Service Availability and Readiness for Essential Health Services in Somalia: A Narrative Review of Facility Evidence and Health‐System Priorities

Essential health services are central to universal health coverage; however, nominal service availability does not necessarily indicate that facilities are ready to deliver care safely, continuously and equitably. In Somalia, evidence on service availability and readiness remains dispersed across facility assessments, policy documents, programme reports and peer‐reviewed studies, limiting its use for planning and equitable resource allocation. This narrative review synthesizes Somalia‐specific evidence on service availability, facility readiness, readiness‐related delivery constraints and health‐system priorities for strengthening essential health services. Evidence was classified as direct facility‐readiness measures, readiness‐related delivery‐system indicators or coverage, programme‐performance and outcome indicators to distinguish structural readiness from indirect signals of delivery‐system performance. Available evidence suggests important readiness gaps across emergency and critical care, surgical services, maternal and newborn health, immunization, nutrition, communicable diseases and selected non‐communicable disease services. These gaps are reinforced by donor‐dependent and geographically uneven financing, fragile supply chains, workforce shortages and maldistribution, weak referral and emergency transport systems, fragmented public, private, NGO and humanitarian service delivery, and limited routine use of facility‐assessment data. Rural, displaced, nomadic, pastoralist and conflict‐affected populations experience substantial access barriers. Institutionalizing readiness monitoring and linking facility‐assessment evidence to planning, budgeting, supervision, supply allocation, donor coordination and accountability could help Somalia move from nominal service availability toward effective, continuous and equitable essential health‐service coverage.