WHO’s Somalia Call to Action: Can a Unified Antenatal Platform End Three Major Health Threats
A pregnant woman should not need three separate journeys through the health system to protect her baby from three preventable infections. In Somalia, where many families already face insecurity, displacement, long travel distances and fragile health services, that burden can be too high.
That is why the World Health Organization’s call for a unified antenatal platform in Somalia matters. The idea is simple but powerful: use antenatal care as one common entry point to prevent mother-to-child transmission of HIV, syphilis and hepatitis B. Instead of treating these as separate disease programmes, health workers can test, counsel, refer and treat within one connected pathway.
The linked article points to a practical shift in public health thinking. Somalia does not only need more services. It needs services that meet pregnant women where they are, reduce missed chances and bring health providers together around one goal: safer pregnancies and healthier newborns.
Why one antenatal platform could change the equation
Antenatal care is one of the most important contact points between pregnant women and the health system. It is where blood pressure is checked, nutrition is discussed, danger signs are identified and birth plans begin to take shape. It is also where infections that can pass from parent to child can be detected early.
When HIV, syphilis and hepatitis B are handled separately, the system creates gaps:
A woman may be tested for one infection but not the others.
Test results may not return in time.
Treatment may sit in a different programme, clinic or supply chain.
Records may not connect across maternal health, laboratory and disease control teams.
Follow-up for the newborn may be delayed or lost.
A unified platform tries to close those gaps. It makes antenatal care a single organised pathway for screening, treatment, prevention counselling and follow-up.
This matters because the three infections share one urgent feature: they can affect the baby during pregnancy, birth or early life. Yet they are also conditions where timely testing and care can sharply reduce risk. That makes antenatal care a high-value moment. Missing it can mean missing a chance to prevent lifelong harm.
The WORLD HEALTH ORGANIZATION'S CALL TO ACTION also reflects a wider global push towards integrated health services. Public health programmes often grow in vertical lines, one disease, one fund, one reporting system. That can help build expertise, but it can also fragment care. For a pregnant woman, the distinction between disease programmes is not the point. She needs one safe, respectful, reliable service.
The three health threats that need one coordinated response
The initiative focuses on three major infections that can pass from mother to child. Each has its own medical pathway, but all three benefit from early antenatal contact, reliable testing and clear follow-up.
HIV needs early testing and continued treatment support
Preventing mother-to-child transmission of HIV depends on identifying infection as early as possible and ensuring access to antiretroviral therapy. Care also needs to continue after delivery, including infant testing and advice on feeding based on national guidance and clinical context.
In a fragmented system, a pregnant woman might visit a clinic but not get tested, or she may test positive and face delays before treatment. A unified antenatal platform can reduce those delays by placing HIV services inside routine pregnancy care instead of making them a separate referral journey.
It can also reduce stigma. When testing for HIV is offered as part of a standard package that includes syphilis and hepatitis B, it can feel less singled out. That does not remove all fear or discrimination, but it can normalise testing as part of good maternal care.
Syphilis is preventable but often missed
Syphilis during pregnancy can lead to miscarriage, stillbirth, premature birth or congenital infection. The tragedy is that syphilis can often be detected through simple testing and treated with established medicines when services are available on time.
The challenge is not only clinical knowledge. It is also the reliability of the care pathway. A test must be offered. A result must be known. Treatment must be available. Partners may also need testing and treatment to prevent reinfection.
A unified platform can help because it treats syphilis screening as a routine part of antenatal care, not an optional add-on. It also allows midwives, nurses and doctors to act quickly rather than waiting for a separate disease programme to pick up the case.
Hepatitis B needs birth-linked prevention
Hepatitis B can become a chronic infection and lead to serious liver disease later in life. Preventing transmission during childbirth and the newborn period is a major public health goal. Antenatal screening helps identify babies who need timely preventive care after birth, including vaccination according to national policy.
