{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:50:10Z","timestamp":1785423010689,"version":"3.56.0"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Disability among women of reproductive age is a critical public health issue with significant social and economic implications. Understanding individual- and community-level determinants is essential for targeted interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examines the prevalence and determinants associated with disability among women aged 15\u201349\u202fyears in Somalia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Data from the Somalia Health and Demographic Survey (SHDS) were analyzed using STATA 17.0, employing a multivariable multilevel logistic regression model to assess individual- and community-level determinants of disability. Multicollinearity was assessed and found not to be a concern. The SHDS used a stratified two-stage cluster sampling design in which enumeration areas were selected with probability proportional to size, followed by systematic selection within each cluster, and inclusion of all eligible individuals, ensuring nationally representative data across population groups. Only statistically significant predictors were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Overall, 3.05% of women reported a disability. At the individual level, the odds of disability increased with older age (25\u201334\u202fyears: AOR\u202f=\u202f1.42; 35\u201349\u202fyears: AOR\u202f=\u202f2.17) and among women who were divorced (AOR\u202f=\u202f2.34), abandoned (AOR\u202f=\u202f4.99), widowed (AOR\u202f=\u202f2.20), or never married (AOR\u202f=\u202f3.36), while higher education (AOR\u202f=\u202f0.51), larger household size (6\u201310 members: AOR\u202f=\u202f0.71; \u226511 members: AOR\u202f=\u202f0.67), higher wealth (highest quintile: AOR\u202f=\u202f0.63), and health insurance coverage (AOR\u202f=\u202f0.04) were protective. At the community level, rural residence (AOR\u202f=\u202f0.45) and living in the southern areas (AOR\u202f=\u202f0.75) were associated with lower odds of disability compared with urban and northern areas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings underscore the need for targeted, evidence-informed policies that address the determinants associated with disability among women of reproductive age in Somalia. Priority should be given to expanding access to education for women, improving health insurance coverage for disadvantaged and low-income groups, and reinforcing social protection systems for the marginalized groups. In addition, efforts should focus on improving the availability, accessibility, and quality of disability-related health services, with particular emphasis on urban areas and the northern areas, where the likelihood of disability was relatively higher compared with rural residence and the southern areas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1846271","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T05:31:53Z","timestamp":1780291913000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and associated determinants of disability among women aged 15\u201349\u202fyears in Somalia: evidence from a 2018\/2019 nationwide survey"],"prefix":"10.3389","volume":"14","author":[{"given":"Hassan Abdi","family":"Ahmed","sequence":"first","affiliation":[{"name":"Center for Graduate Studies, Department of Statistics and Data Analytics, Jamhuriya University of Science & Technology","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Farah","family":"Hassan","sequence":"additional","affiliation":[{"name":"Center for Graduate Studies, Department of Statistics and Data Analytics, Jamhuriya University of Science & Technology","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e0192971","DOI":"10.1371\/journal.pone.0192971","article-title":"Combined impairments in vision, hearing and cognition are associated with greater levels of functional and communication difficulties than cognitive impairment alone: analysis of interRAI data for home care and long-term care recipients in Ontario","volume":"13","author":"Guthrie","year":"2018","journal-title":"PLoS One"},{"key":"ref2","first-page":"413","volume-title":"Dementia Prevention, Intervention, and care: 2020 Report of the Lancet CommissionLancet","author":"Livingston","year":"2020"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1957","DOI":"10.1007\/s11136-018-1799-2","article-title":"Quality of life in older Adults with Sensory Impairments: a systematic Review","volume":"27","author":"Sara","year":"2026","journal-title":"Qual Life Res"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1017\/S0033291718001617","article-title":"Age and sex differences in hearing loss association with depressive symptoms: analyses of NHANES 2011\u20132012","volume":"49","author":"Scinicariello","year":"2021","journal-title":"Psychol Med"},{"key":"ref5","volume-title":"Global Report on Health Equity for Persons with Disabilities","year":"2022"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12877-022-03322-x","article-title":"Association between dual sensory impairment and risk of mortality: a cohort study from the UK biobank","volume":"22","author":"Zhang","year":"2022","journal-title":"BMC Geriatr"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1186\/s12939-024-02339-5","article-title":"Access to health insurance amongst people with disabilities and its association with healthcare use, health status and financial protection in low- and middle-income countries: a systematic review","volume":"23","author":"Azizatunnisa","year":"2024","journal-title":"Int J Equity