Undernutrition among children aged 6–59 months attending Afgooye Hospital, Somalia: a facility-based cross-sectional study

Background Child undernutrition remains a major public-health problem in Somalia, where conflict, climate shocks, displacement and food insecurity strain health and WASH services. National surveys inform planning but do not describe the children who present to individual facilities. We describe anthropometric undernutrition among children aged 6–59 months attending Afgooye Hospital. Methods In this facility-based cross-sectional study (February–March 2025), children attending growth monitoring were recruited consecutively. Weight, length/height and mid-upper arm circumference (MUAC) were measured following WHO procedures, and Z-scores were calculated with WHO Anthro using the WHO Child Growth Standards. Analysis was descriptive, with Wilson 95% confidence intervals. Displacement status was not recorded and duplicate measurements were not taken. Results Of 422 children, 94.3% (95% CI 91.7–96.1) were stunted (55.9% severely) and 79.9% (95% CI 75.8–83.4) were wasted by weight-for-height Z-score, whereas 39.1% (95% CI 34.6–43.8) had acute malnutrition by MUAC. Colostrum was reported for 47.6% of children, prior exclusive breastfeeding for 20.6%, and diarrhoea in the preceding two weeks for 64.5%. These estimates could not be checked against duplicate measurements and should be interpreted cautiously. Conclusion Children attending Afgooye Hospital in this two-month period had a very high burden of anthropometric undernutrition. Because recruitment was consecutive, at one facility, in the Jilaal dry season, and without duplicate measurements, the estimates describe this clinic cohort and are not district prevalence. They support strengthened facility-based screening and care, and representative, seasonally repeated community surveillance that records displacement status.