Horn of Africa – Kenya and Somalia
HOA: Kenya and Somalia
Ahmed Arale, Secretariat Director
Secretariat Host Organization/ American Refugee Committee (ARC)
Programmatic Focus/ The recognized leader in cross-border collaboration through the Cross-Border Health Initiative and cross-border meetings, CGPP Kenya and Somalia promotes immunization and surveillance activities in high-risk, hard-to-reach border communities which host vulnerable and marginalized IDPs, refugees and nomadic and pastoralist herders. In 2019, CGPP Kenya began integrating community-based surveillance for five priority zoonotic diseases – Anthrax, Trypanosomiasis, Rabies, Brucellosis and Rift Valley Fever – under USAID’s Global Health Security Agenda (GHSA).
CGPP Implementation Sites/ Directly supports 98 cross-border health facilities in six Kenya counties (Garissa, Lamu, Wajir, Mandera, Marsabit and Turkana) and Kamukunji sub-county in Nairobi County, which is home to many Somali refugees; 17 health facilities in Somalia’s three regions bordering Kenya and Ethiopia (Bardere, Elwak, Belet-Hawa, Luq and Dollow districts in Gedo region, and Afmadow and Badhadhe in Lower Juba region and Rabdure and El Barde districts in Bakool region.)
CGPP Implementing Partners/ Five international NGOs and one local organization – American Refugee Committee, International Rescue Committee, Catholic Relief Services, World Vision-Kenya, Adventist Development and Relief Association-Kenya and Somali Aid, a local NGO.
The Horn of Africa experienced a wild poliovirus outbreak in April 2013 with a record number of 223 cases: 199 in Somalia, 14 in Kenya and 10 in Ethiopia. While the outbreak occurred primarily in Somalia, it quickly spread to Kenya and Ethiopia. The Somalia polio cases belonged to cluster N5A that was known to have been circulating in northern Nigeria since 2011. At around the same time, the Global Polio Eradication Initiative (GPEI) entered a new phase with a significant reduction in case counts in endemic countries and a heightened recognition of the risk for the international spread of the virus. In May 2014, WHO declared polio a public health emergency and issued recommendations requiring proof of polio vaccination for travel to and from polio-afflicted countries. The Core Group Polio Project Kenya and Somalia was created in 2014 to prevent and respond to any future outbreaks by building upon existing NGO child survival experience and expertise.
Today, the CGPP works in insecure border districts affected by insurgent attacks, communal violence over grazing lands, and conflict-based mass migrations; political instability and weak health systems additionally contribute to cases of circulating vaccine-derived poliovirus. Frequent cross-border movement of the high-risk mobile populations between Kenya and Somalia and the low level of population immunity in the region continues to be a major threat to ongoing transmission. In collaboration with WHO and both Kenya and Somalia MOHs, the CGPP began holding cross-border meetings in October 2014 – a significant and instrumental move that would shape a systematic, unified and well-coordinated response in the form of the Cross-Border Health Initiative (CBHI).
Known as the “cross-border people,” the CGPP Kenya-Somalia program works to ensure the vaccination of all cross-border populations; to support the detection of suspected cases of AFP; to conduct joint case investigations of trans-border AFP cases, and to support all polio SIAs. The CGPP works with a network of Community Mobilizers (CMs) that supports structured community-based health volunteers (CHVs). CORE Group Kenya and Somalia trained CHVs to support/provide outreach services throughout 115 health facilities. The CHVs are the critical link between the hard-to-reach communities and the health facilities, where they provide essential support to understaffed health facilities. The CGPP employed an array of strategies to achieve high levels of population immunity and increase vaccination uptake. The synchronizing of monthly routine immunization services between border villages, integrating vaccination outreaches with nutrition emergency response outreaches, and increasing the participation of religious and community leaders contributed to improved rates of vaccine acceptance among the high-risk mobile populations.
Ahmed Arale, Director
Somane Mohamed, Deputy Director
Yusuf Ibrahim Ajak, M&E Coordinator
Abdirahman Ibrahim Adan, CG-GHSA coordinator
Abubakar Salah Farah, Program Officer
REPORTS AND RESOURCES
Cross Border Health Coordination Meeting Reports:
Arale, A.; Lutukai, M. ; Mohamed S.; Bologna L.; Stamidis K.V. (2019) Preventing importation of poliovirus in the Horn of Africa: The success of the cross-border health initiative in Kenya and Somalia. Am. J. Trop. Med. Hyg., 101(Suppl 4), pp. 100–106.
Okiror, S. O., Bisrat, F., Lutukai, M., Bhui, B. R. (2015). Community-based surveillance on polio eradication in the Horn of Africa. African Health Monitor, 19, 44-45.
Okiror, S. O., Kisanga, A., Bhui, B. R. (2015). Cross-border Initiative on Polio Eradication in the Horn of Africa. African Health Monitor, 19, 51 – 52.