THE PUNTLAND STATE OF SOMALIA

MINISTRY OF HEALTH

THE HEALTH POLICY FRAMEWORK

2012 – 2007
“REPORT ON THE CONSULTATION PROCESS COORDINATED BY
THE MINISTRY OF HEALTH”

By

Prof. Khalif Bile Mohamud M.D.; Ph.D.

Table of Contents
ACRONYMS .......................................................................................................................................... 3
1. Introduction ............................................................................................................................ 4
2. The preparatory phase of the HPF Process ............................................................................ 5
3. HPF Consultations in Puntland ............................................................................................... 5
3.1. Consultation Meeting with the Health Policy Advisory Group (HPAG): ................................. 5
3.2. Consultation Meeting with the Puntland Women Organization ............................................ 6
3.3. Consultation Meeting with Representatives of Traditional Leaders ...................................... 7
3.4. Consultation Workshop for Health Partners and Health Professional Groups ...................... 8
3.5. Meeting with the Dean Medical College-East African University (EAU) ................................. 9
3.6. Consultation Meeting with the Parliament’s Social Standing Committee ........................... 10
3.7. Consultation Meeting with the Minister of Governance ...................................................... 10
3.8. Consultation Meeting with the Ministry of Education ......................................................... 11
3.9. Meeting the Director of the Puntland Development Research Centre (PDRC) .................... 12
3.10. Consultation Meeting with Garowe Pharmacists ................................................................. 13
4. Priority Setting Exercises ...................................................................................................... 13
5. Meeting with the Vice President of Puntland ...................................................................... 14
6. Courtesy Call to the President o Puntland............................................................................ 15
7. Debriefing and Final Consultation with the Minister of Health ........................................... 15
8. The Galkayo Visit and Consultations .................................................................................... 16
8.1. Consultation Meeting with the Medical Doctors’ Groups in Galkayo .................................. 16
8.2. Meeting with the Medical Community ................................................................................. 16
8.3. Galkayo Medical College ....................................................................................................... 17
8.4. Meeting the Executive Director of the Education Center for Peace and Development ....... 17
8.5. Opportunities for Harnessing Somali Diaspora Technical Support....................................... 17
9. Conclusion ............................................................................................................................ 18
10. Annexes ................................................................................................................................ 19
10.1. Main Participants in the Consultation Processes..................................................................... 19
10.2. Priority Setting Matrices .......................................................................................................... 22
10.3. Assignment Terms of Reference ........................................................................................... 24
ACRONYMS

AIDS Acquired Immunodeficiency Syndrome

DG Director General
HPAG Health Policy Advisory Group
EmONC Emergency Obstetric and neonatal Care
EAU East African University
FGM Female genital Mutilation
FINNSOM Finnish-Somali
HIV Human Immunodeficiency Virus
HPAG Health Policy Advisory Group
HPF Health Policy Framework
IOM International Organization for Migration (IOM)
MOE Ministry of Education
MIDA Migration for Development tin Africa
MOH Ministry of Health
NGO Non-Government Organization
PLWHA people living with HIV/AIDS
PUNSAA Puntland Non-state Actors Association
PSC Parliament Standing Committee
PDRC Puntland Development research Center
SHSC Somalia Health Sector Committee
SRC State Regulatory Council
UNCEF United nations Children’s Fund
UNFPA United Nations Population Fund
WHO World Health Organization
 DEVELOPMENT OF HEALTH POLICY FRAMEWORK FOR THE Puntland State of SOMALIA
“CONSULTATION PROCESSES COORDINATED BY THE MINISTRY OF HEALTH”

1. Introduction
The Puntland State of Somalia is located in the North Eastern part of Somalia and is geographically
recognized by three topographically distinct zones that include the torrid narrow Gulf of Aden
coastal strip that extends across the Cape of Guardafui to the longer coastal belt along the Indian
Ocean; the gradually rising highlands adjacent to the coastal zones of Puntland; and the savannah
sloping plateaus where most of the nomadic pastoral populations reside. Although no accurate data
are available, the size of the population in Puntland is estimated at approximately 2,700,000 million
people. The Gulf of Aden coastal communities traditionally migrate during the scorching hot months
of June, July and August to the inland, where the temperature is relatively moderate, to return later
to their original locations. However, many economically vulnerable families cannot afford the
inherent cost and stay back in these costal urban cities and rural villages. The nomadic pastoral
communities on the other hand pursue a similar predictable pattern of seasonal migration that take
place during the dry months of January, February and March of the “Diraa” season in search of
pastures and water for their animal stock to return to their traditional pastoral locations during the
“Gu” rainy season. These geographical characteristics and population movements would significantly
influence the delivery of health care services to these population groups.

In line with Somali tradition, the tribal leaders have tangible influence on the communities’ diverse
aspects of life that range from mitigating conflict situations; actively participating in peace building
processes; proactively engaging in the political and social development endeavours relevant to their
local areas of jurisdiction or collectively, when related to the wider national issues. This provides an
amble scope and opportunity for community active participation in the different social interventions
such as education, provision of safe drinking water, the establishment of community based health
interventions, and building road infrastructures.

The major economic activities in Puntland range from livestock production and the harvesting of
frankincense and their exportation. The fishing industry is still based on traditional methods and not
yet fully exploited, although a great proportion of the total marine resources of Somalia are found in
the waters of Puntland. The slow progress in fishery is related to the poor road infrastructure that
link to the coastal areas and the lack of appropriate fishing boats and cold chain storage facilities.
The state imports manufactured goods and petroleum products. Another major component of the
economy is related to the trading and services sector that include the operation of a chain of inland
road transportation fleets, the establishment of an expanded network of electronic communication
technologies and the management of shipping line companies that predominantly link the state with
the Middle East Gulf countries. The aridity due to low rainfall and high rate of evaporation has made
the land in Puntland marginal for cropping, except for limited small-scale horticulture on oases
watered by permanent springs. The Diaspora economic contribution to the Puntland society is also
prominent although a defined estimate of its volume has not been prepared. Oil exploration was
recently launched in Puntland, with a potential for economic opportunities.

The HPF process of consultation required to take account of the health implications of the above
outlined geo-social and economic diversities and alert the stakeholders to these contextual realities,
as they will influence the organization and delivery of health care services that respond to the real
and priority health needs of the population. An overriding aspect in these consultations was the
shared understanding that the HPF directions should support the provision of essential health
services that are made universally accessible, cost-effective, and affordable and of assured quality.
To generate the widest participation possible, different social and interest groups were engaged in
the process and their aspirations and concerns about the provision of health care services to the
population, making efforts to produce consistency and consensus between the views expressed
by the different consultation groups to the extent possible.

