SSRA

SSRA-AMOUD PROJECT IN PARTNERSHIP WITH FORUM SYD IN Sh.Osman COMMUNITY IN BORAMA Dr JIBRIl Handuleh,MD PROJECT COORDINATOR AMOUD UNIVERSITY COLLEGE OF HEALTH SCIENCES

Amoud university
Higher education institution with 14 faculties. Oldest and one of the prestigious university in the country

Partners
A.Tropical Health and Educational Trust(THET) B. Global Health Center, Kings College London C.ForumSyd D.Kijabe Teaching Hospital, Kenya

Introduction
Project is a partnership implemented by Amoud University and Somali Swedish Research Association(SSRA) and funded by ForumSyd. Project was proposed in May 2012, grant got accepted in August that year and became operational by November 2012.

Project target population

The project serves 20-30,000 people in Sh.Osman community in Borama 10 female community health care workers were trained for three months on common mental health, childhood and maternal health diseases using appropriate curriculum. Mobilize community to enhance sanitation, access to health information and services.

Primary target groups

Primary target group

The Primary benficiaries of the project include Children Reproductive health education and information Mentally ill patients

Goals
Raise health seeking behavior of the community Empower women to lead the community health care worksers Defend human right value of vulnerable groups Increase primary health care access of community members via awareness and referrals

Project success criteria

SSRA-Amoud members committed to assist with the project implementation Community base of the community Involvement of Project coordination committee Amoud University medical , nursing and public health faculty helping with personal indirectly Maternal and Child Centre in close proximity to project site

Project relevance and Feasibility

Bridging a Major Gap in Essential Life Saving Services Creation of a Community Outreach Training Programme for the University Linking to a Reliable Existing Capacity community ownership of the project implementation Recently with NAFIS FGM group extended mental health counselling to genital mutilation patients

 3 months training of 10 FCHWs on common maternal health , maternal and child care disorders lialison with MCH and district hospital Education for community members

Project aims
To establish a community based Health Program in Borama providing a coverage for 20,000 to 30, 000 rural and per-urban population implemented by FCHWs and made operational in the later part of the year 2012 with focus on MNCH and Mental Health To Select 10 females with 8th grade pass education level, residing in the same catchment areas in which they will be serving with the support of their families and local community leaders

 To develop a three months training curriculum for the CMHWs and organize their training program at the Mental Health Center of Borama, run by the School of Health Sciences of Amoud University To establish a program coordination council comprising of Amoud University, Community Leaders, Regional Ministry of Health and Local Primary Health Care supporting UN and International NGOs to guide and oversee the program implementation and management

Project indicators
AND WHAT HAS BEEN SO FAR!

Results

Indicators expected results

of Activities

Project indicators
Mothers, children and persons with mental disorders access essential maternal and child care and mental health services through a community based program at their door steps
i.

90% of all persons with severe mental health disorders in the project area have been registered and linked to the MHC for diagnosis, treatment and follow-up -80% of mothers with under-six month old infants were counseled about exclusive breast feeding -80% of mothers with children under one year know how
-

- Selection of the catchment areas to be covered - Social mobilization and interaction with relevant authorities and community leaders - Selection of 10 FCHWs according to the set criteria conducting the FCHWs intensive training program for three months followed up by a problem based learning once every month

Indicators of Results results i. Mothers, children and -At least 50% of the persons with severe chained persons with severe mental illness mental illness in the became chain-free with project catchment areas the help of case and received appropriate management family counseling treatment and personal -At least 80% of the and family counseling families caring for persons with severe support

Activities -Regular home visits conducted by the FCHWs -Family education and counseling carried out by FCHWs -Patient referral and case management and follow up at the MHC

mental disorders have received education and counseling

Project objectives continued

iii. A program coordination council (PCC) established comprising of Amoud University, Community Leaders, Regional Ministry of Health and Local Primary Health Care supporting UN and International NGOs to guide and oversee the program implementation and management -At least three stakeholders have membership in the PCC that include community leaders, local health authorities and the university -Community awareness building, social mobilization and project presentation workshop organized by the Amoud University in Borama with the participation of all relevant stakeholders that would be involved in the PCC

-Two consecutive -Conducting a consultation council meeting meeting to nominate the minutes are recorded members of the PCC and define their terms of reference

December 2012- February 2013

10 FCHWS were recruited, trained and became

operational Project steering committee formed Field work started Catchment area identified Three project activities teached, relevant parties engaged A. Mental health B. Maternal health C. Child health

March-June 2013
Home to Home visits fully started Patients and families received counselling and health related teaching on sanitation, common illnesses and early referral to patients Some chained patients are chain free , work in the community and support their families Community mobilized to help clean environment

March-May 2013 cases seen in the community Anemia, vaginal bleeding , Maternal health 490
conditions Number of patients seen Common conditions obstructed labor , prolonged labor, and referral for normal antenatal follow up Breastfeeding 340 Educated mothers and pregnant women about exclusive breastfeeding to reduce childhood illness and suffering to empower them meet their responsibilities Respiratory infections, diarrhea, malnutrition and vaccination taking the life of children in developing countries

Childhood illnesses

647

Mental health
Total

606
1604

Psychosis, depression etc.

Former project THET and Amoud University Partnership 20112013 Introduced mental health service in Borama both in the community and in patient unit in Borama hospital. Started mental health courses for pharmacy students in addition to the KTSP PROGRAM covering med students and nurses Assisted training 2 nurses and 2 doctors working in mental health

 Academic and research collaboration with Kings College london and Maudsley NHS psychiatrists. worked with one Elaj center in Borama Established student counseling center at Amoud medical school campus. Amoud University worked with local and diaspora NGO to empower mental health care in Awdal region.

Publications
Handuleh, J: Establishment of community mental health services in Borama, Somaliland, Somaliland medical association journal, Version 1, Issue 1, 21-22, 2012 Handuleh, J : Experience of establishing mental health services in Somaliland, Intervention, 2012,volume 3, number 3, page 274-278

 Handuleh, J, Whitwell S, Fekadu, D, School Mental health project in Somalia, The Arab Journal of Psychiatry (2013) Vol. 24 No. 1 Page (46 - 51) (doi: 10.12816/0000098) Roxanne Keynejad, M.B.B.S., Faisal R. Ali, M.R.C.P.Alexander E. T. Finlayson, M.R.C.P., Jibriil Handuleh, M.D.GudonAdam,M.D.,JordanS.T.Bowen,M.R.C.P., Andrew Leather, F.R.C.S.Simon J. Little, M.R.C.P., Susannah Whitwell, M.R.C.Psych. Telemedicine for Peer-to-Peer PsychiatryLearning Between U.K. and SomalilandMedical Students, Academic Psychiatry 2013; 37:182186

 Handuleh , J. Transforming a hospital dumping site into psychiatric inpatient unit in Somalia, American Journal of Psychiatry(in press).

Mahadsanid

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