People and Society of Djibouti

Nationality

Djiboutian(s)

Ethnic Groups

Somali 60%, Afar 35%, French, Arab, Ethiopian, and Italian 5%

Population

1,120,849

Population in Major Urban Areas

DJIBOUTI (capital) 496,000

Adequate medical facilities in the capital of Djibouti are limited and trauma services are only for stabilization and air ambulance transfer. Medical services in many outlying areas are nonexistent. Even in the capital, hospitals are unable to treat many ailments and frequently recommend medical evacuation. Visitors to Djibouti should purchase medical evacuation insurance. Hospitals in Djibouti require up-front cash payment for services and do not have service agreements with U.S. insurance companies. Cash payment will be requested in full before the patient is allowed to depart the hospital – reimbursement may then be requested by the U.S. Citizen through their insurance company in the United States. U.S. Motorists should be especially aware that, in case of an accident outside the capital, emergency medical treatment would depend on assistance from passersby. In addition, cell phone coverage in outlying areas is often unavailable, making it impossible to summon help. Ambulance service in Djibouti is limited in effectiveness, must be scheduled and paid for in advance and is only a means of transportation. U.S. Citizen visitors to Djibouti are not permitted to access Embassy or U.S. Military medical facilities and must depend entirely on local medical facilities. Malaria and dengue fever are endemic to Djibouti. Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and even up to one year after returning home should seek prompt medical attention, tell their medical provider about their travel history and what anti-malarial drugs they have been taking. In 2013, polio was found in Djibouti’s neighbors (Somalia and Ethiopia), and health professionals strongly suspect it is present in Djibouti. The Advisory Committee on Immunization Practices (ACIP) recommends that all infants and children in the United States should receive four doses of inactivated poliovirus vaccine (IPV) at 2, 4, 6–18 months and 4–6 years of age. Adults traveling to polio-endemic and epidemic areas and who have received a primary series with either IPV or oral polio vaccine should receive another dose of IPV. For adults, available data does not indicate the need for more than a single lifetime booster dose with IPV. Tuberculosis is a serious health concern in Djibouti, including multi-drug resistant strains. For further information, please consult the CDC's information on TB. In May 2006, avian influenza was confirmed in three chickens and one human in Djibouti.

Life Expectancy at Birth

Life expectancy at birth in Djibouti stands at approximately 63 to 64 years overall, with women living slightly longer than men at around 65 years compared to roughly 62 years for men. These figures place Djibouti in the lower range among African nations, reflecting both the persistent challenges and the gradual improvements the country has made in public health over recent decades. Several factors influence these numbers significantly. Djibouti faces ongoing public health challenges, including a notable prevalence of tuberculosis, HIV/AIDS, and vector-borne diseases. Access to clean drinking water and adequate sanitation remains limited outside of the capital city, contributing to waterborne illnesses that particularly affect infant and child mortality rates. The country's arid climate and limited agricultural capacity also contribute to food insecurity, which in turn affects nutritional health and overall longevity. Infant mortality, while still elevated compared to global averages, has been declining steadily. This improvement is largely attributed to expanded vaccination programs, increased access to maternal healthcare, and international aid supporting healthcare infrastructure. Djibouti's government, in partnership with organizations such as the World Health Organization and UNICEF, has worked to extend basic medical services to more of the population, including rural and nomadic communities that have historically been underserved. Urban residents, particularly those in Djibouti City, tend to have better access to hospitals and clinics, giving them somewhat higher life expectancy prospects compared to those living in more remote areas. The concentration of healthcare resources in the capital creates a notable disparity in health outcomes across the country. Despite these challenges, life expectancy in Djibouti has risen considerably since the 1970s, when it hovered closer to the low 40s, representing meaningful and sustained progress in public health. Continued investment in clean water access, disease prevention, and maternal and child health services will be critical to sustaining and accelerating these gains in the years ahead.

Infant Mortality Rate

Djibouti has made measurable progress in reducing infant mortality over recent decades, though rates remain elevated compared to global averages. The country's infant mortality rate stands at approximately 40 to 43 deaths per 1,000 live births, reflecting ongoing challenges in healthcare access, nutrition, and infrastructure — particularly in rural and peri-urban areas. Infants in Djibouti face heightened risks from preventable and treatable causes, including neonatal infections, diarrheal diseases, acute respiratory infections, and complications arising from preterm birth. Malnutrition compounds these risks significantly, as stunting and wasting among young children remain persistent public health concerns. The country's harsh arid climate, limited freshwater resources, and food insecurity contribute to the vulnerability of newborns and young infants. Disparities in infant survival exist between urban and rural populations. Djibouti City, home to the majority of the country's population, has comparatively better access to hospitals, trained midwives, and maternal care services. In contrast, nomadic and semi-nomadic communities in the interior regions often lack consistent access to skilled birth attendants and postnatal care, placing infants at considerably greater risk during their first weeks of life. Government efforts, supported by international partners including UNICEF and the World Health Organization, have focused on expanding immunization coverage, improving antenatal and postnatal care, promoting exclusive breastfeeding, and training community health workers. Vaccination programs targeting diseases such as diphtheria, measles, and polio have contributed to declines in child deaths over time. Despite progress, Djibouti's infant mortality rate remains higher than the global average of approximately 27 deaths per 1,000 live births, and higher still compared to upper-middle-income countries. Continued investment in maternal and child health systems, clean water access, and nutrition programs is considered essential to sustaining and accelerating reductions in infant deaths. The country's ongoing refugee population, arriving primarily from neighboring Somalia and Ethiopia, also places additional strain on health resources and affects overall infant health outcomes.

Major Infectious Diseases

High

Literacy Definition

Age 15 and over can read and write

• Muslim94.0%
• Christian6.0%

French (official), Arabic (official), Somali, Afar

• Arabic
• French

Crime Information

Accurate Djiboutian crime statistics are not available, but the majority of crimes are petty theft and crimes of opportunity. Anecdotal evidence suggests an increasing frequency of violent crimes against Djiboutian citizens and burglaries of residences in established neighborhoods. Violent crimes against foreigners are rare in Djibouti. However, foreigners are frequent victims of snatch-and-grab robberies and price gouging by unscrupulous taxi drivers. Do not buy counterfeit and pirated goods, even if they are widely available. Not only are the bootlegs illegal in the United States, if you purchase them you may also be breaking local law.

Criminal Penalties

While you are traveling in Djibouti, you are subject to its laws even if you are a U.S. citizen. Foreign laws and legal systems can be vastly different from our own. In some places, you may be taken in for questioning if you don’t have your passport with you. In some places, it is illegal to take pictures of certain buildings. In some places, driving under the influence of drugs or alcohol could land you immediately in jail. These criminal penalties will vary from country to country. There are also some things that might be legal in Djibouti, but still illegal in the United States. For example, you can be prosecuted under U.S. law if you buy pirated goods. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime prosecutable in the United States. If you break local laws in Djibouti, your U.S. passport won’t help you avoid arrest or prosecution. It’s very important to know what is legal and what is not wherever you go. If you are arrested in Djibouti, you have the right to request authorities alert the U.S. Embassy of your arrest. The U.S. does not have an agreement with Djibouti requiring notification of the U.S. Embassy upon your arrest. If you are arrested in Djibouti you should use whatever means of communication available to alert the U.S. Embassy of your situation.