Frontiers in global women's health最新文献

{"title":"Correction: Breaking the silence: the role of forensic dentistry in the identification and prevention of violence against women: a systematic review.","authors":"Camille Drouillard, Ana García Navarro","doi":"10.3389/fgwh.2026.1837251","DOIUrl":"https://doi.org/10.3389/fgwh.2026.1837251","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fgwh.2026.1745030.].</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1837251"},"PeriodicalIF":2.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnant women's perspectives on antenatal care utilization in Cameroon: a cross- sectional mixed-methods study.","authors":"Robert Tchounzou, Harisse Ntongamuah Zisuh, André Wambo Simo, Crysantus Yimlefac Nzometia, Théophile Nana Njamen, Gregory Edie Halle Ekane","doi":"10.3389/fgwh.2026.1688295","DOIUrl":"https://doi.org/10.3389/fgwh.2026.1688295","url":null,"abstract":"<p><p>Antenatal care (ANC) is essential for improving maternal and fetal health outcomes, yet utilization remains suboptimal in Cameroon. This study explored pregnant women's perspectives on determinants of ANC utilization and perceived quality of care in the Buea and Limbe Health Districts, conceptualizing satisfaction both as an outcome of service quality and a contextual influence on continued utilization. An explanatory sequential mixed-methods design was employed, comprising a cross-sectional survey of 410 pregnant women attending public, private, and faith-based health facilities, followed by 20 in-depth interviews. Quantitative data were analyzed using descriptive statistics and multivariable logistic regression, while qualitative data were thematically analyzed and integrated through side-by- side comparison. Only 45.6% of participants achieved the World Health Organization-recommended minimum of eight ANC contacts. Adequate utilization was significantly associated with receiving care in public facilities, formal employment, lower parity, and timing of ANC initiation. The association between second-trimester initiation and adequate utilization reflects cumulative attendance patterns rather than optimal timing and should therefore be interpreted cautiously. Key barriers to ANC use included financial constraints, long waiting times, negative provider attitudes, and delayed disclosure of pregnancy. Although overall satisfaction with ANC services was relatively high, dissatisfaction persisted regarding waiting times, indirect costs, and the quality of health education. Qualitative findings highlighted the importance of respectful, nonjudgmental provider behavior, partner support, privacy during consultations, and clear communication in shaping women's engagement with ANC services. Improving ANC utilization and quality in Cameroon requires woman-centered, multisectoral strategies that address financial barriers, promote respectful maternity care, and strengthen community-based health education to encourage early initiation and sustained engagement.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1688295"},"PeriodicalIF":2.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scaling up long-acting reversible contraception through task sharing and capacity building: an implementation science approach in Balsas, Brazil.","authors":"Moazzam Ali, Adriano Bueno Tavares, Liana Bastos Matos Modesto, James Kiarie","doi":"10.3389/fgwh.2026.1673405","DOIUrl":"https://doi.org/10.3389/fgwh.2026.1673405","url":null,"abstract":"<p><strong>Introduction: </strong>The 2015 Zika outbreak crises in Brazil, exposed major challenges in access to contraception services. This report examines outcomes of project aimed at strengthening and studying family planning services in Balsas, Maranhão, an area severely affected by ZIKV.</p><p><strong>Methods: </strong>The project was guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. It followed a structured, four-phase process to systematically design, implement, and sustain evidence-based interventions aimed at enhancing contraceptive service delivery. Key activities included stakeholder engagement, health system assessments, capacity building, cascade training and task sharing from specialists to general practitioners and nurses.</p><p><strong>Results: </strong>The intervention led to significant improvements in utilization of family planning services. The transformation of the Women's Health Program, based at the Dr. Rosy Kury Municipal Hospital in Balsas, into a center of excellence, enabled the introduction and scale-up of previously unavailable services such as IUD insertion and removal. This resulted in approximately 1,468 voluntary IUD insertions within 1 year, a dramatic increase from only eight in the previous 5 years. Task sharing IUD procedures with general practitioners and nurses significantly expanded service coverage. Comprehensive training and mentoring were extended to all 26 primary care facilities in Balsas and to providers in four neighboring municipalities, with a total of 80 providers trained, contributing to increased contraceptive uptake across the region.