Poverty and women’s health in Somaliland: examining body mass index and maternal mortality

In low-resource settings, such as Somaliland, socio-economic disparities significantly impact women’s health outcomes, particularly in terms of nutrition and maternal health. Despite this, comprehensive analyses of the economic dimensions of these disparities remain limited. The objective of this study is to investigate the influence of socio-economic status on women’s health outcomes, focusing on the effect of poverty on body mass index (BMI) and maternal mortality in Somaliland. A multi-method study design was employed utilizing data from the Somaliland Demographic Health Survey (2020). Our analysis examined the association between poverty and BMI categories, as well as evaluating the effect of poverty on maternal mortality. We employed descriptive statistics, regression analysis, and comparative analysis across poorer and richer wealth quintiles. The study highlights the importance of socio-economic status in influencing nutritional and maternal health outcomes in Somaliland. The findings indicate that higher wealth is associated with higher BMI and lower maternal mortality rates. The poorer wealth quintile is associated with a significant reduction in the BMI compared to the richer quintile indicating a strong negative effect. The logistic regression results revealed that women in the poorer wealth quintile had 2.5 times higher odds of experiencing maternal mortality compared to those in the richer quintile adjusted odds ratio (aOR) (aOR = 2.52, 95% CI: 1.12–5.62, p < 0.01). Women who are economically disadvantaged had higher rates of being underweight and experienced maternal deaths, while wealthier women had higher rates of being overweight and obese and lower maternal deaths. To reduce these disparities, it is important to expand economic assistance programs to improve access to nutritious food and invest in initiatives that promote food security. It is also crucial to provide healthcare subsidies and improve access to maternal care facilities in order to reduce maternal mortality. By improving healthcare financing and increasing investments in healthcare infrastructure and services, socioeconomic barriers affecting women’s health outcomes can be alleviated.