2. The preparatory phase of the HPF Process

The HPF assignment terms of reference were shared with Puntland Ministry of Health (MOH) prior
to the fielding of the consultant to enable them plan and organize the multi-stakeholder
consultations that were relevant to the health system related policy deliberations. The MOH was
prompt in preparing the required technical documentations for desk review analyses and in
formulating a multi-stakeholder Health Policy Advisory Group (HPAG). The MOH also scheduled the
holding of a range of consultations across the different social and political spectra of the Puntland
society. Upon the completion of the consultation process, the MOH facilitated HPF briefing meetings
with the Vice President and subsequently the President of Puntland, with a view to promote the
envisaged HPF at the highest political level and attain their support and commitment for the
deliberated HPF directions as these would need to be urgently sanctioned by the government and
legislative branch of the state. The latter was expected to mobilize the necessary support for
implementation spearheaded by the Puntland government.

3. HPF Consultations in Puntland

Upon the arrival of the consultant on the 22nd of March 2012, preliminary meetings were soon held
at MOH to review the planned agenda and finalize the organization of the different consultations,
ensuring the active participation of all the relevant stakeholder partners of the health sector. The
following is a concise outline of the different consultations carried out and the key contacts made
from the 23rd of March to the 1st of April, 2012:

3.1. Consultation Meeting with the Health Policy Advisory Group (HPAG):

The meeting organized by the MOH on the 23rd March 2012 was chaired by the Deputy Minister and
attended by the Director General of Health and the other members of the HPAG. The group
discussed the processes mandatory to pursue, for the different interest groups to engage and for
setting the schedules of the planned consultation meetings to undertake to develop the Puntland’s
HPF. The collection of the available technical documents and health data relevant to this exercise
were also assigned to several members of the team. The Deputy Minister and the DG Health briefed
the HPAG about the importance of the mission, constituted on the request of the Puntland MOH and
supported by WHO and the Somalia Health Sector Coordination Forum. The Deputy Minister and the
DG highlighted the relevance of this initiative in the light of the political transition that Somalia is
presently undergoing, where the health sector avails the opportunity to move from a two decades’
long humanitarian and emergency mode to an early recovery and development phase. The HPF is
envisaged to guide the development of a health strategy and associated actions plans, collectively
aimed to gear up the future health development of Puntland State of Somalia. The critical oversight
role of the HPAG in the implementation of this exercise involves the facilitation of the consultation
meetings with key stakeholder, and the subsequent HPF validation role of the HPF directions
deliberated by these groups. At this juncture the MOH stressed on its commitment for the
formulation of the HPF, which after endorsement by the Ministry and its HPAG will be submitted to
the Cabinet of Ministers chaired by the President of Puntland and to the Parliament for approval as
the principle charter for health sector development.
In his briefing outline the Consultant explained the four key attributes of any health policy, namely,
a) the content of the policy that carries the key priority areas of the health system; b) the views and
perceptions of the interest groups and stakeholders engaged; c) the context in which the policy is
being formulated and later implemented, in terms of socio-economic, environmental and
geographical framework, and d) the soundness of the pursued processes for its formulation. The
Consultant emphasized on the need to factor these important determinants into the HPF process
exercise, to uphold the relevance of this initiative and mobilize the support necessary for its
successful implementation.

Based on the above premise, consultations were to be organized with stakeholders that included
women and youth groups, the Puntland Non-state Actors Association (PUNSAA), UN agencies and
national and international NGOs, the Social Sector Standing Committee of the Parliament, relevant
line ministries, private health care providers, the Medical College leadership of the East African
University, health professional groups and regional Medical Officers of Puntland. Individual meetings
with the Vice-President of Puntland and final debriefing of the HPAG chaired by the Minister of
Health were also scheduled. The methodology of the process was also defined entailing the use of
nominal group technique with incisive deliberations on key priorities of the health sector,
encountered challenges and the exact modalities for evidence based health system strengthening.

The meeting concluded with the desire to work for a wider consultation to develop a HPF reflecting
the real priority health needs of the people and possessing the maximum political and stakeholders’
support. These consultations were also aimed to generate the capability to positively impact on the
health status of the population, especially the most vulnerable groups such as mothers and children
and the neglected large communities of pastoralist nomads.

3.2. Consultation Meeting with the Puntland Women Organization

On March 26, 2012, a meeting was organized with the women associations of Puntland to perceive
their health concerns and express what they consider to be top priorities for policy consideration.
During this consultation the following subject areas were emphasized:

The weakness of human resource capacities and the inequitable coverage of health service outlets in
the districts of Puntland as well as the insufficient number of health facilities. Emphasis were
directed to the need for standardization of the services provided by the different levels of care, and
resolve the frequent stock outs that hinder the effective utilization of these services. The group
identified the following areas as priority policy domains for the health sector:

 Recognizing maternal, neonatal and child health as top priority areas of public health,
together with mitigating the lack of transport facilities for maternal and child emergencies
referred from distant localities constituting a major impeding factor for effective care and
service utilization.
 Responding to the need of establishing specialized maternal and child health facilities and
hospitals that address the needs of these vulnerable groups
 Addressing the lack of sufficient ambulance services
 Resolving the inability of the health system to employ all the health professionals who
graduate from the training health institutions of Puntland
 Addressing the plight of many communities in the rural areas that cannot access essential
health care services due to the absence of health facilities in their areas
 Facilitating the elimination of the growing gender-based violence against women and related
impunities, this being an overly worrisome subject as well as the female genital mutilation
(FGM).
 Mitigating the lack of health care services for the large nomadic population of Puntland
whose high levels of poverty impede their access to essential care services, why a service
 delivery approach adapted to their contextual realities including mobile health teams will be
necessary to organize
 Promoting community awareness about the public norms and risks to avert the frequent
disease outbreaks during the rainy season that take a heavy toll each year
 The health care services provided to the IDPs are scarce and these underprivileged
populations deserve better care by the government
 Promoting food safety and environmental hygiene both in urban and rural localities as these
constitute major preventive factors and contribute directly to the health status and
wellbeing of the population
 Urgently acting on mental health problems that are frequent and further deteriorated by the
scarcity of adequate health services for these victims, while recognizing khat as a major risk
factor
 Addressing the women group’s expressed worries concerning the private practitioners and
their professional authenticity, underlying the need to improve health professionals and
health care services’ regulation practices
 Training female health workers for the community and midwives and female doctors for all
the districts of Puntland to improve the access and equity dimensions of the health system