</p><p><strong>Conclusion: </strong>The structured implementation approach effectively addressed systemic barriers to contraceptive access in a resource-limited setting. By empowering general practitioners and nurses to deliver a broader range of contraceptive methods, the intervention significantly enhanced service delivery. The success of this model highlights its potential for replication in similar contexts and underscores the importance of ongoing capacity building and strengthened health information systems to sustain long-term improvements.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1673405"},"PeriodicalIF":2.4,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation challenges of India's national anaemia reduction program among pregnant women: insights from mixed-methods implementation research.","authors":"Barsha Gadapani Pathak, Pranay Vats, Arun Jadaun, Naveen Garg, Sarmila Mazumder","doi":"10.3389/fgwh.2026.1695442","DOIUrl":"https://doi.org/10.3389/fgwh.2026.1695442","url":null,"abstract":"<p><strong>Introduction: </strong>Anaemia remains a pressing public health concern in low- and middle-income countries, disproportionately affecting pregnant women. In India, despite longstanding national programs like Anaemia Mukt Bharat (AMB) i.e., \"Anaemia free India\". Anaemia prevalence remains alarmingly high with 53% of pregnant women reported to have anemia in India. This percentage is even higher in underperforming districts such as Palwal in Haryana with 56.8% pregnant women being affected by the condition. This implementation research (IR) aimed to identify implementation and contextual barriers to this program across beneficiaries, community health providers, and the health system.</p><p><strong>Methods: </strong>A convergent parallel mixed-methods design was employed as part of Phase I of this IR nested within the Sustainable Scalable Interventions to Improve Maternal and Newborn Health in India (SIIMA) project. Quantitative data were collected from 370 pregnant women and nine public health facilities through structured assessments and programmatic records. Qualitative data were gathered through 35 in-depth interviews and 6 focus group discussions with pregnant and lactating women, and healthcare providers. The Capability Opportunity Motivation-Behaviour (COM-B) model guided qualitative thematic analysis, supplemented with inductive coding. Integration of findings occurred during the interpretation phase, with qualitative insights used to explain patterns and gaps observed in the quantitative data.</p><p><strong>Results: </strong>Only 67% of pregnant women received at least one dose of iron and folic acid (IFA), and just 48.6% had undergone haemoglobin testing. Among women for whom both Hb and IFA data were available, merely 5% received IFA dosages aligned with their anaemia severity, as recommended. Mean IFA consumption in the previous month was far below expected levels, while no participant achieved full compliance. Qualitative findings revealed that while both beneficiaries and frontline providers were aware of anaemia and its risks, adherence was undermined by cultural misconceptions, limited counselling, lack of follow-up systems, and fragmented supply chains. Providers cited knowledge adequacy but were constrained by erratic stock availability, diagnostic gaps, and lack of structured supervision.</p><p><strong>Conclusion: </strong>Despite reasonable awareness and intent, systemic and behavioural challenges impeded AMB implementation. Enhancing supply reliability, strengthening diagnostic, counselling services, and engaging families in decision-making are vital for optimizing program delivery. These findings will inform the development of tailored implementation strategies in Phase II to improve effective coverage and compliance with AMB guidelines in rural India.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1695442"},"PeriodicalIF":2.4,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for a single-arm, prospective mixed-methods feasibility study of a culturally responsive maternal health promotion intervention.","authors":"Jennifer R Budman, Helen Bourke-Taylor","doi":"10.3389/fgwh.2026.1726319","DOIUrl":"https://doi.org/10.3389/fgwh.2026.1726319","url":null,"abstract":"<p><strong>Background: </strong>Maternal mental health is a critical determinant of women's health and family functioning, yet mothers of children with Attention-Deficit/Hyperactivity Disorder (ADHD) experience elevated stress, stigma, and barriers to health-promoting behaviors. These challenges are intensified in culturally conservative communities, where gender-role expectations and limited access to culturally appropriate services restrict engagement with mainstream health care.</p><p><strong>Objective: </strong>This protocol outlines the implementation, and evaluation of a culturally responsive maternal health promotion intervention for Ultra-Orthodox Jewish (UOJ) mothers of children with ADHD. Earlier phases of the Intervention Mapping process, including needs assessment and intervention development, were completed prior to this protocol. The present study focuses on the final two steps of Intervention Mapping, implementation and evaluation, to support that the program is deliverable, acceptable, and sustainable in real-world practice.