Healthcare in

Somalia

Healthcare in Somalia is largely in the

private sector. It is regulated by the
Ministry of Health of the Federal
Government of Somalia. In March 2013,
the central authorities launched the Health
Sector Strategic Plans (HSSPs), a new
national health system that aims to
provide universal basic healthcare to all
citizens by 2016. Somalia has the highest
prevalence of mental illness in the world,
according to the World Health
organization.[1] Some polls have ranked
Somalis as the happiest people in Sub-
Saharan Africa[2].

History

Dr. Xooshdheere, minister of health for the Dervish

state and oldest Somali in history
During the medieval era, traditional forms
of medicine were often used. During the
colonial era, due to the distrust that
existed in northwest Somalia towards
British colonial administrators, there was
minimal development in healthcare
training. The BMA (British Military
Administration) diminished the inflow of
Italians into southern Somalia which
hampered the building of facilities.[3]
During the time of the Darwiish State,
Xooshdheere was the only doctor
operating within Darwiish territories.[4]

Until the collapse of the federal

government in 1991, the organizational
and administrative structure of Somalia's
healthcare sector was overseen by the
Ministry of Health. Regional medical
officials enjoyed some authority, but
healthcare was largely centralized. The
socialist government of former President
of Somalia Siad Barre had put an end to
private medical practice in 1972.[5] Much
of the national budget was devoted to
military expenditure, leaving few resources
for healthcare, among other services.[6]
The Gardo General Hospital in Qardho is one of
Somalia's many new private healthcare facilities

Somalia's public healthcare system was

largely destroyed during the ensuing civil
war. As with other previously nationalized
sectors, informal providers have filled the
vacuum and replaced the former
government monopoly over healthcare,
with access to facilities witnessing a
significant increase.[7] Many new
healthcare centers, clinics, hospitals and
pharmacies have in the process been
established through home-grown Somali
initiatives.[7] The cost of medical
consultations and treatment in these
facilities is low, at $5.72 per visit in health
centers (with a population coverage of
95%), and $1.89–3.97 per outpatient visit
and $7.83–13.95 per bed day in primary
through tertiary hospitals.[8]

Comparing the 2005–2010 period with the

half-decade just prior to the outbreak of
the conflict (1985–1990), life expectancy
actually increased from an average of 47
years for men and women to 54 years for
men and 57 years for women.[9]
[10][11]

Child mortality and morbidity

The last three decades of armed conflicts,

lack of functioning government, economic
collapse, and disintegration of the health
system and other public services -
together with recurrent droughts and
famines – has turned Somalia into one of
the world’s most difficult environments for
survival. This is bluntly reflected in the
poor child health conditions, as twenty per
cent of the children die before they reach
the age of five, more than one third are
underweight, and almost fifty per cent
suffer from stunting.[12] The under-five
mortality rate in Somalia is among the
highest in the world, while the prevalence
of malnutrition has remained at record
high levels for decades. It is therefore
likely that malnutrition contributes to more
than half of the under-five deaths in
Somalia. Pneumonia, diarrhoea and
neonatal causes account for a large
proportion of childhood deaths.[13]

The number of one-year-olds fully

immunized against measles rose from
30% in 1985–1990 to 40% in 2000–
2005,[10][14] and for tuberculosis, it grew
nearly 20% from 31% to 50% over the
same period.[10][14] In keeping with the
trend, the number of infants with low birth
weight fell from 16 per 1000 to 0.3, a 15%
drop in total over the same
timeframe.[10][15] Between 2005–2010 as
compared to the 1985–1990 period, infant
mortality per 1,000 births also fell from
108 to 85.[10][11][16] Significantly,

Maternal mortality

Maternal mortality per 100,000 births fell

from 1,600 in the pre-war 1985–1990 half-
decade to 850 in the 2015.[10][17][18] The
number of physicians per 100,000 people
also rose from 3.4 to 4 over the same
timeframe,[10][14] as did the percentage of
the population with access to sanitation
services, which increased from 18% to
26%.[10][14]

According to United Nations Population

Fund data on the midwifery workforce,
there is a total of 429 midwives (including
nurse-midwives) in Somalia, with a density
of 1 midwife per 1,000 live births. Eight
midwifery institutions presently exist in the
country, two of which are private.
Midwifery education programs on average
last from 12 to 18 months, and operate on
a sequential basis. The number of student
admissions per total available student
places is a maximum 100%, with 180
students enrolled as of 2009. Midwifery is
regulated by the government, and a license
is required to practice professionally. A live
registry is also in place to keep track of
licensed midwives. In addition, midwives
in the country are officially represented by
a local midwives association, with 350
registered members.[19]

A Somali boy receiving a polio vaccination

According to a 2005 World Health
Organization estimate, about 97.9% of
Somalia's women and girls underwent
female circumcision,[20] a pre-marital
custom mainly endemic to Northeast
Africa and parts of the Near East.[21][22]
Encouraged by women in the community, it
is primarily intended to protect chastity,
deter promiscuity, and offer protection
from assault.[23][24] By 2013, UNICEF in
conjunction with the Somali authorities
reported that the prevalence rate among 1-
to 14-year-old girls in the autonomous
northern Puntland and Somaliland regions
had dropped to 25% following a social and
religious awareness campaign.[25] About
93% of Somalia's male population is also
reportedly circumcised.[26]

Somalia has one of the lowest HIV

infection rates on the continent. This is
attributed to the Muslim nature of Somali
society and adherence of Somalis to
Islamic morals.[27] While the estimated HIV
prevalence rate in Somalia in 1987 (the
first case report year) was 1% of adults,[27]
a more recent estimate from 2014 now
places it at only 0.5% of the nation's adult
population.[28]

