Somalia is a country facing numerous challenges in achieving universal health coverage (UHC) and ensuring adequate healthcare financing, This article explores the complexities and obstacles that Somalia must overcome in its pursuit of UHC, the paper begins by providing an overview of the current healthcare landscape in Somalia, highlighting the lack of infrastructure, political instability, and limited financial resources that hinder the establishment of a comprehensive and equitable healthcare system. It then examines the role of international aid and non-governmental organizations (NGOs) in filling the healthcare gap, while emphasizing the need for a more sustainable, domestically financed solution. Drawing on a range of data sources and case studies, the article proposes a multi-faceted approach to strengthen healthcare governance, improve resource allocation, and foster local capacity building, the study delves into the unique obstacles that Somalia faces, including a lack of infrastructure, political instability, and limited financial resources, which hinder the establishment of a comprehensive and equitable healthcare system. The paper also examines the role of international aid and non-governmental organizations (NGOs) in filling the healthcare gap, while highlighting the need for a more sustainable, domestically financed solution. The findings underscore the importance of political commitment, international cooperation, and innovative financing mechanisms in advancing towards UHC in Somalia, providing valuable insights for other low resource, conflict affected settings.
KeywordsUniversal Health CoverageHealth GovernanceHealth FinanceEquitable Health Access
Universal Health Coverage Partnership Somalia. WHO/OMS Extranet Systems https://extranet.who.int/uhcpartnership/country-profile/somalia
Somalia, UN Renew Promise to Deliver Health for All, Using Universal Health Coverage, Urge Partners to Do the Same. https://www.unicef.org/somalia/press-releases/somalia-un-renew-promise-deliver-health-all-using-universal-health-coverage-urge
WHO Supports Launch of Universal Health Coverage Roadmap in Somalia. https://www.emro.who.int/somalia/news/who-supports-launch-of-universal-health-coverage-roadmap-in-somalia.html
Universal Health Coverage Day: Translating the Dream of ‘Health for All” into a reality. https://reliefweb.int/report/somalia/universal-health-coverage-day-translating-dream-health-all-reality
WHO: World Health Organization (2018) SDG Monitoring Health for SDGs 2018, Aid Flows in Somalia 2018. https://cdn.who.int/media/docs/default-source/gho-documents/world-health-statistic-reports/2023/world-health-statistics-2023_20230519_.pdf
Ifeagwu, S.C., Yang, J.C., Parkes-Ratanshi, R. and Brayne, C. (2021) Health Financing for Universal Health Coverage in Sub-Saharan Africa: A Systematic Review. Global Health Research and Policy, 6, Article No. 8. https://ghrp.biomedcentral.com/articles/10.1186/s41256-021-00190-7
Warsame, A.A. (2020) Somalia’s Healthcare System: A Baseline Study & Human Capital Development Strategy. The Heritage Institute for Policy Studies and City University of Mogadishu. http://www.heritageinstitute.org/wp-content/uploads/2020/05/Somalia-Healthcare-System-A-Baseline-Study-and-Human-Capital-Development-Strategy.pdf
Growth and Economic Transformation Strategy (Gets) for Somalia: Social Sector Education and Health for Women and Youth Empowerment. https://nec.gov.so/wp-content/uploads/2023/04/GROWTH-AND-ECONOMIC-TRANSFORMATION-STRATEGY-GETS-FOR-SOMALIA-SOCIAL-SECTOR-EDUCATION-AND-HEALTH-FOR-WOMEN-AND-YOUTH-EMPOWERMENT.pdf
World Health Organization (2022) Country Cooperation Strategy for WHO and Somalia 2021-2025. Regional Office for the Eastern Mediterranean. https://applications.emro.who.int/docs/9789290211280-eng.pdf
Somalia: Building a Stronger Primary Health Care System. https://www.who.int/news-room/feature-stories/detail/somalia-building-a-stronger-primary-health-care-system
World Population Review. http://worldpopulationreview.com/countries/somalia-population/
Somali Community Health Strategy. https://somalimedicalarchives.org/media/attachments/2021/09/18/somali-community-health-strategy_-final.pdf
UNICEF Somalia. Community Engagement. https://www.unicef.org/somalia/topics/community-engagement
WHO Somalia Country Cooperation Strategy 2019-23. https://www.who.int/publications-detail-redirect/WHO-CCU-17.01-Somalia
Somalia (SOM)—Demographics, Health & Infant Mortality—UNICEF DATA. https://data.unicef.org/country/som/
Somalia—World Health Organization (WHO). https://www.who.int/countries/som/
World Health Organization (2022) Universal Health Coverage. https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)
The Service Availability and Readiness Assessment (SARA). WHO Report 2016. https://www.who.int/data/data-collection-tools/service-availability-and-readiness-assessment-(sara)
Investment Case for the Somali Health Sector 2022-2027. https://www.globalfinancingfacility.org/sites/gff_new/files/documents/GFF-Annual-Report-2019-2020.pdf
Ahmed, Z., Ataullahjan, A., et al. (2020) Understanding the Factors Affecting the Humanitarian Health and Nutrition Response for Women and Children in Somalia Since 2000: A Case Study. Conflict and Health, 14, Article No. 35. https://conflictandhealth.biomedcentral.com/articles/10.1186/s13031-019-0241-x
The Somaliland Health and Demographic Survey 2020. https://somalia.unfpa.org/sites/default/files/pub-pdf/slhds2020_report_2020.pdf
Somali Community Health Strategy’ National Institute of Health—Somalia. https://nih.gov.so/case-studies/somali-community-health-strategy/
Somalia—Health Indicators—Humanitarian Data Exchange. https://data.humdata.org/dataset/who-data-for-somalia
World Bank FULL REPORT: Somalia Economic Update: Investing in Health to Anchor Growth 2022. https://www.worldbank.org/en/country/somalia/publication/somalia-economic-update-investing-in-health-to-anchor-growth
World Bank Group (2017) Somali Poverty Profile: Findings from Wave 1 of the Somali High Frequency Survey. World Bank Group, Washington DC.
Somalia Economic Update: Investing in Health to Anchor Growth. https://www.worldbank.org/en/country/somalia/publication/somalia-economic-update-investing-in-health-to-anchor-growth
5 Ways to Strengthen Our Health Systems for the Future. https://www.weforum.org/agenda/2022/01/5-ways-to-strengthen-our-health-systems-for-the-future-healthcare/
Askar A. (2017) Bridging Gaps in Health Information Systems: A Case Study from Somaliland. http://www.emro.who.int/emhj-volume-23-2017/volume-23-issue-11/bridging-gaps-in-health-information-systems-a-case-study-from-somaliland.html
World Economic Forum (2013) How to Build a Better Health System: 8 Expert Essays. https://www.weforum.org/agenda/2020/10/how-to-build-a-better-health-system/
Somalia’s Women and Children Are among the 1.84 Million to Benefit from Improved Healthcare Services. https://www.worldbank.org/en/news/press-release/2021/07/19/somalia-s-women-and-children-are-among-the-1-84-million-to-benefit-from-improved-healthcare-services
WHO Global Health Workforce Statistics Database. https://www.who.int/data/gho/data/themes/topics/health-workforce
Health Systems Strengthening—World Health Organization (WHO). https://www.who.int/data/gho/data/themes/topics/health-systems-strengthening
The Somali Human Resources for Health Development Policy 2016-2021 https://www.somalimedicalarchives.org/archive/publications/418-the-somali-human-resources-for-health-development-policy-2016-2021