Djibouti Country Brief
Community Health: Policy and Implementation Landscape Mapping in the Middle East and North Africa Region 2024
About
Country Context
The Republic of Djibouti, a country located in the Horn of East Africa, shares its borders with Eritrea to the north, Somalia to the southeast, and Ethiopia to the southwest. The country covers an area of 23,200 km² with an estimated population of 1,024,206 and a population density of 40.5 inhabitants per km². The country is divided into six administrative regions, including Djibouti City, the capital, and the regions of Obock, Tadjourah, Dikhil, Ali Sabieh, and Arta.
Djibouti's health system is based on the Primary Health Care (PHC) strategy and organized according to the district health system approach. The organization of Djibouti’s health system consists of three levels (peripheral, intermediate, and central), complemented by three sub-sectors (public, semi-public, and private). It is governed by the health services map, which must be revised every five years.
The health situation throughout the country has improved in recent years thanks to the health policy reforms led by the Ministry of Health. However, the national health system is still beset by structural and organizational difficulties.
Overview of Community Health
In Djibouti, there is no holistic or overarching system for managing community health activities and associated stakeholders. Since 2000, several community initiatives have been carried out in a scattered and ad hoc manner. Funded by technical partners and donors, a diverse network of community-level actors (including relais communautaires, awareness raisers, health ambassadors/counselors) undertook vaccination, nutrition, sanitation, and women's empowerment projects in various localities.
More specifically, in 2008, 100 community health workers (CHWs) were recruited and received nine months of training at the Higher Institute of Health Sciences, followed by 11 days of practical training on health promotion and curative services packages as well as tools (guides, modules, etc.) developed for this purpose. This initiative continued with an additional recruitment of up to 400 CHWs, i.e., 100 per year.