Health"},{"key":"ref8","volume-title":"World Report on Vision","year":"2019"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e888","DOI":"10.1016\/S2214-109X(17)30293-0","article-title":"Articles magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis","volume":"5","author":"Bourne","year":"2010","journal-title":"Lancet Glob Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"100485","DOI":"10.1016\/j.srhc.2020.100485","article-title":"Sexual & reproductive healthcare barriers to reproductive health services for women with disability in low- and middle-income countries: a review of the literature","volume":"24","author":"Casebolt","year":"2020","journal-title":"Sex Reprod Healthc"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e072535","DOI":"10.1136\/bmjopen-2023-072535","article-title":"Adolescent childbirth and mobility disability among women ages 15\u201349: an analysis of population health surveys income and middle-income countries","volume":"13","author":"Peck","year":"2023","journal-title":"BMJ Open"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1016\/j.archger.2015.06.005","article-title":"The mobility gap between older men and women: the embodiment of gender","volume":"61","author":"Zunzunegui","year":"2015","journal-title":"Arch Gerontol Geriatr"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.2105\/AJPH.2012.301115","article-title":"Socioeconomic inequality in disability among adults: a multicountry study using the world health survey","volume":"103","author":"Hosseinpoor","year":"2013","journal-title":"Am J Public Health"},{"key":"ref14","author":"Mitra","year":"2021"},{"key":"ref15","volume-title":"National Disability Report","year":"2024"},{"key":"ref16","volume-title":"United Nations Office for Disaster Risk Reduction 2023 Annual Report","year":"2023"},{"key":"ref17","volume-title":"The Federal Republic of Somalia Provisional Constitution","year":"2012"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"100239","DOI":"10.1016\/j.gloepi.2025.100239","article-title":"Socioeconomic and regional determinants of optimal antenatal care utilization among women in south and Central Somalia","volume":"11","author":"Abdirahim","year":"2026","journal-title":"Global Epidemiol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"9324","DOI":"10.3389\/fpubh.2026.1779324","article-title":"Prevalence and determinants of disability among the adult population aged 18+ years in Somalia evidence from the 2022 Somali integrated households budget survey","volume":"14","author":"Ahmed","year":"2026","journal-title":"Front Public Health"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1186\/s13690-026-01905-3","article-title":"Bayesian multilevel analysis of multimorbidity among women in Somalia: prevalence, patterns, and determinants","volume":"84","author":"Mohamed","year":"2026","journal-title":"Arch Public Health"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e73","DOI":"10.1017\/gmh.2024.66","article-title":"The unmet need for mental health support among persons with disabilities in Somalia: principal correlates and barriers to access","volume":"11","author":"Zemp","year":"2024","journal-title":"Glob Ment Health (Camb)"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"153","DOI":"10.11604\/pamj.2025.52.153.44405","article-title":"Prevalence and access to disability inclusive social protection services in Somalia; status, gaps and policy implications: a secondary re-analysis of survey data","volume":"52","author":"Koome","year":"2025","journal-title":"Pan Afr Med J"},{"key":"ref23","volume-title":"Disability in Somalia","year":"2018"},{"key":"ref24","volume-title":"Somali Health and Demographic Survey (SHDS)","year":"2020"},{"key":"ref25","volume-title":"Population Estimation Survey 2014","year":"2014"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"100426","DOI":"10.1016\/j.ijedro.2024.100426","article-title":"International journal of educational research open machine learning-driven analysis of academic performance determinants: geographic, socio-demographic, and subject-specific influences in Somaliland\u2019s 2022\u20132023 national primary examinations","volume":"8","author":"Abdulkadir","year":"2025","journal-title":"Int J Educ Res Open"},{"key":"ref27","volume-title":"The Washington Group Short Set on Functioning","year":"2022"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"2773","DOI":"10.1186\/s12889-024-20217-1","article-title":"A descriptive epidemiological study of the prevalence of self-reported sensory difficulties by age group, sex, education, disability, and migration status in Sweden in 2020","volume":"24","author":"Badache","year":"2024","journal-title":"BMC Public Health"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12982-025-00760-x","article-title":"Factors associated with disability among the adult population in Nepal","volume":"22","author":"Dhakal","year":"2025","journal-title":"Discover Public Health"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1080\/15017419.2015.1081616","article-title":"The marital status of disabled women in Canada: a population-based analysis","volume":"18","author":"Savage","year":"2015","journal-title":"Scand J Disabil Res"},{"key":"ref31","volume-title":"Guatemala National Disability Study","year":"2016"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e0273869","DOI":"10.1371\/journal.pone.0273869","article-title":"Are women with disabilities less likely to utilize essential maternal and reproductive health services? A secondary analysis of Pakistan demographic health survey","volume":"17","author":"Id","year":"2022","journal-title":"PLoS