Dr Abdulrazaq Yusuf Ahmed
@drjalaal.bsky.social
I am Dr. Abdulrazaq Yusuf Ahmed (Dr. Jalaaludiin) a Somali physician, health-systems strategist, and public health executive committed to building resilient, equitable care in fragile settings;
Insurance models that rely primarily on payroll deductions struggle where formal employment is limited.
Tax-based systems struggle where revenue collection capacity is weak.
Community-based schemes struggle without scale.
The challenge is not choosing a model.
It is engineering a hybrid architecture
Tax-based systems struggle where revenue collection capacity is weak.
Community-based schemes struggle without scale.
The challenge is not choosing a model.
It is engineering a hybrid architecture
February 8, 2026 at 6:14 PM
Insurance models that rely primarily on payroll deductions struggle where formal employment is limited.
Tax-based systems struggle where revenue collection capacity is weak.
Community-based schemes struggle without scale.
The challenge is not choosing a model.
It is engineering a hybrid architecture
Tax-based systems struggle where revenue collection capacity is weak.
Community-based schemes struggle without scale.
The challenge is not choosing a model.
It is engineering a hybrid architecture
it is imitation.
Insurance models that rely primarily on payroll deductions struggle where formal employment is limited.
Tax-based systems struggle where revenue collection capacity is weak.
Community-based schemes struggle without scale.
The challenge is not choosing a model.
Insurance models that rely primarily on payroll deductions struggle where formal employment is limited.
Tax-based systems struggle where revenue collection capacity is weak.
Community-based schemes struggle without scale.
The challenge is not choosing a model.
February 8, 2026 at 6:14 PM
it is imitation.
Insurance models that rely primarily on payroll deductions struggle where formal employment is limited.
Tax-based systems struggle where revenue collection capacity is weak.
Community-based schemes struggle without scale.
The challenge is not choosing a model.
Insurance models that rely primarily on payroll deductions struggle where formal employment is limited.
Tax-based systems struggle where revenue collection capacity is weak.
Community-based schemes struggle without scale.
The challenge is not choosing a model.
In Somalia, three structural constraints matter:
A large informal economy
Heavy donor dependence
Limited risk pooling mechanisms
Designing UHC without acknowledging these realities is not reform —
A large informal economy
Heavy donor dependence
Limited risk pooling mechanisms
Designing UHC without acknowledging these realities is not reform —
February 8, 2026 at 6:14 PM
In Somalia, three structural constraints matter:
A large informal economy
Heavy donor dependence
Limited risk pooling mechanisms
Designing UHC without acknowledging these realities is not reform —
A large informal economy
Heavy donor dependence
Limited risk pooling mechanisms
Designing UHC without acknowledging these realities is not reform —
High-income systems evolved over decades of:
• Broad tax bases
• Formal labor markets
• Strong regulatory institutions
• High levels of social trust
Fragile states operate under very different political and economic realities.
Replication without adaptation produces fragmentation.
• Broad tax bases
• Formal labor markets
• Strong regulatory institutions
• High levels of social trust
Fragile states operate under very different political and economic realities.
Replication without adaptation produces fragmentation.
February 8, 2026 at 6:14 PM
High-income systems evolved over decades of:
• Broad tax bases
• Formal labor markets
• Strong regulatory institutions
• High levels of social trust
Fragile states operate under very different political and economic realities.
Replication without adaptation produces fragmentation.
• Broad tax bases
• Formal labor markets
• Strong regulatory institutions
• High levels of social trust
Fragile states operate under very different political and economic realities.
Replication without adaptation produces fragmentation.