Public Health Challenges in Somalia: Strengthening Health Systems for Resilient and Equitable Healthcare Delivery

Somalia continues to face multidimensional public health challenges driven by prolonged conflict, political instability, fragmented governance, climate-related disasters, displacement, poverty, and a fragile health system. The country carries a dual burden of communicable and non-communicable diseases (NCDs), alongside persistently high maternal and child mortality and recurrent nutrition and WASH emergencies. These pressures are intensified by workforce shortages, limited laboratory and surveillance capacity, unequal access to care, and heavy dependence on externally financed programmes. In this perspective, health-system resilience refers to Somalia's capacity to anticipate, absorb, adapt to, and recover from shocks while maintaining equitable delivery of essential services. We argue that resilience cannot be achieved through disease-specific or short-term humanitarian programmes alone; it requires stronger public stewardship, coordinated federal-state governance, sustainable financing, integrated primary health care, a retained and equitably distributed workforce, interoperable surveillance, and climate-resilient WASH and referral systems. The central recommendation is therefore a transition from fragmented, crisis-driven service delivery toward an accountable, primary-health-care-centred system that links communities, public and private providers, laboratories, referral facilities, and emergency response mechanisms.