One"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1007\/s00038-015-0742-3","article-title":"Socio-demographic patterns of disability among older adult populations of low-income and middle-income countries: results from world health survey","volume":"61","author":"Reza","year":"2016","journal-title":"Int J Public Health"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1146\/annurev-publhealth-031816-044628","article-title":"The relationship between education and health: reducing disparities through a contextual approach","volume":"39","author":"Zajacova","year":"2019","journal-title":"Annu Rev Public Health"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"2576","DOI":"10.1186\/s12889-024-20064-0","article-title":"Educational differences in years lived with disability due to mental and substance use disorders: a cohort study using nationwide Norwegian and Danish registries","volume":"24","author":"Weye","year":"2024","journal-title":"BMC Public Health"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1016\/j.dhjo.2011.06.001","article-title":"Uninsured persons with disability confront substantial barriers to health care services","volume":"4","author":"Iezzoni","year":"2011","journal-title":"Disabil Health J"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1002\/ajim.70055","article-title":"Healthcare access and health status by primary source of health insurance and occupation","volume":"69","author":"Silver","year":"2026","journal-title":"Am J Ind Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1093\/geronb\/gbx081","article-title":"Living arrangements, disability and gender of older adults among rural South Africa","volume":"73","author":"Schatz","year":"2018","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"2593","DOI":"10.3390\/healthcare11182593","article-title":"The impact of long-term care needs on the socioeconomic deprivation of older people and their families: results from mixed-methods scoping review","volume":"11","author":"Casanova","year":"2023","journal-title":"Healthcare"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"23363","DOI":"10.1038\/s41598-025-03173-7","article-title":"Socioeconomic inequalities in disability prevalence and health service use in Bangladesh","volume":"15","author":"Rahman","year":"2025","journal-title":"Sci Rep"},{"key":"ref41","first-page":"1","article-title":"Disability status and socioeconomic related inequality in receiving quality antenatal care in nine low- and middle-income countries: a multilevel analysis","author":"Turi","year":"2025"},{"key":"ref42","first-page":"1695320","article-title":"Bridging healthcare disparities: a systematic review of healthcare access for disabled individuals in rural and urban areas","author":"Mesmar","year":"2025"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1111\/jrh.12335","article-title":"Differences in rural and urban health information access and use","volume":"35","author":"Schofield","year":"2020","journal-title":"J Rural Health"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1016\/j.amepre.2019.07.022","article-title":"Prevalence of disability and disability types by urban\u2013rural county classification-U.S., 2016","volume":"57","author":"Zhao","year":"2024","journal-title":"Am J Prev Med"},{"key":"ref45","first-page":"1","article-title":"Urban\u2013rural difference in factors associated with childhood functional difficulty in Bangladesh: a cross-sectional study","author":"Yesmin","year":"2023"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"e05727","DOI":"10.1016\/j.heliyon.2020.e05727","article-title":"Correlates of child functional difficulties status in Ghana: a further analysis of the 2017\/18 multiple indicator cluster survey","volume":"6","author":"Eugene","year":"2020","journal-title":"Heliyon"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1186\/s41043-024-00677-2","article-title":"Functional difficulty among children in Malaysia-findings from the national health and morbidity survey (NHMS) 2019","volume":"43","author":"Sahril","year":"2024","journal-title":"J Health Popul Nutr"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"49","DOI":"10.59557\/rpj.26.2.2024.90","article-title":"Decomposing rural-urban variations in maternal healthcare utilisation among women of reproductive age in Tanzania. Evidence from the 2022 Tanzania demographic health survey","volume":"26","author":"Ndifwa","year":"2024","journal-title":"Rural Plan J"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"299","DOI":"10.4314\/dujopas.v10i3b.29","article-title":"Regional disparities and socio-demographic determinants of clean cooking energy use among women in Nigeria","volume":"10","author":"Sani","year":"2024","journal-title":"Dutse J Pure Appl Sci"},{"key":"ref50","first-page":"321","volume-title":"Ital J Pediatr","author":"Osman","year":"2025"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"11786302241284148","DOI":"10.1177\/11786302241284148","article-title":"Prevalence and determinants of household access to improved latrine utilization in Somalia: health demographic survey (SHDS) 2020","volume":"18","author":"Ahmed","year":"2024","journal-title":"Environ Health Insights"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1846271\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T05:31:55Z","timestamp":1780291915000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1846271\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":51,"alternative-id":["10.3389\/fpubh.2026.1846271"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1846271","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]},"article-number":"1846271"}}