Maternal and Child Health Journal最新文献

{"title":"Self-Harm Ideation in Perinatal Mothers in Home Visiting Programs.","authors":"Robert T Ammerman, Alonzo T Folger, Erica Pearl Messer, Jennifer R Frey","doi":"10.1007/s10995-026-04338-0","DOIUrl":"https://doi.org/10.1007/s10995-026-04338-0","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the prevalence and predictors of self-harm ideation during the perinatal period among mothers (N = 9638) enrolled in a home visiting program.</p><p><strong>Methods: </strong>Subjects were all mothers enrolled in a home visiting program in the United States between 2006 and 2023 who completed the Edinburgh Postnatal Depression Scale (EPDS; Cox et al., 1987) prenatally and/or at up to 6 months postpartum. Item 10 of the EPDS, reflecting thoughts of self-harm, was used to operationalize self-harm ideation and severity. Demographic and clinical variables were examined as predictors of self-harm ideation and change over the two time points.</p><p><strong>Results: </strong>6.8% of the sample reported self-harm ideation prenatally, with 33.8% of these mothers endorsing the two highest levels of severity. 4.0% of the sample reported self-harm ideation postnatally. Of those who reported self-harm ideation prenatally, 77.9% no longer reported it postnatally. Reporting of self-harm ideation was associated with mean EPDS scores above the established clinical cutoff (≥ 13). Younger mothers reported higher levels of ideation compared with older mothers.</p><p><strong>Conclusions for practice: </strong>A large proportion of mothers reported self-harm ideation prenatally, and younger mothers reported higher levels of ideation compared with older mothers. Given the dangers of unrecognized and untreated suicide risk in perinatal mothers, home visitors are in a unique and important position to support and link mothers to mental health services.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Paid Family Leave Policies on Intimate Partner Violence in New York City from 2012 to 2022.","authors":"J Bart Klika, Eric L Thibodeau, Catherine A Murphy, Melissa T Merrick, Katherine E Marçal, Kathryn Showalter, Yanghyun Park, Olivia D Chang, Kathryn Maguire-Jack","doi":"10.1007/s10995-026-04332-6","DOIUrl":"https://doi.org/10.1007/s10995-026-04332-6","url":null,"abstract":"<p><strong>Introduction: </strong>Experiencing intimate partner violence (IPV) during the prenatal period can result in maternal mental health challenges, adverse birth outcomes (e.g., pre-term birth and low birth rates), and children's mental, cognitive, and physical health issues (Donovan et al., 2016; Hahn et al., 2018). Access to economic support policies, like state-sponsored paid family leave (PFL), during the perinatal period may be a strategy to reduce financial stress and prevent IPV (Niolon et al., 2017). This paper explores whether living in a state with PFL (i.e., New York) reduces IPV for working mothers during pregnancy.</p><p><strong>Methods: </strong>Data for this study are drawn from the Pregnancy Risk and Monitoring System (PRAMS). We used difference-in-differences (DiD) accounting for multiple time periods and multiple groups to estimate the average treatment effect (ATE) of paid family leave enactment in New York State using data from New York City.</p><p><strong>Results: </strong>We found nearly a 30% reduction in IPV during pregnancy for working mothers in NYC compared to those living in states without a state-sponsored PFL policy.</p><p><strong>Discussion: </strong>These findings suggest economic support policies may have an anticipatory effect on expectant caregivers. Additional research is needed to further understand this association.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternity-Leave Related TikTok Videos: A Cross-Sectional Analysis of Content and Viewer Engagement.","authors":"Carlee Denholtz, Corey H Basch, Helen Yousaf, Rafael Gonzalez Castillo","doi":"10.1007/s10995-026-04340-6","DOIUrl":"https://doi.org/10.1007/s10995-026-04340-6","url":null,"abstract":"<p><strong>Purpose: </strong>Maternity leave policy in the United States is fragmented, leading to inconsistent access to job protection and paid leave. The lack of a universal policy and variation across states contributes to inequities in maternal health, economic stability, and gender equity. This study describes how maternity leave is portrayed on TikTok and examines which content features are associated with viewer engagement as a part of informal policy dialogue.