STORY HIGHLIGHTS
- Since its launch in Somaliland in 2024, the Damal Caafimaad Project has supported 49 health facilities and served over 425,000 outpatients, with a significant rise in antenatal care coverage.
- Female outpatient attendance reached 76,527, representing a 56.5% coverage of the targeted population. Over 16,000 pregnant women completed at least four antenatal care visits in 2024.
- The project is funded by the World Bank and aims to reach 1.84 million beneficiaries across Somalia.
On a warm morning on the outskirts of Hargeisa, in the Maroodi-Jeh region of Somaliland, 34-year-old Ayaan Dahir Ainan cradles her infant son as she waits outside the Hawadle Health Center. Her other five children sit nearby, wide-eyed and curious, as health workers unload vaccine coolers and malnutrition screening kits. Ayaan has been walking for almost an hour to reach this location.
“There was nothing like this before,” she says, adjusting her scarf to shield her face from the sun. “We used to travel far or just wait and pray the children would recover. But now, help is finally reaching us.”
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At Hawadle Health Center, Ayaan and her children receive routine immunizations, malnutrition screening, and maternal health guidance. The turning point came when a community health volunteer visited her neighborhood while she was pregnant with her sixth child. “She told us there was a new team at Hawadle offering free services for mothers and children,” Ayaan recalls. “I brought all my kids with me. Later, I even delivered my youngest child here.”
That decision may have saved her fifth son’s life. “He was very weak and had never been vaccinated,” she explains. “He received his first immunizations here. The health workers also screened all my children for malnutrition and taught me how to feed them properly using what I already have at home.”
Equally life-changing was the maternal health guidance she received. “They taught me how to space pregnancies, how to take care of myself during pregnancy, and what warning signs to look out for. No one had ever explained those things to me before.”
She has noticed a visible difference. “The children are stronger, more active. They don’t get sick as often. I feel more confident and informed as a mother.”
Damal Caafimaad: Scaling impact through partnerships
The Improving Healthcare and Services in Somalia Project, locally known as Damal Caafimaad (meaning “Health Recovery” in Somali), is an initiative of the Government of Somalia funded by the World Bank through the International Development Association (IDA) and the Global Financing Facility (GFF) for Women, Children and Adolescents. It is the first World Bank-financed investment in Somalia’s health sector in 30 years.
Launched in Somaliland in early 2024, the project is implemented by the Ministry of Health Development and supported by Alight International as the service delivery partner. The Damal Caafimaad Project currently supports 49 operational health facilities in Somaliland, providing essential services to thousands of families across the region.
According to the project coordinator, Dr. Mohamed Yusuf, the results are promising. “In 2024, outpatient visits exceeded 425,000, a 27% increase from the previous year. In the last quarter alone, we recorded more than 133,000 visits,” he says.
Women and children made up most of these visits. Female outpatient attendance reached 76,527, representing a 56.5% coverage of the targeted population. The biggest gains were seen in antenatal care: thanks to the Damal Caafimaad Project, over 16,000 pregnant women across Somaliland completed at least four antenatal care visits in 2024, bringing coverage to nearly 23%, just shy of the national target of 26%.
The project is expected to reach 1.84 million beneficiaries, including internally displaced persons (IDPs) and nomadic communities. It also supports government capacity development in areas such as health workforce regulation, health management information systems, and contract management of NGOs.
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Reaching the unseen
A cornerstone of Damal Caafimaad’s success lies in its outreach model, which brings care directly to communities. “Our mission is to make essential health services accessible to families where they live,” says Maryan Abdullahi Yusuf, a nurse at Hawadle Health Center. “Too many mothers and children were left behind previously.”
Maryan and her team use local data and community coordination to reach underserved areas, delivering vaccines, nutrition kits, maternal supplies, and health education in Somali. “We take time to explain things clearly–what each vaccine does, why nutrition matters, and when to return for follow-up,” she says. “We’re now seeing fewer emergency cases, and more women are seeking care on their own.”
As Damal Caafimaad continues to expand across Somaliland and other regions of Somalia, its focus remains clear: to build a health system that is inclusive and resilient by expanding equitable access to essential health and nutrition services, especially for women, children, and underserved communities.