This is where coordination becomes critical. Screening during pregnancy has little value if the delivery site, vaccination team and infant follow-up system do not know what needs to happen next. For hepatitis B, a unified platform must connect antenatal clinics with maternity wards, immunisation services and child health records.
That is a bigger task than adding one more test. It requires a chain that works from the first antenatal visit to the baby’s first months of life.
What makes Somalia’s context especially challenging
Somalia’s health system works under pressures that many countries do not face at the same scale. Conflict, climate shocks, drought, floods, food insecurity and displacement all affect access to care. Mobile populations may move between districts, camps and host communities. Facilities may struggle with staffing, supplies and referral links.
For antenatal care, these conditions create practical barriers:
Some women start care late in pregnancy.
Others attend once but cannot return for follow-up.
Laboratories may be far from primary care facilities.
Stockouts can interrupt testing or treatment.
Data systems may not capture women who move.
Security issues can limit outreach in some areas.
Community mistrust or stigma may stop people from seeking services.
A unified antenatal platform does not automatically solve those problems. It can still fail if the basics are weak. If test kits are unavailable, if health workers are undertrained, if medicines run out, or if women cannot reach clinics, integration remains an idea on paper.
Yet Somalia’s context also makes integration more valuable. When every clinic visit is hard-won, each contact should do as much useful work as possible. If a woman reaches an antenatal clinic, the health system should not ask her to return three more times for services that could have been offered together.
Why collaboration is the centre of the plan
The linked article’s strongest message is the need for shared responsibility. No single group can eliminate mother-to-child transmission of HIV, syphilis and hepatitis B alone.
Maternal health teams may see pregnant women first, but they need support from HIV programmes, sexually transmitted infection services, hepatitis experts, laboratories, immunisation teams, supply chain managers and community health workers. Policy-makers and partners also need to align funding, training and reporting systems.
A strong antenatal platform depends on cooperation at several levels.
Clinics need clear workflows
Health workers should know what happens at the first antenatal visit, what tests are offered, how results are recorded, when treatment starts and how referrals work. A simple protocol can prevent confusion.
For example, a clinic should not need three separate registers and three separate counselling appointments if one integrated process can safely cover all three infections. The goal is not to rush care. It is to make care easier to complete.
Laboratories need to be part of maternal care
Testing is only useful when results return in time. In remote or busy settings, delays can break the prevention pathway. Point-of-care tests may help in some places, while stronger specimen transport and result systems may be needed elsewhere.
Laboratory teams should not sit outside the antenatal plan. They need to be part of decisions on test selection, quality control, reporting and stock management.
Maternity and immunisation services need to connect
Antenatal screening identifies risk before birth. Delivery and newborn care turn that information into prevention. If a woman gives birth in a different facility from where she received antenatal care, her information must still travel with her.
This is especially important for hepatitis B prevention and infant follow-up after HIV exposure. Immunisation teams, maternity staff and child health workers need shared records or referral tools that are simple enough to use under pressure.
Communities need trust, not just messages
Health services do not operate in isolation. Women may face stigma, transport costs, family pressure or fear of a positive diagnosis. Community health workers, local leaders, women’s groups and trusted outreach teams can help explain why testing matters and why early care protects both parent and child.
Trust also means respectful treatment inside clinics. If women feel judged or exposed, they may not return. Integration must come with confidentiality, consent and dignity.
The likely impact on mothers and children
If Somalia can build a functioning unified antenatal platform, the gains could be wide-ranging.
The most direct impact would be earlier detection. Pregnant women who attend antenatal care could receive a broader package of screening in one visit. That can help health workers act before delivery, rather than after harm has already occurred.
The second gain would be faster treatment. When testing and treatment pathways sit close together, women are less likely to be lost between services. This is critical for syphilis, where prompt treatment can prevent severe outcomes, and for HIV, where continuous treatment protects both maternal health and infant health.
The third gain would be better newborn protection. A platform that links pregnancy care with birth and postnatal services can ensure exposed infants receive the care they need. This includes early follow-up, vaccination where indicated, testing, counselling and referral.
