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Evaluation database

Evaluation report

2016 Somalia: A Continuum of Care Approach to Sexual and Reproductive Health in Somalia



Author: Dr Hassan A. Ahmed

Executive summary

With the aim to continuously improve transparency and use of evaluation, UNICEF Evaluation Office manages the "Global Evaluation Reports Oversight System (GEROS)". Within this system, an external independent company reviews and rates all evaluation reports. The quality rating scale for evaluation reports is as follows: “Highly Satisfactory”, “Satisfactory”, “Fair” or “Unsatisfactory”. You will find the link to the quality rating below, labelled as ‘Part 2’ of the report, and the executive feedback summary labelled as ‘Part 3’.

Background:

Reproductive health indicators in Somalia are among the worst in the world with maternal mortality rates estimated to be 1400/100 000live births. This, in conjunction with a high total fertility rate of 6.4, translates into a lifetime risk of death during labour of one in ten mothers. Perinatal death rate is also high at 81/1000 live births. The high maternal mortality is mainly a result of a major lack of access to quality Sexual and Reproductive health (SRH) services (skilled attendance and EmONC) coupled with social, cultural and health seeking behaviour practices that are highly unfavourable for SRH. 

Purpose/Objective:

The overall purpose of this evaluation was to assess the extent to which the “Continuum of care approach to Sexual and Reproductive Health in Somalia” project has improved access to integrated SRH services among the Somali population.

Methodology:

Both HMIS and implementing partner reports were reviewed and analysed so as to get the actual figures and trends over time on both performance and quality indicators of the SRH project.

Findings and Conclusions:

The overall performance rating was found to be between good and very good). With regard to relevance the project was relevant at the time of its conception as it was based on assessments, universal health indicators and baseline surveys. The overall efficiency was found to be good. The project was very effective where interventions were implemented well by UNICEF and its partners, both short term (increased service uptake and awareness) and long-term impacts have been realized (infrastructure, skilled personnel, increased number of HCWs and regular medical supply). Sustainability of the intervention is achieved through linkage to JHNP and is currently running under EPHS.

Recommendations:

  1. Incorporation of HIV services: Although HIV prevalence is reportedly low in Somalia; Prevention of Mother to Child Transmission is the universal way to eliminate paediatric HIV. It was noted that while the project is a SRH project it lacked HIV component. Therefore there is need to incorporate HIV services in such future project. In addition there is need to provide PMTCT training to the HCWs and supply of PMTCT commodities (Testing kits and ARVs).
  2. Provision of quality neonatal care and resuscitation: The project laid more emphasis on maternal health while the intertwined neonatal health was somewhat weak. It also recommended that for future such projects, proper neonatal care training be provided to the Health workers in BEmONC facilities so as to tackle the high neonatal deaths in Somalia.
  3. Reintroduction of systemic and structured supportive supervision to facilities.
  4. Integration of the successes of this project into and expansion of EPHS to offer comprehensive EMONC services in MCHs.
  5. Following the success of SRH, EU should support EPHS in order to sustain the success of the intervention.


Full report in PDF

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Report information

Year:
2016

Country:
Somalia

Region:
ESAR

Type:
Evaluation

Theme:
Youth and Adolescents

Language:
English

Sequence #:
2016/001

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