{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T16:09:43Z","timestamp":1791648583204,"version":"4.3.4"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009828","name":"Universit\u00e4t Erfurt","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009828","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Maternal and child mortality rates remain unacceptably high in fragile and conflict-affected settings, where insecurity, displacement, and systemic disruption hinder access to healthcare. Nigeria is one of the countries most severely affected, and continues to experience widespread maternal and neonatal deaths despite global and national efforts to achieve SDG 3.1. This study explored stakeholders\u2019 perspectives on how armed conflicts shapes maternal and child health-seeking behaviours and outcomes in northeastern Nigeria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative approach was employed, involving Key Informant Interviews with healthcare workers, community leaders, local officials, and caregivers in three fragile and conflict-affected states: Adamawa, Borno and Yobe. These semi-structured interviews explored access to and quality of care, barriers to seeking healthcare, vaccination practices and community trust. The audio recordings were transcribed and translated, then analysed thematically in accordance with Braun and Clarke\u00b4s approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The analysis identified five interrelated themes on how armed conflict shaped maternal and child healthcare seeking behavior. Prolonged insecurity generated psychological trauma, stress-related illnesses, malnutrition, and infectious disease outbreaks, particularly in Internally Displaced Camps. Health systems collapsed due to facility destruction, workforce flight, and drug shortages, limiting service availability. Access was further constrained by poverty, insecurity, transport barriers, gender norms, low literacy, and negative provider attitudes. These challenges contributed to unsafe deliveries, increased maternal and child mortality, declining immunisation coverage, and a heightened fear of vaccine side effects amid misinformation. While trust in frontline health workers often persisted, confidence in government institutions declined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Armed violent conflict undermines maternal and child health through compounded psychosocial, structural, and behavioural pathways. To restore equitable service use in conflict-affected settings, it is essential to leverage residual trust in local healthcare workers, alongside community-based, conflict-sensitive strategies that address issues such as fear, costs, gender norms, transport and vaccine misinformation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-026-27385-2","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T05:37:30Z","timestamp":1776404250000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Health-seeking in fragile and conflict-affected settings: how armed violent conflict shapes maternal and child health-seeking behaviours"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5398-0183","authenticated-orcid":false,"given":"Gbadebo Collins","family":"Adeyanju","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Abreu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Schrage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Brinkel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabiu I.","family":"Jalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musa Muhammad","family":"Bello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aminatu A.","family":"Kwaku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisha Aliyu","family":"Abulfathi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Ibrahim","family":"Jalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Mahmud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Schaub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"27385_CR1","unstructured":"World Health Organisation, UNICEF, United Nations Population Fund and the World Bank. Trends in maternal mortality: 2000 to 2020. WHO Gevenva. 2023. Available at: https:\/\/www.who.int\/publications\/i\/item\/9789240068759. Retrieved 15\/12\/2025."},{"key":"27385_CR2","doi-asserted-by":"publisher","unstructured":"Alibhai KM, Ziegler BR, Meddings L, Batung E, Luginaah I. Factors impacting antenatal care utilization: a systematic review of 37 fragile and conflict-affected situations. Confl Health. 2022;16(33). https:\/\/doi.org\/10.1186\/s13031-022-00459-9. https:\/\/conflictandhealth.biomedcentral.com\/articles\/10.1186\/s13031-022-00459-9.","DOI":"10.1186\/s13031-022-00459-9"},{"issue":"4","key":"27385_CR3","doi-asserted-by":"publisher","first-page":"440","DOI":"10.3390\/ijerph21040440","volume":"21","author":"MA Lateef","year":"2024","unstructured":"Lateef MA, Kuupiel D, Mchunu GG, Pillay JD. Utilization of antenatal care and skilled birth delivery services in Sub-Saharan Africa: a systematic scoping review. Int J Environ Res Public Health. 