Wolli Edris Ahmad (name changed for privacy) purchased a few consumable products, most of them medications for his family and relatives in the village, using the money he got from his relatives overseas.
He left Addis Ababa the next day to see his pastoralist family in Dollo Addo Woreda, Liban Zone of Ethiopia’s Somali Region, which borders Somalia.
“Dollo Ado is mostly inhabited by pastoralist groups that cross the international border multiple times a month, week, or even day to get water, animal feed, and services. My family was in Ethiopia until last week. They may enter Somalia this week.” Wolli says.
Inaccessible health systems in rural places like Dollo Ado hinder Universal Health Coverage (UHC). Poverty, drought, and insufficient health services increase the risk of illness and undernutrition.
The sparse settlement, seasonal movement of pastoralist communities, lack of infrastructure, lack of access to service delivery points, low service utilization, and high turnover of service providers at all health system levels worsen the problem, making conventional health service delivery methods ineffective.
Treatment for my children was difficult. The nearest clinic is far away and may not have the necessary supplies or services. Wolli describes his experience.
Ethiopia’s pastoralist groups have the greatest child nutritional deficiencies, wasting, and underweight rates. According to the 2019 Ethiopian Mini Demographic Health Survey (Mini-EDHS), the Somali Region has the greatest frequency of wasting (21%) and the lowest dietary variety (1%).
A digital platform was needed to enhance nutrition services and pastoralist community care. A framework was also needed to disseminate information and track child development across nations, health institutions, and service providers.
The World Health Organization (WHO) launched a cross-border initiative in Ethiopia and Somalia with funding from the Italian Agency for Development Cooperation (AICS) to improve nutrition services and care for migrant cross-border populations like Wolli Edris and his family.
The project aims to enhance the number of children and expectant women attending the nutritional screening and counselling sessions connected to treatment by 10% by modifying and installing a digital platform (Nutrition Tracker) in the health system.
It also strengthens Ethiopia-Somalia cooperation to promote healthcare and nutrition for pastoralists and vulnerable communities.
“Identifying and Building Capacity for Nutrition Services to Contribute to Universal Health Coverage (UHC): A Regional Strategy Targeting Vulnerable Peoples Seeking Healthcare Cross-borders Utilizing Innovative Technologies (Somalia and Ethiopia)” was the 2021 inception note.
After the inception note, an anthropological study showed access (interruptions in service provision, weak referral linkage, medical supply pipeline breakage, poor community service-seeking behaviour, deficient health information system, rampant, unacceptable dietary diversity practises, and sub-optimal breastfeeding practises).
The research found community mobility and underserved groups in the region, urging WHO to broker health diplomacy between the two nations to collaborate on new, integrated healthcare initiatives.
WHO organized an intercountry coordination conference with the Health Ministries of Ethiopia, Somalia, and other stakeholders.
A basic business need and health facility readiness evaluation for a digital solution was addressed, including a data-sharing framework between the two nations.
An intercountry coordination conference in early July 2023 will help WHO finish the second preparatory phase. Liben Zone, Dollo Addo, Filtu (Ethiopia), and Dellow district will adopt the digital solution (DHIS II Tracker) at the conclusion of the second phase (Somalia).
WHO is speeding up the project’s next phase, which will help 14,800 pregnant and nursing women and 30,000 children aged 0-5 in Ethiopia’s hard-to-reach project locations.
The service will also aid Somali pastoralists who cross the border for grazing.
DHIS tracking will improve service provider capacity and performance monitoring, improving health and nutrition care and providing universal health coverage.
WHO Headquarters and regional offices (AFRO and EMRO) are required to engage regional bodies like IGAD (Inter-Governmental Authority on Development) and mobilize resources to scale up and roll out the programme to new countries.
