Health

The Federal Government of Somalia and Somaliland have established legal and policy frameworks recognizing the right to health for all individuals, including forcibly displaced persons (FDPs) such as refugees, asylum seekers, and internally displaced persons (IDPs). These frameworks emphasize universal health coverage and the integration of FDPs into national health systems. Key instruments include Somalia’s Provisional Constitution, the National Policy on Refugee-Returnees and IDPs, Somaliland’s National Health Policy, and the Puntland IDP Guidelines.

Despite these commitments, access to healthcare for FDPs remains heavily reliant on donor funding. Humanitarian actors, including UNHCR and various NGOs, play a central role in delivering both primary and secondary healthcare services, including hospital care and chronic disease treatment. National health systems lack the infrastructure, staffing, and financial resources needed to offer sustainable, quality services to displaced populations. As a result, healthcare delivery is fragmented, inconsistently available, and lacks long-term planning and integration into national systems.

While legal guarantees provide for non-discriminatory access to healthcare, enforcement and implementation remain limited. Provisions exist affirming that no one may be denied emergency medical treatment and prohibiting discrimination based on nationality, ethnicity, or displacement status. However, practical barriers—such as language differences, limited interpreter services, cultural stigma, and poor legal awareness—undermine these protections and hinder equitable healthcare access for FDPs.

Specialized services are especially constrained. Access to sexual and reproductive health (SRH) care, mental health services, and support for survivors of gender-based violence (GBV) is limited despite policy recognition. For example, sexual offences laws exist in Somaliland but remain largely unenforced. National GBV action plans and reproductive health strategies acknowledge FDPs’ vulnerabilities but are poorly resourced and inconsistently applied. This gap between policy and practice disproportionately impacts displaced women and girls.

The rights of persons with disabilities, including among FDP communities, are reflected in law but face significant implementation challenges. Somalia has ratified the UN Convention on the Rights of Persons with Disabilities (CRPD), and Somaliland has national guidelines addressing physical and mental disabilities. Nonetheless, these frameworks lack funding and institutional support, leaving displaced persons with disabilities largely underserved.

Mental health care remains one of the most neglected areas. While Somaliland has a mental health policy, it is not operationalized, and Somalia lacks a standalone legal framework for mental health. Stigma, insecurity, and limited service availability further marginalize those with psychosocial needs.

Legal remedies exist in theory, including constitutional protections and refugee legislation. However, there are few accessible mechanisms to address complaints specific to health access. Weak institutional capacity, low legal literacy among FDPs, and insecurity further constrain access to justice.