Objective:

To determine the prevalence and determinants of fever, diarrhea, and acute respiratory infections (ARIs) among children aged 5–59 months in Somaliland, highlighting the public health significance of these conditions.

Key Findings:

• Prevalence of fever, diarrhea, and ARI was 6.07%, 4.75%, and 3.66%, respectively, with confidence intervals provided.
• Children aged ≥25 months had significantly lower odds of diarrhea (AOR = 0.53; 95% CI: 0.31–0.90), fever (AOR = 0.53; 95% CI: 0.31–0.90), and ARI (AOR = 0.37; 95% CI: 0.20–0.67) compared to those aged ≤12 months.
• Children in Togdheer had lower odds of diarrhea (AOR = 0.30; 95% CI: 0.14–0.67), fever (AOR = 0.30; 95% CI: 0.14–0.68), and ARI (AOR = 0.29; 95% CI: 0.12–0.71) compared to Maroodi-Jeeh.
• A nomadic lifestyle was associated with decreased odds of diarrhea (AOR = 0.48; 95% CI: 0.31–0.75), fever (AOR = 0.49; 95% CI: 0.32–0.77), and ARI (AOR = 0.58; 95% CI: 0.34–0.98) compared to rural living.
• Access to healthcare was a protective factor against diarrhea (AOR = 0.43; 95% CI: 0.28–0.67) and fever (AOR = 0.44; 95% CI: 0.28–0.68), but not for ARI.

Interpretation:

Childhood illnesses are prevalent in Somaliland, particularly among younger children, with significant regional and lifestyle influences on health outcomes, emphasizing the need for targeted public health interventions.

Limitations:

• Reliance on maternal self-reports may introduce recall bias and misclassification.
• Nomadic households may be underrepresented due to mobility, potentially impacting the findings.
• The cross-sectional design limits causal inferences.

Conclusion:

Targeted interventions focusing on early childhood, improving healthcare access, and addressing regional disparities are essential to reduce morbidity from childhood illnesses in Somaliland, particularly in vulnerable populations.