Work

From Gaps in Maternity Care to Maternal Rescue: An Interprofessional Implementation Agenda for Anesthesia and Maternal Critical Care in Somalia

Year: 2026

Type: article

Abstract: Somalia's maternal health system faces a dual challenge: limited access to skilled maternity care and insufficient capacity to rescue women who deteriorate during or after obstetric emergencies. Hemorrhage, hypertensive emergencies including eclampsia, sepsis, obstructed labor, and urgent cesarean delivery require coordinated maternity, anesthesia, nursing, resuscitation, postoperative surveillance, and critical-care functions. This evidence-informed commentary shifts the discussion from documenting gaps to an interprofessional implementation agenda. We propose five linked priorities: a regulated and supported maternity and obstetric-anesthesia workforce; an evidence-based cesarean safety bundle; step-up maternal high-care capacity; early-warning, crisis resource management, escalation, and referral pathways; and routine measurement through maternal and perioperative quality systems. The approach emphasizes actions that referral maternity hospitals can introduce progressively, with named local accountability, team training, minimum resource requirements, and measurable indicators, while avoiding unsupported assumptions about national critical-care capacity. Somalia does not need to wait for a fully developed intensive-care system before improving maternal rescue. The immediate opportunity is to connect five functions that are too often fragmented: competent anesthesia provision, reliable cesarean safety processes, early recognition of deterioration, monitored maternal high care, and accountable review of outcomes. Strengthening these functions as one interprofessional maternal-rescue pathway offers a practical route to reducing preventable severe maternal morbidity and mortality in Somalia.

Source: International Journal of Women s Health

DOI: 10.2147/ijwh.s647888

Authors: Hamdi Abdi Ali, Nasteho Mohamud Mudei

Institution: SIMAD University

Language: English

Topic: Maternal and fetal healthcare

Subfield: Pediatrics, Perinatology and Child Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836