Banadir Hospital

Background Skin-to-skin contact (SSC) is recognized as an affordable and effective strategy to reduce neonatal mortality; however, its implementation in fragile health systems remains limited. Objective This study aimed to determine the prevalence of mother–newborn SSC and to identify its individual- and community-level predictors in Somalia. Design A nationally representative cross-sectional study. Methods A secondary analysis was conducted using data from the 2020 Somali Demographic and Health Survey involving 6,817 mothers aged 15–49 who had given birth to a live child in the five years preceding the survey. Multilevel binary logistic regression was used to identify predictors. Results Findings revealed that only 18.2% of women reported engaging in SSC after birth. Delivery in a health facility is significantly associated with the likelihood of SSC (aOR = 6.01; 95% CI: 5.12–7.05). Individual-level factors such as higher education, household wealth, maternal employment, and media exposure were positively associated with SSC practice, while divorced mothers had reduced odds. Community-level socioeconomic status also influenced SSC uptake, with mothers from wealthier communities being more likely to practice it. Conclusion SSC is practiced at a very low level with substantial disparities tied to social and regional factors. Improving neonatal survival requires prioritizing interventions that increase access to institutional deliveries, train healthcare providers in essential newborn care, and launch targeted public awareness campaigns to reach vulnerable populations. Registration : Not applicable.

Background Obstetric fistula is a debilitating maternal morbidity that disproportionately affects women in low- and middle-income countries. In Somalia, limited access to healthcare and sociopolitical instability hinder awareness, which is essential for early detection and prevention. This study aimed to predict obstetric fistula awareness among women of reproductive age in Somalia using machine learning models and to identify key determinants through SHapley Additive exPlanations (SHAP) interpretability frameworks. Methods We analyzed cross-sectional data from the 2020 Somalia Demographic and Health Survey (n=8,512). Seven supervised classification algorithms, namely Extreme Gradient Boosting (XGBoost), Gradient Boosting, Logistic Regression, Random Forest, K-Nearest Neighbors, Extra Trees, and Decision Tree, were trained with 10-fold cross-validation and hyperparameter tuning to predict obstetric fistula awareness. The model performance was evaluated using accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUROC) with bootstrapped confidence intervals. The optimal model was interpreted using SHAP to quantify the contributions of sociodemographic and geographic predictors. Results The national weighted prevalence of obstetric fistula awareness was 61.1%. The XGBoost model demonstrated modest exploratory predictive performance (area under the receiver operating characteristic curve: 67.97%, accuracy: 68.54%, recall: 85.44%). SHAP analysis identified administrative region, place of residence, and distance to health facilities as the most influential determinants of disease awareness. Geographic and systemic healthcare factors significantly outweighed the predictive importance of individual demographic variables. Conclusion Ensemble machine learning models provide an exploratory framework for identifying predictors of maternal health knowledge. Our findings highlight that obstetric fistula awareness in Somalia is strongly associated with localized geographic and systemic barriers. Despite the cross-sectional limitations and the use of a self-reported proxy for awareness, these insights provide actionable evidence for precision public health. Public health interventions should prioritize region-specific and residence-aware strategies by integrating fistula education into the existing antenatal care infrastructure to bridge the equity gaps.

