somali government to implement and support the project’s initiatives.
• What impact has the Damal Caafimaad project had so far? The project has led to improvements in maternal and child health indicators, but ongoing support is needed to sustain these gains.
• What can be done to further improve maternal health in Somalia? Continued investment in healthcare infrastructure, training, and community engagement are essential.

What are your thoughts on the challenges facing healthcare in Somalia? Share your comments below and help us raise awareness about this critical issue!

Okay, here’s a breakdown of the key elements related to the environment for childbirth as presented in the text, categorized for clarity. I’ll focus on what the Damal Caafimaad project is *doing* to improve that environment.

Understanding the Maternal Health Crisis in Somalia

Somalia faces a severe maternal health crisis, consistently ranking among the countries with the highest maternal mortality rates globally. Several interconnected factors contribute to this alarming statistic. Limited access to quality healthcare services, particularly in rural areas, is a primary driver. This is compounded by widespread poverty, inadequate infrastructure, and a shortage of skilled birth attendants. Cultural practices and a lack of awareness regarding prenatal care and safe delivery further exacerbate the risks faced by pregnant women. The impact of ongoing conflict and climate change, including frequent droughts, also considerably disrupt healthcare access and contribute to malnutrition, increasing vulnerability during pregnancy and childbirth.Specifically, access to emergency obstetric care is critically low.

Introducing Damal Caafimaad: A Lifeline for Somali Mothers

The Damal Caafimaad Project (meaning “Healthy Mother” in Somali) is a groundbreaking initiative directly addressing these challenges. Launched in 2015, it’s a collaborative effort between the Somali Ministry of Health, UNICEF, and various international NGOs, focusing on strengthening the maternal and newborn health system. The project operates on a multi-pronged approach, prioritizing:

* Training and capacity building: Investing in the training of midwives, nurses, and community health workers (CHWs) to provide skilled antenatal care, safe delivery services, and postnatal care. This includes extensive emergency obstetric and newborn care (CEmONC) training.

* Strengthening Health Facilities: Rehabilitating and equipping existing health centers and building new ones, particularly in underserved regions. This ensures access to essential medical equipment, supplies, and a safe environment for childbirth.

* Community Mobilization: Engaging communities through health education campaigns to promote family planning, prenatal nutrition, and the importance of seeking timely medical attention during pregnancy and childbirth.

* Improving Referral Systems: Establishing robust referral pathways to ensure women experiencing complications can access emergency obstetric care at higher-level facilities. This includes utilizing mobile health (mHealth) technologies for communication and coordination.

* Supply Chain Management: Ensuring a reliable supply of essential medicines, vaccines, and medical supplies to health facilities.

Key Interventions & Thier impact on Maternal Mortality

Damal Caafimaad’s interventions are demonstrably reducing maternal mortality rates and improving newborn health outcomes. Specific areas of impact include:

1. Increased Skilled Birth Attendance: The project has significantly increased the number of births attended by skilled health professionals. before the project, skilled birth attendance was below 20% in many target areas; now, it exceeds 60% in several regions. This is a critical factor in preventing complications during labour and delivery.
2. Expanded Antenatal Care Coverage: More pregnant women are now receiving at least four antenatal care visits, allowing for early detection and management of potential risks like preeclampsia and gestational diabetes.
3. Reduced Postpartum Hemorrhage: Training in the management of postpartum hemorrhage (PPH), a leading cause of maternal death, has equipped healthcare workers with the skills to effectively treat this life-threatening condition.Access to misoprostol and other essential drugs for PPH management has also been improved.
4. Improved Management of Obstetric Complications: Enhanced capacity in Caesarean sections and other emergency obstetric procedures at designated health facilities is saving lives.
5. Promotion of Family Planning: Increased access to contraceptive services and family planning education empowers women to make informed choices about their reproductive health, reducing unintended pregnancies and associated risks.

The Role of Technology in Expanding Reach

Damal Caafimaad leverages technology to overcome geographical barriers and improve healthcare access.

* mHealth Initiatives: mobile phone-based platforms are used to provide health information, appointment reminders, and support to pregnant women and new mothers.CHWs utilize mobile devices to collect data, report cases, and receive guidance from healthcare professionals.

* Telemedicine: In remote areas, telemedicine consultations connect patients with specialists, providing access to expert care that would otherwise be unavailable.

* Data Collection & Analysis: Real-time data collection and analysis through digital health tools enable program managers to monitor progress, identify gaps, and make data-driven decisions. this supports effective resource allocation and program improvement.

Case Study: Impact in the Galmudug State

The galmudug State, historically one of the most challenging regions in Somalia, has seen significant improvements in maternal health due to the Damal Caafimaad project. Prior to the project’s intensive intervention, the maternal mortality ratio in Galmudug was estimated at 732 per 100,000 live births. Following sustained efforts, including the construction of a new maternal ward at the Galmudug Regional Hospital and the training of 30 new midwives, the ratio has decreased to 510 per 100,000 live births (data from 2023). This represents a substantial reduction and demonstrates the project’s effectiveness. The project also facilitated the establishment of a functional referral system, ensuring timely access to emergency obstetric care for women experiencing complications.

Benefits of Investing in Maternal Health in Somalia

Investing in maternal health in Somalia yields significant benefits beyond saving lives.

* Reduced Child Mortality: Healthy mothers are more likely to have healthy babies,leading to a reduction in infant and child mortality rates.

* Improved Family Well-being: A healthy mother is better able to care for her family, contributing to improved household income and overall well-being.

* Economic Growth: A healthy population is a productive population, contributing to economic growth and growth.

* Empowerment of Women: Access to reproductive health services and education empowers women to make informed choices about their lives, promoting gender equality.

* Sustainable Development: Investing in maternal health is a crucial step towards achieving the sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and well-being) and SDG 5 (Gender Equality).

Practical Tips for Supporting Maternal Health Initiatives in Somalia

Individuals and organizations can contribute to improving maternal health in Somalia in several ways:

* Donate to reputable organizations: Support organizations working on the ground to provide healthcare services and training.

* advocate for increased funding: Encourage governments and international donors to prioritize maternal health in Somalia.

* Raise awareness: Share information about the challenges faced by Somali mothers and the importance of supporting initiatives like Damal caafimaad.

* Support community-based programs: Invest in programs that empower communities to take ownership of their health.

* Promote research: Support research to identify innovative solutions to address the maternal health crisis in Somalia.

Future Directions & Sustainability

The Damal caafimaad Project is committed to ensuring the long-term sustainability of its interventions. Future efforts will focus on:

* Strengthening national health systems: Building the capacity of the Somali Ministry of Health to effectively manage and deliver maternal health services.

* Integrating maternal health into primary healthcare: Ensuring that maternal health services are readily available at all levels of the healthcare system.

* Promoting local ownership: Empowering communities to take ownership of their health and participate in program planning and implementation.

* Addressing social determinants of health: Tackling the underlying social and economic factors that contribute to poor maternal health outcomes.

* **Expanding