Jazeera University

Somalia's recurring hunger crises are often viewed as emergencies that can be addressed by emergency food aid. In reality, chronic food insecurity now stems from structural fault lines-poverty, conflict, displacement, climate volatility, weak land tenure, under-resourced ministries, and fractured markets-that short-term food aid cannot repair. Today, 4.3 million Somalis face acute food insecurity, and more than 700,000 children are acutely malnourished, even though the country boasts a 3333-km coastline, fertile river valleys and a rich tradition of pastoralism and farming. Cycles of drought have decimated herds, forced pastoralists into urban slums, and eroded coping mechanisms, while conflict blocks access to productive land and drives up dependence on imports for over 80% of staple foods. Climate change is tightening this vise through erratic rains, scorching heat, and flash floods. To achieve sustainable food security, Somalia must shift from emergency relief to long-term investments in resilient and inclusive food systems. That means channelling at least five percent of public expenditure into irrigation, water harvesting, and extension services; securing land rights to spur on-farm investment; scaling early-warning and climate-smart technologies; and rebuilding rural infrastructure, cold chains, and digital marketplaces so smallholders can reach consumers. Nutrition gains hinge on diversifying production of fruits, vegetables, legumes, and animal proteins, linked to community health and education programs. A national Food Systems Coordination Council should align humanitarian and development actors with regional frameworks, while public-private partnerships unlock finance for Somali agribusiness innovations. Ending hunger is not only a humanitarian obligation; it is a prerequisite for stability, growth, and social justice. With political will, integrated governance, and sustained investment, Somalia can move beyond food aid, harness its land and heritage, and lay the foundation for a resilient, self-reliant future.

Social anxiety is a common and debilitating psychiatric condition marked by an intense fear of negative evaluation in social situations, leading to significant impairments in occupational, academic, and daily functioning. Among medical students, this fear can significantly impede essential interpersonal interactions and academic performance. Despite its clinical significance, social anxiety remains under-researched in low-resource contexts, including Somalia. This study aims to assess the distribution and severity of social anxiety symptoms and identify its associated factors among medical students in Mogadishu, thereby informing targeted mental health interventions. A cross-sectional study was conducted between April and May 2025 among 290 undergraduate medical students from six private universities in Mogadishu, Somalia. Data were electronically collected using a structured questionnaire and validated instruments, including the Social Phobia Inventory (SPIN), the Patient Health Questionnaire-9 (PHQ-9), the Oslo Social Support Scale-3 (OSSS-3), and the Rosenberg Self-Esteem Scale (RSES-10). Logistic regression analysis identified independent factors associated with social anxiety, sex differences were assessed via the Mann–Whitney U test, and associations with psychosocial variables were analyzed using Spearman’s rank-order correlation. Statistical significance was set at a p-value < 0.05. Of the 290 participants, 35.5% (95% CI: 30.0–41.3) met the criteria for social anxiety. Female students (AOR = 1.79; 95% CI: 1.03–3.14) and those who reported physical inactivity (AOR = 2.33; 95% CI: 1.17–4.61) had significantly higher odds of social anxiety. Psychosocial factors significantly associated with social anxiety included low self-esteem (AOR = 2.87; 95% CI: 1.19–6.95), depressive symptoms (AOR = 5.61; 95% CI: 2.91–10.82), poor social support (AOR = 2.33; 95% CI: 1.15–4.73), and parental criticism (AOR = 2.22; 95% CI: 1.20–4.13). This study demonstrates a high level of social anxiety among medical students in Mogadishu, Somalia, and identifies significant associations with demographic, behavioral, and psychosocial factors. The results underscore the importance of enhancing mental health awareness and psychoeducation within medical schools, alongside supportive and preventive approaches that address modifiable factors such as physical inactivity, low self-esteem, depressive symptoms, and limited social support. Strengthening general mental health literacy and supportive environments may contribute positively to students’ well-being and academic experiences and support the long-term resilience of the future medical workforce.

