SHINE Supply
World Health Day: thanking nurses and midwives for their commitment

World Health Day 2020

Today we celebrate World Health Day. The focus this year is on the work of nurses and midwives, reminding world leaders of the critical role they play in keeping the world healthy.

Sufficient support for these vital workers is necessary if we are to achieve Sustainable Development Goal 3 targets that relate to universal health coverage, as well as maternal and child health. Improving maternal health has also been a longstanding objective for UK aid and the SHINE Supply programme helps to work towards this goal.

The issue

Maternal mortality rates in Somalia are amongst the highest in the world. Midwives and nurses are part of a critical workforce in Somalia where women have a one in 22 lifetime risk of maternal death (UNFPA, 2018). Somalia’s neonatal mortality rate is also extremely high. These deaths can be prevented with access to well-trained midwives and nurses during antenatal and postnatal visits, and if deliveries overseen by skilled birth attendants.

Nurses and midwives can impart simple yet lifesaving knowledge to those that need it most. Too often, knowledge on disinfectants, handwashing, breastfeeding within the first hour, skin-to-skin contact (the kangaroo method), proper cord care and good nutrition does not reach those most at risk.

Case Study

There is a great demand for nurses and midwives in Somalia and Somaliland, but many are ill-equipped and over-stretched. We spoke to two midwives at Dilla Health Facility in the Awdal region of Somaliland where 3 midwives are running a 24-hour service.

Nurses, Halima and Sahra at Dilla Health Facility

Nurses, Halima and Sahra at Dilla Health Facility

Halima, the chief midwife explained that to really meet demand effectively, and to ensure that her colleagues take enough rest, the facility would need 4 midwives. This department was overseen by just two midwives until the introduction of the SHINE Supply, when the facility was able to employ a third midwife – Sahra.

Halima is the chief midwife. She has been working at the facility for over 6 years and is overjoyed that Sahra came to join her team. The facility oversees an average of 65 births per month. To offer a quality service, and to make sure that her colleagues are well-rested, Halima told us that 4 midwives would be ideal. “We are understaffed and overworked. The long shifts take a toll, but we have to provide this service for our community”, Sahra told us.

Despite the continued challenges, Safiya and her colleagues have seen significant improvements at Dilla HF since the introduction of the SHINE Supply in February 2019. Health workers, including the midwives, at the HC now receive top-up payments regularly. The essential supplies required to provide quality services to mothers and children are now available.

Encouragingly, all four regions that SHINE Supply supports – Awdal and Toghdeer in Somaliland and Banadir and Galgaduud in the Federal Regions of Somalia – have seen an increase in antenatal care (ANC) visits since the Programme started, with Galgaduud seeing the biggest upwards trend – rising from 878 in January 2019 to 3,006 in December 2019. Deliveries with a skilled birth attendant have also risen in all regions, apart from Awdal. SHINE partner – the SAHAN programme, managed by PSI – continues to complement the supply of an essential package of health services (EPHS) with demand creation activities that seek to increase the uptake of these services and supplies.

Covid-19

Nurses and other health workers are at the forefront of COVID-19 response. As the virus spreads in the Federal Regions of Somalia and Somaliland, it will be vital to equip these frontline workers with personal protective equipment, as without nurses there will be no response.