Preventing maternal deaths in Somalia requires stronger primary health care and functional emergency referral systems.

Maternal mortality remains a critical public health crisis in Somalia, driven by structural vulnerabilities, low utilization of essential maternity care, and fragmented health service delivery. The vast majority of maternal deaths result from preventable obstetric complications such as hemorrhage, hypertensive disorders, sepsis, and obstructed labor. Current national surveys demonstrate severe gaps across the continuum of maternal care, particularly among rural, pastoralist, and internally displaced populations. Reducing preventable maternal deaths requires moving away from isolated emergency initiatives toward comprehensive health system strengthening. Priorities include scaling up primary health care facilities, expanding community midwifery networks, building organized emergency referral pathways with reliable communication and transport, and establishing maternal death surveillance systems. Connecting community-based health infrastructure directly to functional emergency obstetric facilities is essential to guarantee timely, life-saving care for pregnant women across Somalia.