3.3. Consultation Meeting with Representatives of Traditional Leaders

On March 26, 2012, a meeting was organized with several prominent and politically and socially
influential community traditional leaders. Following a briefing about the purpose of the meeting
these important personalities outlined the following remarks about the required health policy
directions in Puntland:

 The health policy direction should focus on the neglected health needs of the nomadic
pastoralist population that constitute a considerable majority in Puntland and, as well as on
the health needs of the rural and hard to reach populations of the state
 Recognizing the necessity and feasibility of community health related cost-sharing ventures,
especially with regard to the training and remuneration of female health workers for the
nomadic community, pursuing the traditional course known as “Xoola-Goyn-donating
animals”, where each member of the community could donate as per tradition an agreed upon
number of animals, usually goats to these female community based health workers
 Acknowledging the widely used traditional medicines and healing practices, as a large number
of the population still depend on these for their health care needs, making it imperative on the
government to integrate traditional medicine into the main stream of the health system and
authenticate the use of herbal medicines and other traditional practices after assessing their
safety and health advantages
 Expanding the health care delivery network in Puntland, as health facilities are limited, forcing
many patients referred from distant localities to reach with advanced stage conditions that are
serious and life threatening and often impossible to treat
 Extending health care services to the coastal areas that are being deserted, with people
migrating due to the lack of social services including education and health and with emerging
livelihood challenges that are difficult to sustain
  Improving the poor ambulance services and promoting health mobile teams to scale up access
to emergency health care and nomadic and other outreach services
 Ensuring the availability of anti-snake venom, as snake bites are frequent and presently little is
being done to effectively treat the victims, hence the need to improve the supply of these
commodities, especially during the rainy season
 Responding with urgency to the rural, nomadic and hard to reach populations health needs, as
they are not yet able to see the benefits of national governance and many are asking what
difference the government is making in addressing their basic needs including health. One of
the Traditional leaders present in the meeting recalled few poem verses recited long ago by
Mr Aden Arab, a famous Somali Poet in this respect as follows:

 Sidiibaan majaha ugu socdaa Moodhir-  I am still using my legs to march for lack of
li’diiye transport
 Sidiibaan maqaar ugu hurdaa meel la ii  I still sleep on the same mat furnished on
dhigaye the ground
 Sidiibaan miraha uga gurtaa madaxa  I continue to collect wild fruits at the upper
toomoode end of the forest
 Sidiiban martida caana geel ugu  I still cannot afford beyond honouring my
macsuumaaye guests with camel milk
 Sidiibaan marqaafyo u sitaa laba  I continue merely to wear two American
mareykaane cotton cloths
 Bal muxuu macna ah ee tiray ministarkaan  What then was the point of my electing last
doortay! time that minister!

This piece of poetry was recited as a metaphor for which most the traditional Somalis are known for,
to disseminate the strong message that governments are only relevant when they address the basic
needs of the common citizen, while in the alternative, no value is attributed to their existence or
power.

3.4. Consultation Workshop for Health Partners and Health Professional Groups

On March 27th a HPF consultation workshop was organized in the MOH, attended by a number of
health partners to deliberate upon their views and participate in a systematic and well structured
exercise organized for this purpose. The outputs of this consultation were reflected as an integral
part of the overall considerations made by the different stakeholders and interest groups that took
part in Puntland HPF consultations. The same resulted in a set of priority health problems and health
system strengthening needs that are being incorporated in the document. The key areas outlined by
the team included the following:

 Focusing on maternal, neonatal and child health along with nutrition promotion and education
 Addressing the existing inequities in the health system network and those related to the
health workforce distribution and social determinants of health with the ultimate objective of
improving health care outcomes throughout Puntland
  Assigning special importance to health promotion and education, as the public health needs of
Puntland cannot be realized without a strong and wide range public awareness dissemination
about preventive health measures that include personal and environmental health and
hygiene and without health behaviour change and their maintenance
 Establishing Basic Health Units in nomadic settings and expanding the training and deployment
of female health workers at the grassroot level providing health coverage to the nomads
 Revitalizing the large number of non-functional health posts in the different regions to
improve the delivery of essential services to the population
 Integrating the delivery of the different national programmes in terms of logistic support,
supervision and monitoring and other relevant management activities
 Improving the human resource gaps in the state through the urgent establishment of training
institutions to address this shortage, especially with regard to community midwives and mid-
level health professionals
 Establishing better coordination with and lending capacity building support to all health
training institutions including those operated by the private sector to ensure their community
oriented and community based training as well as enhancing the training of professional
groups, whose shortage is negatively affecting health system performance
 Considering the effective implementation of decentralization to the regional and district
entities of public health and improving the community role in planning, management and
delivery of health care services
 Improving the health information system and launching birth registration to better assess and
improve access levels to essential maternal and child health care services
 Strengthening the regional and district health system to raise the cost-effectiveness of health
interventions
 To improve the retention, motivation and the equitable distribution of the health workforce,
the MOH and health organizations should make a collective effort to standardize salaries and
incentives based on qualification, experience, assigned roles and responsibilities and
performance outputs.
 Enhancing intersectoral collaboration and community participation in all critical aspects of
health system development
 Improving the monitoring and evaluation of the health system to ensure evidence based
decision making and operational efficiency
 Establishing Regional and District Health Development Boards and Hospital Boards to raise the
community participatory role in the management and logistic support for the health sector
 Building public private partnerships for scaling up the scope of service delivery and improve
the quality of care

3.5. Meeting with the Dean Medical College-East African University (EAU)

The Dean of the Medical College of the EAU in Bosasso joined the health professionals’ consultation
and briefed the audience on the role of the college in human resource development, and its desire
to establish strong links with MOH and with the service delivery system. The college had its first
induction of 43 students in September 2008. Currently there are 196 students in four patches and
has a faculty staff of 15 members. The challenges being faced by the college include the shortage of
faculty and the lack of training material and teaching aids especially the skill laboratories. The
college welcomes the HPF and is looking forward for greater collaboration in the field of human
resource development for health with MOH and with the different partners assisting the health
sector.

