The Future of Healthcare in Somalia: A Bold Step Towards a Nationally Funded and Transparent System

This policy paper sets out a long-term vision for Somalia’s health system reformed by increased domestic financing, greater transparency and accountability, and a nationally owned reform process. It suggests that health can have its own binding logic – institutions and infrastructure will no longer be built around the needs of outside ‘projects’, but as critical parts of state-building, institutional resilience and public confidence. 

Based on both national evidence and international best practice, the paper provides a whole-of-government approach that links health financing, resource planning, workforce policy, accountability, primary health care, and federal-state relations. 

It identifies cross-cutting priority reform areas, such as institutionalising phased resource increases, strategic purchasing, accountable public financial management, workforce exit strategies, and transparent procurement.

For each, the paper provides a set of incremental reform recommendations, with an emphasis on sequencing, priorities, and safeguarding essential services, building implementation capacity, and ownership, rather than ‘just’ expanding and stabilising the donor-funded patchwork of today. At its core, it makes the case that health is integral to governance, social stability, and state-building.

The Future of Healthcare in Somalia: A Bold Step Towards a Nationally Funded and Transparent System