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Background <p>Globally, neglected tropical diseases (NTDs) affect &gt; 1.7 billion people and remain a major cause of morbidity in fragile, resource-limited settings. Somalia, the 44th largest country worldwide, is situated in Africa and ranks among the top 20 countries with the highest number of zero-dose children. Protracted conflict, climate shocks, and displacement hinder effective surveillance and service delivery, exacerbating the prevalence of infectious diseases and active outbreaks. We assessed frontline perspectives on barriers and opportunities for neglected tropical diseases (NTDs) control and eradication in Mogadishu.</p> Methodology <p>We conducted a mixed-methods, facility-based cross-sectional study (January–June 2025) across seven hospitals (2 public, 5 private). A structured questionnaire captured sociodemographic and perceptions from 535 health workers (specialists, general practitioners, nurses, pharmacists, midwives, laboratory staff). Qualitative data comprised 15 key informant interviews (KIIs) and 6 focus group discussions (FGDs; 60 participants) with clinicians, CHWs, and managers. Quantitative data were analyzed with descriptive statistics and bivariate tests; qualitative data underwent thematic analysis.</p> Result <p>Of 535 participants, 341/535 (63.7%) were female most had 1–5&#xa0;years of experience and bachelor’s degrees. Training on NTDs was moderate (58.1%). Priority barriers were lack of funding (61.5%), limited infrastructure (17.4%) and low public awareness (14.2%). Perceived opportunities included improved infrastructure (38.5%; <i>n</i> = 206), health education (37.8%) vaccination campaigns (32.7%) joint CHW–provider training (46.0%), and mHealth for surveillance/reporting (32.9%) PPPs were viewed as essential/important (89.9%). KIIs/FGDs triangulated these findings, adding themes of stigma (especially leprosy), access barriers in IDP/conflict-affected areas, and underused PPP channels.</p> Conclusion <p>NTD progress in Somalia is constrained by financing, capacity, and coordination gaps, but integrated, feasible interventions exist: multi-year financing tied to performance; competency-based upskilling for clinicians/CHWs; standardized CHW–facility referral feedback and digitized reporting within IDSR/DHIS2; formalized PPPs for commodities/reporting/supervision; and climate-aware vector control with WASH messaging prioritized for IDP-dense, flood-prone districts.</p>

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Challenges and opportunities in controlling and eradicating neglected tropical diseases: Public and private health operators in Somalia 2025

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月27日

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  • Saadaq Adan Hussein,
  • Marian Muse Osman,
  • Mohamed Mohamoud Hassan,
  • Abdirahman Aden Hussein,
  • Abdinur Hussein Mohamed,
  • Mohamed Farah Yusuf Mohamud,
  • Rage Adem,
  • Mohamed MAli Fuje,
  • Khadar Hussein Mohamud,
  • Ayan Nur Ali,
  • Abdirahman Moallim Ibrahim,
  • Hassan Ahmed Mohamed,
  • AbdulJalil Abdullahi Ali

摘要

Background

Globally, neglected tropical diseases (NTDs) affect > 1.7 billion people and remain a major cause of morbidity in fragile, resource-limited settings. Somalia, the 44th largest country worldwide, is situated in Africa and ranks among the top 20 countries with the highest number of zero-dose children. Protracted conflict, climate shocks, and displacement hinder effective surveillance and service delivery, exacerbating the prevalence of infectious diseases and active outbreaks. We assessed frontline perspectives on barriers and opportunities for neglected tropical diseases (NTDs) control and eradication in Mogadishu.

Methodology

We conducted a mixed-methods, facility-based cross-sectional study (January–June 2025) across seven hospitals (2 public, 5 private). A structured questionnaire captured sociodemographic and perceptions from 535 health workers (specialists, general practitioners, nurses, pharmacists, midwives, laboratory staff). Qualitative data comprised 15 key informant interviews (KIIs) and 6 focus group discussions (FGDs; 60 participants) with clinicians, CHWs, and managers. Quantitative data were analyzed with descriptive statistics and bivariate tests; qualitative data underwent thematic analysis.

Result

Of 535 participants, 341/535 (63.7%) were female most had 1–5 years of experience and bachelor’s degrees. Training on NTDs was moderate (58.1%). Priority barriers were lack of funding (61.5%), limited infrastructure (17.4%) and low public awareness (14.2%). Perceived opportunities included improved infrastructure (38.5%; n = 206), health education (37.8%) vaccination campaigns (32.7%) joint CHW–provider training (46.0%), and mHealth for surveillance/reporting (32.9%) PPPs were viewed as essential/important (89.9%). KIIs/FGDs triangulated these findings, adding themes of stigma (especially leprosy), access barriers in IDP/conflict-affected areas, and underused PPP channels.

Conclusion

NTD progress in Somalia is constrained by financing, capacity, and coordination gaps, but integrated, feasible interventions exist: multi-year financing tied to performance; competency-based upskilling for clinicians/CHWs; standardized CHW–facility referral feedback and digitized reporting within IDSR/DHIS2; formalized PPPs for commodities/reporting/supervision; and climate-aware vector control with WASH messaging prioritized for IDP-dense, flood-prone districts.