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The report examines the overlapping claims of Somaliland and Puntland to the Sool and Sanaag regions, highlighting how colonial legacies and clan identities create divergent visions of administration. It details recent military clashes in Tukaraq and the militarisation of Sanaag, while noting that economic and social ties persist despite political tensions. The author argues that a durable solution requires consulting local populations and moving beyond identity-based power-sharing.

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 has maintained relative peace and stability since 1991 through a consensus-driven approach and effective administration, though it faces socio-economic challenges and delayed elections. Despite this, it lacks international recognition and remains in conflict with Puntland over the Sool and Sanaag regions.