Authors: A.M. Alia, J. Handulehb, P. Patelc, S. Whitwelld, K. Harrisd, F.R. Alie, R.J. Southgatef, B. Godmang,h, N. Al-Hadithyi, L.L. Gustafssong and A.E.T. Finlaysond

Medicine, Conflict and Survival, 2014

Abstract

Somalia currently performs poorly against the United Nations’ definition of ‘human security’, which encompasses ‘freedom from fear, freedom from want and freedom to live in dignity’ (UNDP 1994). The multiple ways in which poor security has manifested itself across all spheres of society renders Somalia the most insecure nation included in the Human Security Index (ranked 232 out of 232) which combines elements of social, economic and environmental security (Human Security Index n.d.). In this context, it is unsurprising that Somalia performs poorly on numerous metrics of population health, with a life expectancy at birth of 50 years and under-five mortality rate of 18% (WHO 2013).

This paper outlines some of the key political and socio-economic drivers to instability in Somalia and the challenges faced in delivering healthcare in a country where neither economic support nor stability of the healthcare workforce can be assured. We will describe the scope of international assistance and explore key priorities for healthcare system strengthening in the future.