Health research prioritization in Somalia: setting the agenda for context specific knowledge to advance universal health coverage

IntroductionDespite recognition that health research is an imperative to progress toward universal health coverage, resources for health research are limited. Yet, especially in sub-Saharan Africa, more than 85% of the resources available for health research are spent on answering less relevant research questions. This misalignment is partially due to absence of locally determined health research priorities. In this study, we identified health research priorities which, if implemented, can inform local interventions required to accelerate progress toward universal health coverage in Somalia.MethodsWe adapted the child health and nutrition research initiative method for research priority setting and applied it in 4 major phases: (1) establishment of an exercise management team, (2) a web-based survey among 84 respondents to identify health research questions; (3) categorization of identified health research questions; and (4) a workshop with 42 participants to score and rank the identified health research questions. Ethical approval was received from ethics review committee of the London School of Hygiene and Tropical Medicine (Ref:26524) and the Somali Research and Development Institute (Ref: EA0143).ResultsTwo hundred and thirty-one unique health research questions were identified and categorized under health systems, services and social determinants (77), communicable diseases (54), non-communicable diseases (41) and reproductive, maternal, new-born, child, adolescent health and nutrition (59). A priority score ranging from 1 to 9 was assigned to each of the questions. For each category, a list of 10 questions with the highest priority scores was developed. Across the four categories, an overall list of 10 questions with the highest priority scores was also developed. These related to bottlenecks to accessing essential health services, use of evidence in decision making, antimicrobial resistance, distribution and risk factors for non-communicable diseases, post-traumatic stress disorder and factors associated with low antenatal care attendance among others.Conclusion and recommendationsThe developed priority research questions can be used to focus health research and to inform appropriation of health research resources to questions that contribute to generation of local health system knowledge which is required to accelerate progress toward universal health coverage in Somalia. The Somalia national institute of health should set up a consortium for provision of technical and financial support for research addressing the identified priority research questions, establish a mechanism to continuously monitor the extent to which new health interventions in Somalia are informed by knowledge generated through conducting prioritized health research and prioritize interventions aimed at strengthening the broader national health research system for Somalia

Webmarketing

Avec l'arrivée des nouveaux moyens d'expression sur Internet, tels que les blogs ou les vidéos en ligne, l'internaute n'est plus consommateur d'information mais il en devient producteur. Les entreprises désireuses d'acquérir une réputation sur Internet vont devoir séduire ces nouveaux leaders d'opinion, afin de les transformer en vecteurs de promotion. Mais quelles sont les personnes concernées ? Quel impact espérer ? Comment réaliser une campagne sur le web ? Ce mémoire répondra à toutes ces questions et donnera les stratégies et les outils à adopter pour les sociétés désirant mener une campagne de marketing de masse

Current guidelines for malaria treatment in Somalia : evidence-based recommendations

Case management – rapid diagnosis and prompt administration of artemisinin-based combination therapy (ACT) – is a fundamental pillar of recommended malaria interventions in Somalia. Unfortunately, the emergence and spread of drug resistant falciparum parasites continues to pose a considerable threat to effective case management. With technical and financial support from WHO, the efficacy of recommended ACTs has been regularly monitored in sentinel sites since 2003. These studies provided evidence that supported the adoption of artesunate-sulfadoxine/pyrimethamine as first-line treatment in 2005 and artemether-lumefantrine as second-line treatment in 2011. Efficacy studies conducted between 2011 and 2015 showed high artesunate-sulfadoxine/pyrimethamine treatment failure rates of 12.3% - 22.2%, above the threshold (10%) for a change of treatment policy as recommended by WHO. This was also associated with high prevalence of quadruple and quintuple mutations in the dihydrofolate reductase (Pfdhfr) and dihydropteroate synthase (Pfdhps) genes, which are associated with sulfadoxine/pyrimethamine resistance. Based on these findings, national malaria treatment guidelines were updated in 2016, with artesunate-sulfadoxine/pyrimethamine replaced by artemether-lumefantrine as first-line treatment and dihydroartemisinin-piperaquine recommended as second-line treatment. Subsequent efficacy studies in 2016 and 2017 confirmed that both the current first- and second-line treatments remain highly efficacious (cure rate above 97%).  Technical and financial support from WHO has been instrumental in generating evidence that informs malaria treatment policy and should therefore continue to ensure that effective treatments are available to malaria patients in the country

Social contact data for IDPs in Somaliland (2019)

Social contact data for internally displaced people (IDP) living in Digaale IDP camp in Somaliland. Participants reported all their direct contacts in the 24 hours preceding the survey. This survey was conducted in 2019. Data is formatted to be used in the socialmixr package in R

Social contacts and other risk factors for respiratory infections among internally displaced people in Somaliland.

