Puntland launches its first Health and Demographic Survey

GAROWE, 29th November 2020 – A new report jointly launched today by the Minister of Planning, Economic Development and International Cooperation Honourable Abdiqafar Elmi Hange and the Minister of Health Honourable Jama Farah Hassan of Puntland —titled the Puntland Health and Demographic Survey (PLHDS) Report 2020—offers decision-makers and stakeholders salient information on the health and lives of women and children in Puntland.

Data was collected from over 28,000 households across Puntland as well as difficult-to-reach nomadic households, across Five regions.  

The PLHDS report provides information on housing and household characteristics, health, education, marriage, fertility, birth spacing, water and sanitation, health expenditure, chronic diseases, and children’s and women’s nutrition. The report 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.

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

  • For the first time, Puntland has a Maternal Mortality Ratio (MMR) indicator (622 maternal deaths per 100,000 live births).
  • Pregnant women who attended ANC at least four times increased from 3.3 percent in 2011[1]  to 6.0 percent.
  • The health facility deliveries have increased from 13 percent in 2011[2]  to 19 percent.
  • Early marriage—known to deprive women of opportunities to reach their full potential—has reduced for women married by age 18, from 38 percent in 2011[3] to 23 percent.
  • About two out of three Puntland households (66 percent) own simple mobile phones, and around 59 percent of nomadic households own simple mobile telephones with access to FM radio, opening doors to endless opportunities for the  people
  • Puntland women are empowered to make financial choices—nine out of ten women decide on how their cash earnings are spent, either individually or jointly with their husbands, and around six out of ten women of childbearing age use their phones for financial transactions.


The PLHDS report sheds light on areas that need interventions for women and children to lead better lives. The results show that around one in five  births ( 19 percent) was delivered in a health facility (for births delivered in the five years preceding the survey), and an overwhelming majority of births—around eight out of 10 (81 percent)—were delivered at home. Additionally, only one out of three births (33 percent) were delivered with the assistance of a skilled health care provider and 73 percent of women did not make antenatal visits during their most recent pregnancy in the five years prior to the survey. According to Puntland women aged 15-49, the reasons for their low uptake of health care during pregnancy and child delivery include lack of money, long distances to health facilities, reluctance of spouses to accompany women to the health facility and the need for women to obtain permission from family members before seeking health services.

The PLHDS report further unveils that the fertility rate remain relatively high—the total fertility rate for Puntland is 6.8 children per woman—which would impact planning for the coming years. In addition, female circumcision is still widely practiced across the country—99 percent of women have been circumcised. Although Puntland communities are seen to be moving towards practising the intermediate and mild Sunni forms of circumcision, survey results show that the severe Pharaonic form is still the most common form being practised, with 59 percent of women having 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. Three percent of nomadic women reported they made their first ante-natal care visit within the first four months, as compared to 16 percent and 10 percent of women in urban and rural households, respectively.

“This is a game-changing survey for our state,” said Honourable Abdiqafar Elmi Hange, Minister of Planning, Economic Development and International Cooperation, Puntland State. “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 PLHDS report also shows us that more work needs to be done to bridge the gaps visible among women and children in Puntland, and particularly among men and women, and people 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 Puntland women face in accessing health. We can ensure mothers feel safe while delivering their babies, 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.

Visit http://www.mopicplgov.net; https://www.moh.pl.so; http://www.pl.statistics.so; to read The Puntland Health and Demographic Survey (PLHDS) 2020 Report.

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Note to editors: The PLHDS was conducted over two phases, from 2018-2019. The first phase focused on listing households and obtaining information on maternal mortality. Information presented in the PLHDS apart from maternal mortality was collected during the second phase.

Information on nomadic populations was collected from temporary nomadic households, visited with support from nomadic link workers from local communities, who maintain social ties with nomadic communities.

The PLHDS was carried out by the Puntland Statistics Department and Ministry of Health, in collaboration with UNFPA. The survey was conducted with financial support from The Government of Sweden, The Government of Finland,The Government of Italy, The Italian Agency for Development Cooperation (AICS), The Swiss Agency for Development and Cooperation and the Foreign Commonwealth Office for Development (FCDO) formerly DfID.

Press Release_PLHDS Report Launch