Visceral Leishmaniasis Service Delivery in Somalia: A Comprehensive Literature Review

Visceral leishmaniasis (VL) is a neglected tropical disease (NTD) that affects millions of people globally, particularly in low- and middle-income countries. It is caused by the Leishmania parasite, transmitted through sandfly bites, leading to severe illness and high mortality if untreated. Globally, VL is prevalent in East Africa, South Asia, and parts of South America, with East Africa accounting for a significant proportion of cases. Somalia, a country with a fragile healthcare system, faces a growing burden of the disease, particularly in rural and conflict-affected areas. Despite efforts to control the disease, it remains a public health challenge due to a lack of comprehensive data on its exact burden. In Somalia, VL service delivery is hindered by several barriers, including an under-resourced health system, shortages of skilled healthcare providers, inadequate diagnostic equipment, medication shortages, and weak infrastructure. The ongoing conflict and insecurity have exacerbated these challenges, particularly in areas most affected by VL. Stigma, cultural misconceptions, economic constraints, and limited access to healthcare further impede effective VL management. Current programs, supported by international organizations, provide some relief but are insufficient to address the widespread challenges comprehensively. To improve VL service delivery in Somalia, several strategies are recommended. Integration of VL services into primary healthcare, expanding training for healthcare workers, and increasing domestic funding are critical steps to reduce dependency on international aid. Strengthening community engagement, increasing awareness about VL, and leveraging technological innovations like telemedicine and DHIS2 for surveillance and care are vital. Public-private partnerships should be enhanced to ensure the availability of affordable treatments. Through a multifaceted approach that addresses systemic barriers and builds local capacities, sustainable improvements in VL control and service delivery in Somalia can be achieved.