BACKGROUND: Populations affected by humanitarian crises experience high burdens of acute respiratory infections (ARI), potentially driven by risk factors for severe disease such as poor nutrition and underlying conditions, and risk factors that may increase transmission such as overcrowding and the possibility of high social mixing. However, little is known about social mixing patterns in these populations. METHODS: We conducted a cross-sectional social contact survey among internally displaced people (IDP) living in Digaale, a permanent IDP camp in Somaliland. We included questions on household demographics, shelter quality, crowding, travel frequency, health status, and recent diagnosis of pneumonia, and assessed anthropometric status in children. We present the prevalence of several risk factors relevant to transmission of respiratory infections, and calculated age-standardised social contact matrices to assess population mixing. RESULTS: We found crowded households with high proportions of recent self-reported pneumonia (46% in children). 20% of children younger than five are stunted, and crude death rates are high in all age groups. ARI risk factors were common. Participants reported around 10 direct contacts per day. Social contact patterns are assortative by age, and physical contact rates are very high (78%). CONCLUSIONS: ARI risk factors are very common in this population, while the large degree of contacts that involve physical touch could further increase transmission. Such IDP settings potentially present a perfect storm of risk factors for ARIs and their transmission, and innovative approaches to address such risks are urgently needed

kevinvzandvoort/espicc-somaliland-digaale-survey-2019

Analysis scripts, anonymized data, and questionnaire scripts for: "Social contacts and other risk factors for respiratory infections among internally displaced people in Somaliland". The following questionnaires are available: A household survey asking about household-level risk factors and household demographics; A contact survey asking about social contacts within the 24 hours before the survey, and individual-level risk factors for respiratory infections; A form to enter anthropometric measures; A form to ask neighbours of shelters that were absent on all visits about the status of these shelters. Only a subset of the data collected with these questionnaires during the survey has been used for this analysis. Data has been anonymized, and links between household-, contact-, and nutrition- data have been removed. The anonymized data can be used to replicate all analyses, figures, and tables in the manuscript. The following datasets are included: Reported household-level risk-factors collected with the s1_household form; Age-group and sex of household members collected with the s1_household form; Age of people reported to have left surveyed households in the six months preceding the survey collected with the s1_household form; Age of people reported to have died in surveyed households in the six months preceding the survey collected with the s1_household form; Status of shelters where no individual was present on repeat visits, according to their neighbours collected with the s4_missing_houses form; Non-contact related individual-level risk factors collected with the s2_contacts form; Contact-related information from contactors (participants in the contact survey) collected with the s2_contacts form; Information about contactees reported by contactors collected with the s2_contacts form; Anthropometric assessments of children aged 6 to 59 months old, who were included in the contact survey collected with the s3_anthropometry form and; Combined (aggregated) datasets of contact, participant, nutrition, and household level data, used for logistic regression analysis. Social contact data for internally displaced people (IDP) living in Digaale IDP camp in Somaliland has been uploaded to Zenodo. Participants reported all their direct contacts in the 24 hours preceding the survey. This survey was conducted in 2019. Data is formatted to be used in the socialmixr package in R

Social contacts and other risk factors for respiratory infections among internally displaced people in Somaliland. Data and analyses.

Data and code accompanying the preprint "Social contacts and other risk factors for respiratory infections among internally displaced people in Somaliland"

Social contacts and other risk factors for respiratory infections among internally displaced people in Somaliland. Data and analyses.

Data and code accompanying the preprint "Social contacts and other risk factors for respiratory infections among internally displaced people in Somaliland"

Rebuilding research capacity in fragile states : The case of a Somali–Swedish global health initiative

This paper presents an initiative to revive the previous Somali–Swedish Research Cooperation, which started in 1981 and was cut short by the civil war in Somalia. A programme focusing on research capacity building in the health sector is currently underway through the work of an alliance of three partner groups: six new Somali universities, five Swedish universities, and Somali diaspora professionals. Somali ownership is key to the sustainability of the programme, as is close collaboration with Somali health ministries. The programme aims to develop a model for working collaboratively across regions and cultural barriers within fragile states, with the goal of creating hope and energy. It is based on the conviction that health research has a key role in rebuilding national health services and trusted institutions