Published in PLOS One on 2026-07-07, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Abdullahi Ahmed Tahlil, Naimo Abdikadir Abdillahi, Asho Jama Adam, Anisa Abdi Ali, Fadumo Mohumed Ahmed, Zeynab Osman Abdi, Maryan Muhudin Ali, Muno Abdulle Hubur, Hassan Ibrahim Nor, Mohamed Abdelrahman Mohamed, Liban Abdi Ali, Osman Mohamed Mohamud, Jianhong Zhou, Helen Howard, Olutosin Ademola Otekunrin
Source: PLOS One • DOI 10.1371/journal.pone.0347187
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Maternal undernutrition remains a major public health concern globally, particularly in Somalia, where conflict, poverty, and food insecurity exacerbate nutritional deficiencies. Undernutrition during pregnancy poses serious risks to both maternal and fetal health, including increased maternal mortality, low birth weight, and adverse developmental outcomes. Despite its critical implications, there is limited evidence on the burden and associated factors of maternal undernutrition in Somalia. This study assessed the prevalence and associated factors of undernutrition among pregnant women attending antenatal care (ANC) services in public hospitals in Mogadishu.
A facility-based cross-sectional study was conducted among 734 pregnant women attending antenatal care (ANC) services in public hospitals in Mogadishu. Participants were selected using a multistage sampling technique. Data were collected using interviewer-administered questionnaires and anthropometric measurements. Undernutrition was assessed using mid-upper arm circumference (MUAC < 23 cm), a measure commonly applied in clinical and humanitarian settings. Household food insecurity was assessed using the Household Food Insecurity Access Scale (HFIAS). Data were analyzed using SPSS version 26, and multivariable logistic regression was performed to identify factors associated with undernutrition at a significance level of p < 0.05.
The prevalence of maternal undernutrition was 75.7% (95% CI: 72.6%–78.9%). Factors independently associated with undernutrition included maternal age 25–31 years (AOR = 2.61, 95% CI: 1.28–5.30) and 32–38 years (AOR = 2.18, 95% CI: 1.04–4.55), tertiary education (AOR = 3.43, 95% CI: 1.89–6.21), employee occupation (AOR = 6.38, 95% CI: 2.90–14.04), private business occupation (AOR = 9.79, 95% CI: 4.27–22.43), large household size (AOR = 1.96, 95% CI: 1.34–2.88), urban residence (AOR = 2.40, 95% CI: 1.39–4.15), household monthly income < USD 500 (AOR = 1.98, 95% CI: 1.33–2.94), lack of latrine facility (AOR = 2.00, 95% CI: 1.23–3.26), second (AOR = 8.59, 95% CI: 5.29–13.97) and third trimester (AOR = 6.91, 95% CI: 2.97–16.08), primigravidity (AOR = 2.29, 95% CI: 1.52–3.45), contraceptive use (AOR = 1.98, 95% CI: 1.34–2.90), substance use (AOR = 2.79, 95% CI: 1.93–4.04), and severe household food insecurity (AOR = 1.76, 95% CI: 1.01–3.08). However, some associations with large effect sizes should be interpreted with caution, as they may reflect residual confounding, small subgroup sizes, or model instability.
This study revealed a high prevalence of maternal undernutrition among pregnant women attending ANC services in Mogadishu, with multiple factors found to be associated with undernutrition. These findings highlight the need for targeted, multi-sectoral interventions to improve maternal nutrition through enhanced food security, health education, and access to nutrition-sensitive and nutrition-specific services. Targeted strategies such as supplementation programs, nutrition counseling, and improved water, sanitation, and hygiene (WASH) services are critical to mitigating maternal undernutrition and achieving Sustainable Development Goals related to maternal and child health.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Abdullahi Ahmed Tahlil, Naimo Abdikadir Abdillahi, Asho Jama Adam, Anisa Abdi Ali, Fadumo Mohumed Ahmed, Zeynab Osman Abdi, Maryan Muhudin Ali, Muno Abdulle Hubur, Hassan Ibrahim Nor, Mohamed Abdelrahman Mohamed, Liban Abdi Ali, Osman Mohamed Mohamud, Jianhong Zhou, Helen Howard, Olutosin Ademola Otekunrin. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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