Nursing in Global Health Systems: Somalia


Butts and Rich (2010) believe that “healthcare is one of the most critical human needs” (p. 28). Many governments across the globe use powerful frameworks and policies to ensure their citizens receive quality health support. Such governments attract different players and non-governmental organizations (NGOs) to have stable health delivery systems. The situation encountered in Somalia is very different. Somalia lacks a proper public health system (World Health Organization, 2014). Different regions are inaccessible due to the current insecurity ravaging the nation. Most of the communities in the country do not have access to emergency or immediate care. This gap has encouraged many NGOs and private practitioners to engage in various healthcare practices. Such healthcare “services and functions are undertaken without the government’s oversight” (World Health Organization, 2014, para. 3). The country also lacks a standardized healthcare system thus affecting the outcomes of many people. These issues explain why Somalia is a good choice for an effective analysis.


Somalia is one of the underdeveloped nations in Africa (Somalia, 2015). This “nation is located in the Horn of Africa” (Somalia, 2015, para. 4). The country borders several countries such as the Gulf of Eden, Kenya, and Ethiopia. Somalia is “located between longitudes 41o and 52o E and latitudes 2o S and 12o N” (Somalia, 2015, para. 3). The country has one of the largest coastlines. This is the “case because it borders the Indian Ocean to the east” (Somalia, 2015, para. 4).


According to the World Bank, the population of the country is estimated to be around 10.5 million (Somalia, 2015). The population is also characterized by many internal refugees due to the insecurity issues affecting the country. The majority of the citizens in the country are below the age of 16 years. The country has high neonatal and prenatal mortality rates. The current population is also expected to grow steadily within the next ten years (Somalia, 2015).


The country was ruled by a coalition government in 2008. However, this government encountered numerous threats from Al-Shabaab. This Islamist group has been fighting the government thus making it impossible to have considerable influence on different functions in the country (Somalia, 2015). A new Federal Government was founded in 2012. The “Federal Parliament of Somalia was also formed during the same year” (World Health Organization, 2014, para. 5). The country has a Provisional Constitution that has been in place since 2012 (Somalia, 2015). The government is formed by the president and the Prime Minister (PM). The “PM is usually the head of government” (Somalia, 2015, para. 5).


The economy of this country has not been monitored for several years. This is the case because the political instability experienced in Somalia makes it impossible to get reliable information. The “country’s Central Bank indicated a GDP per capita of 226 US dollars” (Somalia, 2015, para. 6). The “country’s economy is supported by informal activities such as money transfer, livestock keeping, fishing, agriculture, and telecommunications” (Somalia, 2015, para. 7).

The State of Health

Somalia’s health system is ineffective. It is monitored and managed by NGOs. The past governments have not been controlling the quality of services availed to different patients. However, the present government is undertaking various strategies to structure the country’s health sector. The Puntland region is also known to have its unique Ministry for Health. WHO “indicates the leading killer diseases in this country include cholera, malaria, diarrhea, tuberculosis, and measles” (Buckley, 2014, p. 6). The nation is also associated with a high rate of child malnutrition (World Health Organization, 2014). Many people do not have access to quality health support.

Culture and Traditional Medicine

Every society is known to have its unique cultural practices and values. The country has maintained a unique tradition characterized by cuisines, trade activities, and music festivals (Buckley, 2014). The people also embrace different Islamic architectural designs and celebrations (Somalia, 2015). Some traditional health practices are also evident in this society. For instance, herbal medicine is embraced by many people due to the lack of proper health systems. Most traditional herbalists are believed to treat various health complications. Traditional midwives are also common in Somalia. Female circumcision is also embraced by many societies across the nation. Some of these “traditional malpractices are associated with the current health issues and diseases affecting many people in the country” (Somalia, 2015, para. 9).

Healthcare System and Delivery

Government health-related agencies

The “country’s central government cannot monitor or administer specific services to the population” (Somalia, 2015, para. 5). The government lacks the financial strength to support different service delivery systems (Somalia, 2015). However, the Somali Health Authority (SHA) was established in 2012 to promote the best medical practices in the country. SHA implemented “the first Health Sector Strategic Plan (HSSP) in 2012” (World Health Organization, 2014, para. 2). The purpose of the HSSP has been to support the health needs of every underserved population. The main focus has been to address the major challenges affecting the quality of medical services availed to different citizens. The “major problems affecting the quality of healthcare in Somalia include shortage of skilled health workers and inadequate healthcare systems” (World Health Organization, 2014, para. 4). The government is currently committed to providing evidence-based care to many people in the country. SHA is also promoting sustainable medical practices.

