Level of institutional delivery service utilization and associated factors among women who gave birth in the past 12 months, Ga'an libah district, Marodijeh region, Somaliland: a community-based cross-sectional study.

BACKGROUND: Institutional delivery has been considered one of the important strategies to improve maternal and child health and significantly reduce birth-related complications. However, it is still low in developing countries though there are some improvements. even among the community who has access to the health institutions weather health center and hospital including Somaliland. Hence, the aim of this study was to assess the level of institutional delivery service utilization and associated factors among women who gave birth in the last 12 months in Ga'an libah district, Marodijeh region, Somaliland. METHODS: The community-based cross-sectional study was conducted among women who gave birth in the last 12 months from September to December 2022. A simple random sampling technique was employed to select study participants from a total of sample population. Data was collected using semi-structural administered questionnaire through interviewing women. Data was collected with online mobile data collection (Kobo collect). SPSS version 25.0 was used for data management, entering and analysis. Bivariate and multivariable logistic regression models were fitted to determine the presence of a statistically significant association between independent variables and the outcome variable with p-value < 0.05. RESULT: Level of Institutional delivery services utilization in Ga'an libah district was 53.9% [95% Cl 48.2-59.6] gave birth at health institutions. Women who can read and write local were (AOR 2.18, 95% CI 1.08-4.56, p<0.01), Women with their husband can be capable to read and write are [(AOR = 6.95, 95% Cl 2.82-21.58, p<0.002]). Additionally, ability to cost transportation for referral [AOR 5.21, 95% Cl 2.44-11.13, p<0.001]. not good services available [AOR 0.07, 95%Cl 0.01-0.10, p<0.02]. lack of maternal health and child knowledge [AOR 0.034, 95% Cl 0.02-0.57, p<0.01]. were observed associated with level of institutional deliver services utilization. CONCLUSION: The institutional delivery service utilization was relatively high compared to national demographic health services in the study area. A large proportion of women gave both at home without a skilled attendant. Therefore, this finding has important policy implications since changes in the cost of the health service and perceived quality would mean changes in client satisfaction as well as their choice, as well emphasize to expectant women can receive medical advice and ambulance for referrals.

Predicting the short and long term effects of food price inflation, armed conflicts, and climate variability on global acute malnutrition in Somalia.

BACKGROUND: Malnutrition poses a substantial challenge in Somalia, impacting approximately 1.8 million children. This critical issue is exacerbated by a multifaceted interplay of factors. Consequently, this study seeks to examine the long-term and short-term effects of armed conflicts, food price inflation, and climate variability on global acute malnutrition in Somalia. METHODS: The study utilized secondary data spanning from January 2015 to December 2022, sourced from relevant databases. Two distinct analytical approaches were employed to comprehensively investigate the dynamics of global acute malnutrition in Somalia. Firstly, dynamic autoregressive distributed lag (ARDL) simulations were applied, allowing for a nuanced understanding of the short and long-term effects of armed conflicts, food price inflation, and climate variability on malnutrition. Additionally, the study employed kernel-based regularized least squares, a sophisticated statistical technique, to further enhance the robustness of the findings. The analysis was conducted using STATA version 17. RESULTS: In the short run, armed conflicts and food price inflation exhibit positive associations with global acute malnutrition, particularly in conflict-prone areas and during inflationary periods. Moreover, climatic variables, specifically temperature and rainfall, demonstrate positive associations. It is important to note that temperature lacks a statistically significant relationship with global acute malnutrition in the short run. In the long run, armed conflicts and food price inflation maintain persistent impacts on global acute malnutrition, as confirmed by the dynamic ARDL simulations model. Furthermore, both temperature and rainfall continue to show positive associations with global acute malnutrition, but it is worth noting that temperature still exhibits a non-significant relationship. The results from kernel-based regularized least squares were consistent, further enhancing the robustness of the findings. CONCLUSIONS: Increased armed conflicts, food price inflation, temperature, and rainfall were associated with increased global acute malnutrition. Strategies such as stabilizing conflict-prone regions, diplomatic interventions, and peace-building initiatives are crucial, along with measures to control food price inflation. Implementing climate adaptation strategies is vital to counter temperature changes and fluctuating rainfall patterns, emphasizing the need for resilience-building. Policymakers and humanitarian organizations can leverage these insights to design targeted interventions, focusing on conflict resolution, food security, and climate resilience to enhance Somalia's overall nutritional well-being.

