The Health Care System in Somaliland: History and Present Realities

The health care system in Somaliland is characterized by chronic underfunding, significant regional disparities, and a proliferation of unregulated private providers. While international aid and diaspora remittances provide critical resources, they often lack local sustainability and can exacerbate regional inequalities. The document highlights the Hargeisa Group Hospital (HGH) as a successful example of a Regional Health Board and cost-sharing system, though it notes that true community ownership and accountability mechanisms remain underdeveloped.

• Somaliland's public health system suffers from severe underfunding and regional inequality. The 2015 government budget was USD 150 million for 3.5 million people, with health allocations dropping from approximately 3.9 percent to 3.3 percent, and over 60 percent of that spending dedicated to human resources.
• There is a significant proliferation of unregulated private health services. For instance, there are at least 1,000 active pharmacies across Somaliland that are not actively regulated by any government body.
• International health support provides essential resources but creates dilemmas regarding sustainability and equity. High salaries for foreign specialists drain government funds, and security concerns in the Sool and Sanaag regions prevent international staff from accessing those areas, worsening regional disparities.
• The Hargeisa Group Hospital (HGH) utilizes a functional Regional Health Board and cost-sharing system that leverages diaspora donations and small patient surcharges to fund medical supplies and staff.
• Despite the success of the HGH model in fundraising, it fails to ensure genuine community ownership or accountability. The board lacks the power to hold the Ministry of Health accountable, and many patients are unaware of the board's existence.

APA

Horst, C., & Jama, N. (2016). The Health Care System in Somaliland: History and Present Realities. Peace Research Institute Oslo. https://cdn.cloud.prio.org/files/227efc44-452d-4fd1-8438-a9c851e74880/Horst Jama - Resources for Health Care in Somaliland PRIO Policy Brief 23-2016.pdf?inline=true

Chicago

Horst, Cindy, and Nasra Jama. The Health Care System in Somaliland: History and Present Realities. Peace Research Institute Oslo, 2016. https://cdn.cloud.prio.org/files/227efc44-452d-4fd1-8438-a9c851e74880/Horst Jama - Resources for Health Care in Somaliland PRIO Policy Brief 23-2016.pdf?inline=true.

Wikipedia

{{cite report |last1=Horst |first1=Cindy |last2=Jama |first2=Nasra |title=The Health Care System in Somaliland: History and Present Realities |publisher=Peace Research Institute Oslo |date=2016 |url=https://cdn.cloud.prio.org/files/227efc44-452d-4fd1-8438-a9c851e74880/Horst Jama - Resources for Health Care in Somaliland PRIO Policy Brief 23-2016.pdf?inline=true |access-date=23 October 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{horst2016health, author = {Horst, Cindy and Jama, Nasra}, title = {{The Health Care System in Somaliland: History and Present Realities}}, institution = {Peace Research Institute Oslo}, year = {2016}, url = {https://cdn.cloud.prio.org/files/227efc44-452d-4fd1-8438-a9c851e74880/Horst Jama - Resources for Health Care in Somaliland PRIO Policy Brief 23-2016.pdf?inline=true}, urldate = {2026-10-23}, note = {Indexed by Climate Insights Directory} }