Description
Background
Non-communicable diseases (NCDs) account for over 25% of deaths in Somalia, with hypertension (33%) and diabetes (20%) disproportionately affecting displaced populations along the Kenya–Somalia border. Mobile communities face fragmented care due to overcrowded facilities, policy gaps, and administrative barriers. To address these challenges, the Kenya Red Cross, with support from the World Diabetes Foundation through Danish Red Cross, established a cross-border referral system anchored in institutional partnerships and digital tools to enhance care coordination for over 400,000 refugees in Dadaab and border towns.
Methods
Interventions were implemented across 11 facilities in Dadaab (Kenya), Dhobley, and Beled-Hawa (Somalia), targeting health workers (HCWs), community health promoters (CHPs), and NCD patients. Strategies included deployment of EspoCRM, a digital referral platform for real-time tracking; use of standardized forms and WhatsApp/SMS for communication; and training of 210 HCWs and CHPs on NCD care. Facilities were equipped with diagnostic and digital infrastructure to strengthen service delivery.
Results
A total of 331 NCD patients were registered, with 112 cross-border referrals facilitated. Follow-up rates improved from 41% to 59% in Kenya and 34% to 41% in Somalia. Clinical outcomes showed significant progress: 94% of hypertensive patients in Somalia achieved blood pressure control, while 89% of diabetic patients in Kenya attained glycemic control. Community engagement was strong, with 81% of patients in Dadaab receiving regular home visits by CHPs. However, documentation gaps emerged, with only 5 referrals logged digitally versus 112 manually recorded.
Conclusion
Digital referral systems and mobile communication strengthened NCD care continuity in fragile, high-mobility settings. Success was enabled by Kenya Red Cross–Somali Red Crescent partnerships and CHP integration. Sustaining impact requires bilateral health agreements to formalize referrals and data sharing, alongside phased digital scaling and infrastructure investment.
Keywords
Transboundary health issues; Continuity of care; Digital health; Refugee health; Non-communicable diseases.
| Country | Kenya |
|---|---|
| Organization | Non-Governmental Organization (NGO) |
| Position | Health Program officer |
| Received a Grant? | Yes |
| If yes, give grant details | The project was funded by world diabetes foundation through Danish Red Cross from November 2022 to May 2025. |
