ORIGINAL RESEARCH Experiences from the Field: A Qualitative Study Exploring Barriers to Maternal and Child Health Service Utilization in IDP Settings Somalia Adam A Mohamed 1, 2 Temesgen Bocher 1 Mohamed A Magan 1 Ali Omar 1 Olive Mutai 1 Said A Mohamoud 3 Meftuh Omer 1 1 Save the Children International, Mogadishu, Somalia; 2 Department of Public Health, Institute of Health Sciences, Baskent University, Ankara, Turkey; 3 Department of Research, Somali Institute for Development Research and Analysis (SIDRA Institute), Garowe, Somalia Background: In Somalia, maternal and child health service utilization is unacceptably low. Little is known about factors contributing to low maternal and child health service utilization in Somalia, especially in internally displaced people (IDP) settings. This study aimed to understand barriers to the use of maternal and child health-care services among IDPs in Mogadishu. Methods: A total of 17 in-depth interviews (IDIs), 7 focus group discussions (FGDs), and feld observations were conducted on lactating/pregnant mothers, health-care providers, traditional birth attendants (TBA), and IDP camp leaders. The socio-ecological model (SEM) framework was employed for the categorization of barriers to healthcare utilization and further analysis was conducted to understand the major types and nature of barriers. Results: Using the SEM, the following major barriers that hinder maternal and child health service utilization were identifed. Low socio-economic, lack of decision making power of women, TBA trust, poor knowledge and awareness on pregnancy danger signs, fear of going to unfamiliar areas were identifed barriers at individual level. Traditional beliefs, male dominance in decision making, and lack of family support were also identifed barriers at interpersonal level. Security and armed confict barriers and formidable distance to health facility were identifed barrier at the community level. Lack of privacy in the facility, transportation challenges, poor functional services, negative experiences, closure of the health facility in some hours, and lack of proper referral pathways were identifed barriers at organizational or policy level. Conclusion: Overall, various factors across different levels of SEM were identifed as barrier to the utilization of maternal and child health services. Hence, multi-component interventions that target these complex and multifaceted barriers are required to be imple- mented in order to improve maternal and child health services utilization among IDP in Mogadishu, Somalia. Keywords: barriers, utilization, maternal and child health, pregnant and lactating, Somalia Background Maternal morbidity and mortality remain a great public health and humanitarian concern. World Health Organization (WHO) estimated 810 mothers die every day due to pregnancy or childbirth-related causes and additional 6500 newborn babies die, which is unacceptably high (WHO, 2019). Most of the causes are either preventable or treatable. There is a considerable gap of maternal mortalities and morbidities across countries around the world. Around 94% of all maternal deaths occur in low and lower middle-income countries, which refects access and Correspondence: Adam A Mohamed Email Adam.abdulkadir@savethechildren. org International Journal of Women’s Health 2021:13 1147–1160 1147 © 2021 Mohamed et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/ terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). International Journal of Women’s Health Dovepress open access to scientific and medical research Open Access Full Text Article Received: 26 July 2021 Accepted: 12 November 2021 Published: 25 November 2021