2024;21(4):440. https:\/\/doi.org\/10.3390\/ijerph21040440. https:\/\/www.mdpi.com\/1660-4601\/21\/4\/440.","journal-title":"Int J Environ Res Public Health"},{"issue":"10","key":"27385_CR4","doi-asserted-by":"publisher","first-page":"e012464","DOI":"10.1136\/bmjgh-2023-012464","volume":"8","author":"RF Afolabi","year":"2023","unstructured":"Afolabi RF, Salawu MM, Bamgboye EA, Bello S, Adebowale AS, Dairo MD, Kabwama SN, Wanyana I, Kizito S, Ndejjo R, Wanyenze RK, Fawole OI. Regional differences in the utilisation of antenatal care and skilled birth attendant services during the COVID-19 pandemic in Nigeria: an interrupted time series analysis. BMJ global health. 2023;8(10):e012464. https:\/\/doi.org\/10.1136\/bmjgh-2023-012464. https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10603444\/.","journal-title":"BMJ global health"},{"issue":"Suppl 1","key":"27385_CR5","doi-asserted-by":"publisher","first-page":"e003750","DOI":"10.1136\/bmjgh-2020-003750","volume":"5","author":"M Munyuzangabo","year":"2021","unstructured":"Munyuzangabo M, Gaffey MF, Khalifa DS, Als D, Ataullahjan A, Kamali M, Jain RP, Meteke S, Radhakrishnan A, Shah S, Siddiqui FJ, Bhutta ZA. Delivering maternal and neonatal health interventions in conflict settings: a systematic review. BMJ Global Health. 2021;5(Suppl 1):e003750. https:\/\/doi.org\/10.1136\/bmjgh-2020-003750. https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC7903125\/.","journal-title":"BMJ Global Health"},{"key":"27385_CR6","unstructured":"Adejoro L. Child mortality rate drops globally, as funding cuts threaten progress \u2013 UN report. Punch New Online; 2025. Available at: https:\/\/punchng.com\/child-mortality-rate-dropsglobally-as-funding-cuts-threaten-progress-un-report\/. Retrieved 02\/12\/2025."},{"key":"27385_CR7","unstructured":"UNICEF. Maternal and newborn health: Newborns and mothers are still dying in appalling numbers \u2013 mostly from preventable causes. UNICEF. 2025a. https:\/\/www.unicef.org\/health\/maternal-and-newborn-health. Retrieved 24\/03\/2025."},{"key":"27385_CR8","doi-asserted-by":"publisher","first-page":"103906","DOI":"10.1016\/j.midw.2023.103906","volume":"129","author":"GM Gedef","year":"2024","unstructured":"Gedef GM, Girma B, Andualem F, Gashaw A, Tibebu NS. Antenatal care utilization and its determinants in fragile and conflict-affected situations in Sekota Zuria District, Northern Ethiopia, 2022: a community-based cross-sectional study. Midwifery. 2024;129:103906. https:\/\/doi.org\/10.1016\/j.midw.2023.103906. https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0266613823003091.","journal-title":"Midwifery"},{"key":"27385_CR9","doi-asserted-by":"publisher","first-page":"e2023070","DOI":"10.29392\/001c.88917","volume":"7","author":"ML Ajegbile","year":"2023","unstructured":"Ajegbile ML. Closing the gap in maternal health access and quality through targeted investments in low-resource settings. J Global Health Rep. 2023;7:e2023070. https:\/\/doi.org\/10.29392\/001c.88917.","journal-title":"J Global Health Rep"},{"key":"27385_CR10","unstructured":"WHO. World Health Day 2025 to spotlight women and babies\u2019 survival, urging solidarity at a critical moment for global health. World Health Organization. 2025b. https:\/\/www.who.int\/news\/item\/21-02-2025-world-health-day-2025-to-spotlight-women-and-babies--survival--urging-solidarity-at-a-critical-moment-for-global-health. Retrieved 24\/03\/2025."},{"key":"27385_CR11","doi-asserted-by":"publisher","first-page":"2840","DOI":"10.1186\/s12889-024-20314-1","volume":"24","author":"M Tsadik","year":"2024","unstructured":"Tsadik M, Teka H, Gebremichael MW, Gebretnsae H, Yemane A, Fisseha G, Gebregzabher T, Buruh G, Gebresellasie F, Tekie M, Kiros G, Mehari M, Tewelde B, Alemayehu Y, Tesfay FH, Godefay H. Armed conflict and maternal health service utilization in Ethiopia\u2019s Tigray Region: a community-based survey. BMC Public Health. 2024;24:2840. https:\/\/doi.org\/10.1186\/s12889-024-20314-1. https:\/\/healthynewbornnetwork.org\/hnn-content\/uploads\/s12889-024-20314-1.pdf.","journal-title":"BMC Public Health"},{"key":"27385_CR12","unstructured":"UNICEF. Immunization and conflict: children everywhere, in any situation or circumstance, have the right to survive and thrive. UNICEF. 2025. https:\/\/www.unicef.org\/immunization\/immunization-and-conflict. Retrieved 25\/03\/2025."},{"issue":"4","key":"27385_CR13","doi-asserted-by":"publisher","first-page":"211","DOI":"10.15171\/ijhpm.2018.127","volume":"8","author":"J Grundy","year":"2019","unstructured":"Grundy J, Biggs BA. The Impact of Conflict on Immunisation Coverage in 16 Countries. Int J health policy Manage. 