While commemorating World Patient Safety Day yesterday, the Federal Government of Somalia, in collaboration with the World Health Organization (WHO), United Nations Children’s Fund (UNICEF) and United Nations Population Fund (UNFPA), urged health facilities, health care workers and other stakeholders to step up efforts to ensure mothers and newborns remain safe.

This message echoes this year’s theme for World Patient Safety Day — ‘Safe maternal and newborn care’ — and comes at a time when the coronavirus disease-2019 (COVID-19) has disrupted continuity of already overstretched essential health services across the country.

A national ‘pulse survey’ conducted by WHO over seven months in 2020 and 2021 to determine the continuity of essential services in Somalia found that, during May–September 2020, 33% of essential health services had been disrupted (one out of three services), while during January–March 2021, there was continued disruption of 12% of essential health services (six out of 51 services), indicating that substantial disruptions persisted even after one year of the pandemic. Six of the major essential health services where significant disruptions were noted include reproductive, maternal, newborn, child and adolescent health services, that experienced between 5-50% disruption, and immunization services, disrupted by between 5-20%.

Even before the COVID-19 outbreak was confirmed in Somalia, the country was known to have one of the highest maternal mortality rates in the world, at 692 maternal deaths per 100 000, and a neonatal mortality rate of 40 deaths per 1000 live births.

“Before the COVID-19 pandemic, 68% of women did not visit health facilities for antenatal care and only one-third of births were delivered with the help of a qualified health care practitioner,” said Dr Fawziya Abikar Nur, Minister of Health and Human Services for Somalia. “Since the COVID-19 pandemic was confirmed in Somalia, women have been making even fewer visits to seek help. I would like to encourage all our partners to reconsider their strategies to ensure more pregnant women access health facilities for antenatal care, deliveries, and immunization, to offer young children a safe start to their lives.”

As part of this year’s World Patient Safety Day commemorations, all partners, including WHO, are urging all stakeholders to “Act now for safe and respectful childbirth.” Ensuring appropriate and respectful treatment to delivering women and their babies will increase trust in health facilities, utilization of services and support by the communities.

“At the points of care, we need to continue to develop the capacity of health care workers, while maintaining the highest standards of hygiene and safety to prevent any potential spread of diseases and to ensure patients recover,” said Dr Mamunur Malik, WHO Representative to Somalia. “At the same time, we need to encourage family members, including men, to bring pregnant mothers to their nearest health centers for regular antenatal care and delivery, to prevent women and children from dying of preventable causes and unsafe care. With concerted efforts, we can save more lives, but we all need to act now to make a change.”

“Having a skilled pair of hands – a well-trained doctor, nurse or midwife – present during pregnancy, birth and beyond, is key in giving every Somali child a chance to survive and thrive from the very beginning,” said UNICEF Somalia Representative, Mohamed Ayoya. “UNICEF is proud to partner with the Government of Somalia to enhance its efforts to reach vulnerable women and children, living in the most disadvantaged areas and enduring the harshest conditions, who need the support most, amid the COVID-19 pandemic.” “Every mother has a right to a safe delivery through skilled birth attendance at birth. This is a service that can be scaled up to reach the underserved and underprivileged population across the country. This can be achieved through the ongoing engagement of the public sector and the services provided by the non-government sector,” said UNFPA Representative, Mr Anders Thomsen.

Mr Thomsen said skilled birth attendance is an evidence-based public health intervention to reduce maternal and neonatal mortality and morbidity. “UNFPA continues to invest in this effort in close partnership with the Ministry of Health, by supporting health facilities providing life-saving skilled birth attendance at birth as well as ensuring the production of qualified midwives who provide the best option in Somalia for truly reaching the most underserved population in the country with safe and life-saving care,” said Mr. Thomsen.

Introduced in 2019, World Patient Safety Day aims to promote understanding of patient safety, increase public engagement in health care safety, and promote global action to prevent and reduce avoidable harm in health care. This year, on the World Patient Safety Day, WHO, UNICEF and UNFPA committed to support the Federal Ministry of Health and Human Services to introduce new interventions and measures across the health facilities in the country, which will ensure safer maternal and newborn care every year.