The Accessibility and Utilization of Nutritional Services in Hospitals in Qardho district, Bari region, Somalia
Creators: name: Ruun, Ali Abdi
Publisher: name: Zenodo
Year: 2025
Subjects: The Accessibility
Utilization
Nutritional Services
in Hospitals in Qardho
district, Bari region, Somalia

description: Abstract 

Somalia's escalating poverty rate, influenced by political instability, conflict, insecurity, and climate emergencies, has profound implications on food security and nutrition. The significant rise in poverty from 43% in 2002 to 68% in 2017, exacerbated by external shocks and rapid urbanization, has heightened inequality and strained already weak institutions. This scenario is further complicated by the global context, such as the war in Ukraine, which has spiked food prices and affected commodity imports, worsening food insecurity in Somalia. The situation underscores the need for comprehensive strategies that address both immediate needs and long-term socio-economic stability.

The primary objective of this study is to assess the accessibility and utilization of nutritional services in hospitals located in the Qardho district of the Bari region, Somalia. Specifically, it aims to evaluate two key aspects: firstly, the level of accessibility of these nutritional services within the hospitals of Qardho district, and secondly, how these services are being utilized by the community or patients in the same area. This comprehensive assessment will provide insights into both the availability and the effective use of nutritional services in this region's healthcare facilities.

This study, conducted as a cross-sectional survey in Mogadishu, Somalia, will focus on assessing the accessibility and utilization of nutritional services in hospitals within the Qardho district, Bari region. Targeting a diverse group including nutrition and nurse experts, hospital management, staff, clients, society members, patients, and academics, the research will involve 80 participants selected through non-probability sampling. Data will be collected using self-administered questionnaires and analyzed using SPSS, focusing on respondents who are directly associated with the nutritional services in the specified hospitals. The study will exclude individuals not residing in the Qardho district or unrelated to the study’s focus.

The survey of 80 respondents in Somalia highlighted key demographic and occupational trends, as well as perceptions on nutritional services. The age groups 31-40 and 41-50 were most represented, each constituting 31.3% of the sample, with a notable middle-aged presence. In contrast, the age group above 51 years was the least represented at 7.5%. Females formed a majority of the respondents (61.3%), indicating a gender imbalance. The majority of participants were highly educated, with over half holding a PhD. Occupation-wise, 46.3% were self-employed, suggesting a trend towards entrepreneurship, while 71.3% were married, indicating a predominantly married demographic.

In terms of nutritional services, 77.5% of respondents agreed that poor populations face challenges accessing these services due to factors such as lack of knowledge and high healthcare costs. There was a high level of satisfaction with meal services, especially breakfast, though dinner service received some dissatisfaction (31.3%). The importance of a balanced diet was recognized by most (71.3%) for maintaining health, and the role of nurses in patient recovery and diet promotion was acknowledged by 85%. This indicates a clear recognition of the critical role of diet in health and the efficiency of service delivery in nutritional assistance.

To enhance the accessibility and utilization of nutritional services in the Qardho district, Bari region, Somalia, a multifaceted approach is recommended. Key strategies include launching community awareness programs to educate the public on nutrition and the availability of services, complemented by specialized training for healthcare workers in nutritional counseling and malnutrition identification. Improving physical access to services is crucial, potentially through transport services for remote areas, mobile clinics, and integrated nutrition centers in existing healthcare facilities. Emphasizing cultural sensitivity and inclusiveness in program design, considering local dietary habits and preferences, is also vital.

Further, forging partnerships with NGOs and international organizations can bring additional resources and expertise. Implementing a robust monitoring and evaluation system will track progress and inform service improvements. Advocacy for supportive government policies and increased funding is essential, targeting the root causes of malnutrition such as poverty and food security. Utilizing technology, like telemedicine and mobile apps, can enhance service delivery. Community-based interventions addressing local needs and integrating nutritional services with broader healthcare services will ensure a comprehensive healthcare approach. These recommendations aim to significantly improve nutritional service outcomes in the Qardho district.