From Gaps in Maternity Care to Maternal Rescue: An Interprofessional Implementation Agenda for Anesthesia and Maternal Critical Care in Somalia
- 1Department of Anesthesia and Critical Care, Dr. Sumait Hospital, SIMAD University, Mogadishu, Somalia
- 2Department of Obstetrics and Gynecology, Dr. Sumait Hospital, SIMAD University, Mogadishu, Somalia
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.
Related
- Adapting an Interprofessional Medication Adherence Program for Gout (IMAP-Gout): A Theory-Informed Pre-Implementation Analysis Using the Theoretical Domains Framework (TDF).
- SFAR's position: Organization of perinatal care in anesthesia, critical care, and perioperative medicine in France
- Impact of Early Interprofessional Involvement with a Critical Care Pharmacist on Patient Outcomes in the Intensive Care Unit
- The MCH-HB Adjara Study: protocol for a non-randomised hybrid type 1 effectiveness–implementation study of the Maternal and Child Health Handbook in Georgia
- Maternal critical care infrastructure and organisational preparedness in Türkiye: a national analysis of the MaCriCare cross-sectional survey
BibTeX
@article{ali2026from,
title = {{From Gaps in Maternity Care to Maternal Rescue: An Interprofessional Implementation Agenda for Anesthesia and Maternal Critical Care in Somalia}},
author = {Hamdi Abdi Ali and Nasteho Mohamud Mudei},
journal = {International Journal of Women's Health},
year = {2026},
month = oct,
doi = {10.2147/ijwh.s647888},
url = {https://doi.org/10.2147/ijwh.s647888},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - From Gaps in Maternity Care to Maternal Rescue: An Interprofessional Implementation Agenda for Anesthesia and Maternal Critical Care in Somalia
AU - Hamdi Abdi Ali
AU - Nasteho Mohamud Mudei
PY - 2026
DA - 2026/10/25
JO - International Journal of Women's Health
DO - 10.2147/ijwh.s647888
UR - https://doi.org/10.2147/ijwh.s647888
AB - 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.
SN - 1179-1411
ER -