In Daajir, a rural settlement for internally displaced families in southwestern Somalia, many of whom fled drought and insecurity, daily life is shaped by scarcity. Years of prolonged dry spells have eroded livelihoods, deepened food insecurity, and strained fragile health services.
For women, the crisis also limits control over their reproductive health, as survival often takes priority over preventive care.
Leyla, 26, is a mother of seven. For years, she faced repeated unplanned pregnancies while managing a large household under difficult conditions. Her health declined, and the demands of daily life made it hard to keep up with short-term contraceptive methods.
In Daajir, access to reproductive health services is shaped by distance, limited resources, and social norms. Decisions about childbearing are often influenced by partners and relatives, and misinformation can discourage use. Leyla’s husband was initially hesitant, reflecting common concerns in the community. Oral contraceptive pills also proved difficult for Leyla to manage consistently amid illness, fatigue, and constant caregiving.
Through the WISH2 program in Somalia, implemented by partners including the International Planned Parenthood Federation (IPPF) and the Johns Hopkins Center for Communication Programs (CCP), community health workers began holding regular discussions about healthy birth spacing and available contraceptive options.
CCP’s role focuses on addressing the social and gender norms that shape these decisions. Working with local leaders, community health workers created space for open conversation and questions.
Leyla attended one of these sessions and was referred to a nearby health facility within the WISH2 network. There, a trained provider offered confidential counseling. After discussing her experience with pills, Leyla chose to switch to a long-acting contraceptive implant.
“I finally felt calm when I understood my options,” she said. “This method helped me focus on my family again.”
Follow-up was a key part of the process. Community health workers visited Leyla five times after her appointment, checking on her, answering questions and reinforcing key information. They also engaged her husband and relatives, helping to address concerns and build support over time.
With a method that suits her circumstances, Leyla can now space her pregnancies and begin to recover physically. Her stress has decreased, and she has felt better able to care for her children and manage daily responsibilities. She also gained a stronger sense of control over her choices.
Leyla’s experience reflects a broader approach that connects community outreach with accessible, quality services.
“Our project focuses on interventions that go beyond addressing knowledge gaps in reproductive health,” said Mohamed Gelle, who works for the International Rescue Committee (IRC) as part of WISH2 in Somalia. “We deliberately identify and tackle the underlying social and gender norms that act as barriers to uptake and to the overall wellbeing of women and girls.”
In settings like Daajir, where access is limited and needs are high, this kind of coordinated approach can make a difference. “By combining community engagement, respectful care, and ongoing support, programs can help ensure that women have the information and services they need to make decisions about their own health,” said CCP’s Alfayo Wamburi.
“For Leyla, that meant moving from uncertainty to a greater sense of stability. It began with a conversation and continued with support that met her where she was.”
