Determinants of Undernutrition among Children under Age 5 in the Puntland State of Somalia

The purpose of this study was to investigate the determinants of nutritional status among children under age 5 (0-59 months) in Puntland. Undernutrition is a global challenge, it does not only adversely affect short‐ and long‐term health and economic well‐being of children but it is also a leading contributor to death and disability globally. Undernutrition short-term effects include mortality and morbidity where long-term effects are that the children do not reach their full developmental potential and would have poor cognitive performance, which in turn has consequences on the country’s economic productivity. Nutritional status of the Somali children in Puntland is relatively poor due to many reasons such as low economic conditions of Somali households, lack of food security and severe drought that has affected the country in recent years and among other factors. This study used data from the Puntland Health and Demographic Survey 2020 which was conducted by the Department of Statistics at Puntland Ministry of Planning, Economic Development, and International Cooperation with technical support from UNFPA Somalia. The analysis used stunting, wasting, and underweight as dependent variables, while the independent variables were children, maternal, and household characteristics. Bivariate and multivariate Logistic regression models were performed to analyze the determinants of nutritional status among the children. The study showed a significant association between children’s nutritional status and most of the explanatory variables under study. Place of residence, gender of household head, wealth index, source of drinking water, source of energy for cooking, toilet facility, mother’s age, marital status, education, breastfeeding, ANC visits, BMI, work status, child’s sex, child’s age, birth order and size at birth have significant associations with children’s nutrition status. The study found that most variables in child, maternal, and household characteristics were significantly associated with stunting and wasting among children under age five.  Based on these findings, the research recommends that a multi-sectoral approach is needed to address undernutrition in Puntland state. Combined nutrition programmes from different sectors in line with National Development Plans (NDP) need to be designed to address the underlying causes of acute and chronic malnutrition