The Somali Health and Demographic Survey 2020 Indicators for the COVID-19 Response MINISTRY OF HEALTH AND HUMAN SERVICES Mudug Region | June 2020

Why Risk Factors Matter Population characteristics People with risk factors may be more likely to need Population under 5: 26.5% hospitalization or intensive care if they have COVID-19, or Schoolgoing children aged 6-17: 37.6% they may be more likely to die of the infection. Population aged 60+: 4.9% Population aged 65+: 3.3% Composite list of risk factors for Population aged 80+: 1.3% Access to media COVID-19 mortality Population with access to radio: 21.8% Gender Distribution: Population with access to television: 11.0% Male: 46.8% Female: 53.2% Population with access to mobile: 68.6% Elderly pop (%) 5

Household characteristics Households headed by persons aged 60+: 20.3% Stunted children (%) 24 Households headed by persons aged 65+: 11.1% Households headed by persons aged 80+: 3.7% Households with 1 room for sleeping: 57.4% Households with 6 or more household members: 60.4% Households with children under 5: 23.0% Chronic diseases, disability and tobacco use Wasted children (%) 8 Households with household members aged 65+: 3.3% Household members with at least one chronic disease: 5.1% Household with access to electricity: 30.4% Household members who smoke cigarette or use tobacco: 3.3% Population with a basic handwashing facility: 8.2% Disabled persons: 4.9% Population with a limited handwashing facility: 48.0% Underweight children (%) 32

Time to obtain drinking water (round trip): Water on premises: 60.7% <30 min: 15.8% 30+ mins: 22.1% Unknown: 1.5% Pregnant women (%) 17

Water not available for at least one full day in the past two weeks: Obese women (%) 10 Not available for at least one full day: 37.3% Gender-based violence Available throughout: 62.4% Ever married women aged 15-49 who have ever experienced different Don’t know: 0.3% forms of violence: 14.2% Persons with chronic disease (%) 5

Child health and nutrition Children with stunted growth: 23.6% Wasted children: 8.4% Persons who smoke (%) 3 Underweight children: 31.6%

Maternal health and nutrition Access to health care Disabled persons (%) 5 Women aged 15-49 currently pregnant: 16.5% Households with members who have health insurance Women aged 15-49 that are obese: 10.3% policy: 0.3%

