Facebook Twitter (X) Instagram Somali Magazine - People's Magazine
A new study has revealed that while most healthcare workers in Mogadishu know about the World Health Organization’s surgical safety checklist, very few actually use it during operations, leaving patients exposed to risks in Somalia’s already fragile health system.
The research surveyed 422 doctors, nurses, and anesthesiologists between April and July 2024, aiming to understand how the checklist is being applied in Somali hospitals. The results showed a worrying gap. About 81 percent of the participants demonstrated good knowledge of how the checklist works, but only 13.5 percent showed a positive attitude toward using it in real surgical settings.
The WHO introduced the surgical safety checklist in 2008 as a global tool to make surgeries safer and reduce avoidable errors. The checklist includes 19 simple steps that surgical teams can follow to make sure essential procedures are not overlooked, and that everyone involved communicates clearly before, during, and after an operation. It has been credited worldwide with saving lives by catching small mistakes before they become deadly. In Somalia, 88 percent of healthcare workers surveyed agreed that the checklist improves patient safety. But even with this recognition, many admitted they avoid it because they fear it could slow down workflow or cause delays during operations.
The study was carried out by researchers from SIMAD University’s Faculty of Medicine and Health Sciences, including Najib Isse Dirie, Abdullahi Hassan Elmi, Mohamed Mustaf Ahmed, Abdishakor Mohamud Ahmed, Omar Mohamed Olad, and Mulki Mukhtar Hassan. Their findings underline the urgent need for Somalia to strengthen surgical safety practices, especially given the country’s difficult healthcare environment.
Somalia’s hospitals continue to suffer from shortages of staff, equipment, and facilities after decades of conflict. Most of the focus in healthcare has been on handling infectious diseases and humanitarian crises such as malnutrition, cholera outbreaks, and displacement emergencies. This has left surgical care underdeveloped, despite the fact that thousands of Somalis need life-saving operations every year. The researchers stressed that standardized tools like the checklist are particularly important in such contexts, where even basic safety measures can make the difference between life and death.
Experiences from other countries in East Africa offer useful lessons. Ethiopia saw strong enthusiasm for the checklist at first, but compliance dropped over time when regular supervision and training were not maintained. Tanzania, on the other hand, achieved better long-term results by providing continuous training, mentorship, and context-specific strategies to help surgical teams apply the checklist more effectively.
In Mogadishu, most of the healthcare workers surveyed were under 30 years old and had fewer than five years of professional experience. The researchers suggested that this youthful workforce represents both a challenge and an opportunity. With limited practical experience, young professionals may feel pressure to work quickly or skip steps they consider unnecessary. However, with proper mentorship, role modeling, and scenario-based training, they could form a new generation of practitioners who view the checklist as a normal part of safe surgical practice.
The study also made clear that simply raising awareness will not solve the problem. Although most healthcare workers already know the checklist exists, few see it as practical or necessary. The researchers recommended role-specific training so that each member of a surgical team—whether doctor, nurse, or anesthesiologist—understands their exact responsibility in the checklist process. They also emphasized the need for stronger leadership support from hospital administrators and senior staff, to show that surgical safety is not optional but essential.
In addition, the authors proposed that digital tools could help make the checklist easier to use in Somali hospitals. For example, mobile or tablet-based versions could guide teams through the steps more quickly and provide reminders, reducing the fear that it would waste time or delay operations.
Ultimately, the study’s findings point to a critical gap between knowing what should be done and actually doing it. For Somalia’s healthcare system, still struggling with limited resources and years of instability, bridging this gap could save countless lives. The challenge now lies in turning knowledge into practice by giving healthcare workers the tools, confidence, and support they need to make surgical safety a consistent part of their work.