Warsame Abdihamid, Handuleh Jibril, Patel Preeti
Mercy USA for Aid and Development, Mogadishu, Somalia
School of Medicine, Amoud University, Borama, Somalia.
Int Health. 2016 May;8(3):204-10. doi: 10.1093/inthealth/ihv060. Epub 2015 Sep 29.
After years of decline and disintegration, the Somalia Federal Government alongside international and domestic partners is beginning the process of rebuilding its national health system. In this study, we aim to shed light on the current approaches to health system strengthening, as viewed by stakeholders closely involved in its development.
Key informant interviews were undertaken with health and development professionals working within all three administrative regions of Somalia, as well as with Somali ministry of health officials, global health and policy specialists with interests in health system reconstruction in fragile states. A review of published and grey literature on Somalia, health systems, fragile and conflict-affected countries using PubMed and Reliefweb was also conducted. Technical documents designed for Somali health system building by external development partners were also reviewed.
Key priorities identified by participants were, strengthening of local governance and management capacity, scaling-up efforts to structure a robust health financing mechanism, engagement with the burgeoning and dynamic private sector, as well as investing in the appropriate human resources for health.
The study found that there was widespread agreement among participants that health system strengthening through a coordinated system would improve long-term capacity in Somalia's health sector. Future research should focus on the evaluation of the modalities by which health system strengthening interventions are implemented, on neglected topics such as mental health within the Somali health system, as well as on population-level barriers to accessing health systems.
经过多年的衰退和解体，索马里联邦政府与国际和国内伙伴一道，开始了重建其国家卫生系统的进程。在本研究中，我们旨在揭示参与其发展的利益相关者所认为的当前加强卫生系统的方法。
对在索马里所有三个行政区工作的卫生和发展专业人员、索马里卫生部官员、关注脆弱国家卫生系统重建的全球卫生和政策专家进行了关键信息访谈。还使用PubMed和救济网对已发表的和灰色文献中关于索马里、卫生系统、脆弱和受冲突影响国家的内容进行了综述。此外，还审查了外部发展伙伴为索马里卫生系统建设设计的技术文件。
参与者确定的关键优先事项包括，加强地方治理和管理能力，加大力度构建强大的卫生筹资机制，与新兴且充满活力的私营部门合作，以及投资于适当的卫生人力资源。
该研究发现，参与者普遍认为，通过协调一致的系统加强卫生系统将提高索马里卫生部门的长期能力。未来的研究应侧重于评估加强卫生系统干预措施的实施方式，关注索马里卫生系统中被忽视的主题，如心理健康，以及获取卫生系统服务的人群层面障碍。
