Governance Overview
NSHIA is being built on a governance-first model. The institution’s legitimacy depends on strong oversight, disciplined fund management, clear roles, enforceable accountability systems, and transparent engagement with citizens, providers, and government partners.
Institutional Oversight
The Authority operates under the strategic oversight of the Federal Ministry of Health and Human Services and is designed to work in close coordination with the Ministry of Finance and relevant federal and state institutions. Its credibility is tied to compliance with public financial management standards, transparent operations, and accountable stewardship of pooled funds.
Leadership and Implementation Structure
The governance architecture includes leadership by the Director General, supported by a Programme Management Office that coordinates workstreams, manages delivery, tracks risks, and supports disciplined implementation. Core functional areas include legal affairs, Shariah governance, finance and actuarial functions, purchasing and contracting, quality and accreditation, enrollment and grievance redress, ICT and data systems, internal audit and anti-fraud, communications, and operations.
Board and Committee Functions
The governance framework anticipates formal board and committee structures to support institutional oversight and decision-making. Core committees include audit and risk, finance, purchasing and quality, Shariah oversight, and human resources or remuneration. These structures are essential for fiduciary control, operational discipline, and sustained public confidence.
Shariah Governance
NSHIA includes a Shariah-compliant, Takaful-aligned governance approach to strengthen legitimacy and ensure that financing, procurement, investment, and member protection are consistent with ethical and religious expectations. This supports public understanding and helps align reform with trusted social values.
Federal-State Coordination
Because Somalia’s health system operates within a federal context, NSHIA is intended to work through compacts and harmonized arrangements with Federal Member States and Benadir Regional Administration authorities. These arrangements support portability, data sharing, common standards, quality benchmarks, and dispute resolution.
Integrity, Audit, and Anti-Fraud
The Authority is expected to maintain internal controls, audit readiness, fraud reporting mechanisms, verification processes, sanctions pathways, and other integrity systems that protect pooled funds and deter abuse.
Transparency and Public Accountability
NSHIA’s governance model emphasizes public dashboards, financial reporting, independently audited statements, complaint and appeal systems, and regular publication of performance indicators. Timely provider payments, accessible grievance channels, and visible accountability are practical foundations of trust in fragile settings.