From fragmentation to integration: digital health as a catalyst for universal health coverage in Somalia

Universal Health Coverage (UHC) remains a major challenge in Somalia, where prolonged conflict, weak governance, fragmented service delivery, and donor dependence continue to undermine health system performance. Although digital health has emerged as a promising strategy for strengthening health systems, its implementation in Somalia has largely been characterized by fragmented, donor-driven, and disease-specific initiatives with limited integration into national health system reform. This Perspective argues that a major barrier to digital health-enabled progress toward UHC in Somalia is the fragmentation of governance, financing, health information systems, and implementation, rather than simply the absence of digital technologies. Drawing on recent evidence from Somalia and other low- and middle-income countries, we propose reframing digital health as strategic public infrastructure that integrates governance, service delivery, information systems, and financing to support health system transformation. We identify five strategic priorities: strengthening digital health governance, building interoperable digital architecture, accelerating digitally enabled primary health care, ensuring sustainable financing through effective public-private collaboration, and advancing digital equity with workforce capacity. Collectively, these priorities provide a policy-oriented framework for moving from fragmented digital initiatives toward a more integrated, resilient, and people-centred health system that could support progress toward Universal Health Coverage in Somalia.