Assessing the health needs of settlement residents in the eastern Sanaag district of northern Somalia

Background: The Sool/Sanaag region in northern Somalia is currently claimed by both Somaliland and Puntland and has been the site of political tension as a result. Due to perceived insecurity as a result of political conflict, the provision of services to the communities of Sanaag has been continually interrupted and the region remains largely un-assessed in terms of health. Objective: To collect information from community members on health practices, knowledge and perceived needs in order to form recommendations for community-based, low-cost interventions that use existing systems, have immediate impacts and produce sustainable results. Methodology: Quantitative: Household survey applied to a random sample from 8 representative villages in the Sanaag region. Qualitative: Focus groups with community member from different socio-economic levels, in-depth interviews with community leaders, healthcare workers and key informants. Results: Information was collected on health care seeking behavior, barriers to access to health care facilities, levels of satisfaction with current health care options and basic health knowledge and beliefs about antenatal/infant care, common diseases, hygiene practices, HIV/AIDS knowledge, vaccination coverage, women's health and female circumcision. Implications: The continued perception by government and aid organizations that the region is inaccessible has had a negative impact on the health status of communities in Sanaag. Through this assessment, it was determined that the communities in Sanaag are potential targets for increased and improved assistance in the area of primary care, maternal and child health and women's health issues through community-based interventions as indicated in the final recommendations contained in this report.