</p><p><strong>Methods: </strong>This protocol outlines a prospective, single-arm, mixed-methods feasibility study without a control group, to be conducted with UOJ mothers in telehealth-based groups. The six-session program integrates psychoeducation, peer discussion, and action planning, supported by culturally adapted materials and a moderated WhatsApp group. Implementation and acceptability will be evaluated through recruitment, retention, attendance, and structured feedback surveys, supplemented by qualitative focus groups. Intervention outcomes will include maternal stress, ADHD-related knowledge and beliefs, stigma, and engagement in health-promoting activities, assessed using validated instruments. Quantitative data will be analyzed using descriptive and repeated-measures statistics, and qualitative data will undergo thematic analysis.</p><p><strong>Conclusion: </strong>By integrating systematic planning with cultural tailoring, this protocol aims to contribute a model for developing and evaluating women's health interventions in underserved, culturally conservative populations. The study seeks to advance maternal health equity by demonstrating how culturally responsive approaches may reduce barriers, foster engagement, and promote sustainable health-promoting practices.</p><p><strong>Trial status: </strong>Recruitment commenced in November 2024 and remains ongoing at the time of manuscript submission. No interim analyses or outcome data analyses have been conducted at the time of manuscript submission.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1726319"},"PeriodicalIF":2.4,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mixed-methods evaluation of outreach service provision by the \"Strengthening Migrant Access to Reproductive Health in Thailand\" Initiative, 2020-2024.","authors":"Ahmar Hashmi, Ko Ko Aung, Nan San Wai, Prapatsorn Misa, May Myo Thwin, Kanyaw Paw, Suphak Nosten, Mi Wah Jitham, Chanapat Pateekhum, Waraporn Pimpasorn, Boonrid Wongchawengsup, Francois Nosten, Rose McGready","doi":"10.3389/fgwh.2026.1637785","DOIUrl":"https://doi.org/10.3389/fgwh.2026.1637785","url":null,"abstract":"<p><strong>Introduction: </strong>Despite considerable progress, pregnancy-related health outcomes are still below Sustainable Development Goal targets for many low-to-middle-income countries. This study evaluated the Strengthening Migrant Access to Reproductive Health in Thailand (SMARH-T) Initiative that included an outreach service provision (2020-2024) to address upstream determinants of prenatal care and a family planning service provision for undocumented migrant women and newborns along the Thailand-Myanmar border.</p><p><strong>Methods: </strong>This study employed a sequential explanatory mixed-methods design with a quantitative survey followed by qualitative interviews and focus group discussions. Participants were asked about their experiences with the initiative and its delivery of prenatal and family planning services. Implementation outcome frameworks were used to understand the acceptability, end-user satisfaction, appropriateness, feasibility, reach, and sustainability of the initiative.</p><p><strong>Results: </strong>A total of 407 migrant women were surveyed and 17 interviews and discussions with health providers, staff, and stakeholders (<i>n</i> = 98) were conducted. The outreach service provision allowed for comparable convenience (<i>p</i> < 0.001), travel time (<30 min, <i>p</i> < 0.001), and costs (<USD 2.75, <i>p</i> < 0.001) to reach care compared with women receiving services at fixed clinics. A thematic analysis of qualitative data demonstrates the acceptability, appropriateness, and improved reach due to the outreach service provision, despite the logistical and management burden involved. Improved organizational processes for program logistics and administration helped enhance the sustainability of the initiative.</p><p><strong>Discussion: </strong>This mixed-methods evaluation of the SMARH-T Initiative demonstrated high service utilization, satisfaction, and reach for migrant women along the Thailand-Myanmar border. The multipronged approach incorporated reparative strategies to address this particularly vulnerable population in this context.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1637785"},"PeriodicalIF":2.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of plasma exosomal differential proteins and bioinformatics in intrahepatic cholestasis of pregnancy.","authors":"Yuxuan Jiang, Lei Nie, Zhiyuan Liang, Li He, Liming Shen, Danqing Zhao","doi":"10.3389/fgwh.2026.1751936","DOIUrl":"https://doi.org/10.3389/fgwh.2026.1751936","url":null,"abstract":"<p><strong>Introduction: </strong>Intrahepatic cholestasis of pregnancy (ICP) is a gestational liver disorder characterized by maternal pruritus and elevated serum bile acids, which is associated with an increased risk of adverse fetal outcomes. The identification of stage-specific diagnostic markers of ICP is crucial for timely diagnosis and stratified intervention.