IntroductionThe global development discourse primarily emphasizes the vital role of international aid in post-conflict health systems and governance. Somalia’s post-conflict health recovery has relied heavily on multisectoral aid that saved lives but entrenched parallel systems. While the national budget rose from ~ SOS 200 million (2015) to ~ SOS 1.3 billion (2025), the Ministry of Health’s share remained ≤ 7%, leaving sustainability and local ownership at risk. Recent funding cuts have reduced food, health, and WASH services, heightening disease and malnutrition risks. This review examines the long-term impacts of multisectoral aid on Somalia’s health system and governance, focusing on its effectiveness, sustainability, and unintended consequences.MethodWe conducted a narrative review (1990–2024; final search April 25, 2025) across PubMed, Scopus, Web of Science, Google Scholar, and gray literature (WHO, UNICEF, World Bank, USAID, FMoH). Using SANRA guidance, two reviewers screened 221 records plus prior evidence; 334 studies/reports were synthesized via hybrid thematic coding (NVivo) across five domains: aid-driven system development; aid–governance interactions; consequences of dependency; comparative insights; and sustainability pathways.ResultsAid delivered tangible “fruits”: expanded immunization and MCH coverage; high 2024 delivery performance (health 95% with US$69.8 M spent; nutrition 95.5% with US$73.9 M); and total donor inflows of ~ US$721.9 M fully deposited. However, most funds flowed off-budget through vertical programs and parallel supply/data chains, fragmenting governance and dampening state capacity. Despite the health share peaking at 7% (2023) and stabilizing near 6.8% (2025), cuts in 2025 curtailed essential services, leaving millions more vulnerable. Comparative cases (Liberia, Sierra Leone vs. South Sudan, Afghanistan) show sustainability improves when pooled funding, government payroll integration, and PHC-first strategies are adopted.ConclusionFor Somalia to transition from aid dependency to sustainable health governance, a deliberate shift is needed by strengthening FMoH leadership, funding PHC, unifying systems, integrating staff into public payroll, and ensuring epidemic readiness.

The study titled “A Study on the Relationship Between Gender and Perceptions Toward the Use of UPI/Digital Wallets” investigates how gender influences users’ attitudes, trust, and behavioral intentions toward digital payment systems in India. With the growing adoption of Unified Payments Interface (UPI) and digital wallets, understanding gender-based perceptions is crucial for promoting inclusive digital financial growth. The research utilized a structured questionnaire distributed among 188 respondents and analyzed the data using SPSS software through descriptive statistics, reliability tests, and correlation analysis. The reliability of the instrument, confirmed by a Cronbach’s Alpha value of 0.814, indicated high internal consistency among the items. The results revealed significant gender-based differences in perceptions of convenience, trust, security, and motivational factors influencing digital payment use. Male respondents exhibited higher comfort and confidence in using digital wallets and security features, whereas female respondents expressed greater concerns regarding privacy and fraud risks. The study also found that cashback rewards, peer influence, and time-saving benefits strongly motivated both genders. These findings highlight that while digital payment adoption is increasing, gender-specific concerns and behavioral differences continue to shape user experience and trust levels. The research concludes that a gender-sensitive approach is essential for fintech companies and policymakers to enhance user satisfaction, build trust and promote inclusive digital financial participation. The study offers practical and theoretical insights for developing secure, accessible, and user-friendly payment systems in India’s digital economy

The global population is increasing rapidly, with projections for suggesting this will rise to 60% by 2030 and 70% by 2050. Africa’s long-term vision aligns with Agenda 2063 and Somalia’s development trajectory, including the launch of its National Transformation Plan (NTP) for 2025–2029. This plan highlights the country’s evolving national development strategies, from the post-independence National Development Plans (NDPs) to more recent frameworks. Despite ambitious goals, previous plans have struggled due to institutional fragility, political instability, and heavy reliance on external aid. Somalia, located on the Horn of Africa, has faced numerous challenges, including conflict, climate vulnerability, and economic stagnation, which have hindered long-term progress. The paper traces Somalia’s historical development journey and offers a comprehensive review of how past lessons can inform future planning. The NTP 2025–2029 marks a significant shift in Somalia’s approach to national development. For the first time, the country adopts a participatory, systems-based methodology through the Lab Approach. This approach integrates multiple stakeholders, including federal and member state institutions, civil society, and international partners, to collaboratively design solutions tailored to Somalia’s unique needs. The NTP seeks to foster inclusive economic growth, resilient governance, and environmental sustainability, all aligned with the United Nations Sustainable Development Goals (SDGs) and the African Union’s Agenda 2063. This holistic transformation focuses on overcoming previous obstacles, such as weak institutions and fragmented governance. While NTP presents a forward-thinking framework, its successful implementation is contingent on overcoming significant challenges. The article highlights Somalia’s security threats, technical capacity gaps, and political fragmentation, suggesting strengthening institutional frameworks, enhancing fiscal autonomy, and prioritizing climate resilience through robust monitoring and stakeholder engagement. The NTP aims for a prosperous, democratic, and resilient Somalia by 2029, providing a clear and actionable roadmap for the country’s long-term development and stability.

