Somalia, a low income country in the Horn of Africa, has been ravaged by war and famine that has exerted a significant human and economic cost to the Somali population. This is evidenced by low socio-economic indicators. A lack of social safety nets, a weakened public health infrastrucure and reliance on private health services has resulted in high out-of-pocket spending on health that limits access to health services for the majority of the Somali population.The Somali healthcare sector has primarily been financed through out of pocket (OOP) expenditures by the populace, completed by direct funding from external donors over the past few decades. Most public health services provided in country have been “off budget and off treasury” and regarded as humanitarian services provided by donors through implementing NGOs, UN agencies, and the Red Cross/Red Crescent. Estimates are that half of total health expenditure in Somalia comes from donors, with OOP bearing the balance; the public sector contributes only a nominal share. Donors provided over US$92 million in external funding to the Somali health sector in 2020, 96.8 percent of it falling outside government structures. In 2020, NGOs received 61.2 percent of donor funding, followed by UN agencies which received 29.8 percent, and Red Cross/Red Crescent which received 5.9 percent.
The key tasks in phase 1 implementation will be identified and presented in the ProDoc. Using an adaptive approach for MSD implementation, rather than predetermining which activities and how they will be undertaken, allows for a greater chance of success. The iterative and continuous learning process will allow PSPH to either terminate unsuccessful interventions or further invest in promising ones. Each output will be managed as a seperate intervention.
Swiss TPH, with our excellent track record of implementing SDC health systems strengthening projects, and a specific health financing portfolio which also covers post-conflict and highly unstable contexts in Sub-Saharan Africa will be giving technical assistance to interventions focusing on health financing. Local partner in Somalia is Somali Research and Development Institute (SORDI), registered in Mogadishu, with experience in Somalia project delivery and strong relationships with local public and private sector.