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Healthcare in Somalia

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Healthcare in Somalia is largely in the private sector. It is regulated by the Ministry of Health of the Federal Government of Somalia.

Overview

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.[1] Much of the national budget was devoted to military expenditure, leaving few resources for healthcare, among other services.[2]

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.[3] Many new healthcare centers, clinics, hospitals and pharmacies have in the process been established through home-grown Somali initiatives.[3] 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.[4]

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 48.2 years for men and 51.0 years for women.[5][6] Similarly, the number of one-year-olds fully immunized against measles rose from 30% in 1985–1990 to 40% in 2000–2005,[5][7] and for tuberculosis, it grew nearly 20% from 31% to 50% over the same period.[5][7] 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.[5][8] Between 2005–2010 as compared to the 1985–1990 period, infant mortality per 1,000 births also fell from 152 to 109.6.[5][6] Significantly, maternal mortality per 100,000 births fell from 1,600 in the pre-war 1985–1990 half-decade to 1,100 in the 2000–2005 period.[5][9] The number of physicians per 100,000 people also rose from 3.4 to 4 over the same timeframe,[5][7] as did the percentage of the population with access to sanitation services, which increased from 18% to 26%.[5][7]

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.[10]

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,[11] a pre-marital custom mainly endemic to Northeast Africa and parts of the Near East.[12][13] Encouraged by women in the community, it is primarily intended to protect chastity, deter promiscuity, and offer protection from assault.[14][15] 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.[16] About 93% of Somalia's male population is also reportedly circumcised.[17]

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.[18] While the estimated HIV prevalence rate in Somalia in 1987 (the first case report year) was 1% of adults,[18] a more recent estimate from 2014 now places it at only 0.5% of the nation's adult population.[19]

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.[20] The current Minister of Health is Ahmed Mohamed Mohamud.[21] The autonomous Puntland region maintains its own Ministry of Health,[22] as does the Somaliland region in northwestern Somalia.[23]

Hospitals

Medical universities and facilities

Burao Institute of Health Sciences

Demographic statistics

The following demographic statistics are from the CIA World Factbook:[19]

Population

10,085,638 (2012 est.)

Age structure

0–14 years: 44% (male 2,293,746/female 2,298,442)
15–64 years: 52.4% (male 2,663,729/female 2,588,716)
65 years and over: 2.3% (male 95,859/female 142,383) (2014 est.)

Population growth rate

1.75% (2014 est.)

Birth rate

40.87 births/1,000 population (2014 est.)

Death rate

13.91 deaths/1,000 population (2014 est.)

Sex ratio

at birth: 1.03 male(s)/female
under 15 years: 1 male(s)/female
15–64 years: 1.07 male(s)/female
65 years and over: 0.66 male(s)/female
total population: 1.01 male(s)/female (2014 est.)

Infant mortality rate

100.4 deaths/1,000 live births (2012 est.)
male: 108.89 deaths/1,000 live births
female: 92.12 deaths/1,000 live births (2014 est.)

Life expectancy at birth

total population: 51.8 years
male: 49.58 years
female: 53.65 years (2014 est.)

Total fertility rate

6.08 children born/woman (2014 est.)

HIV/AIDS

HIV/AIDS - adult prevalence rate: 0.5% (2009 est.) HIV/AIDS - people living with HIV/AIDS: 31,200 (2009 est.) HIV/AIDS - deaths: 2,500 (2009 est.)

Major infectious diseases

degree of risk: high
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever
vectorborne diseases: dengue fever, malaria, and Rift Valley fever
water contact disease: schistosomiasis
animal contact disease: rabies (2009)

See also

Notes

  1. ^ Maxamed Siyaad Barre (1970) My country and my people: the collected speeches of Major-General Mohamed Siad Barre, President, the Supreme Revolutionary Council, Somali Democratic Republic, Vol. 3, Ministry of Information and National Guidance, p. 141.
  2. ^ "Better Off Stateless: Somalia Before and After Government Collapse" (PDF). Retrieved 27 June 2010.
  3. ^ a b "Entrepreneurship and Statelessness: A Natural Experiment in the Making in Somalia". Scribd.com. 1 October 2008. Retrieved 30 December 2010.
  4. ^ "Estimates of Unit Costs for Patient Services for Somalia". Who.int. 6 December 2010. Retrieved 12 June 2011.
  5. ^ a b c d e f g h UNDP (2001). Human Development Report 2001-Somalia. New York: UNDP.
  6. ^ a b "UNdata – Somalia". Data.un.org. 20 September 1960. Retrieved 12 June 2011.
  7. ^ a b c d World Bank and UNDP (2003). Socio-Economic Survey-Somalia-2004. Washington, D.C./NewYork: UNDP and World Bank.
  8. ^ World Bank and UNDP (2003). Socio-Economic Survey-Somalia-1999. Washington, D.C./NewYork: UNDP and World Bank.
  9. ^ UNDP (2006). Human Development Report 2006. New York: UNDP.
  10. ^ "The State Of The World's Midwifery". United Nations Population Fund. Retrieved August 2011. {{cite web}}: Check date values in: |accessdate= (help)
  11. ^ "Prevalence of FGM". Who.int. 9 December 2010. Retrieved 30 December 2010.
  12. ^ Rose Oldfield Hayes (1975). "Female genital mutilation, fertility control, women's roles, and the patrilineage in modern Sudan: a functional analysis". American Ethnologist. 2 (4): 617–633. doi:10.1525/ae.1975.2.4.02a00030.
  13. ^ Herbert L. Bodman, Nayereh Esfahlani Tohidi (1998) Women in Muslim societies: diversity within unity, Lynne Rienner Publishers, p. 41, ISBN 1555875785.
  14. ^ Suzanne G. Frayser, Thomas J. Whitby (1995) Studies in human sexuality: a selected guide, Libraries Unlimited, p. 257, ISBN 156308131.
  15. ^ Goldenstein, Rachel. "Female Genital Cutting: Nursing Implications". Journal of Transcultural Nursing. 25.1 (2014): 95-101. Web. 19 February 2014.
  16. ^ "Somalia: Female genital mutilation down". Associated Press via The Jakarta Post. 16 April 2013. Retrieved 17 May 2013.
  17. ^ "Male Circumcision and AIDS: The Macroeconomic Impact of a Health Crisis by Eric Werker, Amrita Ahuja, and Brian Wendell :: NEUDC 2007 Papers :: Northeast Universities Development Consortium Conference" (PDF). Center for International Development at Harvard University. Retrieved 30 December 2010.
  18. ^ a b Ali-Akbar Velayati, Valerii Bakayev, Moslem Bahadori, Seyed-Javad Tabatabaei, Arash Alaei, Amir Farahbood, Mohammad-Reza Masjedi (2007). "Religious and cultural traits in HIV/AIDS epidemics in sub-Saharan Africa" (PDF). Archives of Iranian medicine. 10 (4): 486–97. PMID 17903054. Archived from the original (PDF) on 13 April 2008.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  19. ^ a b "Somalia". The World Factbook. Langley, Virginia: Central Intelligence Agency.
  20. ^ "The Regional Office And Its Partners – Somalia". Emro.who.int. Retrieved 30 December 2010.
  21. ^ "SOMALIA PM Said "Cabinet will work tirelessly for the people of Somalia"". Midnimo. 17 January 2014. Retrieved 17 January 2014.
  22. ^ Ministry of Health – Puntland State of Somalia. Health.puntlandgovt.com. Retrieved on 2011-12-15.
  23. ^ "Somaliland – Government Ministries". Somalilandgov.com. Retrieved 30 December 2010.

References

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