Prevalence and associated factors of acute diarrhea among under-five children living in Hargeisa Internally Displaced Persons, Somaliland: a community-based cross-sectional study.

Introduction: in developing countries, diarrhea is a major cause of child death among those under five years old. Dehydration, malnutrition, delayed physical development and early childhood mortality are the major consequences of diarrheal diseases. In Somaliland, diarrheal diseases have been endemic and a major problem since 1994, with epidemics occurring annually. This study aimed to assess the prevalence and risk factors of acute diarrhea among children under five years old living in Hargeisa Internally Displaced Persons (IDPs), Somaliland. Methods: a community-based cross-sectional study was conducted among mothers of children under five from August to September 2020 in Hargeisa IDPs. A total of 383 mothers were selected using single population proportional formula. Data was entered, cleaned, and analyzed using SPSS version 22. To explore the association between variables, bivariate logistic regression was performed for each independent variable with the dependent variable. Variables with a p-value of < 0.05 were adjusted in multivariate logistic regression. Finally, variables with a p-value < 0.05 were recognized as determinants of acute diarrheal disease. Results: the prevalence of diarrhea among children under five living in Hargeisa IDPs was 51% (95% CI: 46%-56%). Children older than one year (AOR= 3.59, 95% CI: 2.05-5.20), those not exclusively breastfed (AOR= 4.01, 95% CI: 3.27-4.60), those not given colostrum milk (AOR= 36.41, 95% CI: 25.76-47.90), those drinking water stored in jerry-cans (AOR = 4.90, 95% CI: 1.31-8.39), and those with poor hand washing practices (AOR = 5.74, 95% CI: 1.38-7.82) were more likely to develop diarrhea than their counterparts. Conclusion: this study concludes that the prevalence of diarrhea was very high (51%). Lack of awareness of exclusive breastfeeding and colostrum feeding, storing drinking water in unprotected containers, and poor hand-washing practices were identified as significant predictors for childhood diarrhea (p-value < 0.05).

Prevalence of Stunting and Its Associated Factors Among Children Residing in Internally Displaced Persons (IDP) Camps in Hargeisa, Somaliland: A Community-Based Cross-Sectional Study.

Background: Stunting, a consequence of prolonged malnutrition, remains a critical global health issue affecting 165 million children under the age of five, with 10.6 million associated deaths. Its stunting prevalence is particularly pronounced in developing nations, notably Sub-Saharan Africa. Chronic protein-energy malnutrition, identified as a major cause of morbidity and mortality in displaced settings, underscores the urgency of understanding its impact in such contexts. Objective: This study aimed to assess the prevalence and associated factors of stunting among children aged 12-59 months and residing in IDP camps in Hargeisa, Somaliland. Methods: A community-based cross-sectional study was conducted in Hargeisa from May 5 to July 30, 2022, utilizing systematic random sampling, online mobile surveys, and caregiver interviews with anthropometric measurements. The SPSS version 25 was utilized in handled data entry, processing and analysis. Multivariable logistic regression, with p < 0.05 significance, included variables from bivariate analysis (p < 0.2). Stunting assessment utilized WHO AnthroPlus software, categorizing HAZ scores < -2.0 SD. Results: The prevalence of stunting among children living in IDP camps was found to be 21.1% [95% CI: 17.0-24.91%]. Vaccination status (adjusted odds ratio [aOR] = 0.19, 95% CI: 0.09-0.38), deworming practice (aOR = 6.5, 95% CI: 2.91-14.52), place of delivery (aOR = 0.14, 95% CI: 0.07-0.30), measles experience in the last year (aOR = 0.12, 95% CI: 0.04-0.34), ANC visits (aOR = 0.33, 95% CI: 0.14-0.81), and maternal insufficient extra food intake (aOR = 2.15, 95% CI: 1.11-4.15) were significantly associated with stunting. Conclusion: The observed stunting prevalence in IDP camps (21.1%) was substantial, highlighting the need for targeted interventions. Future efforts should aim to reduce stunting from the current rate to an estimated 5-10%, emphasizing comprehensive measures such as deworming, maternal nutrition, postnatal care improvement, robust immunization, and promoting healthcare facility deliveries.