Somaliland Launches its first Health and Demographic Survey (SLHDS 2020); Real-time data on the health and lives of Somaliland women and children, including its Nomadic communities

A new report jointly launched today by the Minister of Planning and National Development Hon. Hassan Mohamed Ali and the Minister of Health Development Hon. Omar Ali Abdillahi of Somaliland —titled the Somaliland Health and Demographic Survey (SLHDS) Report 2020—offers the decision-makers and stakeholders vital information on the health and lives of Somaliland women and children.


Data was collected from over 20,000 urban and rural households, as well as difficult-to-reach nomadic households, across the six regions.

Somaliland Launches Its First Health And Demographic Survey (SLHDS 2020)
“The data inside the report is a great benefit to our nation. So, I urge the Ministry to translate it to Somali and to disseminate it to the public through media channels for information”. Said the Vice-President of Somaliland H.E Abdirahman Saylici.

The SLHDS report provides information on housing and household characteristics, health, education, marriage, fertility, birth spacing, employment, water and sanitation, health expenditure, chronic diseases, and children’s and women’s nutrition. It also offers information on married women’s knowledge of HIV/AIDS and attitudes towards people living with HIV, women’s empowerment, gender-based violence, FGM/C, and adult and maternal mortality.

Somaliland Launches Its First Health And Demographic Survey (SLHDS 2020)
“It is indeed shocking and terrifying that the prevalence rate of FGM in our country is 98% and many still argue to perform FGM. So, we should together eradicate the GBV in our country” Said Hinda Gani, Minister of Ministry of Employment, Social and Family Affairs.

The report reveals that gains have been made in important areas:

  • For the first time, Somaliland has an MMR indicator (396 maternal deaths per 100,000 live births).
  • Pregnant women who attended ANC at least four times increased from 15 percent in 2011 to 20 percent.
  • The health facility deliveries have increased from 31 percent in 2012 to 33 percent.
  • Early marriage—known to deprive women of opportunities to reach their full potential—has reduced for women married by age 18, from 31 percent in 2013 to 23 percent.
  • About three out of four Somaliland households (71 percent) own simple mobile phones, and around one out of two nomadic households own simple mobile telephones with access to FM radio, opening doors to endless opportunities for these individuals.
  • Somaliland women are empowered to make financial choices—nine out of ten women decide on how their cash earnings will be spent, either individually or jointly with their husbands, and around six out of ten women of childbearing age use their phones for financial transactions.
Somaliland Launches Its First Health And Demographic Survey (SLHDS 2020)
“It is the first time in history to conduct Somaliland Health and Demography Survey in the country,” Said Muna Ahmed, the Director of Central Statistics of the Ministry of Planning & National Development.

In recognition of the efforts it took to bring the survey to fruition, Adam Abdelmoula, UN Resident Coordinator and Humanitarian Coordinator for Somaliland/Somalia remarked, “It has been a pleasure for us to witness the Somaliland Government roll out a survey of this scale—that is a rich source of such diverse and crucial information. The SLHDS will help the international community to define and shape humanitarian and development strategies, and emergency responses so they are more effective.” The SLHDS report sheds light on areas that need intervention for women and children to lead better lives. The results show that around one in three births was delivered in a health facility (for births delivered in the five years preceding the survey), and an overwhelming majority of births—around seven out of ten—were delivered at home. Additionally, only four out of ten births were delivered with the assistance of a skilled health care provider and 52 percent of women did not make antenatal visits during their most recent pregnancy in the five years prior to the survey. According to Somaliland women aged 15-49, the reasons for their low uptake of health care during pregnancy and child delivery include the lack of money, long distances due to the lack of health facilities, the reluctance of spouses to accompany women to the health facility, and the need for Somaliland women to obtain permission from family members before seeking health services.

Somaliland Launches Its First Health And Demographic Survey (SLHDS 2020)The SLHDS report further unveils that fertility rates remain relatively high—the total fertility rate for Somaliland is 5.7 children per woman—which would impact planning for the coming years. In addition, female circumcision is still widely practiced across the country—98 percent of women have been circumcised.

Although Somaliland communities are seen to be moving towards practicing the Intermediate and mild Sunni forms of circumcision, survey results show that the severe Pharaonic form is still the most common form being practiced, with over 60 percent of women have undergone this type of circumcision.

The survey highlights the need for support for nomadic populations in accessing health and other social services. For instance, births to women in urban areas are more likely to be protected against neonatal tetanus than births to women in nomadic areas, and more nomadic women delay antenatal care to the last trimester compared to women from urban and rural settings. Two percent of nomadic women reported they made their first ANC visit within the first four months, as compared to thirty-two percent and sixteen percent of women in urban and rural households, respectively. “This is a game-changing survey for our country,” said Hon Hassan Mohamed Ali, Minister of Planning, and National Development, Government of Somaliland. “The data obtained and systems used will be useful to map out COVID-19 hotspots and respond swiftly to curb its spread, for instance. The SLHDS report also shows us more work needs to be done to bridge the gaps visible among Somaliland women and children, and particularly among men and women, and Somalilanders of different educational backgrounds, income levels, and areas of residence.” “Every number presented in the findings of the report has a story behind it. For example, these numbers will guide us to address the barriers Somaliland women face in accessing health. We can ensure mothers feel safe while delivering their babies in Somaliland, young people have a better chance to make choices, particularly regarding reproductive health, and that children have better access to the right nutrition and vaccinations required to lead full and productive lives,” said Anders Thomsen, the United Nations Population Fund (UNFPA) Representative for Somalia/Somaliland.

Executive Summary
Unlocking a brighter, healthier future for Somalilanders.

There has never been a better time to make sure that Somalilanders have access to quality education, better health, nutrition, and sanitation. Voices from over 20,000 Somaliland households recorded through two phases of the Somaliland Health and Demographic Survey (SLHDS) presented in this report. Policymakers and stakeholders now have access to opulent and diverse information that will be key to opening up a bright future for Somalilanders, especially women of childbearing ages and children. The needs of nomadic, rural, and urban communities are brought forward by this report. This report highlights the existing gaps of inequality that have existed among people of different residences, lifestyles, ages, and health status.

No. of pages: 462

Publication date: October 2020

Author: The Government of Somaliland/UNFPA

Visit the Somaliland Central Statistics Department to read The Somaliland Health and Demographic Survey (SLHDS) 2020 Report or Download the full report here

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