Health and disease among Somali primary school children in Hargeisa

ABSTRACT

Background and objective: Limited data exist on health conditions of school children in Somaliland. School Health Intervention Pilot Program (SHIPP) was conducted through Edna Adan University Hospital to screen children and offer interventions. We present the results of the general health screening of the school children, and also describe the association between nutritional status and other variables.

Methods: In this cross-sectional study children from two public primary schools in Hargeisa were assessed for general health by nursing students. Nutritional status was assessed by BMI-for-age z-scores and visual acuity by Paediatric Snellen Chart.

Results: We screened 2,093 children aged 4–19 years; 58% were boys. Very low BMI-for-age (z-score < −3) was detected in 10%; 6% had visual acuity below 0.7; 26% had dental caries. Children reported low exposure to health services: 33% reported no prior vaccination; 46% reported they had never visited a health clinic or hospital.

Conclusion: A significant number of children were malnourished, had reduced visual acuity or treatable infections which could impact their ability to learn. Public schools are a feasible entry point for public health action including screening, treatment, and referral in fragile countries.

KEYWORDS:

• School health screening
• Somali children
• malnourishment
• impaired vision children
• vaccination status

Responsible Editor Stig Wall, Umeå University, Sweden

Responsible Editor Stig Wall, Umeå University, Sweden

Acknowledgments

This survey is based on the School Health Intervention Pilot Program, implemented by Edna Adan University Hospital. We sincerely thank Edna Adan Ismail for her initiative and engagement into this program. We also thank the students, teachers and medical doctors at Edna Adan University and Hospital for their contribution. We also want to thank Professor at Centre for International Health, University of Bergen, Sven Gudmund Hinderaker, for his inputs into this paper. Also, thanks to Public Health Nutritionist Møyfrid Elin Nordstrand for the follow up of the malnourished children, and her writing assistance on the manuscript.

Authors contributions

MAN, DSS, MAM and MBA conceived on the presented idea. MAN, DSS and MAM collected the data, encouraged by MBA. MAN, DSS and MAM did the data analysis, MBA contributed with the interpretation. MAN, DSS and MAM drafted the article. MA helped with critical revision of the article. MAN, DSS, MAM and MBA give the final approval of the version to be published, and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics and consent

In the absence of any ethical committee at Edna Adan University Hospital, such issues were considered and approved by the Director of the Hospital, by the President of the University and the Ministry of Education. The approval letter from the Ministry of Education is submitted. In addition, the parent`s committees of both schools were informed about the programme and their consent was given to perform the health screening and to de-worm the children.

Paper context

The first school health program in post-civil war Somaliland has provided valuable data on the health condition of 2093 public primary school children in Hargeisa. A significant number of children were malnourished and unvaccinated; many had reduced visual acuity, obvious dental caries or treatable infections. For most of these children, this was the first encounter with any health professionals. Therefore, a provision of simple routine primary health care to primary schools is needed.

Additional information

Funding

None.