(2015; 44 pages)
Somalia is one of the most fragile states in the world, with one of the most complex and protracted conflicts. A high‐level forum in June 2015 asked for a comprehensive review of the Somali health sector, which was reinforced by a similar request by the Minister of Health of Somalia. The World Health Organization (WHO) responded by fielding a high‐level review in September 2015. The overall objectives of the review was to assess progress made against the Somali health sector strategic plans (HSSPs) 2013–2016 and humanitarian plans of action, and provide strategic and programmatic recommendations for improvements in the health sector. The review took due cognizance of the Somali Compact and the “New Deal for Somalia” as the overarching strategic framework for coordinating political, security and development efforts.
The Somali government has endorsed a national health policy and developed comprehensive HSSPs for 2013–2016 in Somalia’s three zones – South Central Somalia, Puntland and Somaliland. There are significant variations between the zones as far as implementation of the strategic plans is concerned. The decentralization policy is widely supported, however, it has not been effectively implemented and continues to face significant challenges. Loss of human capital is the main cause of weak institutional capacity. Lack of accountability and transparency is among the key challenges for the health sector. Regulation of health professionals and facilities and enforcement of health regulations are almost non‐ existent. Public health laws are outdated and have not been reviewed for more than 25 years.
Strategic priorities have been proposed for reform of the Somalia health system; for each, there are well‐defined action points. The following strategies are proposed.
- Improving synergy between developmental and humanitarian assistance through enhanced coordination among development partners and the government.
- Improving the stewardship and governance capacities of ministries of heath for evidence‐based polices and plans, engagement with non‐state actors and better partner coordination.
- Developing a medium‐term strategy and a business plan that provides for a sustainable approach to health sector financing.
- Scaling up essential health workforce cadres to ensure improved access to health services in the short term.
- Rapid expansion of EPHS and community based health services of acceptable quality through innovative approaches, including training of community‐based health workers and outsourcing of service delivery to nongovernmental organizations.
- Improving the availability and use of information by strengthening management information systems, implementing household surveys and improving civil registration and vital statistics.
- Improving access to and rational use of medicines and essential technologies.
- Strengthening public health preparedness and response capacity to effectively confront and tackle health emergencies.