Environmental Systems and NBS Pillar - Iridinstitute

Performance and Effectiveness Evaluation of iCCM/iCCM+ Service Delivery in Gedo and Kismayo, Somalia

Sun, 21 Jun 2026 07:38:36 +0000

Performance and Effectiveness Evaluation of iCCM/iCCM+ Service Delivery in Gedo and Kismayo, Somalia

An independent IRID assessment of Trócaire Somalia’s community case management programme, generating evidence to strengthen child health coverage, quality of care, and long-term sustainability.

Partner & Institutional Framework

This assignment is being implemented in partnership with Trócaire Somalia, working closely with the Federal and Jubaland Ministry of Health, district health authorities, and community health structures across the Gedo region and Kismayo district. The assessment draws on IRID’s national team of community health specialists, researchers, and MEAL practitioners.

Background

Somalia’s health system continues to face significant constraints from protracted conflict, limited financing, recurrent drought, and weak health-seeking behaviour, with rural and nomadic communities — 65% of the population — disproportionately underserved. The country’s maternal mortality ratio stands at 396 per 100,000 live births, neonatal mortality at 44 per 1,000, and an estimated 20.7% of children under five are stunted, with 13.5% acutely malnourished. A chronic shortage of health workers — roughly 3.4 essential health workers per 10,000 people, below the WHO minimum of 4.5 — has limited facility-based access, particularly outside urban centres.

To close this gap, Integrated Community Case Management (iCCM) has been implemented in Somalia since 2017 as a cost-effective strategy that trains and equips community health workers (CHWs) to diagnose and treat malaria, pneumonia, and diarrhoea at community level, referring complicated cases onward. The expanded iCCM+ model adds nutrition screening, treatment, and referral through Community Management of Acute Malnutrition (CMAM), extending the reach of life-saving care to children in the hardest-to-reach communities.

Project Overview

Trócaire Somalia currently delivers iCCM/iCCM+ services across 59 sites in six districts — Luuq, Dollow, Beledhawo, Elwak, Garbaharay, and Kismayo.

Trócaire supported by 10 fixed referral and link health facilities, with 7 sites providing the expanded iCCM+ nutrition component. IRID was commissioned to conduct an independent Performance and Effectiveness Evaluation of this programme, examining service utilisation, quality of care, referral effectiveness, nutrition integration, and routine data quality, and generating practical, evidence-based recommendations for programme strengthening, scale-up, and long-term sustainability.

Objectives
The assessment is structured around eight specific objectives:

Assess service utilisation trends and treatment coverage at the community level.
Evaluate the quality of CHW service delivery, including adherence to clinical protocols and referral practices.
Examine the effectiveness of referral pathways between CHWs and health facilities.
Assess integration between iCCM and nutrition programming, including CMAM linkages.
Conduct a rapid data quality assessment of routine monitoring systems.
Identify implementation enablers, bottlenecks, and contextual constraints.
Capture community perceptions, trust, satisfaction, and acceptability of services.
Generate actionable recommendations for programme improvement, scale-up, and sustainability.

Activities and Approach

IRID is applying a mixed-methods evaluation design, benchmarked against the WHO/iCCM Global Benchmark Framework’s eight programmatic components, OECD-DAC evaluation criteria, and Somalia’s national health strategies, to triangulate findings across the following workstreams:

Quantitative Data Collection

Routine data analysis — twelve months of programme data on service utilisation, treatment coverage, and referral completion.
CHW survey — knowledge, protocol adherence, and case management practice, cross-checked against registers and stock cards.
Health facility assessment — referral systems, service readiness, and feedback mechanisms.
Household survey — approximately 500 households (20 per site across 25 sites) on care-seeking behaviour and service uptake.

Performance and Effectiveness Evaluation of iCCM/iCCM+ Service Delivery

Download Full Report

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Health National Adaptation Plan (HNAP) Stakeholder Consultation Workshop, Somalia

Wed, 28 Jun 2023 07:17:08 +0000

Project Title
Health National Adaptation Plan (HNAP) Stakeholder Consultation Workshop, Somalia

Partner & Institutional Framework
The workshop was organized in collaboration with national institutions, led by the Ministry of Health, with technical contributions from climate, health, and energy experts. The process engaged government representatives, development partners, technical specialists, and sector stakeholders involved in climate change, public health, and resilience building in Somalia.

