Somalia - Health

Health

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 between $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 have undergone 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 deter promiscuity and to offer protection from assault. 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 2007 now places it at only 0.5% of the nation's adult population despite the ongoing civil strife.

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 Qamar Adan Ali. The autonomous Puntland region maintains its own Ministry of Health, which is headed by Dr. Mohamed Bashir Ali Bihi, as does the Somaliland region in northwestern Somalia, with its Ministry of Health led by Osman Bile Ali.

Some of the prominent healthcare facilities in the country are East Bardera Mothers and Children's Hospital, Abudwak Maternity and Children's Hospital, Edna Adan Maternity Hospital and West Bardera Maternity Unit.