3.6. Consultation Meeting with the Parliament’s Social Standing Committee

A meeting was organized with the Parliament’s Standing Committee (PSC) for Social Affairs within
their conference room. The committee was briefed about the development process of the HPF, the
progress achieved and the priority policy directions deliberated upon so far through the organized
consultations. The PSC for Social Affairs expected the following policy measures to be taken into
consideration:

 “Health is an area strongly supported by the parliament with the realization that an
improvement of the health care situation and population health status will have a direct
impact on the socio-economic development of the Puntland state” the PSC emphasized
 The equity dimension in the delivery of health care services to the entire population should
remain a priority area for action
 Focusing attention on maternal, neonatal and child health should remain a top priority, as
these constitute major public health concerns of the Puntland population
 The health care of the pastoralist nomads is an area yearning for action since a long time
 Acknowledging the impact that other sectors can induce on the health of the population
such as environment, water and sanitation and other social services and communication,
prompting the need for intersectoral collaboration to bring about meaningful and
integrated health development
 The quality of essential drugs is a major concern, hence the need to regulate this sector, as
the case has been for the private sector medical practices for which a Health Bill is now
being finalized by the parliament
 The community role in health and the public private partnerships need to be encouraged

At the end of the meeting the Committee promised to extend every support to the HPF and
ensure its positive consideration by the parliament in its imminent June 2012session.

3.7. Consultation Meeting with the Minister of Governance

By virtue of its cross-cutting nature, the Ministry of Governance established to promote good
governance in all the sectors across the government, bears a strong relevance to the health care
system. Accordingly a meeting was organized with the Minister to better understand the scope of
this ministry and how the lessons learned could benefit the HPF development. H.E. Mohamed Farah
Gashan, the Minister for Governance outlined the following challenges constraining the
establishment of good governance in Puntland:

 The lack of adequate financial remuneration sufficient to cover the basic needs of the
workforce is an area of major concern
 The poor accountability measures at government institutions need to be adjusted by
responsibly undertaking the required roles in managing and implementing the assigned
tasks, accepting responsibility and being answerable

The Minister outlined some of the cardinal efforts that his ministry is pursuing in different
institutions which are summarized as follows:
  Defining the results that need to be achieved by public institutions and the actions required
to attain them
 Creation of good governance radio and TV advocacy programmes founded on the motto of
“Let us jointly address our needs and shared interests” (An Isla-doonanno daneheenna),
organized through talk shows where the public can also participate through live telephone
contacts
 Controlling the ill-effects of corruption and the recognition of the international anti-
corruption day of 9th December as the national anti-corruption day
 Encouraging institutional leadership and recognizing good performers as accepted role
models and proponents of good governance
 Promoting the intersectoral collaboration as an effective good governance model that
contributes to efficiency
 Upholding monitoring and auditing techniques as essential tools for good governance
 Improving the coordination of national and international partners working with different
sectors to raise their coherence and avoid duplication of efforts, while enhancing the
effectiveness of the pursued collaborative interventions in support of Puntland

The minister appreciated the operational roles assumed by the MOH and recognized how a good
governance endeavour can benefit the translation of the HPF into a meaningful action that can
produce lasting health gains for the people of Puntland.

3.8. Consultation Meeting with the Ministry of Education

A consultation meeting was organized at the office of the Minister of Education H.E. Abdi Farah
Saeed Juha also attended by the DG of Education. The Minister was briefed on the HPF and its
intersectoral dimensions, especially in relation to the Ministry of Education. In this framework, the
school health dimensions were discussed and the important role of the Ministry of Education
outlined. The four major school health interventions include school health education, nutrition
promotion, healthy school environment and early screening and diagnosis of childhood disease with
first aid health services that are all squarely the responsibility of the MOE, except the referral and
technical support provided by the MOH. A proactive partnership between the two ministries would
provide the best possible support for the school population’s health within the jurisdiction of the
Puntland government. Following this constructive dialogue the following deliberations were made:

 The Ministry of Education acknowledges its direct role in school health promotion and
accepted the proposal of establishing a department or Unit of school health within the
Ministry that is staffed by skilled health workers liaising their interventions with the MOH and
international partners, especially the technical aspect domains of this initiative
 The need to develop a close partnership between the MOH and MOE on the planning and
implementation of school health interventions with the formation of a joint task force for this
purpose
 Improving the school level curricula of the different grades to enhance their knowledge and
skills about healthy lifestyle and nutrition
 Considering the integration of health components of school health such as health education,
nutrition education, healthy environment and health services and integrate these into the
MOE curriculum development processes
  Integrating non-formal education in the context of school health programme, where Quranic
schools are provided the due health attention and care through the collaboration between
MOH and MOE

The Minister indicated that the MOE is currently engaged in a policy development process, offering
the right opportunity to carry this initiative forward.

3.9. Meeting the Director of the Puntland Development Research Centre (PDRC)

On the 29th of March a consultation meeting was held with Dr Abdirahman Abdulle Osman (Shuke)
the Director of PDRC, a prominent non-governmental organization playing a key role in research, and
promoting the development of local peace and effective governance initiatives in Puntland. As peace
is a major determinant of health development, it was necessary to attain the perspective of PDRC on
the envisaged HPF development for Puntland. Dr Shuke welcomed the initiative and reflected how a
strong health system and attention for the burning health needs can contribute to sustainable
peace. He also outlined that although health is not part of the PDRC domains of research and action,
yet health issues are collaterally raised in all the avenues, where peace is being debated and
negotiated. The perspective of PDRC was outlined as follows

 The shortage of qualified human resources in many districts requires a policy direction for
rectifying this gap especially with regard to midwives, nurses and pharmacists
 Deliberating a policy support for strengthening the existing training institutions including
medical education especially with regard to developing competent faculty staff
 Communicable diseases such as tuberculosis and malaria raise a lot of community concern in
most of the regions of Puntland, hence they merit priority consideration
 Health promotion and education are prime areas that boost cost-effective preventive
interventions and generate positive health behaviours among the population with a focus on
personal and environmental hygiene, safe drinking water and sanitation, waste disposal and
nutrition promotion
 The establishment of mobile units will have an effective role in enhancing the care seeking
behaviour of the hard to reach populations and address their health problems through
periodic visits to their localities
 Build the professional associations operating in the health sector to create better
communication between these experts for regulating the practice and endeavouring on
shared actions that can improve the health status of the population
 Puntland is facing a serious risk in procuring counterfeit medicines and expired food
commodities with all the implications of ill-health, thus the need for the HPF to offset these
challenges
 The establishment of collaborative linkages between the health sector and the mayors of the
urban centers both at regional and district level are essential to build a local ownership and
accountability for the delivery of health services for the population
 The risk of HIV/AIDS is growing , hence the need for targeted attention with the establishment
of free and confidential screening and counselling centers in all the districts of Puntland with
support provided to people living with HIV/AIDS (PLWHA)

Dr Shuke concluded his note with a desire to extend any support possible to the health sector as
it constitutes a critical area of human development.
 3.10. Consultation Meeting with Garowe Pharmacists

To attain a close perspective about the private health sector, a meeting was held on the 29th of
March with a group owning and operating pharmacies in the Puntland capital city of Garowe. The
main objective of this meeting was to gain insight into the operational challenges that the drug
stores’ industry face in terms of business practices and assess their technical needs and perceive
their collaborative potential with the public health sector. The following aspirations in relation to the
policy direction were expressed:

