Orange = unstable transmission risk; green = hypo-endemic risk; and red = meso-endemic risk

Malaria interventions coverage

Source: MICS 1999, MISC 2006, * WHO 2005; **: Lynch 2005; ***: Graham 2005

I. Epidemiological background

Parasite (Plasmodium) types	P. Falciparum is reported to be the predominant parasite species (95% of all infections)
Main vector (mosquito) types	An. Arabiensis the main vector.
Total population	8,228,000 (2005)
Population at risk	7,300,000 (2004)
~ 88% of the Population lives in areas at risk of malaria
Number of reported clinical malaria / fever cases	15,329 (2006)
Reported Malaria deaths	29 (2006)
Under 5 mortality rate ( per 1000 live births)	219 (2006)
Infant mortality rate (per 1 000 live births)	133 (2005)*

*Source: WHO statistics 2007

II. Current Policy and Strategy

Primary interventions: Policy & Strategy

Case management

ACTs/RDTs are available in hospital and MCH centres that are accessible to around 30% population Health Posts (above 500) are planned to be strengthened for malaria diagnosis (RDTs) and management of uncomplicated cases. This will result in reduction in reliance on under skilled and under resourced private sector. Increase in access to ACTs MCHs and Hospitals are getting strengthened for management of both complicated and un complicated malaria Patients diagnosed positive during various surveys gets on the spot treatment

Prevention: Vector control

LLITNs The mainstay of vector control/personal protection in Somalia Round 2 and 6: 2 millions nets are planned to be distributed Implementation Strategies: Free of charge Targeted distribution in hotspots Through MCHs (Maternal and Child Health), hospitals, health posts and distribution campaigns Distribution cannot be linked with Immunization campaigns (logistics and clan competition implications for WHO) IRS: Only in hyper-endemic/ outbreak situations

For more details see the Strategic plan 2005-2010

III. Primary interventions

[+] Global Fund Grant performance

[+] View data

Indicator Name	Baseline	Round 2	Round 6 Target (Yr 3)	Round 6 Target (Yr 5)
% HH with 1 LLITN (target areas)	10	19.4	75	80
% <5 sleeping under nets	2.6	9.2	70	80
% Pregnant women sleeping under net	-	17	70	80
% people know malaria prevention	52		60	80
% epidemic detected and controlled	0		80	90

IV. Challenges and Priority support needs (2008 - 2010)

Challenges Lack of infrastructure for referral laboratories and of systems for supervision and quality control of the laboratory network Lack of sustained resources to finance supplies such as LLINs and appropriate quality drugs Private sector that is unregulated or controlled Little capacity within the health ministries and few resources Poor health information system and lack of reliable health statistics Skilled human resource and technical capacities at all levels Distribution of supplies to health centres Surveillance : Proper surveillance system non existent which makes efficient planning and prioritization of areas for interventions very difficult Private Sector development Entomological surveillance and Integrated Vector Management (IVM)

Prioritis Capacity building and human resource development in all malaria aspects Implementation of the updated drug policy in all level of health facilities and monitoring the compliance and effectiveness Strengthening malaria lab diagnosis and quality assurance Strengthening epidemic preparedness and response Implement the strategy for scaling up the use of ITNs Technical support for developing integrated vector management strategy Technical support for strengthening malaria M&E and surveillance system

V. Key RBM Partners in Somalia

• WHO
• UNICEF

For questions, contact Ms Nadia Lasri, RBM Partnership facilitation
Dr James Banda, RBM Partnership facilitation Coordinator

RESOURCES & LINKS:

Malaria Control Strategic plan 2005-2010
Malaria Communication Strategy for Somalia 2006 - 2010

Malaria treatment protocols:
WHO Global AMDP database

Malaria contry profiles
WHO/EMRO

Online publications:
PubMed

Maps:
MARA/ARMA Somalia maps