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.
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. Much of the national budget was devoted to military expenditure, leaving few resources for healthcare, among other services.
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. Many new healthcare centers, clinics, hospitals and pharmacies have in the process been established through home-grown Somali initiatives. 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.
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. Similarly, the number of one-year-olds fully immunized against measles rose from 30% in 1985–1990 to 40% in 2000–2005, and for tuberculosis, it grew nearly 20% from 31% to 50% over the same period. 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. Between 2005–2010 as compared to the 1985–1990 period, infant mortality per 1,000 births also fell from 152 to 109.6. 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. The number of physicians per 100,000 people also rose from 3.4 to 4 over the same timeframe, as did the percentage of the population with access to sanitation services, which increased from 18% to 26%.
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.
According to a 2005 World Health Organization estimate, about 97.9% of Somalia's women and girls underwent female circumcision, a pre-marital custom mainly endemic to Northeast Africa and parts of the Near East. Encouraged by women in the community, it is primarily intended to protect chastity, deter promiscuity, and offer protection from assault. 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. About 93% of Somalia's male population is also reportedly circumcised.
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. While the estimated HIV prevalence rate in Somalia in 1987 (the first case report year) was 1% of adults, a more recent estimate from 2014 now places it at only 0.5% of the nation's adult population.
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. The current Minister of Health is Ahmed Mohamed Mohamud. The autonomous Puntland region maintains its own Ministry of Health, as does the Somaliland region in northwestern Somalia.
Health Sector Strategic Plans
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.
In May 2014, the Federal Government launched the Essential Package of Health Services (EPHS) within the framework of the Health Sector Strategic Plans. 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. 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.
- Dr. Aden Farah Abraar Regional Hospital
- Borama Fistula Hospital
- Alaale Hospital
- Al Hayat Medical Centre
- Hudur Hospital
- Banadir Hospital
- Digfeer Hospital
- Dr. Xasan Jis Memory Hospital
- Keysaney Hospital
- Lazaretto Forlanini Hospital
- Martini Hospital
- Medina Hospital
- SOS KDI M&C Hospital
- Yardimeli Hospital (under construction)
- Bosaso General Hospital
- Qardho General Hospital
- Baidoa Hospital
- Burhakaba Hospital
- Dinsor Hospital
- Abudwak Maternity and Children's Hospital
- Adaado Hospital
- Dusamareb Hospital
- El-Dher Hospital
- Istalin Hospital
- East Bardera Mothers and Children's Hospital
- Garbahaarey Hospital
- Khalil Hospital
- Luuq Hospital
- West Bardera Maternity Unit
- Dove Voluntary Hospital
- Lower Juba
- Kismayo Hospital
- Mareerey Hospital
- 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
- Galkayo South Hospital
- Mudug Regional Hospital
- Nugal General Hospital
- Badhan Hospital
- Dhahar Hospital
- Erigavo Referral Hospital
- Las Khorey Hospital
- Las Anod Hospital
- Taleh Hospital
- Buhoodle District Hospital
- Sheikh Hospital
- Woqooyi Galbeed
Medical universities and facilities
- 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
- Hargeisa Institute of Health Sciences
- Hargeisa University
- Indian Ocean University
- Kismayo 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
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 - 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)
- 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.
- "Better Off Stateless: Somalia Before and After Government Collapse" (PDF). Retrieved 27 June 2010.
- "Entrepreneurship and Statelessness: A Natural Experiment in the Making in Somalia". Scribd.com. 1 October 2008. Retrieved 30 December 2010.
- "Estimates of Unit Costs for Patient Services for Somalia". Who.int. 6 December 2010. Retrieved 12 June 2011.
- UNDP (2001). Human Development Report 2001-Somalia. New York: UNDP.
- "UNdata – Somalia". Data.un.org. 20 September 1960. Retrieved 12 June 2011.
- World Bank and UNDP (2003). Socio-Economic Survey-Somalia-2004. Washington, D.C./NewYork: UNDP and World Bank.
- World Bank and UNDP (2003). Socio-Economic Survey-Somalia-1999. Washington, D.C./NewYork: UNDP and World Bank.
- UNDP (2006). Human Development Report 2006. New York: UNDP.
- "The State Of The World's Midwifery". United Nations Population Fund. Retrieved August 2011.
- "Prevalence of FGM". Who.int. 9 December 2010. Retrieved 30 December 2010.
- 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.
- Herbert L. Bodman, Nayereh Esfahlani Tohidi (1998) Women in Muslim societies: diversity within unity, Lynne Rienner Publishers, p. 41, ISBN 1555875785.
- Suzanne G. Frayser, Thomas J. Whitby (1995) Studies in human sexuality: a selected guide, Libraries Unlimited, p. 257, ISBN 1-56308-131-8.
- Goldenstein, Rachel. "Female Genital Cutting: Nursing Implications". Journal of Transcultural Nursing. 25.1 (2014): 95-101. Web. 19 February 2014.
- "Somalia: Female genital mutilation down". Associated Press via The Jakarta Post. 16 April 2013. Retrieved 17 May 2013.
- "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.
- 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.
- "Somalia". The World Factbook. Langley, Virginia: Central Intelligence Agency.
- "The Regional Office And Its Partners – Somalia". Emro.who.int. Retrieved 30 December 2010.
- "SOMALIA PM Said "Cabinet will work tirelessly for the people of Somalia"". Midnimo. 17 January 2014. Retrieved 17 January 2014.
- Ministry of Health – Puntland State of Somalia. Health.puntlandgovt.com. Retrieved on 2011-12-15.
- "Somaliland – Government Ministries". Somalilandgov.com. Retrieved 30 December 2010.
- "Somalia aims to provide universal basic health care by 2016". News-Medical. 25 March 2013. Retrieved 6 July 2014.
- "JOINT PRESS RELEASE Essential Package of Health Services launched in Somalia to improve maternal and child health". Warbahinta. UNICEF. May 2014. Retrieved 7 July 2014.
- "Launch of the Essential Package of Health Services, Mogadishu". British Embassy Mogadishu. Retrieved 7 July 2014.
- "Hospital in Somalia" (PDF). WHO. Retrieved 7 July 2014.
- "Health Care Delivery in Somalia". Google. Retrieved 7 July 2014.