Risk score out of 900 109 COVID-19 Vulnerability Mapping by 4. COVID-19 Cases COVIDRisk Factors-19 Vulnerability Mapping by T4.here COVID were -3319 and Cases 13 confirmed cases of COVID-19 in Risk Factors Gaalkacyo North and South respectively as of first week of Gaalkacyo Town, Mudug Region JuneThere 2020 were. 33 and 13 confirmed cases of COVID-19 in Gaalkacyo North and South respectively as of first week of JuneGaalkacyo 2020 Town, Mudug Region BelowJune 2020 are. curves showing the cumulative count of cases in Mudug region, and States. 1.June Introduction 2020 Below are curves showing the cumulative count of cases in Mudug Cumulativeregion, Puntland count and of casesGalmudug and deaths States in. Mudug Gaalkacyo1. Introduction town falls in the region of Mudug in . It is Confirmed cases Active cases divided into Gaalkacyo North and Gaalkacyo South. Gaalkacyo Cumulative count of cases and deaths in Mudug NorthGaalkacyo falls town under falls the in thePuntland region ofState Mudug of inSomalia Somalia., whileIt is ConfirmedRecovered cases ActiveDeaths cases dividedGaalkacyo into South Gaalkacyo falls under North the and Galmudug Gaalkacyo State South. of Somalia. Gaalkacyo 5 North falls under the Puntland State of Somalia, while Recovered Deaths 5 2.Gaalkacyo Risk SouthFactors falls under the Galmudug State of Somalia. 4 A. Household Density 2. Risk Factors 4 The A.household Household density Density was generated from data on dwelling 3 structures obtained from The Somali Health Demographic The household density was generated from data on dwelling 3 Survey (SHDS) by the use of Kernel Density, a spatial analysis 2 toolstructures in ArcGIS. obtained The toolfrom calculates The Somali the numberHealth ofDemographic households perSurvey unit (SHDS) area (sq. by km). the use of Kernel Density, a spatial analysis 2 tool in ArcGIS. The tool calculates the number of households 1 Areasper unit with area high(sq. km).household density and limited access to sanitation and health facilities are considered more vulnerable 1 toAreas the riskwith of highspread household of COVID -density19 infections and . limited access to 0 COVID-19 Vulnerability Mappingsanitation and health by facilities Risk are considered Factors more vulnerable 0 to theB. risk Sites of spread for Int ofernally COVID -Displaced19 infections Persons. Gaalkacyo Town, Mudug Region | June 2020 MINISTRY OF HEALTH AND As GaalkacyoB. Sites hostsfor Int internallyernally Displaceddisplaced personsPersons ( IDPs), data Data source: HDX HUMAN SERVICES used on IDPs was obtained from the Camp Coordination and 1. Introduction areAsCamp close Gaalkacyo M anagementto each hosts other. ( CCCMinternally There) 2019 isdisplaced anda vegetable partners persons onmarket the(IDPs ground. close), data to Data source: HDX Below is a representation of the number of confirmed cases in used on IDPs was obtained from the Camp Coordination and Cumulative count of cases and deaths in Galmudug the border of Gaalkacyo North and South. GalmudugBelow is a representationand Puntland Statesof the numberof Somalia: of confirmed cases in Active cases, recoveries and deaths Gaalkacyo town falls in the region of Mudug in Somalia. It is TheCamp m Majorityanagement of IDPs (CCCM in ) Gaalkacyo2019 and partnersoriginate on from the ground. Mudug, Confirmed cases Active cases Cumulative count of cases and deaths in Galmudug Galmudug and Puntland States of Somalia: divided into Gaalkacyo North and Gaalkacyo South. Gaalkacyo It isMiddle important Shabelle, to identify Banadir, the Hiraanmarkets and and Bay bus regions stations (Shelter in order Recovered Deaths Galmudug Puntland ClusterThe m ajoritySomalia of 2014). IDPs in Gaalkacyo originate from Mudug, North falls under the Puntland State of Somalia, while Gaalkacyo 120 Confirmed cases Active cases Confirmed cases in Galmudug and Puntland 1 to Middlecome upShabelle, with proper Banadir, mitigation Hiraan plansand Bayto curb regions the spread(Shelter of 6 Recovered Deaths Dhusamarreb 1 South falls under the Galmudug State of Somalia. COVID-19.ThereCluster were Somalia 33 2014).IDP camps in Gaalkacyo North—of the total 120 Deaths population, 41% were males and 59% were females. 100 1 GaalkacyoThere were South 33 IDP had camps 48 IDP in campsGaalkacyo—48% North and— 52%of the of total the 100 Gaalkacyo South 13 2. Risk Factors individualspopulation, are41% male swere and femalemaless respectivelyand 59% (CCCMwere 2019).female s. 80 3. GaalkacyoHealth Facilities South had 48 IDP camps—48% and 52% of the Bossaso 27 Recovered 14 55 individuals are males and females respectively (CCCM 2019). 80 A. Household Density HealthIDP sitesfacilities are areextremely crucial invulnerable carrying outto theCOVID-19 spread tests,of COVID isolating-19 60 Gaalkacyo North 33 due to the congested nature of their shelters and limited The household density was generated from data on dwelling infected people and treating symptomatic patients. Qardho accessIDP sites to are saniextremelytation vulnerableresources. toIDPs the spreadalso ofdepend COVID -19on 60 34 40 Active structures obtained from The Somali Health Demographic Survey Therecommunaldue areto twothe, shared isolationcongested facilities centres nature in intheof Gaalkacyo theircamps, shelters further North and andincreasing limited South, Cadaado 51 Data source: WHO 97 202 access to sanitation resources. IDPs also depend on Cases (SHDS) by the use of Kernel Density, a spatial analysis tool in withthe capacities risk of spread of 20 of thebeds COVID and- 1719 virus.beds respectively, (Ministry 40 Garowe 85 communal, shared facilities in the camps, further increasing 20 ArcGIS. The tool calculates the number of households per unit of theHealth riskC. (MOH)ofBus spread Stations Somalia). of the and COVID Markets-19 virus. Data source: WHO 20 area (sq. km). An equitable distribution of well-equipped health facilities is vital 0 Bus stationsC. Bus and Stations markets and tend Markets to be high-risk areas due to the Areas with high household density and limited access to sanitation for the testing, treatment and control of COVID-19. high influx of people. Bus stations in Gaalkacyo town are 0 The number of active cases, recoveries and deaths for and health facilities are considered more vulnerable to the risk Bus stations and markets tend to be high-risk areas due to the closely located. Some passengers use the bus stations to Galmudug and Puntland States is shown below: of spread of COVID-19 infections. connecthigh influx to otherof people. parts Bofus Somalia.stations Mostin Gaalkacyo of the markets town are in 4. closelyCOVID-19 located Cases. Some passengers use the bus stations to Data source: HDX 4.GaalkacyoCOVID town-19 areCases close to each other. There is a vegetable COVID-19 Vulnerability Mapping by marketconnect closeto other to the parts border of ofSomalia. Gaalkacyo Most North of andthe South.markets in The number of active cases, recoveries and deaths for Galmudug There were 33 and 13 confirmed cases of COVID-19 in Gaalkacyo Data source: HDX Risk Factors Gaalkacyo town are close to each other. There is a vegetable Cumulative count of cases and deaths in Puntland and Puntland States is shown below: B. Sites for Internally Displaced Persons NorthThereItmarket is andimportantwere close South 33 to to therespectivelyand identify border 13 theconfirmed of marketsasGaalkacyo of first casesand North weekbus of and stations ofCOVID JuneSouth. in -192020. order in As Gaalkacyo hosts internally displaced persons (IDPs), data Gaalkacyoto come upNorth with properand South mitigation respectively plans to ascurb of thefirst spread week of of Below is a representationCumulativeConfirmed count of the casesof casesnumber and deathsof confirmed Activein Puntland cases cases in Active cases, recoveries and deaths Gaalkacyo Town, Mudug Region BelowJuneIt is 2020 importantare . curves to identifyshowing the the markets cumulative and bus count stations of incases order in used on IDPs was obtained from the Camp Coordination and COVID-19. Galmudug and Puntland States of Somalia: Mudugto come region, up with Puntland proper mitigationand Galmudug plans to States. curb the spread of 300 ConfirmedRecovered cases ActiveDeaths cases Galmudug Puntland Camp Management (CCCM) 2019 and partners on the ground. June 2020 BelowCOVID3. Healthare-19. curves Facilities showing the cumulative count of cases in Confirmed cases in Galmudug and Puntland 1 300 Recovered Deaths 6 The majority of IDPs in Gaalkacyo originate from Mudug, Middle Mudug region, Puntland and Galmudug States. Dhusamarreb250 1 Health3. Health facilities Facilities are crucial in carrying out COVID-19 tests, Deaths 1.Shabelle, Introduction Banadir, Hiraan and Bay regions (Shelter Cluster isolatingCumulative infected peoplecount ofand cases treating and deathssymptomatic in Mudug patients. Galdogob250200 1 Somalia 2014). Health facilities are crucial in carrying out COVID-19 tests, Gaalkacyo town falls in the region of Mudug in Somalia. It is Confirmed cases Active cases Gaalkacyo South 13 divided into Gaalkacyo North and Gaalkacyo South. Gaalkacyo isolatingThere are infected two isolation people centres and treating in Gaalkacyo symptomatic North patients. and South , 200150 There were 33 IDP camps in Gaalkacyo North—of the total Bossaso 27 North falls under the Puntland State of Somalia, while with capacitiesRecovered of 20 beds and 17 beds Deathsrespectively, (Ministry Recovered 14 55 150 Gaalkacyopopulation, South 41% fallswere under males the and Galmudug 59% were State females. of Somalia. Gaalkacyo 5Thereof Health are ( twoMOH isolation) Somalia). centres in Gaalkacyo North and South, Gaalkacyo100 North 33 South had 48 IDP camps—48% and 52% of the individuals are with capacities of 20 beds and 17 beds respectively, (Ministry 100Qardho50 34 2.males Risk and Factors females respectively (CCCM 2019). Anof Health equitable (MOH distribution) Somalia). of well-equipped health facilities is Active 4 Cadaado 51 Data source: WHO 97 202 A. Household Density vital for the testing, treatment and control of COVID-19. 500 Cases IDP sites are extremely vulnerable to the spread of COVID-19 An equitable distribution of well-equipped health facilities is Garowe 85 Thedue householdto the congested density nature was generated of their shelters from data and limitedon dwelling access 3vital for the testing, treatment and control of COVID-19. 0 Data source: WHO structuresto sanitation obtained resources. from IDPs The also Somali depend Health on communal, Demographic shared

