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Puntland Report 2020 Somali Health and Demographic Survey The information contained in this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior permission but with acknowledgement of this publication as a source. Suggested citation: Puntland Statistics Department, Puntland State of Somalia. The Puntland Health and Demographic Survey 2020. Additional information about the survey can be obtained from: Puntland Statistics Department, Ministry of Planning, Economic Development and International Cooperation, Puntland State of Somalia. Email: [email protected] Website: http://www.mopicplgov.net https://www.moh.pl.so http://www.pl.statistics.so Telephone no.: +252 906796747 or 00-252-5-843114 Social media: https://www.facebook.com/mopicpl https://www.facebook.com/ministryOfHealthPuntlamd/ https://twitter.com/PSD_MoPIC This report was produced by the Puntland State of Somalia, with support from the United Nations Population Fund, Somalia and key donors. Puntland Report 2020 Somali Health and Demographic Survey With technical support from: With financial contribution from: Puntland Report 2020 IV Somali Health and Demographic Survey (SHDS) V Acknowledgments The Puntland Health and Demographic Survey (PLHDS) was realized with the commitment and dedication of several organizations and individuals. The Department of Statistics of the Ministry of Planning, Economic Development and International cooperation (MoPEDIC) and the Ministry of health were instrumental in ensuring all stages of the survey were carried out with attention to detail. In response to the State’s demand to have data for better planning and policymaking, the following experts steered the processes for the PLHDS: Hon Abdiqafar Elmi Hange (Minister MoPEDIC), Hon Shire Haji Farah (Former Minister MoPEDIC), Sharmarke Hassan Ali (DG MoPEDIC), Hussein Abdi Jama (Former DG MoPEDIC), Abdifatah Mohamed Abdulle (Director of Statistics MoPEDIC), Abdi Mohamoud Ali (PLHDS Coordinator) and Abdinasir Ali Dahir (Technical Lead and Demographer). From the Ministry of Health we would also like to acknowledge Hon. Jama Farah Hussein (Minister MoH), Abdinasir Osman Isse (Former Minister, MoH), Abdirisak Hirsi Hassan (DG MoH), Abdirisak Hassan Isse (Former Director of Planning policy and Development, MoH), Suidi Hamid Isse (Reproductive Health Manager MoH), Deka Muse Ahmed (Health Strengthening System Coordinator) and Abdi Muse Kamil (Technical Advisor MoH). We would like to express our sincere appreciation to the United Nations Population Fund (UNFPA) for their technical guidance and for ensuring our teams developed their capacity and skills in several areas. The Foreign, Commonwealth and Development Office (FCDO) formerly United Kingdom Department for International Development (DfID), The Government of Sweden, The Government of Finland, The Government of Italy, The Italian Agency for Development Cooperation (AICS) and The Swiss Agency for Development and Cooperation provided key financial support that went into creating a legacy for the country. This survey would not have been fulfilled without the support and leadership of Anders Thomsen (Representative, UNFPA Somalia), as well as Walter Mendonça Filho (Deputy Representative, UNFPA Somalia) who provided key support to the survey, Bahsan Said, UNFPA Assistant Representative Puntland office, the Puntland Report 2020 VI Somali Health and Demographic Survey (SHDS) support provided in administration and finance by Kevin Kibubi, Kamal Abdulkadir, Dahir Farah and Hawo Jibril (Operations Unit, UNFPA Somalia), Nasra Adow, Samwel Andati, Halimo Ahmed (UNFPA P&D team) that went a long way to ensure the smooth implementation of the survey. Further, we would like to particularly point out Mariam Alwi, UNFPA’s Population and Development (P&D) Specialist and Head of Unit for her total commitment, enthusiasm and patience in guiding the project. Also, we are indebted to Nikolai Botev (Former Representative, UNFPA Somalia) for his unequalled devotion and headship during his tenure. We would also like to acknowledge the Population and Development team of experts from UNFPA Somalia, without whom the survey would not have come to fruition. These individuals include Felix Mulama (Technical Lead and Demographer), Richard Ng’etich (Statistician), Umikaltuma Ibrahim (GIS Analyst), Zena Lyaga (Demographer), Josyline Gikunda and Amina Omar (GIS Assistants), Kamal Ahmed (Communication and Advocacy). Finally, this report is the culmination of a wide range of efforts from Somali respondents, enumerators, supervisors, quality assurance teams and other field personnel, who sometimes had to brave conflict, poor weather and limited infrastructure in their quest to collect the data that made