Peer-reviewed article
Experiences of mothers and female community health workers accessing and implementing the Marwo Caafimaad programme in Somalia
Ayan Mohamed, Kathleen West, James Pfeiffer, Ahmed Ali, Farah Mohamed et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5This study looked at a program in Puntland, Somalia called Marwo Caafimaad, which trains local women as community health workers to provide reproductive health education and basic care to mothers. Researchers interviewed 45 mothers and 9 health workers in 2022 to understand their experiences. Mothers valued the program because it brought trusted, home-based health support closer to them, cutting down on distance and cost barriers. However, both mothers and health workers said the program was limited by a lack of nearby health centres, shortages of medicine, too few staff, insufficient training, and delayed pay. The study concludes that more investment is needed to strengthen the program's impact.
Key points
- Mothers valued trusted, home-based support that reduced barriers related to distance, cost and family responsibilities
- Community health workers reported strong community acceptance and supportive supervision
- Both groups identified lack of local maternal and child health centres as a major barrier
- Shortage of medicines, supplies, inadequate staffing, limited refresher training were cited as barriers
- Delayed or insufficient remuneration for health workers limited programme impact
Limitations
The study is based on qualitative interviews and focus groups from a small number of villages, so it cannot measure actual health outcomes or determine how representative the experiences are of the wider population.
Abstract
Background: Somalia has one of the highest maternal mortality ratios globally, with low antenatal care coverage and low skilled birth attendance. In Puntland, Somalia, the Marwo Caafimaad programme trains female community health workers to provide reproductive health education, basic care and referrals. Aim: To assess the experiences of mothers and female community health workers accessing and implementing the Marwo Caafimaad programme in Puntland, Somalia. Methods: In 2022, we conducted focus group discussions with 45 eligible mothers accessing services through the Marwo Caafimaad programme in 7 villages of Puntland, Somalia, and in-depth interviews with 9 community health workers involved in implementing the programme. We analysed the data thematically using Dedoose version 9.0.107. Results: The mothers valued the programme for providing trusted, home-based support and reducing barriers to care related to distance, cost and family responsibilities. Female community health workers reported strong community acceptance and supportive supervision of the programme. Both groups identified lack of local maternal and child health care centres, shortage of medicines and supplies, inadequate staffing, limited refresher training, and delayed or insufficient remuneration as barriers limiting programme impact. Conclusion: The services provided by Marwo Caafimaad were highly valued in the remote communities of Puntland, however, resource and workforce constraints limited the impact of these services. Additional investment in local facilities, supplies, remuneration, workforce expansion, and training is needed to strengthen the programme.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Training female community health workers to provide reproductive health education, basic maternal care and referrals through the Marwo Caafimaad programme
- Population
- Mothers and female community health workers in 7 villages in Puntland, Somalia
Key finding
Mothers valued the trusted, home-based support and reduced access barriers
Mohamed et al. · OpenAlex · 3 Sept 2026