Survey (SHDS) by the use of Kernel Density, a spatial analysis 2 Data source: HDX toolfacilities in ArcGIS. in the camps,The tool furthercalculates increasing the number the riskof households of spread of the COVID-19 virus. The number of active cases, recoveries and deaths for per unit area (sq. km). Data source: HDX 1 Galmudug and Puntland States is shown below: Areas with high household density and limited access to sanitationC. Bus Stations and health and facilities Markets are considered more vulnerable to the risk of spread of COVID-19 infections. 0 Bus stations and markets tend to be high-risk areas due to the highB. influx Sites of forpeople. Int ernallyBus stations Displaced in Gaalkacyo Persons town are closely located. Some passengers use the bus stations to connect to As Gaalkacyo hosts internally displaced persons (IDPs), data Data source: HDX usedother onparts IDPs of wasSomalia. obtained Most from of the the markets Camp Coordination in Gaalkacyo and town Camp Management (CCCM) 2019 and partners on the ground. Cumulative count of cases and deaths in Galmudug The majority of IDPs in Gaalkacyo originate from Mudug, Confirmed cases Active cases , Banadir, Hiraan and Bay regions (Shelter Recovered Deaths Cluster Somalia 2014). 120 There were 33 IDP camps in Gaalkacyo North—of the total population, 41% were males and 59% were females. 100 Gaalkacyo South had 48 IDP camps—48% and 52% of the individuals are males and females respectively (CCCM 2019). 80

