Multilevel Analysis on the Prevalence and Associated Risk Factors of Audiovisual Ability Impairment among the Somali Population: Evidence From Somali Health and Demographic Survey (SHDS) 2020

Audiovisual impairments, encompassing both vision and hearing difficulties, significantly impact an individual’s quality of life and societal development, particularly in low- and middle-income countries. While the global burden of these conditions is significant, research on their prevalence and associated risk factors in Somalia and the Horn of Africa remains limited. This study, utilizing data from the nationally representative Somali Health and Demographic Survey (SHDS) 2020, investigates the prevalence and determinants of audiovisual impairment within the Somali population. Employing a multilevel statistical analysis framework, we analyzed data from 52,154 individuals, exploring the influence of individual and community-level factors. Our findings revealed that 3.35% of the Somali population reported experiencing audiovisual impairment. Notably, significant demographic and socio-economic associations were identified, with higher rates of impairment observed among older individuals, females, and those with lower educational attainment. Furthermore, the multilevel analysis highlighted the importance of regional differences, type of residence, and community-level factors in shaping the risk of impairment, with rural and nomadic lifestyles emerging as potential protective factors, indicating a unique interplay between environment and disability experience. To address these findings, we recommend the Somali Ministry of Health to implement targeted interventions, including: (1) establishing community-based screening programs for early detection of audiovisual impairments, particularly among older adults and women in high-risk regions; (2) strengthening primary healthcare services in rural and nomadic areas by providing mobile clinics and training healthcare workers to identify and manage sensory impairments; and (3) developing culturally appropriate educational materials to promote awareness of risk factors and preventive measures. This study provides critical baseline data for Somalia, contributing to a broader understanding of audiovisual impairment within a low-income context. Our findings offer valuable insights for informing public health policies and interventions aimed at improving access to healthcare, promoting early detection and rehabilitation, and fostering inclusive environments for individuals with disabilities