Papers In Academic Journals

This Paper was originally published on https://journals.plos.org/globalpublichealth/ Despite global progress in childhood vaccination coverage, fragile and humanitarian countries, with high burden of infectious diseases, continue to report a significant number of zero-dose and under-vaccinated children. Efforts to equitably reach zero-dose children remain thus critical. This study assesses the prevalence and determinants of zero-dose children in fragile context of Somalia. We used secondary data from 2020 Somali Health and Demographic Survey (SHDS) to determine status of unvaccinated children aged between 12 to 23 months. Variables related to socio-demographic, household, health seeking, and community level factors were extracted from the SHDS data. Variables that were shown to be significantly associated with zero-dose children at p< 0.05 in the single logistic regression analysis were identified and included in a final multiple logistic regression analysis. A total of 2,304 women and their children aged between 12–23 months were used to determine the prevalence and determinants of zero dose children in Somalia. Approximately 60.2% of the children were zero dose children and did not receive any dose of the four basic routine vac- cines. Children living in rural and nomadic areas were more likely to be zero dose (aOR 1.515, 95% CI: 1.189–1.93). Mother with primary education and above (aOR 0.519, 95% CI: 0.371–0.725), those who attended antenatal care (aOR 0.161, 95% CI: 0.124–0.209) and postnatal care (aOR 0.145, 95% CI: 0.085–0.245) and listen frequently to radio (aOR 2.212, 95% CI: 1.106–4.424) were less likely to have children with zero dose than with their counterparts. Majority of children under two years of age in Somalia are reported to be zero dose children. Context and population specific interventions that target vulnerable mothers and their children, in rural and nomadic areas, and from lower wealth quintile index families with no education and adequate access to antenatal and postnatal care remain critical.

This Paper was originally published on www.mdpi.com Somalia is one of 20 countries in the world with the highest numbers of zero-dose children. This study aims to identify who and where zero-dose and under-vaccinated children are and what the existing vaccine delivery strategies to reach zero-dose children in Somalia are. This qualitative study was conducted in three geographically diverse regions of Somalia (rural/remote, nomadic/pastoralists, IDPs, and urban poor population), with government officials and NGO staff (n = 17), and with vaccinators and community members (n = 52). The data were analyzed using the GAVI Vaccine Alliance IRMMA framework. Nomadic populations, internally displaced persons, and populations living in remote and Al-shabaab-controlled areas are three vulnerable and neglected populations with a high proportion of zero-dose children. Despite the contextual heterogeneity of these population groups, the lack of targeted, population-specific strategies and meaningful engagement of local communities in the planning and implementation of immunization services is problematic in effectively reaching zero-dose children. This is, to our knowledge, the first study that examines vaccination strategies for zero-dose and under-vaccinated populations in the fragile context of Somalia. Evidence on populations at risk of vaccine-preventable diseases and barriers to vital vaccination services remain critical and urgent, especially in a country like Somalia with complex health system challenges.

This Paper was originally published on www.frontiersin.org Amidst the ever-expanding debates in various academic and policy fields around migrant and refugee integration and local integration, we bring these two concepts in conversation with one another. Until very recently, theories of integration have had a state-centric focus in the Global North. This article expands and complicates this literature to focus on displaced Somalis within Somalia and its borderlands living in the cities of Kismayo and Garowe using mixed qualitative and quantitative methods in five displacement settlements. Toward this end, we use the often- engaged term “domains of integration” to frame integration. In our conceptualization, however, we incorporate the concept of “local integration” as a durable solution. In brief, we see the domains of integration as a productive concept in the Somali context. However, in Somalia, where clans are interwoven into the state, which lacks resources and power, clan affiliation represents social connections domains, yet also influences the state’s role in the foundational domain of rights and citizenship and makers and means (employment, housing, education, health). International donors and NGOs, as well as international capitalist urban expansion also have a large role in these processes. As such, we argue that the ten domains of integration (discussed in detail below) intersect and blur to an even greater extent than in European and North American contexts, particularly around crucial issues such as housing, land, and property; a key factor in people’s decisions to remain or leave.

This Paper was originally published on www.sciencedirect.com A growing literature documents the significant barriers to accessing care that Internally Displaced Persons (IDPs) face. This study focuses on gender-based violence (SGBV), an issue often exacerbated in times of forced displacement, and adds to extant debates by considering the wide range of social connections (pathways and actors) involved in providing care beyond the formal biomedical (and justice) system. This research asks, who do IDPs turn to following SGBV and why? How effective do IDPs perceive these social connections to be? To answer these research questions, the study used ‘participatory social mapping’ methodology for 31 workshops held with over 200 participants in Somalia and the Democratic Republic of the Congo in 2021/2022. Pathways to SGBV-related care for IDPs appear eclectic and contingent upon not only the availability and accessibility of support resources but also social, cultural and gendered beliefs and practices. ‘Physical’, mental health, and justice needs are intertwined. They are hard to decouple as many actors cut across need categories, including family, faith and aid organisations, and customary institutions. Comparing Congolese and Somali sites of displaced communities, we see significant similarities and overlaps in pathways to care. While both countries have experienced severe erosions of state capacity, NGOs and parallel faith-based and customary legal, psychological, and health systems have filled the state’s weakness to varying degrees of acceptance by IDP participants. A comprehensive understanding of the local milieu, which requires illuminating the logics behind where people actually turn to for care, is crucial for interventions supporting SGBV victims/survivors; indeed, they risk being inefficient if they only address barriers to formal systems.