Building infrastructure for the health of children and communities
UNICEF works with countries and communities on construction projects to create long-term solutions for health systems and address inequalities in access to healthcare.

In 2020, five million children died before the age of five, mainly from preventable or treatable causes. A woman in sub-Saharan Africa is 130 times more likely to die during pregnancy or childbirth than a woman in Europe or North America.
Alongside our rapid response initiatives for health emergencies, UNICEF works with countries and communities to address these inequalities by supporting health systems strengthening initiatives.
Improving health systems requires multiple interventions like the construction of health-related facilities. UNICEF initiatives include building warehouses with cold storage to support early childhood vaccination programmes and constructing government health offices and rural health infrastructure, such as primary health facilities delivering essential maternal and newborn care.

Healthcare decentralization in Somalia
Decentralization of health services capacity is a major priority for Somalia’s Federal Government as well as the UNICEF country office in Somalia. The delivery of health services, especially at regional levels, is a considerable challenge in the country. UNICEF reported in 2021 that most of the country’s disease outbreaks were the result of low vaccination coverage, shortage of functional public health facilities, low capacity for surveillance and lack of rapid response to health alerts.
To make healthcare more accessible to populations outside major urban centres, UNICEF supports the Ministry of Health in rolling out a national healthcare decentralization programme.
Health services strengthening at a regional level requires improving healthcare planning, management and service delivery. Construction also has a critical enabling role. Between 2019 and 2021, UNICEF rehabilitated health offices in the regional capitals of Garowe and Galkayo. These regions are home to 300,000 people – many of whom are internally displaced by the ongoing conflict.
The rehabilitated health offices can now support regional health management teams and provide space to preposition emergency supplies such as paracetamol, amoxicillin and ready-to-use therapeutic food (RUTF). Solar panel systems generate renewable energy that powers the building’s lighting. The building now features rainwater harvesting and systems for collection of greywater, which is water from showers and sinks that can be reused for other purposes.
Read more about UNICEF’s sustainable construction techniques.
Strengthening rural health infrastructure in Niger
Niger is currently ranked 190 out of 191 countries on the 2020 Human Development Index despite recent economic gains. On average, women in Niger have seven children – reflecting the world’s highest population growth rate. Several critical indicators confirm that healthcare is lagging. High costs and long distances put primary health care out of reach for families in many rural communities. In 2021, only 44 per cent of women who gave birth were attended by a skilled practitioner.
UNICEF supported local governments in constructing 65 Integrated health centres (centres de santé intégré or CSIs), which has been critical in strengthening rural health infrastructure in rural Niger. CSIs provide maternal, neonatal and child health services. Life-saving interventions include preventing and managing postpartum haemorrhages.

Each new CSI includes a treatment centre and maternity unit and the refurbishment and extension of the existing Maternal and Child Health Centre. UNICEF has also supported the installation of solar generators and drinking water points and the construction of a laboratory, an office block, staff accommodations and toilets and showers for staff and patients.
The centres serve 65 villages in 17 districts in Maradi, Dosso and Zinder regions. In all, 700,000 people can now access improved health services.

Improving distribution of childhood vaccines in Burkina Faso
Over 50 per cent of Burkina Faso’s population is under 18 years of age and 44 per cent is under 15. The expanding conflict that began in 2018 has forced many health facilities to reduce services or close down completely. However, while 95 per cent of the population has been affected, Burkina Faso’s under-five mortality rate has declined steadily and is currently at 85 per 1,000 live births – and this is owed mainly to high-impact interventions to prevent and treat childhood diseases.
In 2019, the Government’s Expanded Programme on Immunization (EPI) conducted an evaluation of vaccine management capacity of the country. The country had expanded its management of vaccines to a total of 15, covering the deadliest vaccine-preventable diseases for pregnant women and children.
To help enable the continuity of health services, UNICEF worked in collaboration with the Ministry of Health to construct new warehouse facilities in Ouagadougou to house health and medical supplies, including essential childhood vaccines for EPI. The facility, completed in 2022, stores life-saving vaccines that reach 1.6 million children and over one million pregnant women. It consists of dry stores (2,000 m2) and cold stores (1,800 m2). Thanks to the project, vaccine storage capacity for Burkina Faso increased from 420 m3 to 1,260 m3.
UNICEF’s construction projects in the health sector contribute to improving responses to healthcare emergencies and building long-term, sustainable health systems for children to survive and thrive. UNICEF’s work in this area is highlighted under Goal Area 1 of the UNICEF Strategic Plan 2022 – 2025.