article · Frontiers in Global Women s Health
Maternal and neonatal survival in Somalia remains severely constrained by significant barriers to emergency obstetric and newborn care. Ongoing conflict, displacement, climate shocks, poverty, and geographical isolation leave pregnant women and newborns facing dangerous delays when seeking urgent medical support. A comprehensive review of literature and policy documents from 2010 to 2026 highlights widespread structural shortcomings, including low rates of institutional deliveries, minimal skilled birth attendance, and insufficient coverage of both basic and comprehensive emergency care facilities. Health facilities consistently suffer from weak readiness, marked by critical shortages of qualified healthcare personnel, inadequate blood transfusion capabilities, and unreliable supplies of essential medical commodities. To tackle these inequities, the evidence calls for an integrated policy response. This includes improving rural care access, establishing dependable referral mechanisms, expanding midwifery training, enhancing death surveillance systems, and aligning humanitarian actions with long-term development programmes.
In regions destabilised by conflict and poverty, mothers and infants face life-threatening delays when obstetric complications occur. Understanding the specific systemic bottlenecks, ranging from workforce deficits to broken referral paths, is vital for policymakers, humanitarian agencies, and healthcare funders striving to design targeted health-system interventions that save lives under challenging conditions.
The abstract does not indicate a commercial application pathway, as it focuses on health system reviews, humanitarian programming, and public policy reforms.
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Emergency obstetric and newborn care remains a critical maternal-health and health-system priority for reducing preventable maternal and neonatal deaths in Somalia. Prolonged conflict, displacement, recurrent climate shocks, poverty, and rural access inequities continue to expose pregnant women and newborns to delays in reaching timely emergency care. Although previous reviews have described broad maternal and newborn health challenges in Somalia, less attention has been given to how emergency obstetric and newborn care gaps interact with rural geography, insecurity, referral barriers, workforce shortages, weak facility readiness, and humanitarian service-delivery constraints. This policy and practice review synthesizes peer-reviewed literature, national survey evidence, policy documents, technical guidance, and authoritative reports to examine emergency obstetric and newborn care in conflict-affected Somalia. Sources published or made available between 2010 and 2026 were prioritized, while older seminal sources were retained only when they provided foundational frameworks or technical definitions. The review focuses on rural access inequities, referral barriers, facility readiness, workforce capacity, sociocultural determinants of care-seeking, and policy-practice priorities. The evidence indicates that low rates of skilled birth attendance, limited institutional delivery, inadequate basic and comprehensive emergency obstetric and newborn care coverage, weak referral systems, financial barriers, and shortages of skilled personnel continue to undermine timely care for obstetric and newborn emergencies. Strengthening emergency obstetric and newborn care in Somalia requires an integrated service-delivery and policy approach that expands rural coverage, improves referral coordination, invests in midwifery and emergency obstetric skills, stabilizes essential supplies and blood transfusion capacity, strengthens maternal and perinatal death surveillance, and aligns humanitarian and development programming. Addressing these priorities is essential for improving equitable maternal and newborn survival in conflict-affected and resource-limited settings.
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DOI: 10.3389/fgwh.2026.1914864
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