Somalia is located in the Horn of Africa. The country has been affected by a civil war since 1991 and the situation has been further aggravated by prolonged droughts. The combination of conflict and natural disasters has eroded livelihoods, caused structural food insecurity, population displacements and extreme poverty. Moreover, as a consequence of civil insecurity and of the absence of a central government, the Somali health and educational systems have ceased functioning. The country belongs to the group of Low-Income Countries Under Stress (LICUS).
Poverty and food insecurity affect vulnerable groups such as nomadic pastoral communities and internally displaced people particularly, as well as the rural population as a whole. Agriculture and livestock rearing are the most important sectors of the economy, but the country is still heavily dependant on external aid and remittances from Somali living abroad. The population is predominantly rural and very young, with a high crude birth rate and a very high dependency ratio.
The health and educational sectors now depend on international organizations and NGOs. Problems of insecurity limit the provision of services. As a consequence, the level of indicators of human development in Somalia is very low. Infant, child and maternal mortality rates are extremely high. Incidence of infectious diseases is very high, and immunization rates are low. Life expectancy is estimated at 47 years.
The food supply is based on milk and cereals. The dietary energy supply is insufficient to meet the population's energy requirements. The country depends heavily on imports of cereals, vegetable oil and sweeteners. The supply of fruit and vegetables, as well as that of meat, is low. Agro pastoral communities have a slightly more diversified diet than pastoral communities.
Although breastfeeding is common, the rate of exclusive breastfeeding is low and bottle-feeding is widespread. The limited data available also indicate a short duration of breastfeeding.
The security situation precludes conducting large-scale nutrition surveys. Many district surveys are carried out but an overall assessment of the situation at country level is impossible and trends cannot be estimated. Most surveys show that the level of wasting in underfives is extremely high but important variations between districts and over time are also observed. Central/South Somalia is the region most affected by wasting. Data on stunting are limited.
Iodine deficiency is probably a major public health problem as access to iodized salt is extremely limited, but data are lacking to assess the situation. Limited data show that vitamin A deficiency is highly prevalent. The coverage by supplementation of preschool children and mothers with vitamin A is still insufficient. Small-scale studies also show that the prevalence of anemia is very high among preschool children.