Op-Ed: The Danger of Unregulated Health Care Providers in Somaliland

Op-Ed: The Danger of Unregulated Health Care Providers in Somaliland

 By Abdiaziz Ali Adani
Many people in countries with underdeveloped public healthcare infrastructure, like Somaliland, rely instead on unregulated private clinics and hospitals. These privately owned businesses are not subject to government surveillance, supervision, or control. As a result, there are several incidents of unscrupulous operators taking advantage of desperate patients by providing subpar or fraudulent care. Because there is no government control, these clinics frequently hire inexperienced employees, re-use expired pharmaceuticals, and perform unnecessary treatments.

Lack of Government Oversight
The Somaliland healthcare system is complex and comprises several different types of providers. These providers include hospitals (public and private), health posts, and traditional medical centres. The Ministry of Health oversees public hospitals and health posts but does not oversee private clinics. The lack of government oversight has allowed many unregulated private healthcare providers to emerge.

Unqualified Staff & Fraudulent Practices
Many patients who access unregulated healthcare providers find that staff working in these facilities are not qualified. The lack of qualified staff and improper use of equipment are significant concerns for patient safety in these unregulated health facilities. There have been many fraud cases in health facilities that aren’t regulated. In one case, a dead person was kept in some hospitals’ intensive care units (ICU) for almost a week without anyone looking at them. Another shocking thing that came to light was that doctors leave gauze inside patients after surgery. This was found years later. In other cases, patients were given treatments that were unnecessary or not up to par.

For instance, a mother was told that her child had a disease that could be treated with antibiotics. After the treatment, the mother was told that the child did not have the disease. Sometimes sick and hurting people are given the wrong medicine, which makes their condition worse. In other cases, doctors told patients to have surgeries they didn’t need, like appendicectomy and caesarean sections.
Similarly, it has often been seen that patients are referred to labs simply to make money, even when they are not required. Also, many providers work with pharmacies that sell low-quality drugs and are likely to recommend treatments that make them more money. Many of these scams are likely done by people in the medical field who want to make more money.

Improving Healthcare systems: To what end do we put this?

To improve the situation in terms of regulation and oversight of healthcare providers in Somaliland, the government needs to take the following actions:

  • Strengthen the health system: The government should strengthen the public health system. This means ensuring that public health facilities are adequately staffed and equipped and that public health facilities accommodate patients. Additionally, the government should try to find funding for public hospitals, which often face significant financial challenges.
  • Establish the Health Care Regulatory Framework: The government should build the ability to ensure that they can adequately regulate health care providers. This will likely involve hiring qualified staff to help the government regulate health facilities. This capacity could also be used to support the government develop a system to monitor the health system, which would be helpful even in the absence of regulation.

The way forward
The unregulated healthcare sector needs to be regulated to improve the situation in Somaliland. This can be done by strengthening the government system and building the capacity of the regulatory system. The lack of government oversight of unregulated healthcare providers has led to a situation where people do not receive proper care, and the public health system is further undermined.
Controlling the quality of drugs and the knowledge of foreign doctors: The government should take strict measures against hospitals that bring foreign doctors without the knowledge they claim. Before doctors enter the country, they should undergo an official background check and get a short time license subjected to check every six months.

The government should adopt stringent legislation and establish transparent protocols to ensure that the pharmaceuticals brought into the country are of a high standard. It is unacceptable to enable anyone to bring in their supply of medicine. Only government-approved enterprises should be allowed to import pharmaceuticals.


Abdiaziz has been working in development for the last 10+ years as a civil society actor, a development practitioner, and a researcher. He has been involved in development discourse and practises at both the national and international levels, mostly in the areas of policy advocacy, people’s empowerment, social mobilisation, and livelihoods.

The views expressed in this article are the author’s own and do not necessarily reflect the Horndiplomat editorial policy.
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