Maternal and Child Health Journal最新文献

{"title":"Fragmented Care and Unmet Needs: A Multi-methods Study of Sexual and Reproductive Health Services in Libya.","authors":"Mariam Omar Elsaltani, Angel M Foster","doi":"10.1007/s10995-026-04323-7","DOIUrl":"10.1007/s10995-026-04323-7","url":null,"abstract":"<p><strong>Objectives: </strong>Prolonged conflict and political instability have severely strained Libya's healthcare system, creating significant gaps in sexual and reproductive health (SRH) services. We aimed to assess the availability and accessibility of comprehensive SRH services in three regions of Libya and identify avenues for improvement.</p><p><strong>Methods: </strong>We conducted this multi-methods qualitative study in Benghazi, Sabha, and Tripoli. Our research included a desk review, a service mapping exercise, 16 in-depth interviews with women of reproductive age, nine focus group discussions involving 60 women, and 11 key informant interviews with healthcare providers, policymakers, and non-governmental organization representatives. We analyzed these data for content and themes using deductive and inductive techniques and triangulated the results.</p><p><strong>Results: </strong>Sexual and reproductive health services are centralized in urban hospitals, leading to overcrowding and limited access in other geographic areas. Although pregnancy and delivery services are available, family planning programs are limited, emergency contraception is virtually absent, and abortion services are restricted to life-threatening cases. Cultural stigma, workforce shortages, disorganized referrals, and government hostility exacerbate barriers to care. Many women turn to the private sector, which is costly and often inadequate for their complex needs.</p><p><strong>Conclusions for practice: </strong>We highlight critical gaps in Libya's SRH service delivery landscape, driven by systemic, infrastructural, and cultural barriers. Decentralizing services, strengthening referral systems, addressing cultural stigma, and improving government responsiveness are essential for advancing equitable access to SRH care and improving health outcomes for Libyan women. Future research should explore long-term strategies to address these challenges in this conflict-affected and fragile setting.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1283-1290"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041382","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":"Barriers and Facilitators to Implementing Evidence-Based Breastfeeding Support in Miami-Dade County Maternity Wards.","authors":"Cynthia Lebron, Vanessa Morales, Alexa Parra, Sydney Litten","doi":"10.1007/s10995-026-04319-3","DOIUrl":"10.1007/s10995-026-04319-3","url":null,"abstract":"<p><strong>Objectives: </strong>This qualitative study assessed the breastfeeding environment across all 12 maternity hospitals in Miami-Dade County, Florida, to identify institutional factors that influence breastfeeding support.</p><p><strong>Methods: </strong>Interviews were conducted with lactation consultants and nurses and analyzed using the Consolidated Framework for Implementation Research (CFIR).</p><p><strong>Results: </strong>Hospitals varied substantially in adherence to Baby-Friendly Hospital Initiative (BFHI) guidelines, regardless of official designation. Participants identified high cesarean rates, staffing shortages, cultural misconceptions, and inconsistent clinical protocols as key barriers to breastfeeding initiation and exclusivity. Despite these challenges, many hospitals employed innovative strategies, such as virtual lactation support and community partnerships, to promote breastfeeding. Notably, lack of prenatal education and limited physician involvement were seen as critical missed opportunities.</p><p><strong>Conclusions for practice: </strong>Results underscore the importance of coordinated, multilevel interventions that align clinical practice, staff training, and patient education. Recommendations from community partner BreastfeedMIAMI highlight the need for expanded lactation coverage, standardized staff training, culturally tailored education, and greater institutional investment. These insights can inform policy and programmatic efforts to foster more equitable, supportive breastfeeding environments in diverse hospital settings.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1247-1261"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008875","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":"Frontline Perspectives: WIC Clinic Emergency Preparedness Following Hurricane Helene.","authors":"Amber Riley, Ella Zhao, Sarah E Scales, Jennifer A Horney","doi":"10.1007/s10995-026-04325-5","DOIUrl":"10.1007/s10995-026-04325-5","url":null,"abstract":"<p><strong>Introduction: </strong>The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) targets nutrition and health behaviors of high-risk populations. WIC is administered by the U.S. Department of Agriculture and provides services in 4 areas: nutrition education, breastfeeding promotion and support, healthy food access, and healthcare and social services referrals.