Perinatal mental health among women in Somalia a silent emergency demanding urgent health system action.

This paper examines perinatal mental health in Somalia, where depression and anxiety affect approximately one in four pregnant and postpartum women but receive no attention in routine maternal care. The authors identify structural barriers including three decades of conflict, gender-based violence, weak health systems, and very low facility-based birth rates. They propose integrating mental health screening into primary healthcare, using community health workers, adapting interventions culturally, and strengthening governance. The authors argue that addressing perinatal mental health is essential for reducing maternal and neonatal mortality and protecting child development.

Key points

• Depression and anxiety affect approximately one in four perinatal women in Somalia
• Maternal mortality ratio is 621 per 100,000 live births with fewer than 21% of births in health facilities
• Perinatal mental health is entirely absent from routine maternal care
• The barriers include three decades of protracted conflict, gender-based violence, and one of the world's weakest health systems
• Proposed solutions include screening and brief interventions in primary healthcare, task-shifting to community health workers, and culturally adapted psychosocial interventions

Limitations

This is a perspective piece rather than an empirical study, so it does not present new data on the prevalence or outcomes of perinatal mental health interventions in Somalia. The document identifies the problem and proposes solutions but does not evaluate the effectiveness of these approaches.