INTRODUCTION:Child mortality is a critical global health indicator, reflecting a nation's development and healthcare quality. Despite significant progress in reducing child mortality globally, Somalia continues to experience high rates, particularly among infants and young children, due to preventable and treatable conditions. Malnutrition, birth complications and infectious diseases are the leading causes of death. OBJECTIVE:To assess and analyse the trends in pediatric mortality over the past 2 years at a national referral hospital in Mogadishu, Somalia. METHODS:This retrospective cross-sectional study, conducted in the pediatric Department of Banadir Hospital in Mogadishu, Somalia, reviewed records of 1513 pediatric deaths during the study period, of which 70 were excluded due to incomplete records, leaving 1443 cases that met the inclusion criteria for analysis. RESULTS:The overall pediatric mortality rate during the study period was 5.3%. Male children accounted for 56.5% of deaths, whereas females represented 43.5%. Infants under 1 year were disproportionately affected, contributing to most deaths. The primary causes of death were severe acute malnutrition (29.04%), birth asphyxia (10.33%) and preterm (13.65%). The majority of deaths occurred within the first 24 h after admission and between 2 and 5 days of hospitalisation. Significant associations were found between the age of the child and the cause of death (χ2 = 537.485, p < 0.001). Additionally, there were significant associations between the year of death and the age of the child (χ2 = 17.669, p < 0.001), as well as the number of deaths in children per year (χ2 = 89.057, p < 0.001). CONCLUSIONS:The leading cause of pediatric death was SAM, followed by prematurity and birth asphyxia. Most deaths occurred within the first 24 h of hospital admission. Nationwide, multi-centre studies and interventions are highly recommended.

Purpose: Nocturnal enuresis, or enuresis during sleep, is a widespread condition in childhood influenced by genetic factors, delayed development of bladder control, and various behavioral factors. The main objective of the study was to determine the prevalence and factors associated with nocturnal enuresis among children aged 6-14 years who attended selected hospitals in Mogadishu, Somalia. Patients and Methods: A hospital-based cross-sectional study was conducted among 320 children attending pediatric outpatient departments at Banadir and SOS Hospitals. Data were collected using structured questionnaires administered to caregivers. Logistic regression analysis was used to identify factors associated with NE, and adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported. Results: The overall prevalence of nocturnal enuresis was 31.9%. Significant factors associated with NE included younger age (6-8 years: AOR = 4.228; 95% CI: 1.768-10.113), male sex (AOR = 6.456; 95% CI: 3.041-13.709), low parental education (AOR = 3.567; 95% CI: 1.385-9.185), drinking fluids before bedtime (AOR = 4.555), psychosocial stress (AOR = 3.742), constipation (AOR = 5.708), urinary tract infection (AOR = 7.211), deep sleep (AOR = 0.170), and a positive family history of NE (AOR = 10.076; 95% CI: 4.658-21.800). Conclusion: Nocturnal enuresis is highly prevalent among children in Mogadishu and is significantly associated with various sociodemographic, behavioral, and medical factors. These findings highlight the need for early screening, parental education, and targeted interventions. Further multi-center and qualitative studies are recommended to improve understanding and management of enuresis in Somalia.

PurposeThis study aims to analyze age-standardized prevalence of mental disorders in Sierra Leone from 2000 to 2019, examining sex inequalities.Design/methodology/approachThis study provides a novel examination of sex-based disparities in mental disorder prevalence in Sierra Leone over a 19-year period, contributing to the limited body of research on mental health equity in low-resource settings. By leveraging WHO's Health Equity Assessment Toolkit, it offers valuable insights into gender inequalities that can inform targeted policy interventions.FindingsAge-standardized prevalence of mental disorders in Sierra Leone was stable from 2000 to 2019, declining from 12,211.2 to 12,154.0 per 100,000. Females had higher rates than males. Female prevalence in 2000 was 12,753.4 (95% CI: 11,612.0-14,000.4) versus 11,605.7 (95% CI: 10,587.1-12,780.0) for males. The sex gap peaked at 1,257.8 cases in 2015 before reaching 1,232.6 in 2019, with females maintaining 10% higher prevalence (R = 1.1). PAF ranged from -5.0% to -5.3% and PAR from -605.5 to -618.4 cases.Research limitations/implicationsThis study adopts a cross-sectional design, which limits the ability to establish causality between sex-based differences and mental disorder prevalence. Additionally, the data may not fully capture contextual factors such as socioeconomic conditions, cultural stigma, or access to mental health services in Sierra Leone, which could influence the observed disparities. Future longitudinal studies are needed to explore causal relationships and the impact of these external factors on mental health outcomes over time.Originality/valueUsing WHO's Health Equity Assessment Toolkit, this study analyzed mental disorder prevalence per 100,000 population by sex.