There is also a systems benefit. Health workers can move from disease-by-disease activity to person-centred care. Data can become more useful because it follows the mother-baby pair across services. Supplies can be planned around an integrated antenatal package. Training can focus on real clinic workflows rather than separate programme requirements.
For families, the benefit is simpler: fewer missed chances, fewer unnecessary trips and more confidence that pregnancy care is complete.
What could slow implementation
The promise is real, but implementation will be difficult. Public health plans often succeed or fail on details that rarely appear in headlines.
One challenge is financing. Integrated services still need money for test kits, medicines, vaccines, transport, training, supervision and data systems. If funding remains tied to single diseases, clinics may struggle to deliver one joined-up package.
Another challenge is workforce capacity. Somalia needs health workers who can counsel, test, treat, record and refer with confidence. Overloading already stretched staff can backfire. Training must be practical, short enough to scale and backed by regular supervision.
Supply chains are another weak point. A unified platform depends on several items being available at the same time. If HIV test kits are present but syphilis tests are out of stock, or hepatitis B vaccines are unavailable at birth, the platform loses strength. Integration raises the standard for supply planning.
Data systems also matter. Health teams need to know how many pregnant women were tested, how many received results, how many started treatment, and how many babies received follow-up. Without this, gaps stay hidden. Paper records may still play a role, but they must be simple and consistent.
Stigma could be one of the hardest barriers. HIV, sexually transmitted infections and hepatitis can carry fear and shame. A unified package may reduce some stigma by making testing routine, but health workers still need training in confidentiality and respectful care.
Security and displacement add another layer. Services must work for women who move. That may require mobile clinics, outreach teams, referral cards and coordination across districts and humanitarian partners.
What success should look like
Success should not be measured only by policy adoption. A real unified antenatal platform would show progress in the everyday experience of care.
A pregnant woman should be able to visit a clinic and receive clear information, respectful counselling and recommended screening without being sent from one service to another. If a test is positive, she should know what happens next before she leaves. Her treatment or referral should begin quickly. Her records should help the delivery team protect the baby. After birth, the newborn should remain visible to the health system.
At the programme level, success would mean:
Siloed care | Unified antenatal care |
Separate disease registers and pathways | One coordinated maternal health pathway |
Missed tests during pregnancy | Routine screening as part of antenatal visits |
Delayed referrals | Faster treatment and follow-up |
Weak links to newborn care | Connected pregnancy, delivery and child health services |
Programme-level reporting | Mother-baby tracking across the care journey |
This kind of platform would not replace specialised care. Women with HIV, syphilis or hepatitis B still need clinical support from trained providers. The point is to make specialised care easier to reach through the antenatal system.
A realistic path forward
Somalia’s call to build a unified antenatal platform should be seen as both urgent and practical. It does not require inventing a new purpose for antenatal care. It asks the health system to use one of its most valuable entry points better.
The next steps should focus on the basics:
Agree on one national package for antenatal screening and prevention.
Train frontline staff in integrated counselling, testing and referral.
Keep essential tests, medicines and vaccines available.
Link antenatal, maternity, laboratory and immunisation records.
Support community outreach so women start care earlier.
Protect confidentiality and dignity at every point of care.
Align donors and partners behind one national plan.
The strongest part of the WHO-backed approach is that it treats maternal and child health as connected. A pregnancy visit is not only a check-up. It is a chance to prevent infection, protect a newborn and strengthen trust in the health system.
This content is for general information only and is not a substitute for medical advice, diagnosis or treatment. Clinical decisions should follow national guidelines and qualified health professionals.
Somalia’s path will not be easy. Health workers face real constraints, and families face barriers no policy can erase overnight. But a unified antenatal platform offers a clear way to reduce missed opportunities. If providers, programmes, communities and partners work from the same plan, one antenatal visit can do far more than it does today. That is the promise at the heart of WHO’s call to action.
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