Programme Index Listing

Main implementer
DT Global
Other implementers
Somali Research and Development Institute (SORDI) / Swiss Tropical and Public Health Institute (Swiss TPH)
Swiss Agency for Development and Cooperation (SDC)
2021 - 2024 (Phase 1)
Total budget
USD $4 million
Annual budget
USD $1.3 million

Project description / objective

The programme has been designed to follow the MSD approach with the general objective of providing Somali citizens, including the most disadvantaged groups, with better access to quality and affordable health services.

Market systems focus

Healthcare finance

Formal and informal innovative financing mechanisms that will benefit the poor:

Private healthcare in Somalia is primarily financed through out-of-pocket (OOP) expenditures. The risk of financial burden on poor populations is especially severe. Many Somalis forego or defer treatment due to inability to pay.

The health market is distorted as there is little domestically generated tax base with which to support social health insurance, and the overall federal budget is highly dependent on donor funding. Private health insurance coverage is low, estimated at only two per cent.

Healthcare service delivery

Organising and supporting the private sector through health associations and networks:

Longstanding fragility in Somalia has resulted in fragmented and parallel healthcare systems and structures. Most public health services provided in-country have been 'off-budget and off-treasury', regarded as humanitarian services provided by donors through implementing NGOs, UN agencies and the Red Cross/Red Crescent.

The health market lacks adequate service delivery mechanisms; there are significant gaps in the areas of regulation, quality control, staffing/human capacity, medicines, equipment, and access to services. The commercial private health sector is highly fragmented with no single dominant player. However, despite a high official poverty rate, the Somali private health sector is vibrant and continues to grow rapidly.

Programme interventions

Healthcare finance

  • PSPH works with existing commercial insurers in Mogadishu to introduce affordable mass-market private health insurance in Somalia and Somaliland.
  • Product development: assisting with health insurance benefit package design, limits/co-pays/deductibles and premium pricing.
  • IT systems and technology: assistance with design and implementation of integrated IT systems that serve the needs of policyholders, insurers and providers.

Healthcare service delivery

  • PSPH works with service provider networks in Mogadishu and Hargeisa (hospitals, clinics, and pharmacies) to foster common quality standards, develop the regulatory system, offer better value for money, act as trusted service providers for insurers and the public health system, and signal the availability of affordable, quality assured healthcare to the mass market.
  • Network governance: assisting with development of fit-for-purpose, sustainable, member-supported governance frameworks that serve each network’s long-term objectives.
  • Standards: assisting with establishing network membership standards and quality standards.

For both market systems

  • Strategic action planning: facilitating partner-owned action plans focused on achieving sustainability and scale.
  • Primary research: examining health-seeking and health-spending behaviour in Somalia and Somaliland, where there are data gaps, through FGDs and surveys.
  • Marketing: assisting with marketing strategy, branding, and consumer outreach and awareness.
  • Business skills training: customer care, cash flow management and intervention-specific technical training of partner staff.
  • Networking and matchmaking: joining service providers to finance providers; fostering referrals among providers.

Notable results (systemic change, poverty impact)

Market system changes    

The programme just finished the first year of a planned 12-year, multi-phase programme and does not claim market system changes at this early stage.

Impact on poverty

Similarly, the programme has not yet reached impact level and does not claim impact on poverty at this early stage.

[uploaded February 2023]