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Dietary diversity and associated factors among households and children in internally displaced person camps in Southern Somalia: A cross-sectional study
Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing. Research Evaluation, Accountability, Learning and Monitoring (REALM) Save the Children International, Somalia Country Office, Mogadishu, Somalia.ORCID iD: 0000-0002-0119-5394
Dalarna University, School of Health and Welfare, Medical Science. Uppsala University, Uppsala; Epistat AB, Uppsala.ORCID iD: 0000-0002-7437-9047
Dalarna University, School of Health and Welfare, Caring Science/Nursing.ORCID iD: 0000-0002-4013-1553
Research Evaluation, Accountability, Learning and Monitoring (REALM) Save the Children International, Somalia Country Office, Mogadishu, Somalia.
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2024 (English)In: Maternal and Child Nutrition, ISSN 1740-8695, E-ISSN 1740-8709, Vol. 20, no 4, article id e13707Article in journal (Refereed) Published
Sustainable development
SDG 3: Good health and well-being
Abstract [en]

The study aimed to assess household and child dietary diversity in Southern Somalia by identifying determinants of adequate dietary diversity in three internally displaced person (IDP) camps in Baidoa, Dayniile and Dharkanley. A total of 1655 female main caregivers with 2370 children (6-59 months old) were included. Data on household dietary diversity score and child dietary diversity score indicators were collected from all households. The questionnaire was read face-to-face to the female main caregivers. Multivariate logistic regression analysis was performed to identify factors associated with adequate dietary diversity, which was defined as the consumption of at least four food groups within 24 h before the survey. The proportion of households achieving adequate HDDS was high in all locations 95.8%, 96.9% and 89.0% in Baidoa, Dharkanley and Dayniile, respectively, and the total adequate household dietary diversity score (AHDDS) was 95.6%. The proportion of adequate child dietary diversity score (ACDDS) was achieved in 63.5%, 8.5% and 38.3%. The main factors associated with AHDDS were larger household size, greater wealth, attendance of antenatal care (ANC) and joint decision-making between husband and wife, while factors associated with ACDDS included ANC attendance, age, the consumption of ready-to-use therapeutic food and deworming tablets. These findings can guide future programmes and policies aimed at improving maternal and child nutrition in IDP camps in Somalia. By tackling these diverse factors, a promising pathway emerges to enhance the nutritional welfare of both households and children in IDP camps.

Place, publisher, year, edition, pages
2024. Vol. 20, no 4, article id e13707
Keywords [en]
IDPs, Somalia, antenatal care, child dietary diversity score, household decision making, household dietary diversity score
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:du-49274DOI: 10.1111/mcn.13707PubMedID: 39082225Scopus ID: 2-s2.0-85200049934OAI: oai:DiVA.org:du-49274DiVA, id: diva2:1892392
Available from: 2024-08-26 Created: 2024-08-26 Last updated: 2025-10-09Bibliographically approved
In thesis
1. Undernutrition and food security in children in internally displaced person camps: Prevalence, risk factors, and the impact of a cash transfer and nutrition counseling intervention
Open this publication in new window or tab >>Undernutrition and food security in children in internally displaced person camps: Prevalence, risk factors, and the impact of a cash transfer and nutrition counseling intervention
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Undernutrition in children under five years old is a critical issue, particularly in internally displaced person (IDP) camps, where families face many challenges, including food insecurity, inadequate healthcare, poor hygiene, and suboptimal feeding practices. Interventions such as cash transfers and nutrition education have been implemented in various humanitarian settings to improve food security and caregiver knowledge, but their impact on child growth in IDP camps remains underexplored. Aim: The primary aim of this thesis was to assess the prevalence, risk, and protective factors associated with undernutrition in children under five living in IDP camps. This thesis also sought to evaluate household and child dietary diversity, infant and child feeding practices, and hygiene, as well as the impact of nutrition counselling (NC) and unconditional cash transfer (UCT) interventions on children’s undernutrition and household food security. Methods: The studies were conducted in three IDP camps in Somalia. Data were collected from 1,655 caregivers and 2,370 children aged 6–59 months using structured questionnaires based on the UNICEF/WHO guidelines on infant and young child feeding. Anthropometric measurements were taken to assess child nutritional status, and dietary diversity was evaluated using the Household Dietary Diversity Score and Child Dietary Diversity Score. Logistic regression analysis was utilized to identify the determinants of undernutrition. A quasi-experimental design was employed to assess the effects of NC and NC+UCT interventions. Results: The studies revealed high rates of underweight (24.5%), wasting (10.9%), stunting (38.3%), and concurrent wasting and stunting (WaSt, 4.14%). The vast majority of households (95.6%) achieved adequate dietary diversity, whereas less than half of the children (43.3%) achieved adequate diversity. The risk factors for undernutrition included poor maternal health, lack of antenatal care, household food insecurity, and poor hygiene practices. Protective factors included timely complementary feeding, maternal decision-making autonomy, and adequate household food security. The NC and NC+UCT interventions did not significantly affect child growth or food security. Conclusion: This thesis underscores the importance of addressing the multiple factors contributing to undernutrition in IDP camps, including feeding practices, hygiene, and dietary diversity. Sustainable interventions focused on maternal education, improved hygiene, and better child dietary diversity are critical for reducing undernutrition and improving child health in IDP settings.

Place, publisher, year, edition, pages
Falun: Dalarna University, 2025
Series
Dalarna Doctoral Dissertations ; 44
Keywords
Malnutrition, IDP camps, Nutrition counselling, Cash transfers, Food security, Somalia
National Category
Nursing
Identifiers
urn:nbn:se:du-50423 (URN)978-91-88679-95-6 (ISBN)
Public defence
2025-08-25, at the Embassy of Sweden in Nairobi, Kenya and online, 13:00 (English)
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Supervisors
Available from: 2025-06-16 Created: 2025-04-03 Last updated: 2025-10-09Bibliographically approved

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Ali, Mohamed KalidBerglund, LarsFlacking, RenéeOsman, Fatumo

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