The prolonged devastation of climate change on public health in Somalia: a silent crisis

Abstract Introduction Somalia, one of the world’s most climate-vulnerable nations despite contributing minimally to global emissions, is facing escalating public health crises due to climate change. Rising temperatures, erratic rainfall, recurrent droughts, and floods have intensified food insecurity, disease outbreaks, and population displacement. These changes have compounded existing challenges in a fragile health system, severely affecting children, pregnant women, and internally displaced persons Internally displaced people (IDP). This scoping review aims to map the extent and scope of published evidence on the prolonged public health impacts of climate change in Somalia, identifying key health outcomes, vulnerable populations, and research and policy gaps. Methods Following the PRISMA-ScR guidelines, a comprehensive search was conducted in PubMed, Scopus, Web of Science, and Google Scholar, as well as gray literature from WHO, UN agencies, and Somali institutions. Studies published between 1990 and 2025 in English and addressing the intersection of climate change and public health in Somalia or the Horn of Africa were included. Data were charted and synthesized thematically. Results Out of 379 retrieved articles, 142 met the inclusion criteria. Key themes emerged: (1) direct health impacts of climate change, (2) indirect health impacts, (3) vulnerable populations, (4) weak health infrastructure and system readiness, and (5) historical droughts and their cumulative health impacts. Children under five, pregnant women, and displaced persons are disproportionately affected. The review highlights significant evidence gaps in mental health, health system resilience, and early warning systems. Conclusion This scoping review highlights the severe and multifaceted public health impacts of climate change in Somalia, the fragile healthcare infrastructure in Somalia, and a heavy reliance on external aid. This review provides a foundation for future efforts to mitigate the public health impacts of climate change and build resilience in Somalia and similar vulnerable regions.