</p><p><strong>Methods: </strong>To better understand services provided and populations served during Hurricane Helene and document personal and organizational preparedness, data were collected via an online survey. Descriptive statistics were used to characterize respondents. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for associations between self-assessed preparedness and need for additional training.</p><p><strong>Results: </strong>Of 95 WIC contacts, 29 responded (30.5%). Of four key WIC services, breastfeeding support was most frequently disrupted (43.5%; n = 10), followed by health care and social service referrals (39.1%; N = 9). Respondents characterized rural residents (47.8%; n = 11) and new clients seeking services (39.1%; n = 9) as most impacted. Respondents with confidence in their organization's ability to respond to a disaster or in their personal knowledge of disaster preparedness were less likely to want additional training. Qualitative responses described challenges providing services to evacuated clients, food security, and internet outages.</p><p><strong>Discussion: </strong>Disaster research has identified \"gendered disaster vulnerability\" as a challenge in emergency preparedness and response. Women and children often face intersectional risks from poverty, social marginalization, and disability in disasters. As such, the WIC workforce should be considered first responders and have access to emergency preparedness planning and training resources at the organizational and individual level.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1219-1226"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041398","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":"Investigating the Relationship Between Highly Collaborative Local Health Jurisdictions and County-Level Perinatal Health Outcomes.","authors":"Amelia L Mitchell, Taryn A G Quinlan, Glen P Mays","doi":"10.1007/s10995-026-04321-9","DOIUrl":"10.1007/s10995-026-04321-9","url":null,"abstract":"<p><strong>Objectives: </strong>Clarifying how cross-sector collaboration relates to perinatal health outcomes is essential in establishing tools to improve maternal and infant health. This study aims to establish if residence in a highly collaborative local health jurisdiction relates to one's probability of experiencing poor perinatal health outcomes.</p><p><strong>Methods: </strong>We measured collaboration between local health departments and social service organizations using data from the 2018 National Longitudinal Survey of Public Health Systems (NALSYS). We then used Latent Class Analysis to identify high and low collaborating counties, followed by multiple logistic regressions to assess the probability of six selected perinatal health outcomes among those residing in high and low collaborating counties at the time of labor and delivery. Health outcome data was selected from the 2018 National Vital Statistics System (NVSS) data.</p><p><strong>Results: </strong>Using a national sample of local health departments across the United States, we found significant racial differences in the association between residence in a high collaborating county and the probability of poor perinatal health outcomes. White women experienced a lower probability of poor perinatal health outcomes if they resided in a high versus a low collaborating county, whereas the inverse was true for Black women. When stratified by payer, privately insured individuals had a lower risk of gestational diabetes if they resided in a high collaborating county, whereas those covered by Medicaid saw little to no effect.</p><p><strong>Conclusions for practice: </strong>These results suggest that local health jurisdictions should give greater attention to the needs of historically marginalized populations when planning and implementing collaborative activities to address community health needs.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1262-1272"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018385","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":"Perceived Child Vulnerability and Protective Behavior by Parents of Children with Chronic Kidney Disease.","authors":"Elke De Bruyne, Sunny Eloot, Lore Willem, Koen Van Hoeck, Johan Vande Walle, Ann Raes, Wim Van Biesen, Liesbet Goubert, Eline Van Hoecke, Evelien Snauwaert","doi":"10.1007/s10995-026-04313-9","DOIUrl":"10.1007/s10995-026-04313-9","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic kidney disease (CKD) in childhood not only impacts the child itself, but may also result in higher stress and anxiety in parents. This study aims to assess whether these parents perceive their child as more vulnerable and use more protective parenting behavior, compared to parents of healthy children. Additionally, it explores the associations of perceived child vulnerability (PCV) and overprotection (OP) with parenting stress and anxiety, and various clinical and sociodemographic variables.