Determinants and regional inequalities in pregnancy deworming uptake in Somalia: findings from the 2020 Somalia demographic and health survey

• Deworming coverage during pregnancy in Somalia is extremely low at 4.09%. • ANC attendance, education, wealth, and iron supplementation are major predictors. • Significant regional inequalities exceed tenfold differences in uptake. • Nomadic women show higher odds of receiving deworming medication. • Findings highlight urgent need to improve ANC access and drug supply systems. Soil-transmitted helminth (STH) infections remain widespread in Somalia, yet national evidence on deworming uptake during pregnancy is scarce. This study exams Determinants and Regional Inequalities in Pregnancy Deworming Uptake in Somalia: Findings from the 2020 Somalia Demographic and Health Survey. This study analyzed data from 14,419 women in the 2020 Somalia Demographic and Health Survey (SDHS). Weighted descriptive statistics, bivariate analyses, and multivariate logistic regression were applied to identify determinants of deworming drug use. All analyses accounted for survey clustering, stratification, and sampling weights. National deworming coverage during pregnancy was 4.09%, among the lowest in sub-Saharan Africa. Uptake was significantly associated with ANC attendance (AOR=0.49), iron supplementation (AOR=0.16), wealth (AOR=1.81 among the richest), parity (AOR=1.73), and maternal education (AOR=1.72 for higher education). Marked geographic disparities were observed, with substantially higher odds in Lower Juba (AOR=11.48), Bakool (AOR=8.32), and Bay (AOR=5.50) relative to Awdal. Nomadic women had increased odds of uptake (AOR=6.01), while women in female-headed households were less likely to receive deworming (AOR=0.86). Deworming uptake in Somalia is critically low and shaped by socioeconomic and regional inequities, underscoring the need to improve ANC access and drug supply.