Jaamacadda Gaalkacyo oo shir caalami ah uga Qayb Gashay Wadanka Sweden

“Action for Somali Health Research and Development”
Statement by participants in a seminar held in Umeå, Sweden, 2-3 December 2014

Draft 9 December 2014

The seminar brought together 54 participants representing Somali universities, Swedish universities and agencies, as well as Somalis in the Diaspora.

Based on our fundamental recognition of health as a human right, we shared information about ongoing efforts to rebuild the Somali health system, and identified the needs and opportunities for national and international collaborative partnerships. Special focus was given to the role of national academic institutions in promoting health development, and to building their capacity for training and research in cooperation with Swedish agencies and institutions as well as with the Somali Diaspora.

We noted the ongoing efforts and determination to extend essential health services to communities all across Somalia, while recognising the many constraints and challenges facing the country, which include:

• The lack of trained staff, adequate infrastructure and financial resources at all levels of the health systems, as well as for academic institutions;
• The need to address the glaring health and nutrition problems of mothers and children, which also demonstrates the need for reliable community data to set priorities and evaluate programmes;
• The urgent need to provide high quality health services and, adopting a gender perspective, to give high priority to the elimination of harmful traditional practices like female genital mutilation, which are the cause of much suffering;
• The inadequate attention being paid to the social determinants of health, which are essential in efforts to achieve universal access to basic primary education, gender equity, provision of safe water and sanitation, and the safeguarding of human security and development;
• The striking lack of coordination, due to political and safety concerns, which limits the outreach and efficiency of both the health services and university systems.

With this background, we affirmed our commitment to the following:

Health services for all
• All levels in the health system, and all associated policies, need to be developed and supported so that they are accountable, of high quality, and well regulated.
• Enhanced and continuing education for all health workers, managers, and administrators is a central pre-requisite for an effective health system, and should be prioritised.
• Among other key concerns, the health services should focus on reproductive, maternal, newborn and child health and the control of communicable diseases, and they should be delivered and managed by well-trained health professionals, including a strong cadre of female community health workers.
• The direction of the health services should be guided by evidence derived from operational research, which in turn should be based on a comprehensive situational analysis of service delivery needs.

Community participation and ownership
• It is critical that the voice of the Somali people is taken into account in the provision of universally accessible and acceptable health services. Priorities should be based on situational analyses, which take the perceived health needs of the community into account, and which may require social and anthropological research. The particular needs of neglected and vulnerable populations – such as pregnant women, children under the age of 5, people with mental disorders and the disabled – should be in focus.
• The social determinants of health, particularly water and sanitation, security, food, and education, should be investigated, as should health-seeking behaviours and community health financing. It is only through such efforts that the health services will be ‘owned’ by the community, a key pre-requisite for their effectiveness and sustainability.
• The training of traditional birth attendants, community health workers (in particular women), and managers, is essential, and should be guided by lessons learned from other post-conflict settings.

Academic institutions as key actors
• The links between health research, policy and practice need to be actively nurtured. The respective actors and stakeholders in each of these spheres must work together to ensure the provision of high quality, evidence-based health services that meet the needs of the people.
• The Swedish International Development Cooperation Agency (Sida) could play a key role in revitalizing the Somali health services by defining Somalia as a priority country for research cooperation in order to create a knowledge base for policy development and to forge sustainable links between policy and action programmes in the health sector.
• In order to ensure a consistent and high quality of medical and other health professional training in the country, the educational curricula in all the Somali institutions providing such training must be harmonised. The Somali Research and Education Network (Somali-Ren) should take the lead in organising the required mapping and coordination of all the stakeholders (local as well as foreign). All academic institutions involved in training health professionals should be accredited by recognised government regulatory bodies and relevant Somali education and health authorities.
• Development of academic research capacity is required, from Bachelors through to post-graduate level. A new post-graduate sandwich training programme between Somali and Swedish academic institutions would support this process.
• Universities should engage in vocational and mid-level health professional training, so that the health needs of the community are addressed.
• A comprehensive mapping of specific research needs (learning from other post-conflict settings) is required; the establishment of a health and demographic surveillance system would provide an excellent platform for such research over the longer term.
• Sustainable research collaborations need to be built in direct support of health service delivery, with the involvement of international partners and members of the Somali Diaspora, based on long term funding commitments.

We, the participants of this meeting, commit ourselves to work for the promotion of national and international partnerships in support of health development in Somalia, and to pursue all the noble objectives delineated above towards that end. We pledge to promote health research as a key component of the national rebuilding process, to bridge the gap between knowledge and action in the country, and to contribute to developing the Somali primary health care system based on the principle of universal and equitable access to health and health care.
Somali-Swedish Action GroupSomali-Swedish Action Group

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