Beyond therapeutic feeding: a call for integrated strategies to end child malnutrition in Somalia.
5 affiliations
- 1Pediatric Department, Benadir Maternity and Children Hospital, Mogadishu, Somalia.
- 2Faculty of Medicine and Surgery, Mogadishu University, Mogadishu, Somalia.
- 3Ministry of Health and Human Services, Federal Government of Somalia, Mogadishu, Somalia.
- 4Department of Public Health, Faculty of Graduate Studies and Research, Somali National University, Mogadishu, Somalia.
- 5Center for Epidemic Intelligence, Preparedness and Response, Mogadishu, Somalia.
Abstract
Somalia records one of the highest global burdens of child wasting and stunting, with approximately 1.7-1.85 million children under five estimated to be affected by acute malnutrition annually during 2022-2025, including approximately 421,000-513,550 children with severe acute malnutrition. For over two decades, the dominant policy response has been community-based management of acute malnutrition (CMAM), a curative intervention that treats clinical endpoints rather than underlying drivers. Despite meeting international cure-rate standards, CMAM alone cannot address the food insecurity, water, sanitation and hygiene (WASH), microbial and parasitic infectious diseases, health-system, and climatic drivers that perpetuate malnutrition. This paper integrates recent Somali survey, programme-evaluation, and administrative data to show that the national burden of acute malnutrition has remained high despite continued treatment scale-up, with stunting falling only 9.7 percentage points over 24 years, relapse after discharge remaining a documented challenge, and nationally representative Somalia-specific estimates of CMAM treatment coverage remaining unavailable. Diagnostic discordance between screening tools leaves an unknown share of wasted children undetected, and persistent sex- and region-based disparities highlight structural gaps. Ending child malnutrition in Somalia requires rebalancing investment from an emergency, treatment-centred paradigm toward integrated, multisectoral strategies combining therapeutic feeding with WASH investment, maternal and infant feeding support, primary health-care strengthening, climate-resilient livelihoods, and shock-responsive social protection. We propose four policy shifts: sustaining CMAM while addressing diagnostic gaps, mandating nutrition-sensitive financing, institutionalizing relapse prevention, and expanding anticipatory financing. These shifts require governance reforms and multi-year donor commitment to address the determinants of child nutrition in Somalia comprehensively.
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BibTeX
@article{tahlil2026beyond,
title = {{Beyond therapeutic feeding: a call for integrated strategies to end child malnutrition in Somalia.}},
author = {Abdifatah Mohamed Tahlil and Mohamed Jama Hashi and Hafsa Mohamed Hassan and Mukhtar Baryare Matan and Abdifatah Hassan Elmi and Ali Mohamud Samatar and Mohamed Abdirahman Abdi and Abdullahi Ahmed Tahlil},
journal = {Frontiers in public health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1941811},
url = {https://europepmc.org/article/MED/42898312},
note = {CC BY},
}
RIS
TY - JOUR
TI - Beyond therapeutic feeding: a call for integrated strategies to end child malnutrition in Somalia.
AU - Abdifatah Mohamed Tahlil
AU - Mohamed Jama Hashi
AU - Hafsa Mohamed Hassan
AU - Mukhtar Baryare Matan
AU - Abdifatah Hassan Elmi
AU - Ali Mohamud Samatar
AU - Mohamed Abdirahman Abdi
AU - Abdullahi Ahmed Tahlil
PY - 2026
DA - 2026/10/05
JO - Frontiers in public health
DO - 10.3389/fpubh.2026.1941811
UR - https://europepmc.org/article/MED/42898312
AB - Somalia records one of the highest global burdens of child wasting and stunting, with approximately 1.7-1.85 million children under five estimated to be affected by acute malnutrition annually during 2022-2025, including approximately 421,000-513,550 children with severe acute malnutrition. For over two decades, the dominant policy response has been community-based management of acute malnutrition (CMAM), a curative intervention that treats clinical endpoints rather than underlying drivers. Despite meeting international cure-rate standards, CMAM alone cannot address the food insecurity, water, sanitation and hygiene (WASH), microbial and parasitic infectious diseases, health-system, and climatic drivers that perpetuate malnutrition. This paper integrates recent Somali survey, programme-evaluation, and administrative data to show that the national burden of acute malnutrition has remained high despite continued treatment scale-up, with stunting falling only 9.7 percentage points over 24 years, relapse after discharge remaining a documented challenge, and nationally representative Somalia-specific estimates of CMAM treatment coverage remaining unavailable. Diagnostic discordance between screening tools leaves an unknown share of wasted children undetected, and persistent sex- and region-based disparities highlight structural gaps. Ending child malnutrition in Somalia requires rebalancing investment from an emergency, treatment-centred paradigm toward integrated, multisectoral strategies combining therapeutic feeding with WASH investment, maternal and infant feeding support, primary health-care strengthening, climate-resilient livelihoods, and shock-responsive social protection. We propose four policy shifts: sustaining CMAM while addressing diagnostic gaps, mandating nutrition-sensitive financing, institutionalizing relapse prevention, and expanding anticipatory financing. These shifts require governance reforms and multi-year donor commitment to address the determinants of child nutrition in Somalia comprehensively.
SN - 2296-2565
ER -