IDP sites are extremely vulnerable to the spread of COVID-19 60 due to the congested nature of their shelters and limited access to sanitation resources. IDPs also depend on communal, shared facilities in the camps, further increasing 40 the risk of spread of the COVID-19 virus. 20 C. Bus Stations and Markets 0 Bus stations and markets tend to be high-risk areas due to the high influx of people. Bus stations in Gaalkacyo town are closely located. Some passengers use the bus stations to connect to other parts of Somalia. Most of the markets in Gaalkacyo town are close to each other. There is a vegetable Data source: HDX market close to the border of Gaalkacyo North and South. Cumulative count of cases and deaths in Puntland It is important to identify the markets and bus stations in order to come up with proper mitigation plans to curb the spread of Confirmed cases Active cases COVID-19. 300 Recovered Deaths 3. Health Facilities 250 Health facilities are crucial in carrying out COVID-19 tests, isolating infected people and treating symptomatic patients. 200

There are two isolation centres in Gaalkacyo North and South, 150 with capacities of 20 beds and 17 beds respectively, (Ministry of Health (MOH) Somalia). 100

An equitable distribution of well-equipped health facilities is 50 vital for the testing, treatment and control of COVID-19. 0

Data source: HDX COVID-19 Vulnerability Mapping by Risk Factors Gaalkacyo Town, Mudug Region June 2020

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