The study estimated all-age and under-5 excess mortality by district and month across Somalia, 2015 to June 2024. Ground data came from 496 SMART household surveys, with reconstructed population denominators and district-month predictors. Predictors included a composite drought index, malnutrition admissions, and suspected measles and malaria incidence. Against a 2015-2016 counterfactual, 71,100 excess deaths occurred from January 2022 to June 2024 (95% CI 28,200-125,100). Of these 64,500 were under 5; the 2017-2019 drought gave 79,600 excess deaths, 61% under 5. Survey clusters systematically omitted densely populated parts of southern and central Somalia.
Why it is interesting: It shows how excess mortality can be estimated by district and month where no vital registration exists. The method is reproducible and applies to other crisis settings.
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