Spatial Distribution and Determinants of Inadequate Vitamin A-Rich Food Consumption Among Children Aged 6-23 Months in Somalia: Evidence from the 2020 Somalia Demographic and Health Survey.

Purpose: Vitamin A deficiency (VAD) is a critical public health issue in Somalia, yet evidence regarding dietary practices remains limited. This study assessed the prevalence, geographical distribution, and determinants of Vitamin A-rich food consumption among children aged 6-23 months. Methods: Using 2020 Somali Demographic and Health Survey (SDHS) data (n=2,806), we employed two-level multilevel mixed-effects logistic regression to identify individual and community-level determinants. Spatial analysis, including Global Moran's I and Getis-Ord Gi* statistics, was performed to assess geographical clustering and identify consumption hotspots. Results: Only 33.75% of children consumed adequate Vitamin A-rich foods. Multilevel analysis revealed that children aged 18-23 months (AOR=2.78), those with formally educated mothers (AOR=1.42), and urban residents were more likely to consume these foods. Conversely, children with a birth order of two or more (AOR=0.44), and those from rural (AOR=0.72) or nomadic (AOR=0.22) households, had significantly lower odds of consumption. Spatial analysis confirmed significant geographical clustering (Moran's I = 0.24, p=0.048), identifying high-consumption hotspots in Awdal and Shabeellaha Dhexe, and low-consumption coldspots in Bari, Gedo, and Woqooyi Galbeed. Conclusion: Somali children face a substantial deficiency in Vitamin A-rich food intake, driven by pronounced sociodemographic and geographical disparities. These findings underscore the urgent need for multisectoral interventions. Strategies should prioritize enhancing maternal education and implementing context-specific programs for rural and nomadic communities to mitigate the burden of VAD in Somalia.