{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T06:27:12Z","timestamp":1786602432759,"version":"build-2736575974"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Glob. Women\u2019s Health"],"abstract":"<jats:p>Emergency obstetric and newborn care remains a critical maternal-health and health-system priority for reducing preventable maternal and neonatal deaths in Somalia. Prolonged conflict, displacement, recurrent climate shocks, poverty, and rural access inequities continue to expose pregnant women and newborns to delays in reaching timely emergency care. Although previous reviews have described broad maternal and newborn health challenges in Somalia, less attention has been given to how emergency obstetric and newborn care gaps interact with rural geography, insecurity, referral barriers, workforce shortages, weak facility readiness, and humanitarian service-delivery constraints. This policy and practice review synthesizes peer-reviewed literature, national survey evidence, policy documents, technical guidance, and authoritative reports to examine emergency obstetric and newborn care in conflict-affected Somalia. Sources published or made available between 2010 and 2026 were prioritized, while older seminal sources were retained only when they provided foundational frameworks or technical definitions. The review focuses on rural access inequities, referral barriers, facility readiness, workforce capacity, sociocultural determinants of care-seeking, and policy-practice priorities. The evidence indicates that low rates of skilled birth attendance, limited institutional delivery, inadequate basic and comprehensive emergency obstetric and newborn care coverage, weak referral systems, financial barriers, and shortages of skilled personnel continue to undermine timely care for obstetric and newborn emergencies. Strengthening emergency obstetric and newborn care in Somalia requires an integrated service-delivery and policy approach that expands rural coverage, improves referral coordination, invests in midwifery and emergency obstetric skills, stabilizes essential supplies and blood transfusion capacity, strengthens maternal and perinatal death surveillance, and aligns humanitarian and development programming. Addressing these priorities is essential for improving equitable maternal and newborn survival in conflict-affected and resource-limited settings.<\/jats:p>","DOI":"10.3389\/fgwh.2026.1914864","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T05:33:06Z","timestamp":1786599186000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Emergency obstetric and newborn care in conflict-affected Somalia: rural access inequities, referral barriers, and health-system priorities \u2014 a policy and practice review"],"prefix":"10.3389","volume":"7","author":[{"given":"Abdukadir Mohamed","family":"Hassan","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Dr. Sumait Hospital, SIMAD University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdiwali Mohamed","family":"Hussein","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dr. Sumait Hospital, SIMAD University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Omar","family":"Siyad","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Dr. Sumait Hospital, SIMAD University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"B1","year":"2023"},{"key":"B2","unstructured":"Somalia: Maternal and Newborn Health Country Profile. Healthy Newborn Network\n          \n          2024"},{"key":"B3","unstructured":"Monitoring Emergency Obstetric Care: A Handbook. World Health Organization\n          \n          2009"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1284","DOI":"10.1016\/S0140-6736(06)69381-1","article-title":"Strategies for reducing maternal mortality: getting on with what works","volume":"368","author":"Campbell","year":"2006","journal-title":"Lancet"},{"key":"B5","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/S0140-6736(14)60792-3","article-title":"Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost?","volume":"384","author":"Bhutta","year":"2014","journal-title":"Lancet"},{"key":"B6","unstructured":"The Somali Health and Demographic Survey. 