# Determinants and regional inequalities in pregnancy deworming uptake in Somalia: findings from the 2020 Somalia demographic and health survey

## TL;DR

Pregnancy deworming in Somalia is very low, with major factors including antenatal care, education, and wealth, and large regional differences in uptake.

## Contribution

Identifies key predictors and significant regional disparities in deworming uptake during pregnancy in Somalia using national survey data.

## Key findings

- Deworming coverage during pregnancy in Somalia is extremely low at 4.09%.
- Regional disparities in uptake are marked, with some areas showing over tenfold differences.
- Nomadic women have higher odds of receiving deworming medication compared to others.

## Abstract

•Deworming coverage during pregnancy in Somalia is extremely low at 4.09%.•Antenatal care attendance, education, wealth, and iron supplementation are major predictors.•Significant regional inequalities exceed tenfold differences in uptake.•Nomadic women show higher odds of receiving deworming medication.•Findings highlight urgent need to improve antenatal care access and drug supply systems.

Deworming coverage during pregnancy in Somalia is extremely low at 4.09%.

Antenatal care attendance, education, wealth, and iron supplementation are major predictors.

Significant regional inequalities exceed tenfold differences in uptake.

Nomadic women show higher odds of receiving deworming medication.

Findings highlight urgent need to improve antenatal care access and drug supply systems.

Soil-transmitted helminth (STH) infections remain widespread in Somalia, yet national evidence on deworming uptake during pregnancy is scarce. This study exams determinants and regional inequalities in pregnancy deworming uptake in Somalia: findings from the 2020 Somalia demographic and health survey (SDHS).

This study analyzed data from 14,419 women in the 2020 SDHS. Weighted descriptive statistics, bivariate analyses, and multivariate logistic regression were applied to identify determinants of deworming drug use. All analyses accounted for survey clustering, stratification, and sampling weights.

National deworming coverage during pregnancy was 4.09%, among the lowest in sub-Saharan Africa. Uptake was significantly associated with antenatal care attendance (adjusted odds ratio [AOR] = 0.49), iron supplementation (AOR = 0.16), wealth (AOR = 1.81 among the richest), parity (AOR = 1.73), and maternal education (AOR = 1.72 for higher education). Marked geographic disparities were observed, with substantially higher odds in Lower Juba (AOR = 11.48), Bakool (AOR = 8.32), and Bay (AOR = 5.50) relative to Awdal. Nomadic women had increased odds of uptake (AOR = 6.01), while women in female-headed households were less likely to receive deworming (AOR = 0.86).

Deworming uptake in Somalia is critically low and shaped by socioeconomic and regional inequities, underscoring the need to improve antenatal care access and drug supply.