 The HPF has to address the needs of the private sector and create opportunities for public
private partnership that can improve the scope, efficiency and quality of health services
 The MOH may establish an office that coordinates with the private pharmacies where the
shared concerns and issues can be discussed and solutions generated for action
 The medical practice by non-licensed professionals raises serious problems to pharmacies who
fail to place the accountability on these doubted professionals, hence the need for the
ministry to regulate the licensing of the different health professional groups
 Consider the launching of pharmacist technician courses and the organization of refresher
trainings for practicing pharmacists
 The group outlined some areas for potential public private partnerships such as the
procurement of Hepatitis B vaccines for adults, community training on first aid, regulation of
the pharmaceutical sector for greater quality and the rational prescription and use of
medicines

The group appreciated this encounter, recognizing it to be the first time when such a close
interaction had occurred and when the voice of pharmacists was considered in the domain of public
health and HPF formulation.

4. Priority Setting Exercises

During the different consultation meetings, various priority setting exercises were carried out, some
being less structured where the participants deliberated in a brain storming exercise on disease
burden and health system priorities that best address the health needs of the population. This type
of exercise was undertaken when the groups had little previous exposure to health system
technicalities and the identification of health needs was the major shared domain to which the
participants had direct experience. For the health professionals and stakeholder partners the
structured approach of priority setting was pursued, whereby, the participants were assigned to two
consecutive priority setting working sessions. In the first, the disease burden entities outlined in a
preset checklist was made the scope of the exercise, where an initial exposure to the quantitative
information about the health system was followed by a qualitative exercise, and the different sub-
groups, having two persons in each, presenting their consensus priority ranking. A cumulative
analysis of these proposals then resulted in setting a final ranking of diseases and conditions burden
priorities. The second exercise was about health system priority ranking out of a list of health system
functions for their subsequent consideration in the HPF. The final outcome of these exercises is
summarized in the table below:
Ranking of the identified priority health interventions as expressed by the participating organizations
during the stakeholders’ consultation workshop

Health Priority Requiring Policy
Support and Action
1. Neonatal, Infant, and child health
2. Casualties and other health
problems related to violent civil
conflicts and terrorist activities
3. Maternal health and adverse ill-
health effects of Female Genital
Mutilation
4. Maternal and child nutrition
5. Acute watery Diarrhoea including
Cholera and other prevalent
communicable diseases
6. Tuberculosis
7. Malaria
8. Blindness
9. Road traffic injuries
10. Mental Health and substance
abuse including Khat
consumption as a major risk
factor
11. HIV/AIDS
12. Oral and dental health problems
13. Scabies ad other skin conditions
14. Hepatitis viral infections and
chronic
15. Other non-communicable
diseases and the major risk posed
by Tobacco use
Identified Priority Interventions for Weak Health System Areas
 Human resource development with focus on community
based workers and mid-level technical staff with effective
retention schemes
 Regulation of professional associations and the private sector
and promote public private partnership and community co-
financing schemes
 Strengthen HMIS and build health system observatory
 Improving the management and leadership capacity of the
central MOH and at the regional and district level
 Introducing the essential drug list and drug regulation, quality
control and quality assurance and their effective management
and rational use
 Improve public health sector financing and enhance
efficiency and avert duplication of resource allocations
 Rehabilitation and reconstruction of the District Health System
Network
 Introducing the mobile strategy and female health workers to
reach out to the nomadic pastoralist communities and
eliminate the perennial health neglect
 Pursue the integration of the management and implementation
of the different priority health programmes to enhance access,
equity and cost-effective use
 Coordinating and standardizing the multi-stakeholder
supported health interventions to avert duplication and
improve efficiency
 Improving the scope and quality of the health information
system and advance operational research for evidence based
decision making

5. Meeting with the Vice President of Puntland

The Consultant along with Dr Duale, the Deputy Health Minister called on the Vice President H.E. Mr
Abdisamad Ali Shire in his office on the 29th March, 2012 and briefed him about the process being
pursued about the Puntland HPF and the major delineated policy directions. The courtesy call also
aimed at seeking his contribution to this initiative. The Vice-President made the following remarks:

 The initiative of embarking on a HPF is very timely and a necessary endeavour for Puntland
future health development for which the Ministry of Health deserves appreciation and support
 The government will lend full support to this initiative and impress upon the legislative branch
of the state to approve and pass this policy framework
 The Vice President commended the focus of this policy on the nomadic pastoralist health and
the other vulnerable groups of the society
 6. Courtesy Call to the President o Puntland

The Consultant along with the Minister of Health Dr Ali Abdullahi Warsame, paid a courtesy call on
the President of Puntland H.E. Abdirahman Mohamed Mohamud Farole during the evening of 29th
March, 2012 at the Presidential residence in Garowe. The President was briefed on the ongoing
effort for the development of the Puntland HPF and the processes pursued in this regard. The
President expressed his full support to this vision and commended the process of participatory
consultation. The President outlined his strong association with the health sector based on his
previous public health experience and background. He indicated his full support for the key
deliberations delineated for policy consideration and singled out the following as its flag bearers:

 Maternal, neonatal and child health and nutrition care with attention to the elimination of
gender based violence for the major public health challenge they pose
 Providing primary health care essential services to the nomadic pastoralist populations and
other vulnerable hard to reach Puntland communities
 Enhance the human resource development for health to ensure the equitable deployment of
skilled health workers to the different regions and districts of Puntland
 Provide a strong policy focus to the preventive and promotive services of public health to raise
public awareness and the Puntland communities’ active participation in the implementation of
health services
 Strengthening the health partnerships both at the national and international level

The specific remarks expressed by the President inculcated a high confidence on the available
potential support for the HPF and its future translation into operational strategy and action plans.