2020. Directorate of National Statistics\n          \n          2020"},{"key":"B7","unstructured":"Time to Act: Making Motherhood and Childhood Safer in Somalia. WHO EMRO\n          \n          2023"},{"key":"B8","unstructured":"WHO launches training to transform the care of mothers and newborns in Somalia"},{"key":"B9","unstructured":"Essential Package of Health Services Implementation Strategy. Federal Ministry of Health and Human Services\n          \n          2024"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1016\/0277-9536(94)90226-7","article-title":"Too far to walk: maternal mortality in context","volume":"38","author":"Thaddeus","year":"1994","journal-title":"Soc Sci Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1186\/s12884-023-05871-4","article-title":"Antenatal care utilization and its associated factors in Somalia: a cross-sectional study","volume":"23","author":"Miikkulainen","year":"2023","journal-title":"BMC Pregnancy Childbirth"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e0004102","DOI":"10.1371\/journal.pgph.0004102","article-title":"Level of completion of maternity continuum of care among ever-married women: an analysis of Somalia's Health and demographic survey 2020","volume":"5","author":"Mohamed","year":"2025","journal-title":"PLOS Glob Public Health"},{"key":"B13","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1007\/s44197-025-00475-x","article-title":"Antenatal care utilization in Somalia, 2020 Somalia demographic health survey","volume":"15","author":"Abdi","year":"2025","journal-title":"J Epidemiol Glob Health"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1216290","DOI":"10.3389\/fgwh.2024.1216290","article-title":"Does living in major towns favor institutional delivery in Somalia?","volume":"5","author":"Sheikh","year":"2024","journal-title":"Front Glob Womens Health"},{"key":"B15","doi-asserted-by":"publisher","first-page":"560668","DOI":"10.2147\/IJWH.S560668","article-title":"Prevalence and determinants of facility delivery among women in Somalia: insights from the 2020 Somali demographic and health survey (SDHS)","volume":"18","author":"Osman","year":"2026","journal-title":"Int J Womens Health"},{"key":"B16","doi-asserted-by":"publisher","first-page":"606754","DOI":"10.2147\/IJWH.S606754","article-title":"Maternal and newborn health in Somalia: a narrative review of health system challenges and public health priorities","volume":"18","author":"Mohamoud","year":"2026","journal-title":"Int J Womens Health"},{"key":"B17","doi-asserted-by":"publisher","first-page":"608398","DOI":"10.2147\/IMCRJ.S608398","article-title":"Conflict-related disruption of maternal health services: a case report of maternal death in transit due to obstructed labour in Somalia","volume":"19","author":"Hassan","year":"2026","journal-title":"Int Med Case Rep J"},{"key":"B18","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/S0140-6736(09)61926-7","article-title":"Responsibility for protection of medical workers and facilities in armed conflict","volume":"375","author":"Rubenstein","year":"2010","journal-title":"Lancet"},{"key":"B19","year":"2018"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e1196","DOI":"10.1016\/S2214-109X(18)30386-3","article-title":"High-quality health systems in the sustainable development goals era: time for a revolution","volume":"6","author":"Kruk","year":"2018","journal-title":"Lancet Glob Health"},{"key":"B21","year":"2021"},{"key":"B22","doi-asserted-by":"publisher","first-page":"CD007754","DOI":"10.1002\/14651858.CD007754.pub3","article-title":"Community-based intervention packages for reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes","volume":"2015","author":"Lassi","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"B23","doi-asserted-by":"publisher","first-page":"142","DOI":"10.56557\/jomahr\/2025\/v10i29632","article-title":"Community-based healthcare systems: a strategic lever for achieving health equity and universal health coverage","volume":"10","author":"Foster-Pagaebi","year":"2025","journal-title":"J Med Health Res"},{"key":"B24","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1136\/jech-2014-204784","article-title":"Male involvement and maternal health outcomes: systematic review and meta-analysis","volume":"69","author":"Yargawa","year":"2015","journal-title":"J Epidemiol Community Health"},{"key":"B25","year":"2022"},{"key":"B26","doi-asserted-by":"publisher","first-page":"010401","DOI":"10.7189\/jogh.06.010401","article-title":"Effectiveness of mHealth interventions for maternal, newborn and child health in low- and middle-income countries: systematic review and meta-analysis","volume":"6","author":"Lee","year":"2016","journal-title":"J Glob Health"},{"key":"B27","year":"2016"}],"container-title":["Frontiers in Global Women's Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgwh.2026.1914864\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T05:33:08Z","timestamp":1786599188000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgwh.2026.1914864\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":27,"alternative-id":["10.3389\/fgwh.2026.1914864"],"URL":"https:\/\/doi.org\/10.3389\/fgwh.2026.1914864","relation":{},"ISSN":["2673-5059"],"issn-type":[{"value":"2673-5059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"article-number":"1914864"}}