Addressing childhood malnutrition in Somalia: a call for urgent multisectoral action

¹Faculty of Health Science and Tropical Medicine, Somali National University, Mogadishu, Somalia, ²Center for Health Research and Innovation, Somali National University, Mogadishu, Somalia

^&Corresponding author
Abdullahi Osman Mohamed, Faculty of Health Science and Tropical Medicine, Somali National University, Mogadishu, Somalia

To the editors of the Pan African Medical Journal    

Childhood malnutrition remains one of the most serious public health challenges in Somalia, continuously threatening child survival, growth, and neurodevelopment [1,2]. This letter calls for urgent, evidence-based, multisectoral action to reduce the persistently high burden of stunting and wasting among Somali children under five [2,3]. The current situation remains severe, especially in rural communities, internally displaced populations, and food-insecure households. The 2019 Somalia Micronutrient Survey estimated stunting at 17.2% and wasting at 11.0% among children under five [2]. Earlier pooled survey data classified Somalia´s burden as high for stunting and very high for wasting, while trend analyses from 291 surveys showed that internally displaced persons were the most affected group and that wasting rose sharply during famine and drought periods [2,4]. More recently, severe malnutrition remained a leading cause of death among internally displaced populations in Banadir, where it clustered with measles, diarrheal disease, and pneumonia as major drivers of under-five mortality [5].

The drivers of childhood malnutrition in Somalia are interconnected, structural, and driven by poverty, disease, displacement, and climate-related shocks. Food insecurity, household poverty, and lower wealth are strongly associated with stunting and wasting, with dose-response relationships reported for both household food insecurity and wealth status [2]. Drought, climate variability, conflict, and displacement continue to disrupt food production, access to care, and livelihoods [1,2,6]. Infection also plays a central role: diarrhoea and inflammation were important risk factors in the 2019 survey, supporting the need to address poor water, sanitation, and hygiene (WASH) conditions and weak access to basic health services [2,4]. The consequences are devastating; stunting increases the risk of infectious disease and poor cognitive development, while wasting carries an acutely increased risk of death [2]. At the population level, child and maternal malnutrition remains Somalia´s leading mortality risk factor, contributing to 49.57% of mortality in the global burden of disease estimates [1].

Addressing this crisis requires prioritizing simultaneous nutrition-specific and nutrition-sensitive interventions. Community-based nutrition programs showed the highest reported success in one Somalia study, outperforming food aid and micronutrient supplementation alone in rural and camp settings [3]. Evidence demonstrates that integrated, multisectoral interventions can significantly reduce this burden. Therefore, exclusive breastfeeding promotion, complementary feeding education, micronutrient support, expanded immunization, and improved maternal healthcare should be integrated into routine child health and humanitarian programming [1,5]. A durable response requires coordinated leadership from government, non-governmental organizations (NGOs), United Nations (UN) agencies, health professionals, and local communities. Alongside emergency treatment, Somalia needs climate-resilient food systems, conflict-sensitive programming, and sustained investment in primary healthcare and community outreach [6,7]. Prioritizing nutrition, healthcare, WASH, and social protection is essential to safeguard the health, support healthy development, and secure the future potential of Somali children.

Competing interests    

The authors declare no competing interests.

Authors' contributions     

All the authors read and approved the final version of this manuscript.

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