The Country Cooperation Strategy for WHO and Somalia 2021–2025 is a five-year framework for supporting Somalia’s health system in a fragile, conflict-affected and climate-vulnerable context. It prioritizes primary healthcare, universal health coverage, emergency preparedness, healthier populations and stronger health governance.
Key insights:
Somalia’s population was estimated at 15.7 million, with 75% under the age of 30 and around 2.9 million people internally displaced.
Life expectancy was 56.5 years, remaining below the average for sub-Saharan Africa.
Somalia faces a double disease burden: communicable, maternal, neonatal and nutritional conditions caused 47% of deaths in 2019, while noncommunicable diseases caused 45.6%.
Tuberculosis, respiratory infections, diarrhoeal diseases, stroke and ischaemic heart disease were among the leading causes of death and disability.
Maternal mortality remained extremely high at 829 deaths per 100,000 live births, while only one third of births were attended by skilled health personnel.
One in seven Somali children died before reaching age five, with an under-five mortality rate of 117 deaths per 1,000 live births.
Mental health is a major concern, with an estimated one in three people living with some form of mental health disorder and very limited access to treatment.
Somalia had the world’s lowest Universal Health Coverage Service Index at 27 out of 100, meaning that most people lacked reliable access to essential health services.
The health system had only 1.69 facilities per 10,000 people and faced severe shortages of trained health workers, medicines and equipment.
Healthcare costs were a major barrier: 65% of women reported cost as an obstacle to care, while out-of-pocket payments accounted for a large share of household health spending.
Immunization improved between 2015 and 2020, but coverage remained low, particularly among rural and nomadic communities.
Climate shocks, drought, floods, conflict, displacement, unsafe water and poor sanitation continued to increase disease risks and disrupt health services.
The strategy identifies four priorities: advancing universal health coverage through primary care, strengthening health security, addressing social determinants of health and improving governance and coordination.
The estimated implementation budget was US$115.3 million, with an anticipated funding gap of US$68.6 million.