</p><p><strong>Methods: </strong>Both parent groups completed a sociodemographic questionnaire, the Child Vulnerability Scale, and the Parental Overprotection Scale. The Parenting Stress Index-Short Form and the Hospital Anxiety and Depression Scale were simultaneous collected but analyzed and reported before.</p><p><strong>Results: </strong>The study included 45 parents (32 mothers) of 45 CKD patients (ages 0-18; median age 8; 16 girls). Compared with the control group (N = 45; 35 mothers), parents of CKD patients perceived their children as more vulnerable but did not exhibit higher levels of overprotective behavior. In the CKD group, parenting stress and anxiety were positively correlated with PCV, and medical comorbidities in the child were associated with higher PCV.</p><p><strong>Conclusions for practice: </strong>Parents of CKD patients perceive their children as more vulnerable than parents of healthy children, yet they do not exhibit higher levels of overprotectiveness. Higher PCV was associated with increased parenting stress and anxiety, especially in parents of children with medical comorbidities. These findings underscore the importance of implementing psychosocial interventions targeting these parental adjustment outcomes in pediatric nephrology departments.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1227-1236"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931576","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":"Association of Mandatory COVID-19 Lockdown Exposure with Increased Maternal Prenatal Smoking and Reduced Fetal Head Growth: A Retrospective Cohort Study.","authors":"Luciana Simes, Sofía Salguero, Rosario Alonso, Eduardo Cuestas","doi":"10.1007/s10995-026-04322-8","DOIUrl":"10.1007/s10995-026-04322-8","url":null,"abstract":"<p><strong>Objectives: </strong>Maternal psychological distress during COVID-19 has been linked to reduced neonatal brain volume. This study aimed to determine whether mandatory COVID-19 lockdown exposure was associated with reduced fetal head growth and to identify maternal, behavioral, and obstetric factors associated with this relationship.</p><p><strong>Methods: </strong>A retrospective cohort study compared pregnancies during mandatory COVID-19 lockdown (March-December 2020) with the corresponding 2019 period. Women with SARS-CoV-2 infection, multiple gestations, and congenital anomalies or infections were excluded. The primary outcome was third-trimester fetal head circumference (HC) z-score. Covariates included maternal demographic, obstetric, and clinical factors, including prenatal smoking (consistent reporting at every prenatal visit). Linear mixed-effects models with interaction terms were used.</p><p><strong>Results: </strong>A total of 1,116 pregnancies (545 exposed, 571 unexposed) were included. Lockdown exposure was associated with greater weight gain (11 vs. 10 kg, p < 0.01), higher prenatal smoking (6.1% vs. 1.2%, p < 0.01), more hypertensive disorders (7.2% vs. 4.4%, p = 0.04), and longer gestation (39.1 vs. 39.0 weeks, p < 0.01), plus lower third-trimester fetal HC z-scores (0.7 vs. 0.9, p < 0.01). The interaction between lockdown exposure and prenatal smoking was independently associated with reduced fetal HC (β = -1.6; 95% CI, -2.7 to -0.4; P = 0.03); smoking alone was not significant (β = -5.2; P = 0.24).</p><p><strong>Conclusions for practice: </strong>Mandatory COVID-19 lockdown exposure was associated with reduced fetal head growth, in interaction with increased prenatal smoking, highlighting the need for targeted smoking-cessation support during public health emergencies.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1273-1282"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888181","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":"Comparing Approaches to Measuring Prospective Fertility Desires in the United States: A Population-based Study.","authors":"Brooke W Bullington, Isabel Muñoz, Corinne H Rocca","doi":"10.1007/s10995-026-04327-3","DOIUrl":"10.1007/s10995-026-04327-3","url":null,"abstract":"<p><strong>Objectives: </strong>Fertility desires are central to reproductive health, yet researchers lack consensus on how to best measure them. We compared participants' responses to three individual questions - Timing (\"How do you feel about having a child now or sometime in the future?\"), Importance (\"How important is it to you to avoid becoming pregnant now?\"), and Wantedness (\"Do you want to become pregnant in the next year?\") - to responses to the 14-item Desire to Avoid Pregnancy (DAP) scale, a psychometrically valid measure of pregnancy preferences.</p><p><strong>Methods: </strong>We analyzed data from the Surveys of Women, population-based longitudinal studies of reproductive-aged females in nine US states. We used multinomial logistic regression to generate predicted responses to each individual question by DAP score, and logistic regression to estimate annual incident pregnancy for each approach.