By Ridwan Tukale - Mogadishu-based technology entrepreneur and product manager focused on digital health.
“Somalia cannot train its way out of its doctor shortage alone. It also has to connect its way out.” Ridwan Tukale
It is two in the morning, and a child has a high fever. Her mother has three choices: wait until daylight and hope, pay for transport across the city to a hospital that may not have a doctor on duty, or ask a neighbour, relative or pharmacist and act on whatever they say.
For many Somali families, this is not unusual. It is often how healthcare begins. The first contact with the health system may be delayed, expensive or poorly informed. By the time a patient reaches a doctor, a manageable problem can become a serious one.
A shortage that training alone cannot close#
The World Health Organization uses 44.5 doctors, nurses and midwives per 10,000 people as a benchmark for delivering essential health services. Somalia has about 3.8 per 10,000, according to 2024 WHO workforce data, and health workers are concentrated in Mogadishu and a few other cities, leaving rural and remote communities underserved.
Somalia’s medical schools are growing, and that matters. But training a doctor takes six years or more, and many health workers leave for better-paid jobs abroad. Training more people remains essential, but it will take years to close the gap.
In the meantime, another question needs attention: how many people can each doctor reach, and how early?
The infrastructure is already in place#
Somalia has one of the most mobile societies in Africa. According to the National Evonomic Council in Somalia, around nine in ten Somalis now use mobile money, up from 73 percent of adults in 2017, according to World Bank, and mobile networks reach most of the population. People use their phones to pay school fees, send remittances and run businesses.
The same phone can connect a patient with a qualified Somali-speaking doctor at two in the morning. It can help book an appointment, deliver lab results or a prescription, and provide advice on whether a symptom needs urgent attention.
Digital health can complement traditional healthcare. Physical examinations, emergency care and well-staffed hospitals remain essential. Remote consultations can help determine where care should begin: some concerns can be assessed remotely, while patients who need hospital treatment can be referred sooner to an appropriate facility.
Many doors to care#
Access is not a single service. To reach people with different phones, budgets and circumstances, digital health needs to work through several channels.
Voice before apps. Most Somalis do not need a smartphone to speak with a doctor. Interactive voice lines and free hotlines, with simple Somali-language menus, can work on basic handsets without data or reading. Services built only for smartphones may leave out older people, rural families and those with weak connections.
Outreach before illness. Health systems often wait for patients to arrive. Hospitals can also use calls and text messages to send vaccination reminders, maternal health advice and outbreak warnings to households.
Care closer to home. Home nursing and sample collection can serve older people, new mothers and patients recovering from surgery who find it difficult to travel. This can save families a day’s journey and lost wages.
Better referrals. When patients are assessed before they arrive, hospitals can receive them at the right time and direct them to the appropriate service.
Prevention at work. Conditions such as high blood pressure and diabetes often go unnoticed until they become emergencies. Regular screening through employers can help identify them earlier.
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Several Somali companies now offer services of this kind. Their contribution should be assessed through evidence on who they reach, the quality and affordability of care, and patient outcomes.
What makes digital health work#
Technology alone does not build trust. Patients need Somali-speaking clinicians who understand their circumstances, and referrals to health facilities they know. Digital health is more likely to earn trust when it is developed with health workers, hospitals and clinics.
Cost also shapes access. When the first point of contact is free or affordable, people may seek advice sooner. Early advice can be cost-effective for both families and the health system.
No single provider can build this system alone. Telemedicine companies, hospitals, telecom operators, insurers and government need shared standards, clear referral pathways and financing that reflects how Somalis live and pay.
What needs to happen next#
Digital health in Somalia is moving beyond its early pilots. Four steps could help it reach more people.
Clear regulation. Somalia needs a national framework for telemedicine that sets out who may consult remotely, how electronic prescriptions work and how patient data is protected. Clear rules can protect patients and give providers and investors greater confidence.
Sustainable financing. Employers, insurers, humanitarian agencies and government should consider digital first-contact services as part of the care they fund. Mobile payment options that allow families to spread the cost could widen access. A remote consultation that leads to earlier treatment may cost less than a hospital admission after a condition has worsened.
Integration with the health system. Digital services should connect with public referral pathways and, with proper safeguards, support disease surveillance. Calls to health hotlines can also provide information about emerging health concerns and where they are occurring.
Investment as infrastructure. At the recent EU–Somalia Business Forum in Mogadishu, the digital economy featured alongside energy and logistics on the investment agenda. Digital health belongs in that discussion as part of the infrastructure needed to deliver essential services.
The question that matters#
The question is not whether Somalia will have enough doctors in ten years. On current trends, it is unlikely to. The question is whether the doctors it has today can reach the mother with the feverish child tonight.
The technology and networks are already available, and Somali patients are using mobile services in other parts of their lives. Government, health providers, partners and investors can help connect those tools to trusted care, so access to a doctor depends less on where a family lives or what it can afford.
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About the author:
Ridwan Tukale is a Mogadishu-based technology entrepreneur and product manager focused on digital health.
The views expressed in this article are those of the author and do not necessarily reflect the position of Dawan Africa.