Somalia

Somali Red Crescent Society (SRCS), supported by Norwegian Red Cross, has implemented community-based surveillance (CBS) in Somaliland. CBS aims to reduce the high risk of epidemics by strengthening early warning and response from and at community level, particularly where there is a weak public health surveillance system. CBS is implemented through SRCS community volunteers, who report unusual health events within the community via SMS to the software platform Nyss.

All volunteers were selected and recruited in close collaboration with the communities themselves. Community leaders proposed candidates based on selection criteria provided by SRCS: trusted and accepted by the community, basic literacy, living in the community for long-term, sex and age balanced, willingness to volunteer, commitment to RCRC principles. Volunteers were trained in standardised IFRC training packages, adjusted to the context and project, including e.g., community engagement and accountability; epidemic control; and community health and first aid. Based on this foundation of basic knowledge, they were then trained on CBS over 2–3 days.

A study of CBS data from between March and December 2020 of Togdheer region in Somaliland found that:

• 90% of the targeted villages were covered by a SRCS volunteers reporting on CBS at least once per month.
• Weekly completeness of reporting was at 47% on average.
• Most reports were sent in in the correct format (95%).
• Health risk reports were accurately matching the community case definition with an average of 88%.
• 78% of the alerts were notified to the public health authorities within 24 hours, the mean was at 2 days and 21 hours.
• Actions were taken in 91% of the escalated alerts.

Read more about CBS in Somalia in this 2024 BMC article.

And read an example of how a Somali Red Crescent volunteer detected an emerging cholera outbreak.