</p><p><strong>Results: </strong>While responses to individual fertility desire questions aligned with DAP scores, the approaches yielded substantially different categorizations. The lowest and highest categories of Timing, Importance, and Wantedness largely captured individuals with low and high DAP scores, respectively. However, the highest categories also included large proportions of individuals with a moderate preference to avoid pregnancy (Timing: 45% of those with mid-range DAP scores, Importance: 43%, Wantedness: 70%). Similarly, the non-polar categories of the individual fertility desire questions included individuals across wide ranges of DAP scores.</p><p><strong>Conclusions for practice: </strong>Asking about wanting pregnancy can identify those most open to pregnancy but does not differentiate fertility preferences among individuals not explicitly desiring pregnancy, which is most people. While single questions are efficient, lack of measurement precision or evidence that they accurately categorize respondents is a compelling drawback to their use.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1291-1303"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116762","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":"Multivariate Analysis of Indicator-Specific Determinants of Childhood Malnutrition in Rajasthan, India: Evidence from NFHS-5.","authors":"Prashant Verma, Shagun Khare, Mukti Khetan, R Preetha","doi":"10.1007/s10995-026-04309-5","DOIUrl":"10.1007/s10995-026-04309-5","url":null,"abstract":"<p><strong>Background: </strong>Childhood malnutrition remains a major public health challenge with significant implications for child survival and development. Understanding the differential determinants of stunting, wasting, and underweight is essential for designing targeted interventions.</p><p><strong>Objective: </strong>To identify and analyze factors associated with stunting, wasting, and underweight among children under five years in Rajasthan, India, using data from the National Family Health Survey (NFHS-5, 2019-21).</p><p><strong>Methods: </strong>A cross-sectional study was conducted using data on 12,549 children aged 0-59 months. Nutritional outcomes were defined using the WHO Child Growth Standards. Multivariate logistic regression analyses were performed separately for stunting, wasting, and underweight to assess their associations with socio-demographic and maternal factors.</p><p><strong>Results: </strong>The prevalence of stunting, wasting, and underweight was 32.14%, 16.78%, and 25.71%, respectively. Female children had significantly lower odds of all three malnutrition indicators compared to males. Socioeconomic status was a consistent determinant, with children from poorer households exhibiting higher odds across all outcomes. Urban residence was associated with reduced odds of wasting, but not of stunting. Higher birth order was significantly associated with increased odds of stunting and underweight, but not wasting. Low birth weight was significantly associated with wasting and underweight, but not with stunting. Maternal education showed a protective effect only against underweight. Caste was associated with wasting and underweight but not stunting. No significant associations were observed for maternal anemia or maternal age at childbirth.</p><p><strong>Conclusions: </strong>Determinants of childhood malnutrition vary across stunting, wasting, and underweight, highlighting the need for indicator-specific interventions. Policies should focus on reducing socioeconomic inequalities, improving maternal education, and addressing risks associated with low birth weight to combat child malnutrition effectively.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1152-1160"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726156","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":"Trends and Determinants of Unmet Need for Family Planning Among Adolescent Girls and Young Women Aged 15-24 Years in Nepal: Evidence from Three Demographic and Health Surveys.","authors":"Mamta Verma, Ganesh Bhandari, Amit Timilsina, Wayne Gao, Mattia Sanna","doi":"10.1007/s10995-026-04311-x","DOIUrl":"10.1007/s10995-026-04311-x","url":null,"abstract":"<p><strong>Introduction: </strong>Unmet need for family planning (UNFP) among adolescent girls and young women (AGYW) remains a major public health concern because it contributes to unintended pregnancy and adverse reproductive health outcomes. Although Nepal has expanded family planning programs over the past decade, evidence on trends and factors associated with UNFP among AGYW is limited. This study assessed trends and factors associated with UNFP among currently married AGYW aged 15-24 years using nationally representative data from the 2011, 2016, and 2022 Nepal Demographic and Health Surveys.