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Health reform in Djibouti

The problem

Children with welcome signsThe health sector in Djibouti has in recent years been characterised by wasteful spending, corruption scandals – and international media reports of clinics without (paid for) equipment, and consumables. One scandal involved aid-funded spending on HIV prevention and treatment.

It is true that those in Djibouti with money fly to Dubai or even Bangkok for treatment.

State hospital facilities have some good staff but are in a less than adequate condition.

The results are sadly evident. Infant and maternal mortality is unacceptably high for a country with such a level of GDP per capita. Support for the elderly is almost non-existent and many curable diseases elsewhere often prove fatal in Djibouti.

Prevention programmes are thin on the ground, and charitable organisations struggle to keep pace with demand for help.

Proposed reforms

First, a key step is to ensure that expats and the better off can access services in Djibouti, thus developing the sector and skill levels, and refocusing resources on state or subsidised provision.

A practical assessment needs to be made of what is currently being provided free and what members of the public are actually paying for. Reliable information on such issues is not yet available, yet this is key to the implementation of policy and for allocation of funds to the sector.

An important focus of resources will be training and bringing in professionals who can train doctors and nurses.

The reforms to the health sector will take time. Meanwhile, an urgent focus for state funds is the provision of mobile clinic services for villages, peri-urban areas and informal dwelling communities, focused on the most urgent problems – malaria, maternal health, serious infections and life-threatening stomach problems.

However, it should be remembered that in Djibouti, many illnesses arise from poor nutrition. Food related measures, including the lifting of food taxes, will contribute to health improvements.

Getting things done

In the shorter term, through collaboration with NGOs, the provision of mobile clinics specialising in key common problems will be prioritised.


  1. Jean Marie Abdo says:

    I am glad that you brought up this problem. I would like to point out a key detail. The healthcare system is crumbling and the poor are paying the price, dearly. It’s not because we lack the resources or the will. Healthcare workers lack ambitions and the adequate training to achieve progress.
    Our neighboring countries like Ethiopia, Somalia or Eritrea do not have the adequate facilities and yet their mortality rate is no worse than ours. What we need a Healthcare reform, targeting many areas. Such as training, ethics and establishing a pay scale bracket to show that our healthcare professional matter. And mostly importantly, that people matter.

  2. Houmad says:

    health and education will be our priority to reform and give not only training our skilled labour but give them incentive to stay in djibouti, as you may know we are loosing our best humain resorces leaving djibouti.

  3. Jojo says:

    Et ben cher Monsieur Boreh , je vais vous dire quelque chose , puisque manifestement vous faite d’un amateurisme hors du commun , c’est bien que vous voulez changer les choses j’en conviens de grâce avec vous.
    Mais , svp renseigner vs sur le sujet avant de faire de tel proposition, et surtout dans un cadre aussi serieux que la politique.
    Les priorités à Djibouti , c’est pas de soigner les expatriés et les plus influents comme vs le dite , je comprend d’ailleurs votre préoccupation puisque expatrié vous l’êtes de fait “malgré vs ” et influent vs l’étiez jusqu’à il y’a quelque temps pas par votre “intelligence d’esprit” , mais grâce au népotisme et à la corruption du régime de votre meilleur ami d’hier .
    Alors de grâce ne venez pas piétiner avec votre amateurisme à 2 balles , le peu de chose qui reste aux djiboutiens à savoir leur dignité

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