Determinants of Acute Respiratory Infection Among Children in Somalia: A Secondary Analysis of the Somali Demographic and Health Survey 2020

: Experienced symptoms of Acute respiratory infection is a significant public health challenge for children in low- and middle-income countries. In Somalia, the prevalence of ARI among under-five children was 8% in 2020, according to the Somali Demographic and Health Survey (SDHS). This study investigates the key determinants of ARI among under-five children in Somalia. : This study employed a cross-sectional design using secondary data analysis of the 2020 Somalia Demographic and Health Survey (SDHS). Data was collected via standardized questionnaires through a multi-stage cluster sampling strategy. A total of 2,301 children under five were included. Logistic regression was employed to identify determinants of ARI. : The descriptive analysis reveals that a substantial percentage of under five years of children 184(8%) possessed Acute respiratory infection and 2117 (92%) not ARI .The logistic regression model identified that Children from the highest wealth index category were more likely to experience ARI [AOR= 2.004; 95% CI: 1.087, 3.696, p =.026)]. than children from lowest category, highlighting socioeconomic factors that might contribute to their exposure and or susceptibility. Moreover, children belonging to parents who did not work were significantly less likely to have ARI [OR= .228; CI:.091 - .569];p< .001). Also basic amenities like, access to an unimproved sanitation access have 2.5 times odds of acquiring ARIs, with an OR =2.585;95% CI=[ 1.154 -5.794], p=.021 and having an unimproved water source (OR = 1.571, 95% CI [1.102, 2.24], p = .013). Furthermore, Factors such as child's birth order were assessed but did not show a statistically significant association with ARI in the final model (p > 0.05). : The study highlights the significant influence of socioeconomic status (wealth), access to improved water and sanitation facilities, parental employment, and birth order on ARI risk in Somali children. Findings emphasize the need for multi-faceted interventions targeting these specific factors, specifically addressing low socioeconomic status (wealth), poor access to water and sanitation (WASH), and parental employment issues.