Although healthcare is now largely

concentrated in the private sector, the
country's public healthcare system is in
the process of being rebuilt, and is
overseen by the Ministry of Health.[29] The
current Minister of Health is Ahmed
Mohamed Mohamud.[30] The autonomous
Puntland region maintains its own Ministry
of Health,[31] as does the Somaliland
region in northwestern Somalia.[32]

Health Sector Strategic Plans

Caring for a bone fracture

In March 2013, the federal government

under former Minister of Health Maryam
Qaasim launched the Health Sector
Strategic Plans (HSSPs) for each of
Somalia's constituent zones. The new
national health system aims to provide
universal basic healthcare to all citizens by
2016. While the government's institutional
capacity is developing, UN agencies would
in the interim through public-private
partnerships administer immunization
among other associated health programs.
The HSSPs are valued at $350 USD million
in total, with between 70%-75% earmarked
for health services. Once finalized, the new
national healthcare system is expected to
ameliorate human capital in the health
sector, as well as improve funding for
health programs and overall health
infrastructure.[33]

In May 2014, the Federal Government

launched the Essential Package of Health
Services (EPHS) within the framework of
the Health Sector Strategic Plans.[34] The
EPHS was originally designed in 2008 by
the Somali Ministry of Health, with the
goal of establishing standards for national
health services vis-a-vis governmental and
private healthcare providers, as well as for
partnered UN agencies and NGOs.[35] It
aims to provide a holistic spectrum of free
health services to all citizens, including in
rural areas. With a focus on strengthening
reproductive and emergency obstetric care
services for women and children, the
EPHS's core programmes are to eliminate
communicable illness; ameliorate
reproductive, neonatal, child and maternal
health; improve health control and
surveillance, including water and
sanitation promotion; supply first-aid and
treatment to the terminally ill or wounded;
and to treat common illnesses, HIV and
other STDs, and tuberculosis. The Somali
health authorities are slated to implement
the Essential Package of Health Services
in nine regions, with UNICEF, UNFPA and
WHO representatives providing additional
support. The initiative will continue
through to the end of 2016, and is
expected to ensure that health facilities
operate with better equipment, more
healthcare workers, and for longer shifts. It
is also centered on growing institutional
capacity through training medical
personnel, health sector reform, and policy
development facilitation.[34]

Hospitals
Medical hospitals and facilities in
Somalia's administrative provinces
include:[36][37]

Awdal
Dr. Aden Farah Abraar Regional Hospital
Borama Fistula Hospital
Alaale Hospital
Al Hayat Medical Centre
Bakool
Hudur Hospital
Banaadir
Banadir Hospital
Digfeer Hospital
Dr. Xasan Jis Memory Hospital
Erdoğan Hospital
Kalkaal Speciality Hospital
Keysaney Hospital
Lazaretto Forlanini Hospital
Martini Hospital
Medina Hospital
SOS KDI M&C Hospital
Yardimeli Hospital (under construction)
Daryeel Specialist Hospital (since 2016,
4 darjiino)
 Makka Hospital
MOGADISHU UROLOGICAL CENTER
Bari
Bosaso General Hospital
Qardho General Hospital
Bay
Baidoa Hospital
Burhakaba Hospital
Dinsor Hospital

dr osama hospital

Galguduud
Abudwak Maternity and Children's
Hospital
Adaado Hospital
Dusamareb Hospital
El-Dher District Referral Hospital
Istalin Hospital
Gedo
East Bardera Mothers and Children's
Hospital
Garbahaarey Hospital
Khalil Hospital
Luuq Hospital
West Bardera Maternity Unit
Hiran
Dove Voluntary Hospital
Lower Juba
Kismayo Hospital
Mareerey Hospital
Kismayo Medical Center
Lower Shebelle
Afgooye District Hospital
Belet Hawa Hospital
Brava Regional Hospital
Hayat 2 Hospital
Marka Regional Hospital
Qoryoley District Hospital
VMB Maternity Hospital
Middle Shebelle
Adale Medical Center
Jowhar Regional Hospital
Mudug
Galkayo South Hospital
Mudug Regional Hospital
Harardere District Referral Hospital
Nugal
Nugal General Hospital
Sanaag
Badhan Hospital
Dhahar Hospital
Erigavo Referral Hospital
Las Khorey Hospital
Sool
Las Anod Hospital
Taleh Hospital
Togdheer
Buhoodle District Hospital
Sheikh Hospital
 Woqooyi Galbeed
Berbera Regional Hospital
Edna Adan Maternity Hospital
Gabiley District Hospital
Hargeisa Canadian Medical Center
Hargeisa Group Hospital
Mohamed Aden Sheikh Children's
Teaching Hospital

Medical universities and

facilities
Abrar University
Amoud University, College of Medicine
and Medical Sciences
Benadir University
Bosasso School of Nursing
Burao Institute of Health Sciences
East Africa University
Edna Adan Maternity Hospital
Erdoğan Hospital
Hargeisa Institute of Health Sciences
Hargeisa University
Indian Ocean University
Jazeera University
Kismayo University
Livestock university
Mogadishu Private School of Nursing
Mogadishu Public School of Nursing
Mogadishu University
 Nugaal University
Plasma University
Puntland School of Nursing
Somaliland University of Technology
University of Burao
University of Hargeisa

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External links
Hospitals in Somalia
Medical schools in Somalia

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title=Healthcare_in_Somalia&oldid=902674612"

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