Healthcare personnel

The number of healthcare workers in the country is not clearly understood. This is the case because the country lacks a government-controlled healthcare system. The majority of the healthcare providers are employed by different private practitioners or NGOs. It is agreeable that the country has inadequate caregivers (Buckley, 2014). The current workforce shortage affects the health outcomes of many patients and populations.

Nursing education and accrediting organizations

The country has several medical and nursing institutions. The “purpose of such institutions is to equip more individuals with powerful skills that can make them competent providers of quality health care” (Tiilikainen, 2015, p. 6). The government is currently overseeing various accreditations (World Health Organization, 2014). Experts believe that the country will have a better healthcare system within the next few years.

Nursing associations

The Somali Nursing Association (SNA) is a small group formed to support the needs of different practitioners in the country. However, the association does not have enough members thus affecting its bargaining power (Tiilikainen, 2015). The role of the Somaliland Nursing and Midwifery Association (SNMA) is to address the changing needs of different midwives and nurses.

Health Priorities

The World Health Organization (WHO) is currently focusing on different priorities to support the health expectations of many people in Somalia. To begin with, the international agency collaborates with the government to support the targeted Health Sector Strategic Plans (SSPs). Different international organizations and countries should support the country to construct new infrastructures (Buckley, 2014). The lack of effective infrastructure makes it impossible for healthcare professionals and social workers to access different remote regions.

The issue of insecurity should also be prioritized because it determines the success of the above HSSPs. The “case study of Somalia shows how political instability can affect every government function” (Tiilikainen, 2015, p. 11). This scenario eventually affects the nature and quality of services availed to different communities and populations. The government should also collaborate with different private practitioners and NGOs to achieve positive results. Different international organizations and NGOs should also be encouraged to offer various healthcare services to different patients.

Current priorities should focus on the major diseases affecting the country’s population. The first strategy should focus on various preventable diseases. These vaccinations will ensure more people do not suffer from various diseases such as measles and tuberculosis. Powerful efforts will also be needed to deal with malaria. This disease claims the lives of many citizens across the nation. The “government should partner with different agencies to educate more people about the dangers of various cultural malpractices such as Female Genital Mutilation (FGM), gender inequality, and child abuse” (Tiilikainen, 2015, p. 9).

The government must implement powerful health plans and policies. The Ministry of Health should be supported to promote, monitor, and regulate the nature of services availed to different patients. It should also “acquire medical machines, hire more caregivers, and improve the level of medical supplies” (World Health Organization, 2014, para. 8). Such measures will support the needs of many patients and eventually improve the country’s healthcare delivery system.

Conclusion: Nursing Implications

This analysis presents powerful insights and initiatives that must be embraced in Somalia. To begin with, the nursing fraternity should implement new strategies to attract more healthcare providers. This approach is needed because the country lacks an appropriate healthcare system. The decision to address the current shortage of nurses and caregivers will play a positive role in supporting the needs of different underserved populations (Butts & Rich, 2010). The government should support the SNA and SNMA to empower more nurses. These associations will encourage more nurses to promote the most appropriate health practices. Nurse Leaders (NLs) in Somalia can embrace the best theoretical models whenever supporting their followers (Butts & Rich, 2010). Most of the medical practitioners in this country are not motivated. Proper leadership methods will encourage them to embrace the best ideas in an attempt to address the challenges affecting many citizens.

Different agencies should introduce new medical terminologies, campaigns, and technological resources. Such resources will support many people in the country. The campaigns will educate more people about the dangers of various traditional malpractices such as FGM. Nurses should also use their concepts to provide culturally-competent care (Butts & Rich, 2010). Nursing should also be treated as an “ever-changing field that seeks to support the needs of every patient” (Brown, 2015, p. 12). Somalia requires the best incentives, resources, and policies to support the health expectations of many people (Brown, 2015). These nursing approaches will ensure more patients receive evidence-based and timely medical support.

Reference List

Brown, B. (2015). Beyond the Brink: Somalia’s Health Crisis. Human Rights and Human Welfare, 1(1), 6-16.

Buckley, J. (2014). Assessment of the Private Health Sector in Somaliland, Puntland and South Central. HEART, 1(1), 1-56.

Butts, J., & Rich, K. (2010). Theories of Advanced Nursing Practice. New York, NY: Jones & Bartlett Learning.

Somalia: Health Priority Issues. (2015). Web.

Tiilikainen, M. (2015). Somali health care system and post-conflict hybridity. Afrikas Horn of Africa Journal, 1(1), 1-13.

World Health Organization: Somalia. (2014). Web.

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