ArticleFrontiers in pediatrics2026
Determinants of counseling on neonatal danger signs among women in Somalia: a multilevel mixed-effects logistic regression analysis of the 2020 SDHS.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Neonatal mortality remains a major public health challenge in low- and middle-income countries, including Somalia, where access to maternal health services is limited. Although counseling on neonatal danger signs is essential for early recognition and timely care-seeking, evidence on its coverage and determinants in Somalia remains scarce, particularly using nationally representative data. Methods: A cross-sectional study was conducted using data from the 2020 Somalia Demographic and Health Survey (SDHS). A total of 6,413 women aged 15-49 years with a recent birth were included. A multilevel mixed-effects logistic regression model was employed to identify individual- and community-level determinants of receiving counseling. Adjusted Odds Ratios (AORs) with 95% Confidence Intervals (CIs) were reported. Results: Only 4.35% of women reported receiving counseling on neonatal danger signs. Women in the highest wealth quintile were significantly more likely to receive counseling (AOR = 2.77; 95% CI: 1.60-4.80). Adequate antenatal care utilization was associated with increased odds (AOR = 2.10; 95% CI: 1.40-3.13), while facility-based delivery was the strongest predictor (AOR = 4.49; 95% CI: 3.28-6.14). Conclusion: Counseling on neonatal danger signs in Somalia remains critically low and is characterized by substantial socioeconomic and healthcare access inequalities. Strengthening antenatal care services, promoting facility-based delivery, and addressing equity gaps in access to maternal health services are essential to improve maternal knowledge and neonatal outcomes.
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