In 1972, all health facilities and the services of all private medical personnel were placed under state control. Government policy was eventually to provide free medical treatment for all. One of the self-help projects instituted by the SRC was the construction of local clinics. In 1982, there were 76 hospitals and 87 mother and child healthcare centers. In 1990, there were about 500 doctors. The nurse to doctor ratio was 7:1 in 1992. As of 1999, it was estimated that there were fewer than 0.05 physicians per 1,000 people, and 0.8 hospital beds. Total health care expenditures in 1990 were $60 million.
Somalia has a high incidence of tuberculosis (an estimated 365 cases per 100,000 people in 1999), schistosomiasis, and pulmonary disturbances. Malaria and intestinal parasites are endemic. Serious dietary deficiencies are found, particularly in the north. In 1990–96, only 31% of the population had access to pure drinking water, which is rarely available outside the larger cities. Water outside these centers needs to be filtered, boiled, or chemically treated. Somalis, however, take few of these precautions. A very low 17% of the population had adequate sanitation in 1990-96, and only 27% had access to health care services.
As of 2002, the crude birth rate and overall mortality rate were estimated at, respectively, 46.8 and 18 per 1,000 people. Only 1% of married women (ages 15 to 49) have used contraception (1990–95). Average life expectancy in 2000 was only 48 years and the infant mortality rate was 117 per 1,000 live births. The maternal mortality rate was a very high 1,100 per 100,000 live births in 1991. These mortality rates do not include civil warrelated deaths of about 355,000 from 1988 to 1992, or the thousands of deaths between 1993 and 1994.
Immunization rates for children up to one year old in 1990–95 were: tuberculosis, 31%; diphtheria, pertussis, and tetanus, 18%; polio, 18%; and measles, 30%. The rates for DPT and measles as of 1999 were, respectively, 18% and 26%. The number of AIDS cases in 1995 was low, with only 13 cases reported in that year. As of 2001, there were an estimated 43,000 people living with HIV/AIDS. In 1994, there were 2,023 tuberculosis cases. The previous year 3,049 malaria cases had been reported.