Drought, armed conflict and population mortality in Somalia, 2014–2018: A statistical analysis

Abstract

During 2010–2012, extreme food insecurity and famine in Somalia were estimated to account for 256,000 deaths. Since 2014 Somalia has experienced recurrent below-average rainfall, with consecutive failed rains in late 2016 and 2017 leading to large-scale drought, displacement and epidemics. We wished to estimate mortality across Somalia from 2014 to 2018, and measure the excess death toll attributable to the 2017–2018 drought-triggered crisis. We used a statistical approach akin to small-area estimation, and relying solely on existing data. We identified and re-analysed 91 household surveys conducted at the district level and estimating the crude (CDR) and under 5 years death rate (U5DR) over retrospective periods of 3–4 months. We captured datasets of candidate predictors of mortality with availability by district and month. We also reconstructed population denominators by district-month combining alternative census estimates and displacement data. We combined these data inputs into predictive models to estimate CDR and U5DR and combined the predictions with population estimates to project death tolls. Excess mortality was estimated by constructing counterfactual no-crisis scenarios. Between 2013 and 2018, Somalia’s population increased from 12.0 to 13.5 million, and internally displaced people or returnees reached 20% of the population. We estimated an excess death toll of 44,700 in the most likely counterfactual scenario, and as high as 163,800 in a pessimistic scenario. By contrast to 2010–2012, excess deaths were widespread across Somalia, including central and northern regions. This analysis suggests that the 2017–2018 crisis had a lower, albeit still very substantial, mortality impact than its 2010–2012 predecessor. Despite modest elevations in death rate, crisis conditions were widespread and affected a population of millions. Humanitarian response to drought-related crises in Somalia needs to be strengthened, target the most vulnerable and emphasise very early interventions.

Mortality among populations affected by armed conflict in northeast Nigeria, 2016 to 2019

“…During a famine in Somalia (2010 to 2012), the method found that CDR increased about fivefold to eightfold, with some 260,000 excess deaths ( 22 ), while in South Sudan we estimated 380,000 excess deaths, about 1.7 times the counterfactual ( 23 ). Repeat Somalia studies suggested about 45,000 excess deaths during the 2016 to 2018 drought ( 24 ) and a similar amount during the first year of the ongoing drought ( 25 ).…”

Assessing Vaccination Delivery Strategies for Zero-Dose and Under-Immunized Children in the Fragile Context of Somalia

“…The country’s fragile and fragmented health system, unclear governance structure, and limited health financing hampers the routine access and delivery of essential vaccines [ 7 ]. The recurrent humanitarian health emergencies afflicting the country every four to five years further weaken the system by adding to the caseload of vector- and water-borne diseases and severe malnutrition of already vulnerable populations [ 8 , 9 , 10 ].…”

Causal inference to study food insecurity in Africa

“…Prolonged dry spells significantly contribute to this crisis [14], yet it is crucial to recognize that droughts are not the sole driver. Various factors, including hydrological conditions, food production capabilities, market access, insufficient humanitarian aid, conflicts, and displacement, contribute to the complex challenges households face [13,2,19,3,24]. Studying food security in this context is intricate, involving multiple variables, scales, and non-linear relationships, making it unsuitable for predictive machine learning [25,26].…”