The Effects of Armed Conflict on Healthcare Delivery and Nutritional Services in Somalia: A Narrative Review

ABSTRACT

Armed conflict remains one of the most significant barriers to health system stability and food security in fragile states, such as Somalia. This narrative review synthesizes literature published between 2016 and 2025 to examine how ongoing conflict has shaped healthcare delivery and nutrition services, identifying key challenges, and exploring potential mitigation strategies. A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar, supplemented by credible grey literature, revealed consistent patterns: The destruction of health infrastructure, loss of skilled personnel, disrupted supply chains, and widespread displacement have severely restricted access to essential care. Nutritional programs have been equally affected, with conflict‐induced food insecurity and inflation driving alarming rates of acute and chronic malnutrition, particularly among children, pregnant women, and lactating mothers. Evidence from cash‐based interventions, integrated outreach models, and conflict‐sensitive service planning highlights opportunities to improve health and nutrition outcomes despite insecurity, though scalability remains constrained by funding gaps and access limitations. Health and nutrition workers face high personal risk, low morale, and resource shortages, whereas system‐level weaknesses hinder sustained improvement. Addressing these challenges requires coordinated action to protect facilities and staff, secure food systems, expand adaptable service delivery, and strengthen surveillance for timely response. The findings reinforce that sustainable progress in Somalia's health and nutrition sectors depends on embedding resilience into both emergency and long‐term interventions.