</p><p><strong>Methods: </strong>A cross-sectional content analysis was conducted on 100 TikTok videos tagged with #maternityleave. Videos were coded for thematic content (e.g., humor, policy references, music, presence of infants) and engagement metrics (views, likes, comments, favorites). Descriptive statistics summarized content features and engagement metrics. Independent two-tailed Welch t-tests (α = 0.05) compared views, likes, favorites, and comments between videos with and without each of the four most common content features. False Discovery Rate (FDR) adjustments were applied to account for multiple comparisons, and Cohen's d was used to estimate effect size.</p><p><strong>Results: </strong>The 100 videos generated substantial engagement (41.3 million views, 3.14 million likes, 187,145 favorites, and 114,574 comments), and most featured only women (88%). Videos referencing a specific policy and videos without music received more favorites, while videos featuring an infant showed a trend toward more likes. Humor was not associated with engagement. None of the observed associations remained significant after false discovery rate correction.</p><p><strong>Conclusion: </strong>Maternity leave content on TikTok attracted substantial viewer engagement, and several content features demonstrated exploratory patterns of association with engagement. Policy-referencing videos received more favorites in the unadjusted analysis, while infant-related content showed a non-significant trend toward greater likes. The results suggest that TikTok is one space where maternity leave experiences and policies are discussed. Given the modest convenience sample and the platform's dynamic nature, future research should examine whether engagement with such content relates to viewers' maternity leave knowledge, attitudes, or civic action for national maternity leave policy.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contextualizing Trends in Television Viewing and Computer Use Among U.S. Children Aged 5-11 Years, 2001-2018.","authors":"Ashley W Kranjac, Dinko Kranjac","doi":"10.1007/s10995-026-04333-5","DOIUrl":"https://doi.org/10.1007/s10995-026-04333-5","url":null,"abstract":"<p><strong>Introduction: </strong>Excessive screen time among children is linked to adverse physical, mental, and developmental outcomes. The putative drivers of increasing screen time among school-aged children in the United States remain unclear. Population-level changes may arise from intracohort change (IC)-change in average screen time across survey cycles-or cohort replacement (CR), as later-born cohorts with different levels of screen time replace earlier-born cohorts.</p><p><strong>Methods: </strong>We analyzed nine 2-year National Health and Nutrition Examination Survey (NHANES) cycles from 2001 to 2002 through 2017-2018, including 9,841 children aged 5-11 years old. Screen time was measured as the sum of proxy-reported estimates of daily hours of TV/video viewing and computer use. Using linear and algebraic decomposition techniques, we partitioned total change (TC) in screen time into IC and CR components. Models adjusted for demographic, wellness, family, and food security factors.</p><p><strong>Results: </strong>The weighted mean estimated daily screen time increased from 2.95 to 4.26 h (Δ = 1.31;44%). Boys consistently had higher proxy-reported mean screen time than girls. In the unadjusted model, IC contributed positively to the increase in screen time, whereas CR partially offset it. These opposing contributions persisted across all adjustment models.</p><p><strong>Discussion: </strong>Combined estimated daily screen time among U.S. children aged 5-11 years increased significantly between 2001 and 2018. Increases within birth cohorts were the main source of this rise, while cohort replacement partially offset it. Differences in screen time across birth cohorts were shaped by changing demographics and family environments.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Among Perceived Stress, Prenatal Breastfeeding Self-Efficacy, and Breastfeeding Intention Among Pregnant Women in Taiwan.","authors":"Wen-Chung Wang, Yen-Ju Ho, Ya-Fang Teng","doi":"10.1007/s10995-026-04339-z","DOIUrl":"https://doi.org/10.1007/s10995-026-04339-z","url":null,"abstract":"<p><strong>Objectives: </strong>To examine associations among perceived stress, prenatal breastfeeding self-efficacy, and breastfeeding intention among pregnant women in Taiwan.</p><p><strong>Methods: </strong>This cross-sectional study included 200 pregnant women from a prenatal outpatient clinic in central Taiwan. Participants completed the Perceived Stress Scale, Prenatal Breastfeeding Self-Efficacy Scale, and Infant Feeding Intentions Scale. Descriptive, bivariate, and multiple regression analyses were performed.