Transforming Health in Post-Conflict Somalia: Priorities from a Multi-Stakeholder Roundtable on the 2025–2029 National Plan
Bibliographic record
Abstract
Najib Isse Dirie,1,2 Mohamed Mustaf Ahmed,2,3 Yakub Burhan Abdullahi,4 Jihaan Hassan,2,5 Bashiru Garba,2,6 Ahmed Adam Mohamed,7 Abdirazak Hersi Hassan,7 Amal Naleye Ali,7 Ali Haji Adam Abubakar8 1Department of Urology, Dr. Sumait Hospital, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia; 2SIMAD Institute for Global Health (SIGHt), SIMAD University, Mogadishu, Somalia; 3Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia; 4Faculty of Health Sciences and Tropical Medicine, Somali National University, Mogadishu, Somalia; 5Department of Pediatrics, Dr. Sumait Hospital, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia; 6Department of Public Health, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia; 7Department of Research, eHealth Somalia, Mogadishu, Somalia; 8Ministry of Health and Human Services, Mogadishu, SomaliaCorrespondence: Najib Isse Dirie, Email drnajib@simad.edu.soBackground: Somalia’s health system remains among the world’s most fragile, with a Universal Health Coverage index of only 25% and a critical health workforce density of 0.11 clinicians per 1000 population. While previous national strategies such as NDP-9 and HSSP III provided broad frameworks, the National Transformation Plan (NTP) 2025– 2029 represents a paradigm shift toward multi-stakeholder engagement and evidence-based priority-setting for health system transformation.Aim: This roundtable aimed to identify priority areas and implementation strategies for the NTP health pillar through structured stakeholder consultation, moving beyond traditional top-down planning approaches to incorporate diverse perspectives from Somalia’s fragmented health landscape.Methods: A qualitative multi-stakeholder roundtable was conducted in Mogadishu with 30 purposively sampled participants representing federal and state ministries, universities, public and private providers, non-governmental organizations, and civil society. Ethical approval was waived, and informed consent was obtained. Audio-recorded discussions were transcribed, translated, and analyzed thematically according to the four NTP health domains.Results: Thematic analysis identified four critical priorities. Participants emphasized that primary health care expansion should prioritize female community health workers and rural facility rehabilitation to increase service coverage beyond the current 25%. Participants emphasized that health workforce constraints, with only 0.11 clinicians per 1000 population, require regional training hubs and rural deployment incentives. Participants emphasized that regulation and governance through the newly established National Health Professionals Council need sustainable funding and federal-state accountability frameworks. Participants emphasized that public-private partnerships and digital health integration could leverage telemedicine and private sector capacity for underserved areas.Conclusion: The roundtable produced actionable strategies linking community-centered primary care, workforce development, regulatory strengthening, and technology-enabled partnerships. However, implementation faces significant constraints, including limited domestic financing, weak governance coordination, and ongoing fragility. Success will require sustained political commitment and innovative approaches adapted to Somalia’s unique post-conflict context.Keywords: national transformation plan, primary health care, health workforce, governance, public-private partnership, Somalia
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".