The Republic of Djibouti is located in the Horn of Africa, bordered by Somaliland, Eritrea, the Red Sea, and the Gulf of Aden. While small in geographical size, Djibouti benefits from a particularly strategic location, jutting out into the Gulf of Aden. Its modern port serves important traffic coming across the Red Sea and the Indian Ocean. Djibouti is home to the lowest point in Africa, the saline Lake Assal, which is 509 feet below sea level. The population of about 940,000 is composed of 60 percent Somali and 35 percent Afar people, speaking the official languages of French and Arabic, in addition to Somali and Afar. The vast majority of the population is Sunni Muslim, with a small portion, mostly foreigners, identifying as Christian. More than 78 percent of Djiboutians live in cities. The capital of Djibouti, also named Djibouti, is home to 600,000 people. Other cities throughout the country have significantly lower populations, none exceeding 50,000.

Formerly known as French Somaliland and the French Territory of the Afars and Issas, Djibouti adopted its modern name after it gained independence from France in 1977. Due to Djibouti’s harsh climate and limited arable land, agriculture is not a key economic sector. Rural areas are known for raising sheep and goats in small herds for meat, milk, and skins. Overall, Djibouti faces high levels of unemployment because there are few natural resources, agriculture is not a viable industry, and there is limited development in the manufacturing and industrial sectors. Therefore, the country focuses primarily on the service sector, which accounts for the majority of its GDP. Many Djiboutians struggle with unemployment, and poor housing and insufficient water and sanitation facilities contribute to poor overall living conditions.

Chewing khat, a practice that dates back thousands of years in the Horn of Africa, is widespread in Djibouti, and can lead to adverse health effects, such as depression. In addition to pervasive khat chewing, other factors that contribute to poor health include: malnutrition, unsafe sex, air pollution, high blood pressure, tobacco, dietary risks, high fasting plasma glucose, high body-mass index, kidney dysfunction, non-optimal temperature, and a lack of water, sanitation, and hygiene. The causes of most deaths in the country include HIV/AIDS, neonatal disorders, lower respiratory infections, ischemic heart disease, stroke, tuberculosis, diarrheal diseases, cirrhosis, diabetes, protein-energy malnutrition, and congenital defects. Notably, deaths due to non-communicable diseases such as ischemic heart disease, stroke, cirrhosis, and diabetes have all increased by at least 48 percent or more over the past decade