</p><p><strong>Methods: </strong>This study aimed to identify differentially expressed proteins (DEPs) from patients with ICP at different stages of severity using sequential window acquisition of all theoretical fragment ions (SWATH) proteomics, and to provide preliminary insights into the underlying pathology of the disease. We performed quantitative proteomic profiling of both total exosomes and placenta-derived exosomes isolated from the plasma samples of 35 pregnant women, including 10 with moderate ICP, 10 with severe ICP and 15 healthy controls.</p><p><strong>Results: </strong>SWATH proteomics identified 109 and 46 DEPs in the ICP/CTR comparison for of total exosomes (T-EXO) and placenta-derived exosomes (P-EXO), respectively. Bioinformatics analysis revealed that these proteins are involved in complement activation, blood coagulation and stress responses in pregnant women with ICP. Through the screening of hub proteins, we identified HRG, VWF and PIGR as three key proteins, which were verified by Western blotting.</p><p><strong>Discussion: </strong>We hypothesize that elevated maternal total bile acids (TBA) may induce a fetal stress response, leading to the release of procoagulant factors into the maternal bloodstream. Furthermore, PIGR was consistently upregulated in both plasma and placental exosomes, suggesting its potential involvement in the pathogenesis of ICP.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1751936"},"PeriodicalIF":2.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstetric complications and socio-demographic characteristics associated with severe maternal morbidity at Mbeya Zonal Referral Hospital, Tanzania: a case-control study.","authors":"Erick Justin Mbogoro, Mathew Senga, Rebecca Mokeha","doi":"10.3389/fgwh.2026.1709603","DOIUrl":"https://doi.org/10.3389/fgwh.2026.1709603","url":null,"abstract":"<p><strong>Introduction: </strong>The issue of severe maternal morbidity continues to pose a significant public health challenge globally and has recently emerged as a complementary metric for evaluating the quality of maternal health care. Despite reductions in the maternal mortality ratio in Tanzania, severe maternal morbidity remains a significant threat to women of reproductive age. The aim of this study was to examine obstetric complications and the socio-demographic characteristics that are associated with severe maternal morbidity among women who utilized maternal health services at the Mbeya Zone Referral Hospital in Tanzania.</p><p><strong>Methods: </strong>A facility-based unmatched case-control study was conducted on 768 women (256 cases and 512 controls) at the Mbeya Zonal Referral Hospital in Tanzania. All inpatients fulfilling the criteria of severe maternal morbidity and non-severe maternal morbidity during the study period were eligible for this study. For each identified case, two corresponding women were randomly selected as controls. Bivariate logistic regression analyses were conducted to identify variables for inclusion in the multivariable logistic regression model.</p><p><strong>Results: </strong>The hospital-based severe maternal morbidity incidence ratio was 75.4 per 1,000 live births. Hypertensive and haemorrhagic disorders were the most morbid conditions, comprising 139 (54.3%) and 88 (34.4%), respectively. Women aged 35 years or older (AOR = 2.248, 95% CI: 1.446-3.494), living without a partner (AOR = 2.313, 95% CI: 1.355-3.948) and residing in rural areas (AOR = 2.503, 95% CI: 1.783-3.514) were found to significantly increase the risk of severe maternal morbidity. However, younger women (AOR = 0.480, 95% CI: 0.256-0.890) and those with post-secondary education (AOR = 0.497, 95% CI: 0.297-0.833) revealed a protective effect against severe maternal morbidity.</p><p><strong>Conclusion and recommendations: </strong>Severe maternal morbidity remains a challenging problem in the Southern Highlands of Tanzania. The findings highlight sociodemographic factors, such as age, marital status, education levels, and place of residence, as significant predictors of severe maternal morbidity. Therefore, integrated strategies targeting specific obstetric complications and relevant sociodemographic factors are essential for effective mitigations.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1709603"},"PeriodicalIF":2.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Success and opportunities: maternal mortality and health services in Sierra Leone.","authors":"Kassim Kamara, Bridget Magoba, Tom Sesay, Zainab Bah, Musu Cole, Awol Yemane, Francis Moses, Gebrekrstos Negash Gebru","doi":"10.3389/fgwh.2026.1613691","DOIUrl":"https://doi.org/10.3389/fgwh.2026.1613691","url":null,"abstract":"<p><strong>Introduction: </strong>Sierra Leone has made significant improvements in maternal mortality reduction; however, disparities in maternal healthcare delivery services still exist. This analysis examined the characteristics and disparities in maternal health service indicators and mortality data. The findings guided evidence-based public health interventions and informed the monitoring of their effectiveness.