This research study investigates the relationship between gender and customer perceptions regarding the recent increase in minimum balance requirements in private sector banks. The primary objective was to determine whether gender influences awareness, perceived fairness, satisfaction, and behavioral intentions toward this policy change. A total of 156 respondents participated in the study, representing various age groups, educational levels, and income categories. Using SPSS for data analysis, descriptive statistics, frequency distribution, and correlation tests were conducted to examine the relationships. The results revealed that gender has a significant impact on several perception-based variables, including awareness of the minimum balance policy, perception of service quality, and satisfaction levels with private banks. Male respondents generally exhibited higher awareness and acceptance of the balance increase, while female respondents showed more neutral or negative attitudes, indicating a gap in financial information and trust. However, gender showed no significant relationship with the intention to shift banks, suggesting that behavioral loyalty remains relatively stable despite dissatisfaction. The reliability test (Cronbach’s Alpha = 0.734) confirmed the consistency of the data. The study concludes that transparency, communication, and service quality play crucial roles in shaping customer perceptions. Private sector banks must adopt more inclusive communication strategies and customer education initiatives to ensure policy acceptance and trust among all demographic groups

BackgroundAcute pulmonary embolism (APE) and non-ST elevation myocardial infarction (NSTEMI) are two of the most common cardiovascular emergencies with overlapping clinical presentations, which frequently produce diagnostic dilemmas. Both APE and NSTEMI share elevation in D-dimer and troponin I, rendering them less specific when utilized singly.ObjectiveThis study aimed to investigate whether the ratio of D-dimer to troponin I could serve as a discriminative biomarker for differentiating between APE and NSTEMI.MethodsAn observational cross-sectional analysis was performed in 40 patients with confirmed APE and NSTEMI cases. Demographic factors and laboratory variables (D-dimer, troponin I, and estimated D-dimer-to-troponin ratio) were recorded. Statistical analysis was conducted with IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). Continuous data were reported as mean±SD, and the categorical data were given as frequencies and percentages. Comparisons between groups were made using t-tests and correlation with Pearson's coefficient, and p<0.05 was considered significant.ResultsPatients' mean age was 55.9±8.8 years for APE and 52.4±6.3 years for NSTEMI. APE patients showed much higher ratios of D-dimer to troponin (42.1±34.7) than NSTEMI patients (0.36±0.49; p<0.001). Sex-related differences were not statistically significant in both groups. Troponin I was negatively correlated with the ratio in APE (r=-0.590; p<0.001), while D-dimer was significantly correlated with the ratio in NSTEMI (r=0.798; p<0.001) in correlation analysis.ConclusionThe D-dimer-to-troponin ratio well differentiates between APE and NSTEMI, reflecting their unique pathophysiologic mechanisms. This ratio can perhaps offer clinicians an easy, inexpensive adjunct to enhance early diagnostic precision and direct proper treatment strategies.