</p><p><strong>Results: </strong>Mean scores were 16.37 (SD = 5.15) for perceived stress, 73.25 (SD = 13.08) for prenatal breastfeeding self-efficacy, and 9.87 (SD = 3.71) for breastfeeding intention. Perceived stress was negatively correlated with prenatal breastfeeding self-efficacy (r = - .36, p < .001) and breastfeeding intention (r = - .18, p = .013), whereas prenatal breastfeeding self-efficacy was positively correlated with breastfeeding intention (r = .29, p < .001). In multiple regression, prenatal breastfeeding self-efficacy (β = 0.17, p = .018), a prenatal plan to breastfeed (β = 0.49, p < .001), and age (β = 0.12, p = .049) were significantly associated with breastfeeding intention, explaining 35% of the variance. In sensitivity analysis excluding the breastfeeding-plan variable, prenatal breastfeeding self-efficacy remained significantly associated with breastfeeding intention (β = 0.29, p < .001).</p><p><strong>Conclusions for practice: </strong>Higher prenatal breastfeeding self-efficacy and a prenatal plan to breastfeed were independently associated with stronger breastfeeding intention, whereas perceived stress was associated with weaker intention only in bivariate analyses. Prenatal care may provide opportunities to assess breastfeeding confidence and discuss feeding plans. Prospective studies are needed to determine whether support targeting these factors improves postpartum breastfeeding outcomes.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding Experiences, Challenges, and Barriers Among Mothers During Hot Weather in Türkiye: A Qualitative Study.","authors":"Fatma Dinç, Aylin Kurt, Emine Güneş Şan","doi":"10.1007/s10995-026-04337-1","DOIUrl":"https://doi.org/10.1007/s10995-026-04337-1","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore mothers' breastfeeding experiences, challenges, and barriers during hot weather in Türkiye.</p><p><strong>Methods: </strong>A qualitative exploratory approach was used in this study. Between August and October 2024, in-depth individual interviews were conducted with mothers who applied to the breastfeeding outpatient clinic at the obstetrics and gynecology hospital in a city in the Western Black Sea region of Türkiye. The sample included 18 mothers who agreed to participate in the study. Thematic analysis was used to analyze the data.</p><p><strong>Results: </strong>Five main themes emerged from the interviews: (1) physical and emotional barriers to breastfeeding, (2) social and privacy barriers to breastfeeding, (3) psychological challenges and support needs, (4) environmental and climatic barriers, and (5) strategies for overcoming breastfeeding barriers. The findings indicate that hot weather conditions are associated with various challenges for mothers, such as physical discomfort, emotional strain, social isolation, and sleep problems. Mothers expressed the need for adequate fluid consumption, appropriate environmental adjustments, and social support; they also highlighted the need for support to cope with the stress and psychological challenges they experience during hot weather conditions.</p><p><strong>Conclusion for practice: </strong>This study shows that hot weather poses significant physical and emotional challenges to the breastfeeding process. In order for mothers to breastfeed comfortably in hot weather conditions, it is important to provide cool environments, increase fluid consumption, establish air-conditioned breastfeeding points in public spaces, expand social support groups, and provide guidance and psychological support from health professionals.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Health Community Engagement: Insights from Statewide Maternal Health Listening Sessions in Alabama.","authors":"Jessica T Chambliss, Kristy C Plump, Britta Cedergren, Anne E Brisendine, Jouri Johnson, Rhiannon Reed, Annie Glover, Matthew Fifolt, Martha S Wingate","doi":"10.1007/s10995-026-04328-2","DOIUrl":"https://doi.org/10.1007/s10995-026-04328-2","url":null,"abstract":"<p><strong>Purpose: </strong>Alabama ranks among the worst states for maternal and infant health outcomes, with maternal mortality rates rising to 56.9 per 100,000 live births between 2018 and 2021. Contributing factors include rural hospital closures, limited obstetric care access, high prevalence of chronic conditions, and lack of Medicaid expansion. To address these disparities, the Alabama Perinatal Quality Collaborative (ALPQC) launched statewide listening sessions to incorporate patient perspectives into maternal health improvement efforts. This study aimed to (1) capture lived experiences of individuals during prenatal, labor/delivery, and postpartum periods; (2) identify barriers and facilitators to maternal health care access and quality in Alabama; and (3) inform clinical, programmatic, and policy strategies to reduce maternal mortality and morbidity through patient-centered approaches.