Operationalising Health Service Delivery in Somalia: Towards Universal Health Coverage

Somalia's health system remains acutely fragile, a direct consequence of protracted conflict, political instability, and recurrent climatic shocks. This has resulted in a fragmented, underresourced, and largely informal health sector, contributing to persistently poor health indicators, particularly for maternal, newborn, and child health. This report comprehensively analyzes the multifaceted challenges confronting health service delivery, including systemic governance failures, chronic underfunding, critical human resource shortages, a dysfunctional pharmaceutical supply chain, and nascent health information systems. National policies, notably the Health Sector Strategic Plan III (HSSP III) and the revised Essential Package of Health Services (EPHS) 2020, articulate a vision for a resilient health system and progress toward Universal Health Coverage (UHC). Innovative service delivery models, such as mobile health camps and community health worker programs, demonstrate potential in reaching underserved populations, while digital health solutions like DHIS2 offer a platform for enhanced information management. However, recurrent humanitarian crises continually disrupt service delivery, and weak monitoring and evaluation systems impede evidence-based decision-making. Achieving UHC necessitates a sustained, multipronged approach focused on strengthening governance, increasing domestic financing, comprehensive human resources for health development, robust regulatory frameworks, and integrating health interventions with broader development, peacebuilding, and climate resilience efforts.