Regional Disparities and Factors Associated With Poverty Among Women of Reproductive Age in Somalia: Evidence From National Survey Data

Background Poverty disproportionately affects women through labor inequities, unpaid care burdens, and limited resource control. In Somalia's fragile context, understanding subnational poverty disparities among reproductive‐age women is essential for targeted health interventions. Methods A cross‐sectional analysis was conducted using data from the 2020 Somalia Demographic and Health Survey (SDHS). The analytical sample included 13,123 birth records from women aged 15–49 years (unweighted n = 13,123; weighted N ≈ 12,774) with complete information on all variables included in the analysis. Poverty status was defined as poor versus nonpoor, using the DHS household wealth index (dichotomizing the poorest and poorer quintiles vs. middle, richer, and richest quintiles). Survey‐weighted descriptive analyses, bivariate associations using design‐based Rao−Scott F ‐tests, and multivariable survey logistic regression were performed in Stata version 18.0 to estimate the crude and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) accounting for clustering, stratification, and sampling weights. Results The overall prevalence was 48.5% (95% CI: 42.4%–54.6%), ranging from 28.2% in Bay to 73.8% in Gedo. Primary schooling (aOR = 0.31, 95% CI: 0.23–0.44), secondary schooling (aOR = 0.08, 95% CI: 0.02–0.36), and higher education (aOR = 0.09, 95% CI: 0.01–0.92) were associated with lower odds of poverty. No media exposure (aOR = 4.47, 95% CI: 2.92–6.83), having an unemployed husband (aOR = 4.18, 95% CI: 3.28–5.31), home delivery (aOR = 3.90, 95% CI: 2.94–5.18), and barriers (aOR = 2.36, 95% CI: 1.84–3.02) were associated with higher odds of poverty. Compared with Awdal, the odds of poverty were lower in Bay, Sanaag, Sool, Bakool, Lower Juba, and Banadir. Conclusion Nearly half of women in the analytical sample were classified as poor on a relative wealth measure, with marked regional disparities and strong associations with education, information access, household dynamics, and maternal health use. Interventions could prioritize girls’ education, information access, employment, and maternal healthcare in high‐poverty areas. Clinical Trial Number Not applicable.