{"id":987502049,"date":"2023-02-03T08:20:07","date_gmt":"2023-02-03T07:20:07","guid":{"rendered":"https:\/\/p4h.world\/country\/somalia\/"},"modified":"2025-03-25T23:59:01","modified_gmt":"2025-03-25T22:59:01","slug":"somalia","status":"publish","type":"country","link":"https:\/\/p4h.world\/en\/countries\/somalia\/","title":{"rendered":"Somalia"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;!! PLEASE DO NOT EDIT !!!&#8221; _builder_version=&#8221;4.19.5&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row use_custom_gutter=&#8221;on&#8221; gutter_width=&#8221;1&#8243; admin_label=&#8221;!!! PLEASE DO NOT EDIT !!!&#8221; _builder_version=&#8221;4.20.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.19.5&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text admin_label=&#8221;TEXT &#8211; BLOCK 1&#8243; _builder_version=&#8221;4.21.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||1em||false|false&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Somalia\u2019s health care system has been profoundly affected by decades of conflict and governance challenges,<sup><a href=\"#1\">[1]<\/a><\/sup> leading to a fragmented and underfunded health sector. Nearly <a href=\"https:\/\/dt-global.com\/projects\/psph\/\">50% of current health expenditure (CHE)<\/a> comes from international sources, including nongovernmental organizations (NGOs) and United Nations agencies. The <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10867962\/\">shift to federalism<\/a> in 2012 aimed to improve governance, with overlapping responsibilities having further complicated the health financing landscape. The Federal Government of Somalia (FGS) now faces <a href=\"https:\/\/www.frontiersin.org\/journals\/public-health\/articles\/10.3389\/fpubh.2024.1205327\/full\">considerable challenges<\/a> in mobilizing domestic resources for health to build a cohesive health system and associated policy framework.<\/p>\n<p>[\/et_pb_text][et_pb_text admin_label=&#8221;TEXT &#8211; BLOCK 2 &#8221; _builder_version=&#8221;4.21.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||1em||false|false&#8221; global_colors_info=&#8221;{}&#8221;]It is noteworthy that no National Health Account survey has been done in Somalia, and no data are available on the Global Health Expenditure Database for the country.[\/et_pb_text][ba_gradient_heading title=&#8221;Barriers to sustainable health financing&#8221; html_tag=&#8221;h3&#8243; primary_color=&#8221;#455A64&#8243; secondary_color=&#8221;#455A64&#8243; admin_label=&#8221;HEADING (50-60 characters)&#8221; _builder_version=&#8221;4.21.0&#8243; _module_preset=&#8221;default&#8221; title_font=&#8221;||||||||&#8221; title_font_size=&#8221;26px&#8221; title_line_height=&#8221;1em&#8221; custom_padding=&#8221;||10px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][\/ba_gradient_heading][et_pb_text admin_label=&#8221;TEXT &#8211; BLOCK 3&#8243; _builder_version=&#8221;4.21.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||1em||false|false&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><span style=\"font-weight: 400;\">Somalia&#8217;s health financing is characterized by several critical barriers.<\/span><\/p>\n<ul>\n<li style=\"padding: 15px 0; font-weight: 400;\" aria-level=\"1\">Limited government revenue generation: The FGS has struggled both to generate sufficient domestic revenue and to dedicate it for health due to a weak tax base and ongoing security concerns. Consequently, government expenditure on health remains low, estimated at just <a href=\"https:\/\/p4h.world\/en\/documents\/somalia-economic-update-investing-in-health-to-anchor-growth\/\">1.3%<\/a> of total government spending in 2019.<\/li>\n<li padding: 15px 0; style=\"font-weight: 400;\" aria-level=\"1\">High out-of-pocket expenditures: No out-of-pocket spending or CHE data are available, but almost half of all households <a href=\"https:\/\/p4h.world\/en\/documents\/health-sector-strategic-plan-iii-hssp-iii-2022-2026\/\">(48%)<\/a> report finance health expenses using their own income despite low income levels, increasing their risk of experiencing catastrophic health spending.<\/li>\n<li style=\"padding: 15px 0; font-weight: 400;\" aria-level=\"1\">Fragmented private sector: While the private health care sector could account for <\/span><a href=\"https:\/\/dt-global.com\/projects\/psph\/\">60%<\/a> of CHE, it is largely unregulated and concentrated in urban areas, creating equity concerns and leaving rural populations underserved.<\/li>\n<li style=\"padding: 15px 0; font-weight: 400;\" aria-level=\"1\">Dependence on donor aid: In recent years, external aid has been substantial, with figures reaching approximately <a href=\"https:\/\/www.scirp.org\/journal\/paperinformation?paperid=129471\">US$ 137 million<\/a> in 2019. However, this funding often <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10867962\/\">aligns with donor priorities<\/a> rather than the expressed needs of the Somali health authorities.