Somaliland is a self-declared but internationally unrecognised state in the Horn of Africa. Following a brutal civil war which ended in 1991 most of the states health infrastructure had been destroyed and many of its health workers had been displaced.

Somaliland now suffers from a serious shortage of health workers, recently estimated at 197 doctors, 1,256 nurses and 344 midwives, serving a population of around 3.5 million. This level of coverage falls far short of the WHO-recommended minimum health worker/population ratio of 2.3/1,000. This shortage is compounded by significant skills gaps in the workforce, with very few opportunities for clinicians to access formal postgraduate training, leading to the absence of specialists in most areas of clinical practice.

During this last year we have greatly benefited from the leadership of our new Country Director, Nura Aided Ibrahim, a Somaliland nurse and health educator, with extensive experience working with partners to strengthen the health workforce. This expertise and experience has made a valuable contribution to our role in the King’s College led Prepared for Practice programme. This is funded through the DFID Strategic Partnerships for Higher Education, Innovation and Reform (SPHEIR) programme. With support via this programme, significant strides are being taken to strengthen the quality of medical education in Somaliland.

 

Under the leadership of the Ministries of Health and Education and Higher Education and the two regulatory bodies, the National Health Professional’s Council and the National Commission for Higher Education, a new Medical Education policy has been developed and approved and is in the early stages of implementation. This is a very significant step for a country that is still emerging from years of conflict and which is still awaiting international recognition as an independent country. We have been extremely impressed by the commitment and dedication of the Somaliland health leaders to ensure that medical education in Somaliland results in the right number of doctors with the right skills to provide quality care within the Somaliland health system.

The challenges in ensuring a strong and effective health system are many of course– and we are working with partners to identify how best THET and partners can contribute to addressing some of the priorities. However, strengthening the quality of newly trained doctors is one very important step in this direction and we very much look forward to continuing this journey with our partners.