Gender is a critical social determinant of health, shaping medical practice, healthcare access, and health outcomes. In Somalia, a context marked by conflict and a fragile health system, understanding these gender dimensions is vital for effective policy and intervention. A synthesis of existing evidence on this topic is currently absent. This systematic review aimed to identify, appraise, and synthesise available literature on the gender dimensions of medical practice and health outcomes in Somalia. Its objective was to map how gender roles, norms, and inequalities manifest within the healthcare sector and affect both providers and patients. A systematic search was conducted across multiple electronic databases, including MEDLINE, Scopus, and African Journals Online. Grey literature from relevant organisations was also sought. Peer-reviewed studies focusing on Somalia and addressing gender in relation to clinical practice, the health workforce, or health outcomes were considered. Screening, data extraction, and quality assessment were performed by two independent reviewers. The search yielded a limited number of qualifying studies. A predominant theme was the significant under-representation of women in the formal medical workforce, especially in leadership and surgical specialties. Findings consistently indicated that female patients faced barriers to accessing reproductive health services, influenced by gendered social norms and a shortage of female healthcare providers. Gender profoundly shapes the medical landscape in Somalia, with clear disparities in workforce composition and patient access. The evidence base remains sparse, highlighting a critical research gap, particularly concerning the experiences of male patients and gender minorities, and the impact of gender on non-communicable diseases. Investment in gender-sensitive health systems research in Somalia is required. Programmes should prioritise training and retaining female healthcare professionals and creating enabling environments for their practice. Policy and service delivery must address gendered barriers to care for all patients. gender, medical practice, health outcomes, Somalia, health workforce, access to healthcare, systematic review. This review provides a consolidated analysis of the gendered dynamics within Somalia's healthcare sector, identifying key disparities and critical gaps in evidence to inform future research and policy.
Abdi et al. (Fri,) studied this question.