Safeguarding Patients Through Health Professions Regulation in Somaliland

The regulation of health professions is a cornerstone of effective health systems worldwide. Its primary purpose is to protect patients, uphold professional standards, and ensure that healthcare practitioners are competent, ethical, and accountable. While regulatory arrangements vary across countries, most systems are grounded in common principles that balance public oversight with professional expertise. In Somaliland, strengthening health professions regulation is not only a technical requirement but also a critical component of public safety, health system reform, and state-building.

Models of Health Professions Regulation

Globally, health professions regulation is commonly organized through one of three governance models. In state-led systems, regulatory authority rests directly with government institutions, typically the Ministry of Health, which oversees licensing, standards, and disciplinary processes. This model is prevalent in many European and Asian countries.

In contrast, self-regulatory systems delegate authority to independent professional councils, such as medical or nursing boards, composed primarily of members of the profession. A third approach, often described as co-regulation, combines these models: government establishes the legal framework and policy direction, while independent regulatory bodies manage day-to-day functions such as registration, licensing, and professional conduct. Regardless of the model adopted, the effectiveness of regulation depends less on institutional form and more on the clarity, consistency, and enforcement of core regulatory functions.

Core Functions of Health Professions Regulation

Health professions regulation is structured around four interrelated functions that determine whether a practitioner is fit to practise. The first is education and accreditation. Regulators establish minimum standards for pre-service education and training programmes, ensuring that only graduates from accredited institutions are eligible for professional registration. This function promotes consistency in curricula, clinical competencies, and ethical standards across training institutions.

The second function is registration and licensing. This process provides legal authorization to practice and typically includes verification of identity and credentials, assessment of educational qualifications, and, in many systems, successful completion of national or professional examinations. Character and fitness checks are also commonly required to confirm that applicants have no history of serious misconduct or criminal activity relevant to patient safety.

The third function is fitness to practice, often referred to as professional discipline. Regulatory authorities investigate complaints from patients, employers, or the public and are empowered to impose sanctions when professional standards are breached. These may range from formal warnings and conditions on practice to suspension or permanent removal from the professional register. This function is essential for accountability and for maintaining public confidence in the health system.

The fourth function is continuing professional development (CPD). Regulation is an ongoing process rather than a one-time event. Many regulatory authorities require health professionals to complete a specified number of CPD hours to maintain registration, ensuring that practitioners remain up to date with evolving clinical knowledge, technologies, and practice standards.

Global Variations and Common Challenges

Although the principles of health professions regulation are widely shared, implementation varies significantly by context. High-income countries typically operate highly formalized regulatory systems with digital registers and mandatory CPD requirements. In federal systems, such as Canada and the United States, regulatory authority is often exercised at the provincial or state level rather than nationally.

In low-resource or post-conflict settings, regulatory bodies frequently face capacity constraints and must contend with widespread informal practice due to shortages of trained personnel. Across all contexts, regulation also plays an increasingly important role in managing cross-border mobility of health professionals, with international cooperation supporting workforce movement while maintaining patient safety.

The Importance of Protected Professional Titles

A key regulatory mechanism is the legal protection of professional titles. In regulated systems, it is a criminal offense for individuals to use titles such as “medical doctor,” “registered nurse,” or “midwife” unless they are formally registered and licensed. Protected titles reduce public confusion, prevent fraudulent practice, and reinforce the link between professional identity and regulatory accountability.

The Somaliland Context

In Somaliland, health professions regulation is closely linked to broader goals of health system strengthening and public trust. Following prolonged conflict and fragmentation of health services, the establishment and strengthening of the National Health Professions Commission (NHPC) represents a critical step toward formalizing the healthcare workforce.

One of the most pressing drivers of regulation in Somaliland is the need to protect the public from malpractice and unqualified practice. Prior to formal regulatory oversight, unlicensed individuals frequently provided medical services with limited mechanisms for accountability. Regulation introduces systematic credential verification and complaint investigation, providing legal protection for patients and communities.

Regulation is also essential to addressing the widespread presence of informal providers, particularly in the private sector, which delivers a substantial proportion of curative care. By setting minimum standards of practice and enforcing licensing requirements, regulation supports the transition toward evidence-based care and helps limit the circulation of substandard or counterfeit medicines.

Another critical function of regulation in Somaliland is the standardization of health education. Rapid expansion of training institutions has resulted in variable quality among graduates. Accreditation and competency-based licensing help ensure that educational programs meet national standards and that all new entrants possess the minimum skills required for safe practice.

Finally, regulation plays a significant role in building public trust in the formal health system. Public registers of licensed professionals enhance transparency and reassure patients that care is being provided by qualified practitioners. This trust is essential for achieving national health priorities, including universal health coverage and compliance with international health regulations related to disease surveillance and outbreak response.

Health professions regulation transforms healthcare from an unregulated marketplace into a professionalized public service. In Somaliland, it is a foundational tool for protecting patients, strengthening the health system, and supporting national development. By establishing clear standards, enforcing accountability, and promoting professional competence, regulation helps bridge the gap between a fragmented past and a modern, reliable, and trusted health system.

© The Times of Israel (Blogs)