</p><p><strong>Description: </strong>Nine \"What Moms Want\" listening sessions were conducted across Alabama from July to September 2024. Community organizations hosted sessions to ensure geographic and demographic representation, particularly in rural and underserved areas. Participants included mothers, fathers, and support partners. Sessions followed a structured guide addressing prenatal, labor/delivery, and postpartum experiences.</p><p><strong>Assessment: </strong>Over 250 participants shared experiences, with 75.8% identifying as Black. Six major themes emerged: (1) access and continuity of care, (2) education and resources, (3) self-confidence and empowerment, (4) communication and choice, (5) compassion and respect, and (6) gratitude.</p><p><strong>Conclusion: </strong>Listening sessions revealed critical gaps and opportunities for patient-centered strategies to improve maternal health in Alabama. Findings underscore the value of qualitative data in shaping policy, clinical practice, and community engagement.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Weight and Body Mass Index Changes in Women Conceiving with Assisted Reproductive Technologies in Consecutive Pregnancies: A Retrospective Cohort Study.","authors":"Alexa M Sassin, Haleh Sangi-Haghpeykar, Kjersti M Aagaard","doi":"10.1007/s10995-026-04317-5","DOIUrl":"https://doi.org/10.1007/s10995-026-04317-5","url":null,"abstract":"<p><strong>Objectives: </strong>The amount of weight gained during pregnancy can have immediate and long-term effects on the future health of the pregnant person and their offspring. However, longitudinal prospective datasets that allow for interrogation of pre-pregnancy (PP) weight, gestational weight gain (GWG), and weight at time of delivery (DL) over multiple pregnancies are sparse. We sought to examine how these variables vary from pregnancy to pregnancy in women who have conceived more than once with assisted reproductive technologies (ART).</p><p><strong>Methods: </strong>For this retrospective cohort study, we used a longitudinal, prospectively-acquired delivery database from a 2-hospital, single academic institution in Houston, Texas. Women who conceived via ART with 2 subsequent deliveries were identified (n = 109, 218 deliveries). Maternal PP and DL weight & PP and DL BMI were identified. GWG was calculated and used to determine whether parturients achieved the recommended GWG.</p><p><strong>Results: </strong>There was a significant difference in PP weight (kgs) from the first (P1) (66.79 ± 1.68) to the second ART pregnancy (P2) (68.25 ± 1.68) (p = 0.015) as well as a difference in DL weight from P1 (79.88 ± 1.64) to P2 (81.13 ± 1.64) (p = 0.009). Additionally, we found a significant difference in PP BMI (kg/m²) from P1 (24.42 ± 0.6) to P2 (24.93 ± 0.6) (p = 0.02). There were no differences in GWG (p = 0.41) or the percentages of patients who were \"below,\" \"within,\" or \"above\" the recommended GWG in P1 vs. P2 (p = 0.61).</p><p><strong>Discussion: </strong>Participant PP weight, PP BMI, and DL weight increased from P1 to P2 while the overall rates of achieving the recommended GWG did not. Future prospective studies are needed to determine whether prevention of interpregnancy weight gain and optimization of GWG in ART patients are associated with improved maternal and neonatal outcomes.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital Syphilis in Brazil: Municipal Antenatal Care, Primary Health Care Capacity, and Territorial Inequalities, 2015-2024.","authors":"Alice Ramos-Silva, Camila de Melo Carvalho Nascimento, Luis Phillipe Nagem Lopes, Fabiana Rabe Carvalho","doi":"10.1007/s10995-026-04329-1","DOIUrl":"10.1007/s10995-026-04329-1","url":null,"abstract":"<p><strong>Objectives: </strong>To describe spatial patterns of gestational (GS) and congenital syphilis (CS) in Brazil and assess municipal antenatal care, sociodemographic, and primary-care correlates of CS notifications after accounting for GS burden.</p><p><strong>Methods: </strong>We conducted a nationwide ecological study using routinely collected SINAN, SINASC, and CNES data (2015-2024). Spatial analyses used empirical Bayes smoothing, Global Moran's I, and LISA. Associations were estimated with a Bayesian negative-binomial spatiotemporal model including municipal random effects, annually replicated Besag fields, a first-order random walk, and an estimated coefficient for GS burden. Sensitivity analyses evaluated formulations, adjacency, priors, and age composition.