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Project Overview

The Health National Adaptation Plan (HNAP)

Stakeholder Consultation Workshop was convened on 7 January 2026 to support the formulation of Somalia’s HNAP 2026–2030

The workshop provided a platform to review climate trends and projections, assess climate-sensitive health risks, and validate priority adaptation actions for the health sector.

The consultation aimed to ensure that the HNAP was evidence-based, inclusive, and aligned with national development priorities, while addressing the growing impacts of climate variability and climate change on health outcomes, health systems, and vulnerable populations in Somalia.

IRID’s Role and Key Responsibilities
Under this assignment, IRID contributed to:

Supporting the technical design and facilitation of the stakeholder consultation workshop.
• Presenting climatology evidence on climate trends, variability, and projections relevant to Somalia.
• Contributing to technical discussions on climate–health risks and vulnerabilities.
• Supporting the review of the HNAP 2026–2030 rationale, vision, mission, and guiding principles.
• Facilitating participatory processes, including SWOT analysis and breakout group discussions.
• Supporting synthesis of stakeholder inputs, recommendations, and consensus outcomes to inform HNAP finalization.

Key Outputs

A national stakeholder consultation workshop on the Health National Adaptation Plan.
Technical presentations on climate trends, climate–health risks, and health system resilience.
A SWOT analysis identifying strengths, weaknesses, opportunities, and threats affecting climate adaptation in the health sector.
Consolidated stakeholder inputs

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Enhancing Frankincense Production through Forest Conservation and Management in Somaliland

Wed, 28 Jun 2023 07:15:13 +0000

Partner & Institutional Framework

This initiative was implemented as a collaborative research and development partnership between the Institute for Science, Technology and Veterinary Studies (ISTVS) and doTERRA International, with technical engagement from academic, community, and sector stakeholders in Somaliland.

Project Overview

IRID supported and documented a multi-phase research and development initiative aimed at enhancing frankincense production while promoting forest conservation and sustainable land management in Somaliland. The project responded to increasing pressures on frankincense resources driven by rising global demand, unsustainable harvesting practices, climate stress, and declining tree health, particularly in the Cal Madow mountain range and Erigavo area, where most of Somaliland’s frankincense is produced.

The initiative combined ecological research, socio-economic analysis, capacity building, and propagation trials to strengthen both the sustainability of frankincense forests and the livelihoods of communities dependent on the resin trade.

IRID’s Role and Key Contributions

Under this initiative, IRID contributed to research design, analysis, and knowledge generation by:

Supporting baseline assessments on the status, spatial distribution, population structure, and management of frankincense trees in Erigavo.
Analyzing socio-economic drivers of overharvesting, including livelihood dependency, market pressures, and governance gaps.
Documenting traditional and emerging harvesting, management, and utilization practices, including tree health and regeneration trends.
Supporting the identification and documentation of best practices for frankincense management, drawing from Somaliland, Oman, and Ethiopia.
Contributing to the development of training materials, guidelines, and policy-relevant knowledge products on sustainable frankincense management.

Key Activities Implemented

Baseline ecological and socio-economic surveys conducted across frankincense-producing communities.
Evaluation of frankincense propagation techniques, including seed propagation, cuttings, and tissue culture methods.
Assessment of Boswellia species diversity and agronomic practices sourced from Somaliland, Oman, and Ethiopia.
Expansion of propagation infrastructure at IGAD Sheikh Technical and Veterinary School (ISTVS), including screen houses and tissue culture facilities.
Delivery of community-based trainings for farmers and harvesters on sustainable propagation, tree management, and harvesting techniques.

Key Outputs

Comprehensive baseline report on frankincense ecology, management practices, and utilization in Erigavo.
Documentation of best practices and management guidelines for sustainable frankincense production.
Training manuals and extension materials on propagation, agronomic management, and harvesting techniques.
Improved propagation infrastructure supporting large-scale seedling production.
Policy-oriented briefs and recommendations on frankincense management and forest conservation.

Expected Outcomes

Improved knowledge and practices among frankincense producers on sustainable tree management and harvesting.
Increased availability of healthy frankincense seedlings for restoration and expansion.
Strengthened institutional and community capacity for frankincense conservation and value-chain development.
Enhanced resilience of frankincense forests and dependent livelihoods.

Long-Term Impact

The initiative contributed to the sustainable management of Somaliland’s frankincense resources, improved rural livelihoods, and strengthened the evidence base for conservation-oriented policies. By linking forest conservation with economic value chains, the project supported long-term environmental sustainability and inclusive economic development in frankincense-producing regions.

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