A Looming Crisis: Caesarean Section Clinics in Somalia Face Closure Due to Funding Gaps

In recent years international funding from NGO’s and large organisations such as UN agencies have had funding cuts and withdrawn services they were supporting over the world. The impact has been widespread and devastating. One such example is described here by Ahmed Abdi Abdulahi, New Ways Communications Officer, where Caesarean Section clinics in Somalia face closure.

Somalia, a nation already grappling with decades of conflict, climate shocks, and widespread poverty, is now facing another devastating blow to its fragile healthcare system: the potential closure of vital Caesarean section (C-section) clinics in Lower Shabelle’s only few remaining services providing the operations in Barawe, due to severe funding cuts. This looming crisis threatens to push maternal and infant mortality rates, already among the highest in the world, even further into catastrophic territory.

For expectant mothers in Somalia, childbirth is often a perilous journey. The lack of adequate healthcare infrastructure, skilled medical professionals, and essential supplies means that many women give birth at home, often without any trained assistance. When complications arise during labour – complications that could be life-threatening for both mother and baby, a C-section can be the only life-saving intervention.

However, access to this critical maternity procedure in the Lower Shabelle region in Somalia is incredibly limited. Even in areas where C-section services exist, they are often provided by international NGOs and UN agencies, heavily reliant on external funding. Recent funding cuts indicate a sharp decline in humanitarian funding for Somalia, with the health and nutrition sectors being particularly hard hit. This dire financial situation is forcing aid operations to scale back or even shut down, and Lower Shabelle’s only C-section clinic is on the chopping block. In 2028, UNFPA Somalia supported a health project that offered cesarean section and healthcare professionals training in Barawe. “The new project has reduced maternity death by 50% percent.” (interview with head of the health centre, Nurayn Mohamed, July 2025). In the past years, expectant women in Lower Shabelle traveled hundreds of miles to get to the nearest C-Section which was Mogadishu, Somalia’s capital but UNFPA had soon faced funding cuts which ultimately led to the end of a lifesaving maternity and childcare service in the entire Lower Shabelle region.

Caesarean sections are often life-saving interventions for both mothers and babies facing complicated deliveries. However, in Somalia, the pathway to these essential surgeries is often paved with insurmountable financial hurdles. Hospitals and clinics, already battling limited resources due to new funding cuts, shortages of professional staff, and security issues, struggle to cover the costs of equipment, medication, and even the basic salaries of skilled medical personnel.

“We see women in dire need, but sometimes, by the time they can get here, they need urgent surgery, and we realize we don’t have the resources to conduct such complex operation, it’s tragically too late,” said, Dr. Abdirisak, one of New Way’s two working surgeons in Barawe’s only C-section room. “It’s heartbreaking to know you have the skills to save a life, but the financial means aren’t there.” He added.

“The consequences of this underfunding are grim, delays in accessing care due to cost can lead to severe complications like haemorrhage, obstructed labor, and sepsis, all major contributors to maternal and infant deaths”, doctors in Barawe MCH have warned. Since UNFPA’s departure from the Barawe health facility in 2018, New Ways Organization has been struggling to fund the clinics through the support of its partners and health volunteers. Currently, the majority of the staff at the clinic volunteer to offer critical service, something everyone in Lower Shabelle region and New Ways is extremely grateful for.

“While international aid plays a significant role in supporting Somalia’s health sector, it’s often fragmented and doesn’t always translate into consistent, accessible funding for critical procedures like C-sections at the grassroots level. Communities in Barawe are now calling for more coordinated and sustainable funding mechanisms if humanitarian aid stops, urging both local, national and international stakeholders to prioritize maternal health and ensure that financial barriers do not continue to claim precious lives like the ones who live in hard-to-reach areas controlled by extremists,” said Sharkey while reflecting the prevalence of maternity crisis not only in Barawe but the surrounding areas that are deemed to be unsafe to travel. “The health of Somali mothers and children hangs in the balance.” said Kinsi, New Ways’s Maternity and Childcare Health Facility technical lead and area supervisor.

The reasons for the critical underfunding are complex, ranging from the recent USAID freeze to competing humanitarian crises worldwide. Somalia’s humanitarian response plan for the current year is severely underfunded, with the food and nutrition sectors, which are closely linked to maternal and child health, receiving a tiny percentage of the required support in Lower Shabelle.

Additionally, Somalia’s healthcare system is heavily dependent on external aid. Both federal and regional governments have limited capacity for supporting healthcare in hard-to-reach parts of Lower Shabelle, therefore a substantial portion of health expenditure that New Ways operates comes from donors like UNICEF and Somali Humanitarian Fund. This reliance creates a fragile and unsustainable system that buckles under the weight of funding cuts.

As Kinsi quoted, the lives of countless Somali mothers and babies hang in the balance and it’s true when we assess the looming impact any aid cut can have on the lives of people in Somalia. “We cannot afford to let this crisis unfold. Now, more than ever, sustained commitment and decisive action are needed to ensure that every woman in Lower Shabelle has the chance to give birth safely and every child has a healthy start to life,” Kinsi added, reflecting her two-decade long humanitarian experience in Barawe.

In Somalia, and Lower Shabelle in particular where maternal mortality rates remain tragically high, doctors, nurses and hospital administrators in the region are sounding the alarm that if funding for C-sections pause, it will cost lives. This financial strain puts countless lives at risk and highlights the urgent need for greater investment in the country’s fragile healthcare system. This article is not only about voicing a concern but a call to action to the Federal government, Southwest Regional State and the humanitarian agencies working to address the health challenges in Somalia.

Ahmed Abdi Abdulahi
New Ways Communications Officer, Somalia

October 2025