</p><p><strong>Methods: </strong>We conducted a secondary analysis of maternal deaths and health services data reported in the National Maternal Deaths Surveillance and Response (MDSR) system and the District Health Information System (DHIS2) and supplemented it with line lists using Microsoft Excel 2016.from 2019 to 2024. We excluded uninvestigated deaths or deaths with missing key variables. Using QGIS version 3.12.2, and Microsoft Excel 2016, descriptive and spatial analyses were conducted to examine patterns and disparities in maternal health indicators, with findings presented in tables, graphs, and maps.</p><p><strong>Results: </strong>Overall, Maternal Mortality Rate (MMR) for the six years was 216 deaths per 100,000 live births, whereas the MMR from January through November 2024 was 183.8 per 100,000 live births (95% CI: 166-201.6). The MMR declined over the period under review, from 241 per 100,000 live births in 2019 to 184 per 100,000 in 2024. Skilled Birth Attendance (SBA) remained high, averaging 95% throughout the six years, while 36% women (<i>n</i> = 119) attended four or more antenatal care visits. Approximately 40% (<i>n</i> = 769) of the maternal deathsresulted from postpartum hemorrhage.</p><p><strong>Conclusion: </strong>In Sierra Leone, maternal mortality declined over the study period; however, disparities in service utilization persist. While SBA remains high, coverage of at least 4 ANC visits was suboptimal. Postpartum hemorrhage (PPH) was the leading cause of maternal death. Targeted efforts to improve access to quality antenatal and delivery services in high-burden districts, are essential to accelerating reductions in maternal mortality.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1613691"},"PeriodicalIF":2.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual and community-level determinants of skin-to-skin contact in Somaliland: a multilevel analysis of the 2020 demographic and health survey data.","authors":"Awo Mohamed Kahie, Suhaib Mohamed Kahie, Nura Mohamed Omer, Abdirahman Omer Ali, Nima Muhammad, Saralees Nadarajah","doi":"10.3389/fgwh.2026.1717086","DOIUrl":"https://doi.org/10.3389/fgwh.2026.1717086","url":null,"abstract":"<p><strong>Introduction: </strong>Neonatal mortality remains a significant public health challenge in Somaliland. Skin-to-skin contact (SSC) is an evidence-based intervention proven to improve newborn survival and maternal health outcomes. However, its implementation in low-resource settings like Somaliland is often limited. This study aimed to determine the prevalence of SSC and identify the individual and community-level factors associated with its practice between mothers and newborns in Somaliland.</p><p><strong>Method: </strong>This study utilized a cross-sectional design, analyzing secondary data from the 2020 Somaliland Health and Demographic Survey (SLHDS). A weighted sample of 2,139 mothers who had given birth in the preceding three years was included. The primary outcome was the practice of SSC. A multilevel mixed-effects logistic regression model was employed, grouping variables sequentially by geographic/healthcare, individual/child, and socioeconomic categories to account for hierarchical data structure and identify dominant determinants.</p><p><strong>Result: </strong>The prevalence of mother-to-newborn SSC in Somaliland was 23.8%. The multilevel analysis revealed that both community and individual factors significantly influenced this practice. The most dominant determinant of SSC was the place of delivery; mothers delivering at home had 88% lower odds of practicing SSC compared to those delivering in a health facility (AOR = 0.12, 95% CI: 0.09-0.16). Socioeconomically, mothers from the richest households were 75% more likely to practice SSC than those from the poorest households (AOR = 1.75, 95% CI: 1.17-2.61). Maternal healthcare decision-making capacity was a critical factor: the odds of SSC were significantly lower when the husband decided on healthcare alone (AOR = 0.42, 95% CI: 0.30-0.58) compared to when the mother made decisions independently. Compared to newborns perceived as large at birth, those perceived as small had higher odds of receiving SSC (AOR = 1.88, 95% CI: 1.05-3.37). The null model showed a high intraclass correlation coefficient (ICC = 51.7%), justifying the multilevel approach.</p><p><strong>Conclusion: </strong>The practice of SSC in Somaliland is alarmingly low, driven primarily by disparities in healthcare access, household wealth, and maternal decision-making autonomy. Future public health strategies should prioritize specific interventions such as subsidized transport to improve facility-based deliveries, mandate evidence-based SSC training for attendants, and implement targeted community campaigns engaging male leaders to empower women in healthcare decision-making.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1717086"},"PeriodicalIF":2.4,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}