7. Debriefing and Final Consultation with the Minister of Health

Following the above outlined consultation rounds in Garowe, the Minister Dr. Ali Abdullahi Warsame
chaired a meeting on the 29th of March at his office, attended by the two Deputy Ministers, the
Director General and the heads of the Health Departments, in addition to other members of the
Health Advisory Group. A summary debriefing of the HPF consultations was presented and the
relevance of the different debated issues briefly outlined. The Minister commended the
participatory effort created by the initiative and reiterated his full support and commitment to all
the key recommended policy directions. The Minister outlined the following additional remarks on
the future prospects of HPF translation into action:

 The strong emphasis on the health of the nomadic pastoralists is well placed being an issue of
prime importance that the President himself has reiterated during the recent encounter. The
Minister indicated that all efforts will be made to eliminate the decades’ long neglect of the
health rights of this large population group. The Minister indicated the need to explore the
training of Female Health Workers not only for the settled villages, but for the nomads,
drawing practical lessons from the Quranic teachers who are embedded with the nomadic
groups who live with them and follow them during their seasonal migration between grazing
lands
 The Minister also reiterated the need for human resource development for the health sector
and outlined his commitment to launch a number of training programmes as an offshoot of
 this HPF that include clinical officers, additional midwifery and nursing courses and other
critical midlevel health professionals
 The establishment of human development centers in each province will be an initiative that
will substantiate the commitment of the Puntland government on scaling up the production
and quality of the health workforce
 The Minister emphasized on the need for the public sector to enhance its allocation for the
health sector and work closely with health partners to strengthen the Aid-Effectiveness and
the implementation of the principles outlined in the Paris Declaration of 2005 as this will
inculcate high levels of trust in the value and efficiency of these forged partnerships.
 The Minister stressed on the result based management approach for the health interventions
carried out by MOH and/or its partners, where the outcomes derived from the HPF
implementation will be clearly identifiable and quantitatively measured

8. The Galkayo Visit and Consultations

8.1. Consultation Meeting with the Medical Doctors’ Groups in Galkayo

The short visit of the Consultant to Galkayo was extremely fruitful as it elicited the support and
facilitation provided by the Puntland MOH and the valuable assistance offered by Prof Mahamed
Jama Salad, a veteran Neuro-surgeon and a health leader in the Mudugh region. Through his
facilitation it was possible to have a visit to Galkayo General Hospital and witness the outstanding
work that a group of national professionals are successfully performing. A similar visit was also paid
to the Orthotic Center supported by the Somali Red-Crescent Society, backed by the International
Federation of the Red Cross and Red Crescent Societies. The center is providing exceptional support
to persons affected by a range of disabilities. The majority of the clients are very poor, reflecting the
extreme value of this service.

8.2. Meeting with the Medical Community

On the 31st of March a meeting was organized at the Luxury Hotel of Galkayo attended by the
medical doctors and specialists serving in the Galkayo general Hospital. The group was briefed about
the HPF and the role of the health professionals in translating it into action. The group outlined the
following areas for consideration:

 An urgent need to provide skill training for all the professional groups in the hospital to enable
them acquire additional capacities of medical and surgical knowledge and to train the mid
level cadre through the establishment of the necessary training programmes
 Scaling up maternal, neonatal and child care services in the region, specially at district level
and providing training on advanced surgical skills on EmONC to local gynaecologists as these
skills are not comprehensively yet acquired and hence the dependency on expatriates
 Paying special attention to communicable diseases with enhanced disease surveillance, control
of tuberculosis and to the growing risk of HIV/AIDS infection in the region
 Mental health problems constituting a major and growing burden in the region as everywhere
else in the country, and Khat being a major risk factor, hence the need to set relevant policy
directions for this social hazard
 8.3. Galkayo Medical College

A visit was organized to meet with the third year medical students of the nascent Galkayo Medical
College that is one of the four colleges affiliated with the Puntland University of Sciences &
Technology. Although tangible teaching staff is available, the founder and Dean Prof. Mohamed
Jama Salad, the faculty team and the students were all enthusiastically committed to advance
medical education in this region. Prof M.J. Salad acknowledged the need for, additional efforts to
effectively promote the organization of this university and its affiliated medical college. The Dean
reflected the need for the Puntland HPF to direct special attention in support of medical and health
professional training institutions. The Consultant advised the college to update its educational
prospect and link with the MOH and MOE for greater partnership and cooperation in the fields of
human resource development.

8.4. Meeting the Executive Director of the Education Center for Peace and
Development

A meeting was organized on the 31st of March with Madame Hawa Aden Mohamed at Galkayo
Education Center for Peace and Development (GECPD). The center is extremely relevant to the
health sector as this institution is a community-based organization offering exemplary primary and
vocational education programmes for impoverished, displaced, and minority women and girls. The
center works within the community to promote women’s rights, including the eradication of gender-
based violence and female genital mutilation. An opportunity was provided to the Consultant to visit
the different specialized compounds that were instituted by the center, performing a range of
vocational training, where the production is donated to the trainees for possible engagement in
future income generating activities. The Director, a prominent Somali Women’s Rights Activist was
conferred upon with numerous international awards, the last being the Roger Baldwin Award in New
York, in recognition of her work with Women and Girls affected by Violence.
Following a briefing about the HPF, Madam Hawa Aden envisioned “the potential collaboration with
the health sector, where health literacy programmes for the thousands of women being trained by
the center would have a lasting impact on maternal and child health and nutrition”.

Indeed, the GECPD is an island of success, reflecting how a selflessly committed and devoted woman
leader singlehandedly envisioned the need for establishing this center and enabled it to grow to a
model institution, evolving as a national symbol of perseverance, where her drive to act and
continue on this noble course flourished into a success story and a valuable message of
humanitarian cum development accomplishment that resonated around the World and gained
recognition. The government of Puntland and international partners have to support the replication
of this initiative in other regions of Puntland and Somalia in General to meaningfully raise women’s
voice and improve basic human rights to women. The MOH should build a solid alliance with GECPD
to anchor health promotion messages and health literacy programmes to this grand initiative.

8.5. Opportunities for Harnessing Somali Diaspora Technical Support

The project for the Migration for Development in Africa (MIDA) was first launched by the
International Organization for Migration (IOM) in 2001 as a capacity-building programme that helps
to mobilize competencies acquired by African nationals abroad for the benefit of Africa’s
development. The MIDA FINNSOM was recently launched, where the temporary returns of Somali
professionals from Finland were supported and a vanguard group already placed in Somali land and
Puntland. Up to 50 health professionals will be selected over the next three years to carry out field
assignments for up to 12 months or more. The first patches of these professionals are currently
working with the health sector and are making significant contributions to the programmes to which
they were assigned. This is indeed a highly relevant and cost-effective initiative that can make
significant contributions to human resource gaps in the health sector. As MIDA FINNSOM is a need
based initiative, local capacities for the effective identification of the professional skills required,
planning, recruitment and deployment of these professionals need to be established and proactively
organized.
The Puntland MOH may attract Diaspora professionals irrespective of their native original localities
in Somalia, provide special support to these professionals and cover priority fields such as: human
resource training at national institutions; planning and management officers; medical, nursing and
midwifery professionals and other allied health sciences, specialists in information technology to
guide and assist the Health and Management Information System and disease surveillance; logistic
experts to help emergency preparedness and EPI cold chain management; communication
specialists to support the health promotion and education initiatives of the health sector and
facilitate intersectoral action; anthropolologists that can link community based health interventions
with the prevailing social and cultural norms and gender experts to advance the role of MOH
programmes targeting women health interventions. The MOH may also ask for experts deputed for
short assignments of 2-4 weeks in which Somali and/or expatriate specialists are fielded for the
provision of training cum medical specialized care of pre-planned interventions. The latter can be
based on the experience already matured with the MOH such as those successful interventions of
Cleft lips and Cleft Palates plastic surgeries organized through external visiting expert teams. Other
development partners may also be encouraged to launch similar programmes at a wider scale, to
build a meaningful capacity development support in the different priority areas of the health system.

