- Inconsistent healthcare delivery structures
The Somaliland and Puntland have relatively structured public health systems governed by health authorities or by a variety of international and national NGOs or by a combination of the two, while in the South Central region the delivery of public health services is entirely delivered by external actors with limited government oversight.
- Quality of services
The quality of maternal and child health services provided by health facilities across Somalia is very low relative to international standards, and most facilities operate at a level far below their intended capacity. Lack of skilled staff and insufficient salaries are key barriers to service delivery while supervision and management are ad-hoc at best.
- Impacted level of demand for health services
Given the high levels of illiteracy and isolation among Somali women, knowledge about health risks related to pregnancy and childbirth is low and hardly informed by modern medical practices. There is lower demand for, and mistrust of, preventive services such as vaccination and birth spacing. Poverty, illiteracy and the low value placed on women’s health, lack of female decision-making power over their own health, and social and cultural norms associated with reproduction adversely affect decisions to seek health care and positive outcomes for mother and child.
- Low immunization coverage
Somalia has remained Polio free since March 2007 and immunization coverage rates have continued to increase. However, the present immunization coverage (DPT3) of about 43% in Somalia is far from sufficient to prevent a spread of the vaccine preventable diseases. Only 5 %t of children were fully immunized in 2006 putting children at constant risk of debilitating or fatal disease.
Committing to Child Survival: A Promise Renewed