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Elections, funding cuts and the risk of going backwards

Saving mothers and newborns in Somalia:

Five years of evidence from conflict, crisis, and community

EQUAL Research Consortium  ·  Mogadishu, May 2026

International Rescue Committee (IRC)  ·  Somali Research and Development Institute (SORDI)  ·  Johns Hopkins Center for Humanitarian Health

Funded by UK International Development from the UK Government

BRIEFING  ·  THE BIGGER PICTURE

Elections, funding cuts and the risk of going backwards

Somalia’s MNH gains are fragile. As elections approach and international funding declines, the risk is that progress stalls — or reverses — just as the evidence for what works becomes clear.

 

Maternal and newborn health has never been a campaign issue in Somalia. But it affects every family, in every region, regardless of political affiliation. As the country heads toward elections and international donors cut back, the risk is that MNH — already underfunded and understaffed — falls further down the priority list. The cost will be measured in preventable deaths.

The funding and system context

  • Somalia’s 2025 government budget allocates approximately 7% to the Ministry of Health — below the 15% Abuja Declaration target
  • Most public health facilities depend on short-term humanitarian funding from international donors
  • Both humanitarian and development funding to Somalia are projected to decrease further in 2025
  • 9.1 million people are affected by the ongoing crisis; 5.98 million will need humanitarian assistance in 2025
  • Health centres hold only 8 out of 29 essential medicines on average; primary health units average just 4
  • Somalia has 1,215 operational health facilities — one primary facility per 17,200 people

Where Somalia stands

621

maternal deaths per 100,000 live births

35

newborn deaths per 1,000 live births

1 in 25

lifetime maternal death risk for a girl aged 15

 

For comparison: the global average for maternal mortality is 223 per 100,000 live births. Somalia’s rate is 621. The SDG target is under 70 by 2030. Somalia is not on track.

Somalia’s political leadership — and what it needs behind it

In 2024, Somalia co-initiated a World Health Assembly resolution calling for accelerated global action on preventable maternal and child deaths — a significant act of international advocacy from one of the world’s most fragile states. The country has a National Midwifery Strategy (2024–2029), a Reproductive and Maternal Health Strategy (2023–2027), and a Community Health Strategy currently being revised.

These are real commitments. But strategies without budgets are declarations, not plans. EQUAL’s research shows what implementation actually requires — and what is lost when it is underfunded.

The ask is specific: Fair pay for community health workers. Deployment infrastructure for midwifery graduates. Supervision systems that survive funding cycles. None of these are expensive relative to the cost of the status quo — measured in preventable deaths.

 

 The MNH picture in EQUAL’s two research regions

Galmudug

 

•  34% of women received skilled antenatal care during last birth

•  Only 30% of births occurred in a health facility

•  13% of mothers received a postnatal check within 2 days of delivery

•  76% of women reported at least one barrier to accessing healthcare

•  Compounded by inter-clan conflict, drought and large-scale displacement

Banaadir (Mogadishu)

 

•  49% received skilled antenatal care

•  38% delivered at a health facility

•  Only 8% of mothers received a postnatal check within 2 days

•  70% of women reported at least one barrier to accessing healthcare

•  WHO classifies malnutrition and death rates at ‘emergency’ level despite urban setting

 

Contacts

General EQUAL enquiries: EQUAL@rescue.org

Dr. Abdi Dalmar (SORDI): drdalmar@sordi.so

Dr Mohamed Jimale (SORDI): mohamedjimale@sordi.so

Muna Jama (IRC, community programme): muna.jama@rescue.org  

Website: www.EQUALresearch.org

About EQUAL

The EQUAL Research Consortium is funded by UK International Development from the UK Government and operates in Somalia, DRC, Nigeria and South Sudan. In Somalia, EQUAL is led by IRC, SORDI and Johns Hopkins Center for Humanitarian Health, in collaboration with Somalia’s Federal Ministry of Health. The programme runs July 2021 – April 2026.

 

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