Community engagement in Ethiopia’s Somali Region has demonstrated the greatest effectiveness when approaches are culturally sensitive, trust-centered, and aligned with established community systems. The region’s largely pastoralist and agro-pastoralist population, strong clan-based social organization, and significant religious influence necessitate engagement strategies that emphasize mutual respect, inclusive dialogue, and community ownership. Government institutions and humanitarian partners have implemented diverse engagement approaches across health, nutrition, gender-based violence (GBV) prevention, and disease surveillance interventions, yielding varying levels of impact.
The involvement of religious and clan leaders has been among the most successful engagement strategies. Imams, Sheikhs, and clan elders are widely respected and serve as influential decision-makers within communities. Their participation in promoting maternal and child health, immunization, nutrition practices, and disease reporting has substantially improved community acceptance. Health messages disseminated through Friday sermons, mosque announcements, and community gatherings are viewed as credible and culturally appropriate. Community response to this approach has been particularly positive for interventions that previously encountered resistance, including vaccination campaigns and early health-seeking behaviors.
Health Extension Workers (HEWs) and community volunteers have also played a vital role in maintaining sustained engagement at the household level. Through door-to-door outreach, small group discussions, and follow-up counseling, they provide tailored information to pregnant and lactating women, caregivers, and adolescents. This interpersonal approach has been well received, especially by women, as it supports trust-building and individualized guidance. The strategy has proven effective in improving infant and young child feeding practices, hygiene behaviors, and timely utilization of health services, although the mobility of pastoralist households remains a challenge to consistent outreach.
Engagement efforts have been further strengthened by leveraging existing community platforms. The use of mosques, women’s groups, youth associations, market-day gatherings, and informal social forums has enabled programs to reach broader audiences without disrupting daily activities. Participation tends to be higher when discussions take place within familiar and trusted settings. This approach has been particularly effective for hygiene promotion, GBV awareness, and community-led problem-solving initiatives.
Participatory community dialogue has emerged as a key driver of sustainability and local ownership. By facilitating open discussions that allow communities to identify challenges, address social norms, and develop locally appropriate solutions, programs move beyond one-way information dissemination. Communities have responded positively to being actively involved in decision-making, making this approach effective in addressing harmful practices, improving nutrition behaviors, and strengthening engagement of men and elders.
More recently, the establishment of Village Health Leaders, locally referred to as REEr Health Leaders, has emerged as the most effective and contextually appropriate community engagement approach in the Somali Region. This model builds on existing clan and village leadership structures by identifying respected, trusted individuals within each REEr (village or sub-clan unit) to serve as a direct link between communities and the health system. REEr Health Leaders support health promotion, disease surveillance, nutrition counseling, maternal and child health referrals, and GBV prevention by mobilizing households, facilitating community dialogue, and reinforcing key health messages. The approach has been piloted in selected woredas (administrative districts in Ethiopia), where it has demonstrated strong community acceptance, improved ownership, and timely community response, particularly in hard-to-reach pastoralist settings. Because REEr Health Leaders are embedded within the community and move with pastoralist populations, they effectively address mobility challenges and ensure continuity of engagement. This approach strengthens trust, accountability, and sustainability, making it a highly effective model for scaling community engagement interventions across the Somali Region.
In addition, the use of Somali-language information, education, and communication (IEC) and behavior change communication (BCC) materials, along with local radio programming, has expanded outreach to low-literacy and hard-to-reach populations. Visual materials and radio messages are widely accepted and have proven especially effective during public health emergencies and disease outbreaks.
Overall, community engagement strategies in the Somali Region are most effective when they integrate trusted local leadership, interpersonal communication, participatory dialogue, and culturally appropriate messaging. These approaches build trust, enhance community acceptance, and support sustained behavior change through meaningful community ownership.