this report possible. We express our gratitude to all the above mentioned as well as anyone who participated in any capacity in the production of this report VII Foreword It is a great pleasure for the Ministry of Planning, Economic Development and International cooperation in partnership with the Ministry of Health to present the findings of the Puntland Health and Demographic Survey (PLHDS) based on the Somali Health and Demographic Survey (SHDS), conducted from 2018-2019. This survey is the first of its kind in the history of Somalia. It provides long-awaited information required by policy- and decision-makers, and all other relevant stakeholders to make evidence-based programme and policy decisions that deliver effective services to Puntland. The survey findings will enable the Puntland State of Somalia to monitor its respective sectors in the Development Plan, including those relating to improving the lives of women and children, and overall health in Puntland. The report presents more than just numbers—offering valuable nuggets of information to the Ministry of Health and our partners to strive at all levels to promote universal access to reproductive health care and rights. The survey findings will also offer a glimpse into social behaviour in our communities and encourage our people to adopt positive behavioural changes to improve their own lives. These crucial findings are a result of the great efforts of UNFPA Somalia’s Population and Development Unit that collaborated at every stage with technical teams from Puntland State statistical office—along with all the personnel who have worked on this survey. These professionals worked together diligently to complete every phase of work in a challenging environment. We also remain grateful to the donors of this undertaking— the Government of Sweden, the Government of Finland, the Government of Italy, the Italian Agency for Development Cooperation (AICS), the Swiss Agency for Development and Cooperation for their generous contributions, and The Foreign, Commonwealth and Development Office (FCDO) formerly United Kingdom Department for International Development (DfID), which have created a product that will help turn the dreams of Puntland Population to reality. We look forward to seeing the findings from this report shaping vital plans in Puntland, including the response of the international community to support the Strategic Plans to Puntland Report 2020 VIII Somali Health and Demographic Survey (SHDS) attain the Sustainable Development Goals, and response plans for diseases and emergencies, such ongoing COVID-19 pandemic, locust invasion, and recurrent drought and floods. It is our hope that this report will be used and analyzed even further to drive more positive changes in Puntland. Hon Abdiqafar Elmi Hange Minister of Planning, Economic Development and International Cooperation, Puntland Hon Dr. Jama Farah Hassan Minister of Health, Puntland IX Executive Summary Unlocking a brighter, healthier future for Somalis here has never been a more opportune time to ensure Somalis have better access to health, education, sanitation and nutrition. With the voices of Puntlanders from 28,079 households—documented across two phases of The Puntland Health and Demographic Survey (PLHDS)— presented in this report, policymakers and stakeholders now have Taccess to rich and diverse information that will be key to unlocking a bright future for Puntland, particularly for women of childbearing ages and children. A first of its kind, the report sheds light on the lives and needs of nomadic communities—usually difficult to reach—and people living in urban and rural households. The information presented will help close gaps of inequality that have existed for years among people of different ages, lifestyles, places of residence and health status. Some of the key findings are presented below: Demographic Information and Household Characteristics As one of Puntland’s biggest assets, and possibly untapped potentials, Like the rest of Somalia, Puntland has a young population—around 55 percent of household members are under 15 years of age, and 42 percent of Puntland’s population falls within the working age group. The PLHDS report reveals that the size of an average household in Puntland is 6 people. In addition to nuclear family members, 32 percent of households have foster child and/ or orphaned children. Keeping their ties with family and friends strong, around two-thirds of households own mobile phones. Within the nomadic communities, 59 percent of households own a simple mobile phone with access to FM radio. This presents an opportunity for stakeholders to reach out to Somalis using innovative ways. Education and School
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