Evidence map›Paper›PMID 41845417›Full record

ArticleBMC health services research2026

Healthcare facility accreditation status and associated factors in Somalia: evidence from the 2022-2023 harmonized health facility assessment.

Nor Haji Osman, Abdiweli Mohamed Abdi, Abdirahman Mohamed Jimale, Abdikarim Abdi Adam, Ibrahim Mohamed Abdi, Aweis Ahmed Moallim, Abdisalan Mohamed Roble, Abdirahman Ahmed Mohamud

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Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nor Haji OsmanCenter for Graduate Studies, Department of Statistics and Data Analytics, Jamhuriya University of Science & Technology (JUST), Mogadishu, Somalia. nuurhaaji1997@gmail.com.
Abdiweli Mohamed AbdiCenter for Graduate Studies, Department of Statistics and Data Analytics, Jamhuriya University of Science & Technology (JUST), Mogadishu, Somalia.
Abdirahman Mohamed JimaleCenter for Graduate Studies, Department of Statistics and Data Analytics, Jamhuriya University of Science & Technology (JUST), Mogadishu, Somalia.
Abdikarim Abdi AdamCenter for Graduate Studies, Department of Statistics and Data Analytics, Jamhuriya University of Science & Technology (JUST), Mogadishu, Somalia.
Ibrahim Mohamed AbdiCenter for Graduate Studies, Department of Statistics and Data Analytics, Jamhuriya University of Science & Technology (JUST), Mogadishu, Somalia.
Aweis Ahmed MoallimDepartment of Policy and Planning, HMIS Section, Directorate of Health and Human Services, Banadir Region, Mogadishu, Somalia.
Abdisalan Mohamed RobleDepartment of Digital Health and Innovations, HMIS Section, Ministry of Health and Human Services, Mogadishu, Somalia.
Abdirahman Ahmed MohamudDepartment of Policy and Planning, HMIS Section, Directorate of Health and Human Services, Banadir Region, Mogadishu, Somalia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHealthcare facility accreditation, licensing, and quality assurance are critical mechanisms for improving patient safety and service quality. In fragile and conflict-affected settings such as Somalia, these regulatory and quality assurance systems remain weak and poorly institutionalized. This study assessed the status of facility accreditation and associated factors using data from the 2022–2023 Harmonized Health Facility Assessment (HHFA).

methodsThis study was a secondary analysis of cross-sectional data from the Somalia HHFA 2022–2023, including 1,219 healthcare facilities across Five Federal Member States and Banadir Region. Descriptive statistics summarized facility characteristics and accreditation-related indicators. Bivariate and multivariable logistic regression analyses were conducted using Stata version 17 to identify factors associated with facility accreditation status. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, and p < 0.05 was considered statistically significant.

resultsOverall, only 18.46% (95% CI: 16.28%–20.64%) of healthcare facilities reported having undergone any accreditation. In the adjusted analysis, accreditation was significantly associated with state and facility type, and with certification and licensing status. Facilities certified for specific services (AOR = 8.49; 95% CI: 3.78–19.07) or licensed/registered facility-wide (AOR = 4.79; 95% CI: 2.03–11.34) had higher odds of accreditation. Facilities with a routine quality assurance process were also more likely to be accredited (AOR = 2.34; 95% CI: 1.51–3.64).

conclusionFacility accreditation in Somalia remains extremely limited, reflecting major gaps in regulatory oversight and quality assurance. Certification and licensing indicators and the presence of routine quality improvement processes were key factors associated with accreditation. Strengthening national accreditation frameworks and supporting routine quality improvement including context-appropriate accreditation pathways for complex referral facilities are vital to improve healthcare quality and safety in Somalia.

Indexed as

AccreditationHealth FacilitiesCross-Sectional StudiesHumansQuality Assurance, Health CareSomaliaAccreditation statusFacility accreditationLicensingQuality assuranceSomalia

Identifiers

PMID41845417
PMCPMC13107853

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.