9. Conclusion

The Puntland Ministry of Health has taken the lead in putting together a set of organizational
processes and built series of credible and widely participatory procedures allowing the critical
review of the available quantitative data of the health system, followed by a qualitative analysis
and group discussions on priority setting exercises joined by the stakeholders of the health
sector. The participants in these consultations shared their diverse views, experiences and policy
aspirations for developing a practical and need based HPF. To ensure its legitimacy, the process
was led and guided by the national health authorities and recognized the roles of the different
line departments, the development partners and private sector entities whose operational
mandates directly influence health sector outcomes. These consultations covered in addition to
the MOH senior policy makers and staff, the Puntland Health Policy Advisory Group, health
professionals, national and international health partners’ focal points, civil society organizations,
parliamentarians, traditional leaders, line departments relevant to social determinants of health,
The Vice President and The President of Puntland. These processes were successfully concluded
with the development of a HPF that encompasses the contributions of the participating
organizations and holds their commitment to the final HPF deliberations and its subsequent
translation into action.
10. Annexes

10.1. Main Participants in the Consultation Processes

Health Policy Framework Advisory Group

SN Name Title E-mail

1 Dr Mohamed Hersi Duale Vice Minister of Health mohamedhduale@gmail.com

2 Dr Abdirizak Hersi Hassan Director General of Health Abdirizak30@yahoo.com

3 Abdirizak Abshir Hersi Director PHC Garka99@yahoo.com

4 Abdirizak Hassan Issa Director of planning Abdirisaak20@gmail.com

5 Dr Abdinasir Osman Isse Health Partner Focal Point Aisse1@hotmail.com

6 Dr Khalif Bile Consultant Drkhalif.bile@gmail.com

7 Husssein Abdirahman Isse Health partner Focal Point wiiteeye@gmail.com

8 Dr Abdirizak Mohamed Ali Health partner Focal Point Ama992003@yahoo.com

9 Mrs Suad Mohamed Barre WHO Suad.bdn@gmail.com

 NON STATE ACTORS PARTICIPANTS LIST FOR THE HEALTH POLICY DEVELOPMENT PROCESS IN
Puntland

S.NO PARTICIPANTS NAMES PLACE OF WORK

1 Warsame Arshe Farah PUNSA BOD
2 Muhubo Ali Hussein NABADO NGO SOOL
3 Ardo Saeed Mohamud Haji Abdi Nursing School
4 Shukri Ahmed PUNSA Member
5 Halimo Mohamed PMWD NGO
6 Hussein Abdirahman Consultant
7 Abdikarim Noor SYSA NGO
8 Mohamed Yusuf Muse PUNSA Member
9 Mustafe Yusuf Ali NRDO NGO
10 Khalif Bile Consultant
11 Abdirizak Abshir Hersi MOH
12 Abubakar Sh Ahmed WHO
13 Mohamed Hersi Duale MOH
14 Mohamed Dahir Yusuf PUNSA
15 Maryan Hussein Duale Haji Abdi Nursing School
16 Sahro Abdishakur Haji Abdi Nursing School
17 Fardowso Ali Abdalle Haji Abdi Nursing School
18 Ikram Khalid Ali Haji Abdi Nursing School
19 Sumayo Mohamed Abdi Haji Abdi Nursing School
20 Ardo Abdisalam Isse Haji Abdi Nursing School

PARTICIPANT LIST FOR THE CONSULTATION MEETING WITH THE PARLIAMENTARIANS and NSA

25th March 2012

SN Name Title
1 Abdirashid Mohamed Hersi Speaker
2 Mohamed Ali Guuled Chairman of the economic sector standing committee
3 Ali Jama Farah Chairman of the social sector standing committee
4 Farah Jama boos Chairman of the international cooperation committee
5 Abdiweli Muse Shire MP
6 Ismail Abdi Abdile MP
7 Muse Warsame Omar MP
8 Aideed Mohamed Osman MP
9 Ismail Mohamud Warsame Secretary general of the parliament
10 Said Khalif Muse MP
Community Traditional Leaders participating in the HPF Consultation Process

1. Garaad Abdullahi Ali Eid Tribal Chied (Garaad)

2. Suldaan Said Ali Osman Tribal Chief (Sultan)
3. Aaqil Mohamed Suleyban Ahmed Tribal Chief (Aaqil)
4. Shekh Ahmed Shekh Omar- Law Expert
 10.2. Priority Setting Matrices
Major Health Problems and their Priority Ranking Using Selected Standard Attributes

Priority areas needing supportive health action Adequacy of Problem Urgency of Ensuring Proposed Technical, Promotion Total Score
available magnitude the action greater solution Socio-economic of
knowledge and severity coverage & efficient & & political partnership
to equity cost- conduciveness building
effectiveness

Maternal, Neonatal, child and maternal health

and nutrition
 Infant, neonatal and child health
 Maternal health
 Maternal and child nutrition
Communicable diseases
 Tuberculosis
 Malaria
 HIV/AIDS
 Cholera
 Scabies ad other skin conditions
 schistosomiasis
 Hepatitis viral infections
Non-communicable Diseases
 Cardiovascular diseases
 Diabetes
 Cancer
 Prevention of blindness
 Mental Health
 Oral health
Injuries
 Violence civil conflicts and terrorism
 Road traffic injuries
Health Risks
 Tobacco use
 Khat
 Female Genital Mutilation
 Health system Capacity Ranking and Suggested Action Solutions to Respond Effectively to the Set Priority Ranking