</p><p><strong>Study design: </strong>Data from currently married AGYW aged 15-24 years were analyzed. UNFP was categorized as unmet need for spacing or limiting, defined as non-use of contraception despite intending to delay or stop childbearing. A binary overall UNFP variable (no unmet need vs. total unmet need) and a multinomial UNFP variable (no unmet need, unmet need for spacing and unmet need for limiting) were analyzed. In the first case, modified Poisson regression with robust standard errors was used to estimate Adjusted Prevalence Ratios (aPRs), while, in the second case, multinomial logistic regression was performed to calculate adjusted Relative Risk Ratios (RRR) for UNFP related to spacing and limiting needs, compared to no UNFP. All statistical analyses were performed using R version 4.6.1.</p><p><strong>Results: </strong>Overall UNFP declined from 39.1% (95% CI: 36.5-41.7) in 2011 to 29.0% (95% CI: 26.6-31.3) in 2022. In the Poisson regression analysis, AGYW with one living child (2022: aPR = 1.67, 95% CI: 1.36-2.06) or two or more living children (2022: aPR = 1.65, 95% CI: 1.29-2.11) and those living in female-headed households (2022: aPR = 1.20, 95% CI: 1.04-1.37) had a higher prevalence of overall UNFP, whereas AGYW from rich households had a lower prevalence (2022: aPR = 0.69, 95% CI: 0.57-0.84). Multinomial regression showed that AGYW aged 20-24 years were less likely to report unmet need for spacing than those aged 15-19 years in 2016 (RRR = 0.67, 95% CI: 0.51-0.88). AGYW with one living child were more likely to report unmet need for spacing (2022: RRR = 1.86, 95% CI: 1.37-2.52), whereas those desiring three or more children were less likely to report unmet need for limiting (2022: RRR = 0.47, 95% CI: 0.24-0.93).</p><p><strong>Conclusion: </strong>Despite a decline in UNFP among married AGYW between 2011 and 2022, nearly three in ten still reported UNFP in 2022, indicating a persistently high burden. Reducing this gap requires youth-friendly contraceptive counselling, improved access to preferred contraceptive methods, stronger FCHV-facility referral linkages, greater male involvement and couple-based family planning counselling, and interventions that address socioeconomic barriers and support informed fertility decision-making.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1167-1180"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708117","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":"Completion of the National Childhood Immunization Schedule and Associated Factors Among Children Aged 24-35 Months in Afghanistan: A Nationwide Analysis of MICS 2022-23.","authors":"Omid Dadras, Muhammad Haroon Stanikzai, Essa Tawfiq, Massoma Jafari","doi":"10.1007/s10995-026-04318-4","DOIUrl":"10.1007/s10995-026-04318-4","url":null,"abstract":"<p><strong>Background: </strong>Childhood immunization coverage remains low in Afghanistan, but evidence is limited regarding completion of the broader national immunization schedule beyond the first year of life. This study estimated full-schedule immunization coverage and examined factors associated with its completion among Afghan children aged 24-35 months.</p><p><strong>Methods: </strong>We analysed nationally representative data from the Afghanistan Multiple Indicator Cluster Survey (MICS) 2022-23, including 6342 children aged 24-35 months. Full immunization was defined according to the MICS TC.11b indicator for completion of all vaccinations included in the national childhood immunization schedule. Survey-weighted analyses estimated vaccine-specific coverage, within-series dropout and provincial variation. A prespecified survey-weighted multivariable logistic regression model was used to identify factors associated with full-schedule completion.</p><p><strong>Results: </strong>Only 16.2% (95% CI 14.7-17.7) of children had completed the full national immunization schedule. Coverage was particularly low for Inactivated Poliovirus Vaccine (IPV2) (24.6%) and measles-containing vaccine (MCV)- 2 (36.8%), and 49.2% of children who had received IPV1 had not received IPV2. Full-schedule completion varied markedly across provinces, from 3.1 to 37.7%. In the adjusted analysis, maternal primary education (AOR 1.55, 95% CI 1.11-2.19) and secondary or higher education (AOR 1.72, 95% CI 1.15-2.57), paternal primary education (AOR 1.68, 95% CI 1.13-2.50) and secondary or higher education (AOR 1.94, 95% CI 1.48-2.55), and maternal mobile-phone ownership (AOR 1.29, 95% CI 1.03-1.61) were associated with greater odds of full-schedule completion.</p><p><strong>Conclusion: </strong>Completion of the national childhood immunization schedule remains very low in Afghanistan, with substantial attrition across multi-dose vaccine series and marked geographical variation. Strengthening continuity of vaccination, follow-up for later doses, and accessible family-focused vaccination communication may help improve schedule completion.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1205-1217"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882286","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}