Author: Mohamed Gedi Qayad
2008, Bildhaan An Internationl Journal of Somali studies

Universal access to health care is an ideal goal for all nations. Nations often base their health care development plans on this principle. In Somalia, provision of health care services was also driven by this principle, and delivery of services was publicly funded like other social services, such as education. However, that goal was never achieved and the health status indicators for Somalia, even before the collapse of the central government, showed grim statistics. Health care services in Somalia were shaped by various administrations that adopted different policies, priorities, and health care service approaches, often influenced by local and international paradigms and resolutions. The parliamentary government in the 1960s and the military government in the 1970s to 1990s shared common deficiencies in their national plans. Development plans were driven by institutional history, political interest, and personal desires, instead of need and resource capacities based on empirical evidence. Both administrations failed to maintain established health care delivery infrastructures or sustain their core operations, let alone expand services to the rural population and other vulnerable groups or modernize the system and improve its quality. As a result, health care facilities in many districts collapsed and were unable to provide even the minimum required clinical and preventive services.

In addition, high population growth, environmental degradation, desertification, frequent droughts and famines, urbanization and haphazard settlement, poverty and a weak economy, and poor governance created an unbearable burden of health problems that overwhelmed the nation’s staggering health care system and its coping mechanisms.

These problems stifled the health care system and contributed to the poor health status of the Somali people. it is essential to examine the deficiencies and gaps in the operation of the past health care systems, and to provide a basic framework to ensure a functional and sustainable health care system in the future.