Nearly 30 years of conflict and instability have heavily marked Somalia's recent history. Some gains are being made, but the country still faces many challenges ahead.
Somalia's health indicators, especially for women and children rank among the lowest in the world.
Recently published statistics show that maternal mortality and deaths of children under five remain high, while female genital mutilation is still widespread. Prevalence of early marriage also contributes to high fertility rates. These issues are further exacerbated by cramped conditions in the country's over 2 000 sites for internally displaced persons.
An innovative partnership between WHO, Sweden and Somalia's Ministry for Health was launched to address these and other persistent health problems. The partnership, which is borne out of a policy dialogue and a high-level mission by Sweden to Somalia in 2020, aims to create an independent Somali Public Health authority and to modernize the country's health information management system.
This collaboration between Sweden and WHO in Somalia was inspired by WHO's 2019-2013 General Programme of Work to deliver impact at the country level.
Improving health outcomes in Somalia
Sweden's funding initiatives and active collaboration in the country, supported by WHO, are focused on promoting equitable access to health care and sexual and reproductive health and rights.
Sweden is working closely with WHO to support the establishment of an independent Somali public health authority: The National Institute of Health. This includes technical support from The Public Health Agency of Sweden.
"We strive to contribute to making the National Health Institute a centre of excellence. It is one of the priorities of WHO," said Kyle DeFreitas, External Relations and Resource Mobilization Officer at WHO Somalia.
"We will help build the capacities of the institute, which will enable Somalia to deal more effectively with public health issues into the future, including potential disease outbreaks and pandemics," he added.
Dr Abdifatah Diriye Ahmed, Executive Director of the National Health Institute, said the newly formed institution will be one of the most important and crucial steps towards establishing a strong health system in addition to the areas of equitable access and reproductive health and rights in Somalia. During the past three decades, the health system has been fragmented and has faced many challenges.
"With the goal of becoming the leading evidence-based centre of knowledge excellence and dissemination in research, the National Institute of Health will be the epicentre of efforts to shape Somalia's new health care system and the future of healthy Somalis," he said.
Sweden's second project with WHO and the Somali Ministry of Health is a collaboration with SPIDER Centre, an institute based at Stockholm University. The initiative aims to help authorities digitalize the country's health information management system starting in three pilot locations in Puntland, Galmudug, and Banaadir.
WHO and the National Institute of Health will also work with the SPIDER Centre to help build a state-of-the-art integrated disease surveillance and response system.
A unique partnership
"Sweden as a donor doesn't just give financial support to WHO to carry out a project or a programme. We work together. We network together. We strive towards common goals in the health sector in Somalia. We make resources available and we use them to push things together in the right direction," says Daniel Magnusson, Senior Programme Manager at the Somalia Section at the Swedish Embassy in Nairobi.
A critical feature of the partnership focuses on the exchange of expertise which will happen through the secondment of personnel. An experienced senior professional will join WHO Somalia to, among other duties, focus on supporting the National Institute of Health and collaboration with SPIDER Centre. Another expert consultant will join at a later stage.
After the first stage, the team will assess their progress and make any necessary adjustments.
A cohesive UN system
"Sweden believes in a UN system that works together. Our view of health sector development in countries like Somalia is that there needs to be strong collaboration and coordination between the different multilateral agencies like WHO and bilateral actors like Sweden, combined with a strong engagement with the government at different levels," explained Daniel.
Building a stronger primary health care system is crucial in creating a brighter future for the people of Somalia and is therefore part of WHO's main focus.
"A strong primary health care system can ensure equitable access to health care and rights to health including reproductive and sexual health for women and other marginalized groups. "It is an investment for managing health security threats at the local level before they become a national threat or an epidemic," says Dr Mamunur Malik, WHO Representative in Somalia.
Despite the long road ahead, the collaboration between Sweden, WHO and the Somali Ministry of Health is one significant step towards ensuring that no one in Somalia will be left behind in the journey towards health for all.