Nurses are the foundation of healthcare systems, providing clinical care, emotional support, health education, and patient advocacy. Their frontline role and dedication significantly enhance patient outcomes and healthcare system efficiency. However, the high-pressure nature of nursing exposes them to increased risk of mental health disorders, particularly depression, anxiety, and stress, which can undermine both personal well-being and the quality of patient care. Despite global recognition of this issue, data from resource-limited and conflict-affected settings, such as Somalia, remain scarce. This study therefore aimed to assess the prevalence of depression, anxiety, and stress symptoms and to identify associated factors among nurses in Mogadishu, Somalia. A multicenter, cross-sectional study was conducted between November and December 2024 among 372 nurses across four hospitals in Mogadishu. Data were collected using self-administered online questionnaires comprising a demographic section, the 21-item Depression, Anxiety, and Stress Scale, the Pittsburgh Sleep Quality Index, and the Oslo Social Support Scale-3. Statistical analysis was performed using SPSS version 26, including descriptive statistics, bivariate analyses, and multivariable logistic regression. Statistical significance was set at p < 0.05. The prevalence of depression, anxiety, and stress symptoms among participants was 29% (95% CI: 24.5-33.9%), 32.5% (95% CI: 27.8-37.5%), and 15.1% (95% CI: 11.6-19.1%), respectively. Female was significantly associated with depression (AOR = 1.72; 95% CI: 1.01-2.92; p = 0.045) and anxiety (AOR = 1.69; 95% CI: 1.03-2.80; p = 0.040), while being over 30 years old was linked to anxiety (AOR = 2.59; 95% CI: 1.34-5.01; p = 0.005) and stress (AOR = 2.34; 95% CI: 1.09-5.02; p = 0.029). Stress was further associated with physical inactivity (AOR = 2.00; 95% CI: 1.02-3.81; p = 0.044) and ICU work assignments (AOR = 3.39; 95% CI: 1.08-10.65; p = 0.036). Notably, poor sleep quality and limited social support consistently were strongly associated with all outcomes, with adjusted odds ratios ranging from 4.60 to 8.18 for sleep and 2.46 to 3.86 for social support. The findings underscore a critical mental health burden among nurses in Mogadishu, driven by both occupational and personal factors. High-risk groups such as ICU staff and female nurses appear particularly vulnerable. Urgent institutional responses including regular mental health screenings, support programs (e.g., peer-support groups or employee assistance programs), workload management, and wellness promotion are essential to safeguard nurse well-being and ensure the delivery of high-quality patient care.

PurposePolytrauma presents a devastating event with great impact on the patient’s life. While we are taking great care of improving our treatment algorithms, the rehabilitation often takes place outside of our direct field of vision. Yet, adequate rehabilitation is crucial for the patients to regain their former lives. The aim of this study, on the behalf of SICOT Trauma & Rehabilitation Research Group, was to identify rehabilitation strategies and standards in existing scientific literature.MethodsA systematic literature search of MEDLINE and Embase from 2000 to 2023 was conducted. Inclusion criteria was the description of polytrauma rehabilitation strategies in the acute, post-acute or long-term stage. Reported treatment aims, conducted therapies and challenges were extracted and stratified to either of the stages.ResultsA total of 5212 studies were identified and 6 reviews and one original study were included according to our criteria. Overall, no article of higher evidence on how to perform polytrauma rehabilitation could be identified. From the available literature, disciplines involved in the rehabilitation could be described such as major challenges along the rehabilitation process.ConclusionThis study highlights the need for standardized polytrauma rehabilitation algorithms. Whereas we could identify important information about each rehabilitation stage, we did not encounter specific evidence for prioritization of different therapies or algorithms of treatment. Polytrauma rehabilitation needs to shift from eminence to evidence.

IntroductionPreeclampsia remains a formidable public health challenge, particularly in low- and middle-income countries (LMICs), where it significantly contributes to the high rates of maternal and neonatal morbidity and mortality. The advent of mobile health (mHealth) applications presents a promising avenue for enhancing the management of preeclampsia. This review protocol is designed to systematically assess the effectiveness and equity of mHealth apps in managing preeclampsia within LMICs, with a focus on clinical outcomes and the broader implications for accessibility, affordability, and cultural relevance.Materials and methodsTo achieve the objectives of this review, a rapid review methodology will be employed, encompassing a structured search strategy to identify pertinent studies from databases such as PubMed, Cochrane Library, and Google Scholar, as well as grey literature. The inclusion criteria are set to encompass randomized controlled trials (RCTs), controlled clinical trials (CCTs), observational studies, and qualitative studies that offer insights into the effectiveness and user experience of mHealth apps for preeclampsia management. Participants in these studies will include pregnant women at risk for or diagnosed with preeclampsia, healthcare providers, and app developers. The quality of the included studies will be critically appraised using standardized tools, and data extraction will focus on study characteristics, interventions, outcomes, and equity considerations.DiscussionThe implications of this review are far-reaching, offering the potential to inform stakeholders including policymakers, healthcare providers, and app developers about the deployment and development of mHealth solutions for preeclampsia management in LMICs. Ultimately, the anticipated findings of this review are expected to contribute significantly to the understanding of mHealth apps’ role in improving preeclampsia management and addressing healthcare disparities, thereby guiding future strategies to enhance maternal and neonatal health outcomes in LMICs.