<\/li>\n<\/ul>\n<p>[\/et_pb_text][ba_gradient_heading title=&#8221;Health financing reforms for universal health coverage &#8221; html_tag=&#8221;h3&#8243; primary_color=&#8221;#455A64&#8243; secondary_color=&#8221;#455A64&#8243; admin_label=&#8221; HEADING (50-60 characters)&#8221; _builder_version=&#8221;4.21.0&#8243; _module_preset=&#8221;default&#8221; title_font=&#8221;||||||||&#8221; title_font_size=&#8221;26px&#8221; title_line_height=&#8221;1em&#8221; custom_padding=&#8221;0px||10px||false|false&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;][\/ba_gradient_heading][et_pb_text admin_label=&#8221;TEXT &#8211; BLOCK 4 &#8221; _builder_version=&#8221;4.21.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||1em||false|false&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><span style=\"font-weight: 400;\">To advance universal health coverage, Somalia could implement reforms that address existing barriers.<\/span><\/p>\n<ul>\n<li style=\"padding: 15px 0; font-weight: 400;\" aria-level=\"1\">Strengthening domestic resource mobilization: Having recognized the importance of reducing dependency on donor funding, the government is exploring ways to increase health budget allocations through <a href=\"https:\/\/p4h.world\/en\/documents\/can-debt-relief-transform-somalias-health-sector-covid-19s-role-in-shaping-health-financing\/\">improved tax collection<\/a> and innovative financing mechanisms.<\/li>\n<li style=\"padding: 15px 0; font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/p4h.world\/app\/uploads\/2024\/08\/Health-Sector-Strategy-Plan-III.x23411.pdf\">Capacity building for evidence-based health planning<\/a>: Investments in health information systems and data collection are essential to evidence-based health financing decisions.<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/dt-global.com\/projects\/psph\/\">Enhancing public-private partnerships<\/a>: Leveraging the strengths of both public and private sectors is an option that could potentially improve service delivery and financing.<\/li>\n<li style=\"padding: 15px 0; font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/p4h.world\/app\/uploads\/2024\/08\/Somali-Health-Policy-Directions-and-Priorities-2014.x23411.pdf\">Strategic partnerships with donors<\/a>: Somalia\u2019s government is also focusing on aligning donor contributions with national health priorities, aiming to shift from short-term, project-based funding to more sustainable, long-term investments.<\/li>\n<\/ul>\n<p>[\/et_pb_text][et_pb_text admin_label=&#8221;TEXT &#8211; BLOCK 9 &#8211; Footnotes&#8221; _builder_version=&#8221;4.21.0&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;13px&#8221; custom_margin=&#8221;20px||||false|false&#8221; custom_padding=&#8221;||||false|false&#8221; custom_css_main_element=&#8221;a{color:#4c7e96 }&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><strong>References<\/strong><\/p>\n<p><span style=\"font-weight: 400;\"><span id=\"1\">[1]<\/span> Ministry of Health, Federal Republic of Somalia, <a href=\"https:\/\/www.globalfinancingfacility.org\/sites\/default\/files\/Somalia-GFF-Investment-Case.pdf\">Investment Case for the Somali Health<\/a>, Sector 2022\u20132027<\/span><\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Somalia\u2019s health care system has been profoundly affected by decades of conflict and governance challenges,[1] leading to a fragmented and underfunded health sector. Nearly 50% of current health expenditure (CHE) comes from international sources, including nongovernmental organizations (NGOs) and United Nations agencies. The shift to federalism in 2012 aimed to improve governance, with overlapping responsibilities&#8230;<\/p>\n","protected":false},"author":1,"featured_media":987717633,"template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":""},"acf":[],"_links":{"self":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/country\/987502049"}],"collection":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/country"}],"about":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/types\/country"}],"author":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/users\/1"}],"version-history":[{"count":6,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/country\/987502049\/revisions"}],"predecessor-version":[{"id":987764521,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/country\/987502049\/revisions\/987764521"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/media\/987717633"}],"wp:attachment":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/media?parent=987502049"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}