{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:47:17Z","timestamp":1791870437500,"version":"4.3.4"},"reference-count":34,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"unspecified","delay-in-days":285,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prim Health Care Res Dev"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1463423626101972_as1\">\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>This study aimed to examine the prevalence and predictors of immediate mother\u2013newborn skin-to-skin contact (SSC) in Malawi and factors associated with missed SSC despite being delivered in health facilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423626101972_as2\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>SSC immediately after birth is an evidence-based essential newborn care intervention associated with improved thermoregulation, early breastfeeding initiation, maternal\u2013infant bonding, and neonatal survival. Although facility delivery is expected to promote SSC, a substantial proportion of newborns in low- and middle-income countries still do not receive this recommended practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423626101972_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We analysed data from the Malawi Demographic and Health Survey 2024. After restricting to the most recent live birth per woman and applying a complete-case approach across the outcome and all explanatory variables, the final analytic sample comprised 6,065 mother\u2013newborn pairs (weighted sample: 6,142). The outcome was maternal report of immediate SSC after birth. Weighted descriptive statistics, chi-square tests, and multilevel logistic regression were used to identify factors associated with SSC. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) are reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423626101972_as4\">\n                    <jats:title>Findings:<\/jats:title>\n                    <jats:p>Overall, 77.3% of newborns experienced SSC. In the fully adjusted model, caesarean delivery (aOR = 0.13, 95% CI: 0.10\u20130.17) and multiple births (aOR = 0.47, 95% CI: 0.26\u20130.86) were associated with lower adjusted odds of receiving SSC. Institutional delivery (aOR = 5.20, 95% CI: 1.86\u201314.56) and antenatal care attendance were associated with higher adjusted odds of receiving SSC. Among institutional deliveries, caesarean delivery and multiple births (aOR = 0.44, 95% CI: 0.24\u20130.80) remained associated with lower odds of receiving SSC. Cluster-level variation was substantial (ICC = 0.172\u20130.173).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1463423626101972","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:21:45Z","timestamp":1791868905000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of immediate mother\u2013newborn skin-to-skin contact and missed contact in health facilities in Malawi: a multilevel analysis of the Malawi Demographic and Health Survey-2024"],"prefix":"10.1017","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8155-1841","authenticated-orcid":false,"given":"Redson","family":"Mwandama","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04vtx5s55","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Malawi, Zomba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kadzandira","sequence":"additional","affiliation":[{"name":"Centre for Social Research, University of Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8459-051X","authenticated-orcid":false,"given":"Ben Kalukuni","family":"Lwanja","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04vtx5s55","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Malawi, Zomba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4900-5261","authenticated-orcid":false,"given":"Sydney","family":"Nkhoma","sequence":"additional","affiliation":[{"name":"Lilongwe University of Agriculture and Natural Resources"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2403-9033","authenticated-orcid":false,"given":"Margubur","family":"Rahaman","sequence":"additional","affiliation":[{"name":"MAMTA Health Institute for Mother and Child"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"S1463423626101972_ref13","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.14.04114"},{"key":"S1463423626101972_ref14","volume-title":"Data Analysis Using Regression and Multilevel\/Hierarchical Models","author":"Gelman","year":"2007"},{"key":"S1463423626101972_ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-019-4176-5"},{"key":"S1463423626101972_ref3","doi-asserted-by":"publisher","DOI":"10.1002\/0470114754"},{"key":"S1463423626101972_ref24","doi-asserted-by":"publisher","DOI":"10.1093\/inthealth\/ihad114"},{"key":"S1463423626101972_ref20","volume-title":"Statistical Analysis with Missing Data","author":"Little","year":"2019"},{"key":"S1463423626101972_ref23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0272444"},{"key":"S1463423626101972_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e29732"},{"key":"S1463423626101972_ref4","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-018-1033-y"},{"key":"S1463423626101972_ref16","volume-title":"Applied Survey Data 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of Nigerian women using the 2018 demographic health survey","volume":"5","author":"Obioha","year":"2021","journal-title":"Journal of Global Health 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Development"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1463423626101972","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:21:47Z","timestamp":1791868907000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1463423626101972\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":34,"alternative-id":["S1463423626101972"],"URL":"https:\/\/doi.org\/10.1017\/s1463423626101972","relation":{},"ISSN":["1463-4236","1477-1128"],"issn-type":[{"value":"1463-4236","type":"print"},{"value":"1477-1128","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e125"}}