Prevalence of Diarrheal Diseases and Associated Factors Among Under-Five Children in Abduwak District, Galgudud Region, Galmudug State, Somalia.

Diarrheal diseases remain one of the leading causes of morbidity and mortality among children under five years globally, particularly in low-income countries. Each year, an estimated 1.7 billion cases of diarrhea are reported, contributing to approximately 443,832 deaths among children below five years. In Somalia, the burden is exacerbated by prolonged conflict, displacement, and fragile health systems. The Galgudud Region, including Abduwak District, faces significant challenges due to limited access to clean water, poor sanitation, and underdeveloped healthcare infrastructure. This study aimed to assess the prevalence of diarrheal diseases to identify the demographic, socioeconomic, and environmental factors associated with its morbidity among children under five years in Abduwak District. In this study a cross-sectional research design was employed, targeting households with children below five years. A sample size of 124 respondents was selected using multi-stage and random sampling techniques. Quantitative data was collected through structured questionnaires and observation checklists and analyzed using SPSS version 31. The outcomes indicated that diarrheal disease remains a major public health challenge in Abduwak District, with high prevalence of 26.8% among children under five years. The study found that children aged 7-24 months were most vulnerable (35.0-35.5% prevalence), and 43.4% of cases presented with moderate to severe dehydration. Malnutrition affected 48.2% of children, while immunization coverage was only 45.5%. Strong socioeconomic gradients were evident: diarrhea prevalence reached 32.3% among children of uneducated mothers versus 0% with tertiary-educated mothers, and 36.0% in households earning <$50 monthly versus 0% earning >$200. Critical environmental deficiencies included 60.7% of households using unimproved water sources, 78.6% not treating drinking water, 25.0% practicing open defecation, and only 31.3% having handwashing facilities. Therefore, this study concluded that diarrheal disease in Abduwak District results from the interactions of poverty, limited education, malnutrition, and severe WASH deficiencies, requiring comprehensive and integrated interventions to address these determinants simultaneously rather than focusing on a single-factor approach.