Associated factors with malnutrition among children under-5 years old in Somaliland: evidence from Somaliland health and demographic survey of 2020

Malnutrition in children under five years is a major public health issue in developing countries, mostly in Africa and Asia regions, contributing substantially to child mortality. This study aimed to assess the associated factors of malnutrition among under five year’s old children, utilizing data from the Somaliland Demographic and health survey. The data from this study is sourced secondary data from the Somaliland Demographic and Health Survey, (SDHS) 2020. The dependent variable is malnutrition (stunting. Wasting, and underweight). Descriptive statistics were generated followed by multivariable logistic regression for each malnutrition outcome. The prevalence of stunting, wasting, and underweight was reported as 24.99% for stunting, 21.08% for wasting, and 14.52% for underweight. Regional disparities were observed, with children in Sool (AOR = 6.447, p = 0.017), and Sanaag (AOR = 4.560, p = 0.050) having higher odds of stunting compared to Awdal. Rural residence was significantly associated with increased odds of stunting (AOR = 1.656, p = 0.001). Lack of water availability at the handwashing point (AOR = 0.585, P = 0.022) and use of ash or mud instead of soap (AOR = 2.841, p = 0.005) were significantly linked to wasting. Households were the head was aged above 74 showed increased odds of stunting (AOR = 2.711, p = 0.014). Malnutrition among under-five children in Somaliland remains a significant public health issue. Regional disparities, residence type, and WASH-related factors were associated with malnutrition outcomes. Interventions should focus on high-burden regions and improving WASH conditions.