</p><p><strong>Results: </strong>Spatial analyses included 55,699 municipality-years from 5,570 municipalities; the primary model included 28,436 observations from 3,625 municipalities. CS showed recurrent high-high clusters in the North and Northeast. Per 10-percentage-point increase, fewer than seven antenatal visits (adjusted ratio 1.10, 95% CrI 1.08-1.11) and births to women recorded as Black or Brown (1.07, 1.06-1.08) were positively associated with expected CS notifications, whereas low maternal education was inversely associated (0.93, 0.92-0.95). Each additional registered Family Health Strategy team per 10,000 population was inversely associated (0.89, 0.87-0.91), although this estimate was model-sensitive. GS elasticity was 0.72 (0.71-0.74); estimates were stable under KNN-5.</p><p><strong>Conclusions for practice: </strong>CS remained spatially concentrated, and municipal antenatal-care utilization, sociodemographic composition, and primary-care capacity were associated with expected CS notifications after accounting for GS burden. These ecological findings may help identify territories where care delivery, primary-care capacity, and surveillance warrant closer assessment. They do not estimate individual transmission risk or establish causal effects.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1304-1313"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and inequalities in vitamin A supplementation coverage among children aged 6-59 months in Sierra Leone: 2008-2019.","authors":"Augustus Osborne, Florence Gyembuzie Wongnaah, Khadijat Adeleye, Camilla Bangura, Umaru Sesay, Bright Opoku Ahinkorah","doi":"10.1007/s10995-026-04316-6","DOIUrl":"10.1007/s10995-026-04316-6","url":null,"abstract":"<p><strong>Background: </strong>Vitamin A deficiency is a major public health concern among young children and is associated with an increased risk of infections, vision impairment, and mortality. We examined the trends and inequalities in vitamin A supplementation coverage among children aged 6-59 months in Sierra Leone between 2008 and 2019.</p><p><strong>Methods: </strong>We analyzed data from the 2008, 2013, and 2019 Sierra Leone Demographic and Health Surveys (SLDHS). Inequalities in Vitamin A supplementation were assessed across age, household economic status, maternal education, place of residence, sex of child, and subnational region. The World Health Organization Health Equity Assessment Toolkit (WHO HEAT) software was used to calculate simple measures of inequality; difference (D) and ratio (R), and complex measures; population attributable risk (PAR) and population attributable fraction (PAF).</p><p><strong>Results: </strong>The national vitamin A supplementation coverage among children aged 6-59 months increased from 25.9% in 2008 to 69.1% in 2019. Age-inequality narrowed, with D changing from - 2.6 percentage points in 2008 to - 0.4 percentage points in 2019. PAF and PAR remained were zero throughout the study period. Economic status disparity increased slightly, with D rising from 8.5 percentage points in 2008 to 9.3 percentage points in 2019 and PAR increasing from 6.1 to 6.6. Inequality by maternal education declined, with D decreasing from 11.1 to 4.9 percentage points and PAR declining from 9.2 to 3.4. Rural-urban inequality also narrowed: D decreased from 4.9 to 1.6 percentage points , while PAR declined from 3.6 to 1.0. Inequality by sex of the child remained minimal, with D changing from 0.2 percentage points in 2008 to - 1.0% percentage points in 2019. Both PAF and PAR were zero. Regional disparity decreased, with D declining from 13.4 to 8.6 percentage points and PAR from 8.0 to 3.5.</p><p><strong>Conclusion: </strong>Vitamin A supplementation coverage among children 6-59 months in Sierra Leone improved substantially between 2008 and 2019. However, coverage remained below the 80% national target, inequalities persisted across socioeconomic and demographic groups, particularly by household economic status and subnational region. Sustained and targeted interventions are needed to reach disadvantage populations, strengthen health infrastructure and service delivery in remote areas, improve caregiver education, and ensure sustainable funding and political commitment to child- health programmes.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1237-1246"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}