Influence of Health System Factors on Morbidity of Diarrheal Disease among Under Five Years Children Living in Internally Displaced Population Camps of Hodan District, Mogadhishu-Somalia

Hawa Ali Warsame, Eunice Chomi, Peter Ngwatu


Background: Diarrheal disease (DD) among children under 5 years old remains a major cause of morbidity and mortality worldwide. DD is the main killer with an estimate of 200 deaths per 1,000 live births in Somalia.  Non-functioning government; disintegrated health system (HS); and recurrent droughts contributed to circumstances for severe infectious diarrhea including poor environmental sanitation and hygiene; and inadequate water supplies. This study sought to establish the influence of HS factors on morbidity of diarrhea among under-five children living in Hodan camps.

Methods: Study used descriptive cross-sectional survey design. Multistage sampling technique was used to select 236 primary household caregivers and key informants for face-to-face interviews using questionnaires and key informant interviews. Descriptive and inferential statistical findings were presented as text, tables, and graphs.

Results:  Children in 48% households had suffered from diarrhea in the preceding past 2 weeks. Previously, diarrhea had affected most (45.3%) under-five children as compared to other diseases like malaria (22.9%). DD occurrence rate was highest (74.3%) among children of illiterate Caregivers. The health facilities (HFs) had enough stockpile of drugs though inadequately staffed and overstretched by demand causing increased turnaround time. Project-based HFs collapsed and stopped operating upon termination of projects. Poor health seeking behavior and failed follow-up visits resulted to negative health outcomes and re-lapse. The facilities and staff also lacked adequate supportive supervision.

Conclusion: Poor HS contributed to increased morbidity of DD. Additional HFs and staff would enhance access to health services.  Health education on DD would promote prompt health seeking and ensure timely treatment.


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