{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:53:36Z","timestamp":1791179616933,"version":"4.1.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"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:p>Somalia records one of the highest global burdens of child wasting and stunting, with approximately 1.7\u20131.85 million children under five estimated to be affected by acute malnutrition annually during 2022\u20132025, including approximately 421,000\u2013513,550 children with severe acute malnutrition. For over two decades, the dominant policy response has been community-based management of acute malnutrition (CMAM), a curative intervention that treats clinical endpoints rather than underlying drivers. Despite meeting international cure-rate standards, CMAM alone cannot address the food insecurity, water, sanitation and hygiene (WASH), microbial and parasitic infectious diseases, health-system, and climatic drivers that perpetuate malnutrition. This paper integrates recent Somali survey, programme-evaluation, and administrative data to show that the national burden of acute malnutrition has remained high despite continued treatment scale-up, with stunting falling only 9.7 percentage points over 24\u202fyears, relapse after discharge remaining a documented challenge, and nationally representative Somalia-specific estimates of CMAM treatment coverage remaining unavailable. Diagnostic discordance between screening tools leaves an unknown share of wasted children undetected, and persistent sex- and region-based disparities highlight structural gaps. Ending child malnutrition in Somalia requires rebalancing investment from an emergency, treatment-centred paradigm toward integrated, multisectoral strategies combining therapeutic feeding with WASH investment, maternal and infant feeding support, primary health-care strengthening, climate-resilient livelihoods, and shock-responsive social protection. We propose four policy shifts: sustaining CMAM while addressing diagnostic gaps, mandating nutrition-sensitive financing, institutionalizing relapse prevention, and expanding anticipatory financing. These shifts require governance reforms and multi-year donor commitment to address the determinants of child nutrition in Somalia comprehensively.<\/jats:p>","DOI":"10.3389\/fpubh.2026.1941811","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:32:49Z","timestamp":1791178369000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond therapeutic feeding: a call for integrated strategies to end child malnutrition in Somalia"],"prefix":"10.3389","volume":"14","author":[{"given":"Abdifatah Mohamed","family":"Tahlil","sequence":"first","affiliation":[{"name":"Pediatric Department, Benadir Maternity and Children Hospital","place":["Mogadishu, Somalia"]},{"name":"Faculty of Medicine and Surgery, Mogadishu University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Jama","family":"Hashi","sequence":"additional","affiliation":[{"name":"Pediatric Department, Benadir Maternity and Children Hospital","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafsa Mohamed","family":"Hassan","sequence":"additional","affiliation":[{"name":"Pediatric Department, Benadir Maternity and Children Hospital","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukhtar Baryare","family":"Matan","sequence":"additional","affiliation":[{"name":"Pediatric Department, Benadir Maternity and Children Hospital","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdifatah Hassan","family":"Elmi","sequence":"additional","affiliation":[{"name":"Pediatric Department, Benadir Maternity and Children Hospital","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Mohamud","family":"Samatar","sequence":"additional","affiliation":[{"name":"Pediatric Department, Benadir Maternity and Children Hospital","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Abdirahman","family":"Abdi","sequence":"additional","affiliation":[{"name":"Ministry of Health and Human Services, Federal Government of Somalia","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullahi Ahmed","family":"Tahlil","sequence":"additional","affiliation":[{"name":"Ministry of Health and Human Services, Federal Government of Somalia","place":["Mogadishu, Somalia"]},{"name":"Department of Public Health, Faculty of Graduate Studies and Research, Somali National University","place":["Mogadishu, Somalia"]},{"name":"Center for Epidemic Intelligence, Preparedness and Response","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"ref1","volume-title":"Somalia","year":"2025"},{"key":"ref2","volume-title":"Somalia Calls for Help as 1.8 Million Somali Children under 5 Experience Acute Malnutrition and Health Complications","year":"2023"},{"key":"ref3","volume-title":"Somalia: Acute Food Insecurity and Malnutrition Snapshot, January\u2013June 2024","year":"2024"},{"key":"ref4","volume-title":"Somalia: Drought, Conflict and High Food Prices Risk Pushing 4.4 Million People into Hunger, the Federal Government of Somalia and UN Warn","year":"2025"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1007\/s44197-026-00579-y","article-title":"Trends in stunting prevalence and sex-based disparities among children under five in Somalia, 2000\u20132024: a secondary analysis of WHO model-based 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