Peer-reviewed article
Public Health Challenges in Somalia: Strengthening Health Systems for Resilient and Equitable Healthcare Delivery.
Mohamoud JH, Adam MH, Sheikh Mohamed AM ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001Somalia faces severe public health challenges including high maternal and child mortality, malnutrition, and poor sanitation, worsened by conflict, fragile governance, and a weak health system. The country struggles with both infectious diseases and chronic conditions, with major shortages in health workers, laboratory capacity, and surveillance systems. The paper argues that building a resilient health system requires coordinated governance, sustainable financing, integrated primary care, and better links between communities and health facilities rather than relying on temporary humanitarian responses.
Key points
- Somalia has persistently high maternal and child mortality alongside dual burden of communicable and non-communicable diseases
- Health system faces workforce shortages, limited laboratory and surveillance capacity, and heavy dependence on external financing
- Recurrent nutrition and WASH emergencies driven by conflict, climate disasters, and displacement
- Fragmented, crisis-driven service delivery cannot achieve health-system resilience
- Transition needed toward accountable primary-health-care-centred system with coordinated federal-state governance and sustainable financing
Limitations
This is a perspective paper that identifies problems and recommends approaches but does not present empirical evidence, data on current health indicators, or evaluation of specific interventions. It cannot tell us the magnitude of specific health problems or the effectiveness of proposed solutions.
Abstract
Somalia continues to face multidimensional public health challenges driven by prolonged conflict, political instability, fragmented governance, climate-related disasters, displacement, poverty, and a fragile health system. The country carries a dual burden of communicable and non-communicable diseases (NCDs), alongside persistently high maternal and child mortality and recurrent nutrition and WASH emergencies. These pressures are intensified by workforce shortages, limited laboratory and surveillance capacity, unequal access to care, and heavy dependence on externally financed programmes. In this perspective, health-system resilience refers to Somalia's capacity to anticipate, absorb, adapt to, and recover from shocks while maintaining equitable delivery of essential services. We argue that resilience cannot be achieved through disease-specific or short-term humanitarian programmes alone; it requires stronger public stewardship, coordinated federal-state governance, sustainable financing, integrated primary health care, a retained and equitably distributed workforce, interoperable surveillance, and climate-resilient WASH and referral systems. The central recommendation is therefore a transition from fragmented, crisis-driven service delivery toward an accountable, primary-health-care-centred system that links communities, public and private providers, laboratories, referral facilities, and emergency response mechanisms.