Health System Transformation in Somalia: An Analysis of Justice, Sustainability, and Resilience in a Fragile State

This paper scrutinizes the challenges and opportunities in restructuring Somalia’s health system-especially as related to health justice, sustainability, and resilience-in a fragile, conflict-stricken context. Somalia’s health system is approached using a qualitative synthesis of national policy documents, national health surveys, climate assessments, and relevant Health Policy and Systems Research (HPSR) literature.

Issues like health governance, health financing, service delivery, human resources for health, health information systems, health equity, and climate-resilient health systems are discussed; key obstacles like weak/fragmented governance, inadequate public financing for the health sector, high out-of-pocket payments for health services, limited access to the most essential services, staffing problems, and climate vulnerability are identified. 

The implementation gaps under Somalia’s Health Sector Strategic Plan III are examined, and strategies that reinforce health equity, accountable health governance, sustainable financing for health, climate-resilient health infrastructure, and evidence-informed decision-making are suggested. 

It recommends that, in order to achieve a fairer, sustainable, and resilient health system, context-informed HPSR, a flexible management system, and long-term support investment are essential for strengthening Somalia’s health system.

Health System Transformation in Somalia: An Analysis of Justice, Sustainability, and Resilience in a Fragile State