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Background <p>Household solid fuel use causes significant indoor air pollution, severely impacting health and the environment. Despite high reliance on solid fuels in Somalia, there is limited evidence integrating spatial and multilevel analyses to understand geographic inequalities and contextual determinants. This study aimed to determine the prevalence, associated factors, and spatial distribution of household solid fuel use in Somalia.</p> Methods <p>This cross-sectional study utilized nationally representative data from the 2020 Somalia Health and Demographic Survey (SHDS). Multilevel logistic regression was employed to identify individual and community-level factors, accounting for hierarchical clustering. Spatial analysis (prevalence mapping, Global Moran’s I, and Getis-Ord Gi* statistics) explored geographic patterns and identified significant hotspots.</p> Results <p>Household solid fuel use was substantially high at 95.05%. Multilevel analysis revealed that socioeconomic and infrastructure factors strongly influence fuel choice. No formal education (AOR = 1.70, 95% CI: 1.40–2.07), lack of electricity (AOR = 2.01, 95% CI: 1.42–2.86), and lack of water access (AOR = 1.67, 95% CI: 1.37–2.04) significantly increased the odds of solid fuel use (all <i>p</i> &lt; 0.001). Poor households had significantly higher odds than rich households (AOR = 0.11, 95% CI: 0.07–0.19, <i>p</i> &lt; 0.001). Rural (AOR = 1.82) and nomadic (AOR = 2.19) residences also showed higher odds than urban areas. Spatial analysis identified a statistically significant high-use hotspot in the central and northwestern regions.</p> Conclusion <p>The pervasive use of solid fuels in Somalia is deeply tied to poverty, lack of education, and infrastructure deficits. Findings highlight the urgent need for targeted, action-oriented interventions focusing on clean energy access, rural infrastructure development, and poverty reduction, particularly in identified geographic hotspots.</p>

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Spatial and multilevel analysis of household solid fuel use and its determinants in Somalia using the 2020 demographic and health survey

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月3日

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  • Abdirashid M. Yousuf,
  • Hodo Abdikarim,
  • Mohamed A. Hussein,
  • Harun I. Warsame,
  • Abdikadir N. Abdi,
  • Hamze G. Dahir,
  • Abdisalam Hassan Muse

摘要

Background

Household solid fuel use causes significant indoor air pollution, severely impacting health and the environment. Despite high reliance on solid fuels in Somalia, there is limited evidence integrating spatial and multilevel analyses to understand geographic inequalities and contextual determinants. This study aimed to determine the prevalence, associated factors, and spatial distribution of household solid fuel use in Somalia.

Methods

This cross-sectional study utilized nationally representative data from the 2020 Somalia Health and Demographic Survey (SHDS). Multilevel logistic regression was employed to identify individual and community-level factors, accounting for hierarchical clustering. Spatial analysis (prevalence mapping, Global Moran’s I, and Getis-Ord Gi* statistics) explored geographic patterns and identified significant hotspots.

Results

Household solid fuel use was substantially high at 95.05%. Multilevel analysis revealed that socioeconomic and infrastructure factors strongly influence fuel choice. No formal education (AOR = 1.70, 95% CI: 1.40–2.07), lack of electricity (AOR = 2.01, 95% CI: 1.42–2.86), and lack of water access (AOR = 1.67, 95% CI: 1.37–2.04) significantly increased the odds of solid fuel use (all p < 0.001). Poor households had significantly higher odds than rich households (AOR = 0.11, 95% CI: 0.07–0.19, p < 0.001). Rural (AOR = 1.82) and nomadic (AOR = 2.19) residences also showed higher odds than urban areas. Spatial analysis identified a statistically significant high-use hotspot in the central and northwestern regions.

Conclusion

The pervasive use of solid fuels in Somalia is deeply tied to poverty, lack of education, and infrastructure deficits. Findings highlight the urgent need for targeted, action-oriented interventions focusing on clean energy access, rural infrastructure development, and poverty reduction, particularly in identified geographic hotspots.