Somalia is adopting solar energy to rebuild its public health facilities after a lengthy battle.
In January 2021, the WHO Innovation Hub and the WHO Country Office collaborated with the Somalia Ministry of Health to test a solar-powered oxygen delivery system at Hanano General Hospital in Galmudug state. (SDG3-GAP). The goal of the alliance is to help governments connect demand for implementation-ready technologies with supply so that SDG health targets can be met sooner. Dr. Michael Hawkes, the solution’s creator, and Grand Challenges Canada provided transition-to-scale financing.
The solar-powered oxygen gadget has become a symbol of life for Somali children, whose pneumonia accounts for at least one-fifth of all child deaths. Abdiaziz Omar Abdi, 2, was taken to Hanano Hospital in March 2021 with oxygen levels of 60%, significantly below the recommended requirement of 90%. The patients were given oxygen, antibiotics, and dexamethasone by the doctors. If Abdiaziz had been sick three months sooner, he would not have survived. He was discharged three days later with an oxygen level of 90%. Because her kid wasn’t breathing or breastfeeding properly, Zahra arrived.” He eats by himself. Abdiaziz was looked after for free.
At Hanano Hospital, life-saving oxygen has been used to treat suffocation, pneumonia, injuries, trauma, and traffic accidents. The innovation cut hospital stays in half, from five to one.
Innovation creates more value
Solar-powered equipment kept the vaccine cold chain intact and boosted service delivery during frequent power outages. Unlocking demand and improving healthcare seeking in catchment areas are crucial. “We now bring our children to Hanano to live, not to die,” Abdulaziz’s mother, Zahra, explained.
Dr. Mohamed Abdi, director of Hanaano Hospital, states, “Our initiative has given life back to this hospital; people come from 100 kilometres away.” “Never in my life have I seen an early investment save a life. 180 hospital patients perished last year due to a lack of oxygen. Children were in charge. This is an emergency system. If this procedure is widely adopted in Somalia, he predicts that at least 7,000 children will be saved from pneumonia.
Solar oxygen systems are affordable and require little maintenance because they have few moving parts. They are simple to use and require little training for rural medical providers. We no longer have to worry about the logistical and financial costs of refuelling our diesel generators. A climate-conscious approach and favourable healthcare demand and supply repercussions could help primary healthcare in off-grid and infrastructural challenged places, where the majority of children die.
Somalia is a country known for its ingenuity. Somalia’s federal and state health sectors cooperated with partners to test new service delivery options aimed at increasing zero-dose vaccine coverage for low-income children. Between November 2021 and February 2022, outreach and mobile and fixed-post immunisation strategies will be deployed.
Past SDG3-GAP partners’ investments in Somalia’s EPI, particularly GAVI, WHO, and UNICEF, as well as community trust in vaccinations, were necessary preconditions for expanding immunisation capacity utilising novel service delivery methods. Mobile units, fixed stations, schools, and stadiums quickly joined the country’s present immunisation venues. In under two months, the programme targeted the 54 districts in Somalia (and Somaliland) with the lowest vaccination coverage, the highest number of zero-dose children, and outbreaks of vaccine-preventable diseases. In total, 75 217 children received zero-dose vaccinations, 104 000 for measles, 82 000 for polio, and 954 400 doses of COVID-19. Lessons learnt during the expedited immunisation campaign are being applied to Somalia’s developing immunisation programme and basic health care.
Expansion of innovation
Somalia’s health-system reform target includes solar-powered oxygen and immunisation service delivery improvements. Early successes have spurred requests for similar technologies to be scaled up. Due to dispersed local and global stakeholder networks, achieving stakeholder alignment while scaling revolutionary goods and services is difficult.
The SDG3-GAP partners are leveraging the WHO Innovation Hub’s “Innovation Scaling Framework” to scale up and sustain effective health innovations. Governments, partners, and “aggregators” of innovation collaborate to find and establish supply pipelines for existing, scale-ready ideas. The World Health Organization had a roundtable discussion in March 2022 on “Bridging oxygen access gaps in Somalia: Towards Developing a Resilient Health System in an Uncertain Context.” In Somalia, SDG3-GAP partners undertook a shared assessment of the oxygen ecosystem at basic health facilities, which will help build a road map and pooled financing mechanism for scaling up primary health care.
It works well. Following the pilot in Hanano, the solar-powered oxygen system was expanded to Kismayo, Baidoa, Hudur Hospital, and Dhusamareb with financing from the Canadian and Italian governments. The WHO Somalia national office started scaling up solar arrays to power 100 primary health care centres on World Health Day 2022, allowing for optimal functioning and decreasing chronic power issues while also being environmentally friendly. PSA has built three oxygen centres and distributed 200 portable oxygen concentrators throughout the country.
The Somali government has benefited greatly from WHO’s global health leadership and solid collaborations between SDG-GAP partners and the Somali government, particularly the UN Resident and Humanitarian Coordinator. The SDG-GAP partners are also increasing financial resources available to scale this innovation.
Innovation is fueled by demand
According to SDG3-GAP partners, innovation must meet needs and be accessible. The SDG3-GAP partners work together to improve service delivery and remove barriers to equal access to health care. Partners in humanitarian, development, and peacebuilding efforts have adopted a nexus approach to planning and implementation, agreeing on common outcomes to improve coherence and collaboration. With the help of this increased in-country partnership, the Somalian government was able to revise the Essential Package of Health Services (EPHS 2020) based on lessons learned from previous EPHS implementation gaps (EPHS 2009). In addition, an EPHS 2020 guideline and coordination body have been established. The World Bank is funding the Damal Caafimaad Project (2021-2026) to expand EPHS 2020 coverage in specified geographic areas and boost the Ministry of Health’s stewardship capacity to coordinate and implement mid- and long-term health system development initiatives. The study shows how the nexus technique can be used to improve government processes while still providing essential public services. The WHO is also introducing a ‘Transition To Scale’ funding mechanism to help countries develop, test, and integrate ideas into government programmes in order to scale up product or service delivery innovations.
Early and on-going successes in Somalia in aligning and scaling innovation are promising for everyone’s health and well-being. EPHS is used by the SDG3-GAP partnership to connect innovations to those who need them. As these cooperative activities become more entrenched, Somalia’s journey toward better lives and general well-being becomes more hopeful.