Prioritization of Health System Components Needs measurement Solutions: priority actions to carry out
Satisfactory Weak Very poor Absent score Action 1 Action 2 Action 3
1. Delivery of health services
Health facilities’ infrastructure
Community health workers/village H. Posts
Health centers/MCH centers
District hospitals
Tertiary care hospitals
Programmes:
TB DOTS
Malaria control
HIV/AIDS control
IMCI
EPI
Disease surveillance & epidemic control
Joint health and nutrition programme
2. Health Workforce
Training
Deployment
Remuneration
Retention
Doctors
Dentists
Pharmacists
Nurses/Midwives
Other health professionals
3. Health information
Data regularly generated
Analyzed and disseminated
Used for decision making
4. Medical products, vaccines and technologies
Regulation of essential drug list
Sufficient cold chain capacity
Health technologies standardized per facility
Standard medicines provision as per facility level
5. Sustainable financing and social protection
Raising additional funds for the health sector
User fee guidelines
User fee exemptions for the poor
6. Leadership and governance
Mechanism for health sector coordination
Plan for managerial capacity building
Oversight system & regular supervision plan
Heal related laws/legislation
10.3. Assignment Terms of Reference

Context: Somali Health Sector Strategic Planning Process

Preliminary step: Definition of Health Policy directions for Central South Somalia
(TFG MoH) and Puntland (Puntland MoH)

Terms of Reference for the Health Policy Advisor (Puntland and Central South Somalia / TFG)

Program Title: Joint Health and Nutrition Programme (JHNP, UNFPA, UNICEF and WHO)

Level: Senior Consultancy (P5), linked to a strategic planning team.

Location: Somalia, Mogadishu and Garowe

Duration/Start: Approximately 4 weeks, starting ASAP (March, 2012)

Purpose of consultancy

Support the MoH in Puntland and Central South Somalia in the definition of health policy directions, based on relevant
background documents and on existing drafts.

In early 2012 the Somali health authorities are embarking on a joint- planning process to develop three context specific
national health strategies for Somaliland, Puntland and Central South Somalia/Transitional Federal Government. Strategic
and transitional plans are required as part of health system strengthening activities. The development of such plans is
supported by the inception phase of a new joint health and nutrition programme (JHNP) with UNICEF, UNFPA and WHO
and partners.

As the background for the definition of National Strategic Plans for the health sector, Somaliland has recently revised its
National Health Policy, Puntland has a draft Health Policy document and the concept note for its further definition, while
Central South Somalia makes reference to broader documents, the Somali Constitution and the current Somali Transitional
Charter. For the purpose of defining adequate Health Sector Strategic Plans, there is need to have simple and agreed policy
directions for Puntland and for Central South Somalia.

Brief description of tasks/ deliverables

Under the supervision of WHO and working in close collaboration with the Somali Health Authorities, the Health Sector
Coordination Office, UNICEF, UNFPA and Health Partners, the Health Policy Advisor will support the definition of policy
directions: in Mogadishu, for Central South Somalia, with the TFG MoH, in Garowe, for Puntland, with the Puntland MoH.
Expected deliverables include:

 TFG MoH Health Policy Directions (a brief – max 12 pages - policy document)
 Endorsed consultation report documenting the process in Mogadishu (max 10 pages)
 Puntland MoH Health Policy Directions (a brief – max 12 pages - policy document)
 Endorsed consultation report documenting the process in Garowe (max 10 pages)
 Recommendations on strategic planning process (max 10 pages).

The Health Policy Advisor will have four weeks to complete the assignment, according to the schedule proposed below.
Within the proposed timeframe, the details can be better defined with the respective MoH.

The consultation with relevant officer within the MoH and the arrangement of workshop with other stakeholders will be
the responsibility of the MoH, supported by the local WHO office.
Activity Location Time Product

Desk review of background documents for Somalia TFG MoH - 3 days Outlines and
references

Consultation with TFG MoH – 2 days office work Mogadishu 2 days 1st draft policy
directions

Consultation with other TFG Ministries – 1 day workshop Mogadishu 1 day Notes

Consultation with Somali Civil Society and Private sector – 1 day workshop Mogadishu 1 day Notes

Broader consultation with partners (UN, Donors, NGOs) – 1 day workshop and Mogadishu 1 day Notes
email circulation

nd
Consolidation on inputs and definition of policy directions – 2 days office work. Mogadishu 1 day 2 draft policy
with TFG MoH directions

Desk review of background documents for Puntland MoH - 3 days Outlines and
references

Consultation with Puntland MoH – 2 days office work Garowe 2 days 1st draft policy
directions

Consultation with other Puntland Ministries – 1 day workshop Garowe 1 day Notes

Consultation with Puntland Civil Society and Private sector – 1 day workshop Garowe 1 day Notes

Broader consultation with partners (UN, Donors, NGOs) – 1 day workshop and Garowe 1 day Notes
email circulation

nd
Consolidation on inputs and definition of policy directions – 2 days office work. Garowe 2 days 2 draft policy
with Puntland MoH directions

Finalization of the two documents of Health Policy directions, final consultation - 8 days Final deliverables
and approval by the respective MoHs.

Required qualifications, skills, experience

 Advanced relevant tertiary qualifications;

 At least 10 years of progressive responsibility in policy development and strategic planning within the health
sector, at national and international level;
 Proven experience in capacity building approaches working with high level government bodies; capacity to build
consensus among different stakeholders.
 Strong analytical, negotiating, communication and advocacy skills;
 Ability to work in a complex international and multicultural environment;
 Knowledge of Somali context or similar conflict affected/ transitional environments
 Excellent knowledge of standard computer applications and presentation tools; and excellent command of
written and spoken English required.
 Somali language skills would be an asset.

How to apply:

Qualified candidates are requested to submit a cover letter, a CV and P 11 form (which can be downloaded from the WHO
website at WHO provide link to xxxxxxx with subject line xxxx by xxxx . The selection process for shortlisted candidates
may involve a written assay.
Background Documents (to be completed)

- The Constitution of the Somalia Republic, 1960 www.somalilaw.org/Documents/Constitution1960.pdf

- Somali Transitional Charter. Transitional Federal Charter for the Somali Republic (2004) www.somali-
jna.org/downloads/Transitional%20Feneral%20Charter%20English%20version.doc
- 2010 Millennium Development Goals Progress Report – Somalia
- UNSAS United Nations Somalia Assistance Strategy
www.unctsom.org/documents/United%20Nations%20Somali%20Assistance%20Strategy.pdf
- EPHS - Essential Package of Health Services.(2009) http://www.unicef.org/somalia/SOM_EssentialpackageReport_2-
WEB.pdf
- CCS – Country Cooperation Strategy for WHO and Somalia – 2010 – 2014
www.emro.who.int/somalia/pdf/CCSSomalia.pdf
- RDP – Somali Reconstruction and Development Programme (2007). www.somali-
jna.org/index.cfm?module=ActiveWeb&page=WebPage&s=rdp_implementation_i or http://www.somali-jna.org