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. 2023 Aug 17:11:1215620.
doi: 10.3389/fpubh.2023.1215620. eCollection 2023.

The importance of community health workers as frontline responders during the COVID-19 pandemic, Somalia, 2020-2021

Lilly M Nyagah  1 , Sulaiman Bangura  1 , Omar Abdulle Omar  1 , Mary Karanja  1 , Mashrur Ahmed Mirza  1 , Hossain Shajib  1 , Haron Njiru  1 , Kumlachew Mengistu  1 , Sk Md Mamunur Rahman Malik  1
Affiliations

The importance of community health workers as frontline responders during the COVID-19 pandemic, Somalia, 2020-2021

Lilly M Nyagah et al. Front Public Health. .

Abstract

Introduction: We examined the contribution of community health workers as frontline responders for the community-based surveillance in Somalia during the first year of the COVID-19 pandemic for detection of COVID-19 cases and identification of contacts.

Methods: We retrieved COVID-19 surveillance data from 16 March 2020 to 31 March 2021 from the health ministry's central database. These data were collected through community health workers, health facilities or at the points of entry. We compared the number of suspected COVID-19 cases detected by the three surveillance systems and the proportion that tested positive using the chi-squared test. We used logistic regression analysis to assess association between COVID-19 infection and selected variables.

Results: During the study period, 154,004 suspected cases of COVID-19 were detected and tested, of which 10,182 (6.6%) were positive. Of the notified cases, 32.7% were identified through the community-based surveillance system, 54.0% through the facility-based surveillance system, and 13.2% at points of entry. The positivity rate of cases detected by the community health workers was higher than that among those detected at health facilities (8.6% versus 6.4%; p < 0.001). The community health workers also identified more contacts than those identified through the facility-based surveillance (13,279 versus 1,937; p < 0.001). The odds of COVID-19 detection generally increased by age. Community-based surveillance and health facility-based surveillance had similar odds of detecting COVID-19 cases compared with the points-of-entry surveillance (aOR: 7.0 (95% CI: 6.4, 7.8) and aOR: 7.5 (95% CI: 6.8, 8.3), respectively).

Conclusion: The community health workers proved their value as first responders to COVID-19. They can be effective in countries with weak health systems for targeted community surveillance in rural and remote areas which are not covered by the facility-based surveillance system.

Keywords: COVID-19; Somalia; case notification; community health workers; pandemic.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor OO declared a shared parent affiliation with the authors at the time of review.

Figures

Figure 1
Figure 1
Map of Somalia with suspected COVID-19 cases by state, and display of locations of towns and inset, the Banadir zone, where the capital Mogadishu is situated.
See this image and copyright information in PMC

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