Burden of functional difficulties among children aged 2-17 years in Somalia: analysis of a 2022 nationally representative survey data.

BACKGROUND: Functional difficulty is a substantial public health concern. Empirical data on children experiencing difficulty are indispensable for developing or monitoring laws, policies, strategies, and interventions intended to mitigate disability; however, evidence on the magnitude and underlying determinants affecting children in Somalia remains limited. OBJECTIVE: This study aimed to assess the prevalence and contributing determinants of functional difficulties among children aged 2-17 years in Somalia. METHODS: A cross-sectional analysis was conducted using data from the 2022 Somali Integrated Household Budget Survey (SIHBS). A multiple logit model was run, reporting adjusted odds ratios (AOR) with 95% confidence intervals (CIs) at p < 0.05. RESULTS: The overall prevalence of functional difficulty among children was 5.7% [95% CI: 5.4-6.0]. Household size (AOR = 0.62, 95% CI [0.44, 0.89]), illness status (AOR = 0.46, 95% CI [0.35, 0.60]), and school attendance (AOR = 1.59, 95% CI [1.21, 2.09]). Chronic disease (AOR = 0.12, 95% CI [0.08, 0.19]), poverty status (AOR = 0.62, 95% CI [0.48, 0.81]), and residence (AOR = 1.18, 95% CI [0.99, 1.41]) were all significantly associated with functional difficulty at p < 0.05. CONCLUSION: Functional difficulties among Somali children are shaped by health, socioeconomic, and residential factors. Strengthening disability policies, expanding screening and mobile health services, promoting inclusive education, and providing targeted social protection are essential to address this burden.