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“Because every newborn deserves more than a chance to be born. Every newborn deserves a chance to survive. Every newborn deserves a chance to grow.
By Dr. Mohamed Yaqub Hassan.
A baby’s first breath should mark the beginning of life—not a moment when survival depends on where that baby was born, whether a trained health professional is present, or whether an incubator, oxygen supply or essential medicine is available.
Yet for many newborns in Somalia, these basic conditions cannot be taken for granted.
The first 28 days of life are the most vulnerable period of childhood. Globally, an estimated 2.3 million newborns died in 2024, with prematurity, complications during childbirth, pneumonia and sepsis among the leading causes. Progress in reducing neonatal deaths has also been slower than progress among older children.
For Somalia, the challenge is particularly urgent. UNICEF’s country data estimate a neonatal mortality rate of 34 deaths per 1,000 live births. UNICEF also reports that four in every 100 Somali children die during their first month of life, while more than 80% of newborn deaths are associated with preventable or treatable conditions, including prematurity, birth complications and infections.
Behind these statistics are families who have lost children they hoped to watch grow.
Somalia has made important commitments to improving maternal and child health. In April 2026, the government launched its Community Health Strategy 2025–2029, which includes expanding maternal and newborn care, strengthening immunization, improving childhood illness management and extending community-based services.
These efforts are essential. But what happens to a baby who survives pregnancy and childbirth only to become critically ill in the first hours or days of life?
A newborn with respiratory distress may need oxygen or respiratory support. A premature infant may require thermal protection, feeding support and close monitoring. A baby with suspected sepsis needs timely assessment and treatment, while one affected by birth asphyxia may require immediate resuscitation and specialized care.
In neonatology, minutes matter. Delays in recognizing deterioration, initiating treatment or transferring a critically ill newborn can have irreversible consequences.
Neonatal care must therefore be recognized as a health-system priority in its own right, rather than treated as a minor component of maternal healthcare.
One common misconception is that improving neonatal care simply means purchasing more incubators.
Equipment matters, but equipment alone does not save lives.
A functioning neonatal unit requires trained healthcare professionals, reliable electricity, oxygen systems, infection-prevention measures, essential medicines, feeding support, monitoring equipment, laboratory services and clear clinical protocols.
Most importantly, it needs professionals capable of using these resources safely.
An incubator without trained staff is not a neonatal care system. Nor is a ventilator without reliable electricity, maintenance and appropriately trained personnel.
The objective should not simply be to establish more neonatal intensive care units (NICUs), but to develop safe, functional and sustainable services.
Premature and low-birth-weight babies are among the most vulnerable patients in any healthcare system. They need warmth, appropriate nutrition, careful monitoring, protection from infection and respiratory support when necessary.
Yet many lifesaving interventions do not require expensive technology.
Kangaroo Mother Care, for example, provides skin-to-skin contact that helps maintain body temperature, supports breastfeeding and strengthens the bond between mother and baby. Early breastfeeding, appropriate cord care and basic infection-prevention practices are equally important.
High-quality neonatal care does not always mean high-cost care. Often, it means ensuring that appropriately trained professionals deliver the right intervention at the right time.
Discussions about healthcare investment often focus on hospitals, doctors and equipment. Yet neonatal care depends heavily on skilled nurses and midwives.
Premature and critically ill newborns may require continuous observation, feeding assessments and frequent monitoring of temperature, respiratory rate, oxygen saturation and other vital signs.
Somalia should invest in specialized neonatal nursing and midwifery education, continuous professional development, mentorship and supportive supervision.
Healthcare workers cannot reasonably be expected to provide high-quality neonatal care without adequate training, staffing and working conditions.
For premature and critically ill newborns, infections can rapidly become fatal.
Neonatal units must therefore place infection prevention at the centre of clinical practice. Hand hygiene, environmental cleaning, appropriate sterilization, safe handling of invasive devices and rational antibiotic use should be fundamental requirements.
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Somalia also needs stronger surveillance of healthcare-associated infections and antimicrobial resistance.
Unnecessary or inappropriate antibiotic use risks compromising treatment today while making infections harder to manage in the future.
Critically ill newborns frequently require transfer between healthcare facilities, particularly when specialized services are unavailable locally.
But referral involves much more than transportation.
Safe neonatal transfers require communication between facilities, stabilization before departure, appropriate equipment, trained personnel and reliable transport arrangements.
A newborn’s condition should not deteriorate during transfer because the health system lacks the resources or coordination needed for a safe journey.
Reducing neonatal mortality is essential, but survival alone should not define success.
Prematurity, severe infections and complications during childbirth may have consequences extending beyond the neonatal period.
Newborn services must therefore connect with breastfeeding support, immunization, developmental monitoring, follow-up care and early childhood health programmes.
Saving a newborn is the first victory. Helping that child grow and thrive is the ultimate goal.
Somalia’s health-sector partners are already emphasizing maternal and newborn health, community-level services, specialized care for small and sick newborns, Kangaroo Mother Care, stronger referral systems and improved health data.
These commitments now require sustained implementation, adequate financing and accountability.
Somalia should prioritize:
These priorities are not simply technical improvements. They represent practical steps towards a healthcare system capable of protecting newborns during their most vulnerable days.
A newborn cannot choose where to be born. A premature baby cannot request specialized care, and a child struggling to breathe cannot call for help.
That responsibility belongs to parents, healthcare workers, hospitals, communities and policymakers.
Somalia has made progress in strengthening maternal and child health, but the first 28 days of life require greater attention. Meaningful improvements in child survival will remain difficult while newborns continue to face preventable risks immediately after birth.
Neonatal care must be understood not merely as a specialized service for critically ill babies, but as an essential pillar of Somalia’s healthcare system.
Because every newborn deserves more than a chance to be born.
Every newborn deserves a chance to survive, grow and thrive.
And Somalia’s health system must be strong enough to give them that chance.
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About the Author
Dr. Mohamed Yaqub Hassan Pediatrician and Neonatologist Yardimeli Specialist Hospital, Mogadishu, Somalia.
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The opinions expressed in this article are those of the writer and do not necessarily reflect the views of Dawan Africa.