2019;8(4):211\u201321. https:\/\/doi.org\/10.15171\/ijhpm.2018.127. https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6499911\/.","journal-title":"Int J health policy Manage"},{"key":"27385_CR14","doi-asserted-by":"publisher","first-page":"11085","DOI":"10.1038\/s41598-023-37947-8","volume":"13","author":"AN Sbarra","year":"2023","unstructured":"Sbarra AN, Rolfe S, Haeuser E, et al. Estimating vaccine coverage in conflict settings using geospatial methods: a case study in Borno state, Nigeria. Sci Rep. 2023;13:11085. https:\/\/doi.org\/10.1038\/s41598-023-37947-8.","journal-title":"Sci Rep"},{"key":"27385_CR15","unstructured":"Banyaro S. Nigerian women in conflict zones battle maternal mortality crisis. HumAngle Media. 2024. https:\/\/humanglemedia.com\/nigerian-women-in-conflict-zones-battle-with-maternal-mortality-crisis\/#:~:text=The%20report%20stressed%20that%20although,Haruna%20Mshellia%20said%20in%202017. Accessed 27 Mar. 2026."},{"key":"27385_CR16","doi-asserted-by":"crossref","unstructured":"Souza JP, Day LT, Rezende-Gomes AC, Zhang J, Mori R, Baguiya A, Jayaratne K, Osoti A, Vogel JP, Campbell O, Mugerwa KY, Lumbiganon P, Tuncalp O, Cresswell J, Say L, Moran AC, Oladapo OT. A global analysis of the determinants of maternal health and transitions in maternal mortality. The Lancet Global Health. 2024;12(2):e306-e316. https:\/\/www.thelancet.com\/journals\/langlo\/article\/PIIS2214-109X(23)00468-0\/fulltext.","DOI":"10.1016\/S2214-109X(23)00468-0"},{"key":"27385_CR17","doi-asserted-by":"publisher","unstructured":"Krippendorff K. Content Analysis: an introduction to its methodology. 3rd Edition. Sage. 2019. https:\/\/doi.org\/10.4135\/9781071878781.","DOI":"10.4135\/9781071878781"},{"key":"27385_CR18","unstructured":"VERBI Software. MAXQDA 2022 [computer software]. 2021. https:\/\/www.maxqda.com."},{"key":"27385_CR19","doi-asserted-by":"publisher","unstructured":"Clarke V, Braun V, Saunders B, Kitzinger J, Kitzinger C. Thematic analysis. J Posit PsychologyQualitative Res. 20162014;12(3):297\u20138. https:\/\/doi.org\/10.1080\/17439760.2016.1262613.","DOI":"10.1080\/17439760.2016.1262613"},{"key":"27385_CR20","first-page":"3","volume":"24","author":"A Gebreyesus","year":"2024","unstructured":"Gebreyesus A, Niguse AT, Shishay F, Mamo L, Gebremedhin T, Tsegay K, Gebremariam AG, Kidanu KG, Gidey S. Tesfay, Fisaha. Prevalance of depression and associated factors among community hosted internally displaced people of Tigray; during war and siege. MBC Psychiatry. 2024;24:3.","journal-title":"MBC Psychiatry"},{"key":"27385_CR21","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1186\/s12905-024-03177-x","volume":"24","author":"Y Sarikhani","year":"2024","unstructured":"Sarikhani Y, Najibi SM, Razavi Z. Key barriers to the provision and utilization of maternal health services in low- and lower-middle-income countries: a scoping review. BMC Womens Health. 2024;24:325.","journal-title":"BMC Womens Health"},{"issue":"9","key":"27385_CR22","doi-asserted-by":"publisher","first-page":"e1003810","DOI":"10.1371\/journal.pmed.1003810","volume":"18","author":"M Jawad","year":"2021","unstructured":"Jawad M, Hone T, Vamos EP, Cetorelli V, Millett C. Implications of armed conflict for maternal and child health: a regression analysis of data from 181 countries for 2000\u20132019. PLoS Med. 2021;18(9):e1003810.","journal-title":"PLoS Med"},{"key":"27385_CR23","doi-asserted-by":"publisher","unstructured":"Adeyanju GC, Schrage P, Jalo RI, Abreu L, Schaub M. Armed violent conflict and healthcare-seeking behavior for maternal and child health in sub-Saharan Africa: a systematic review. PLoS One. 2025a;20(2):e0317094. https:\/\/doi.org\/10.1371\/journal.pone.0317094.","DOI":"10.1371\/journal.pone.0317094"},{"key":"27385_CR24","doi-asserted-by":"publisher","unstructured":"Schaub M, Adeyanju GC, Abulfathi AA, Bello MM, Kasserra L, Kwaku AA, Jalo MI, Mahmud A, Schrage P, Jalo RI, Abreu L. Maternal and child healthcare-seeking among victims of violence in armed conflict: a matched case-control study in Northeast Nigeria (2025b-03-13). BMJ Global Health. https:\/\/doi.org\/10.1101\/2025.03.11.25323760.","DOI":"10.1101\/2025.03.11.25323760"},{"key":"27385_CR25","doi-asserted-by":"publisher","unstructured":"Abreu L, Schrage P, Adeyanju GC. et al. Caregivers\u00b4 qualitative insights on trust, resilience and vaccination attitudes shaping child health in conflict affected Northeast Nigeria. Conflict and Health. 2026;20:38. https:\/\/doi.org\/10.1186\/s13031-026-00753-w.","DOI":"10.1186\/s13031-026-00753-w"},{"issue":"6","key":"27385_CR26","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1007\/s10995-025-04111-9","volume":"29","author":"F Misu","year":"2025","unstructured":"Misu F, Gasbarro D, Alam K. Inequality in utilization of maternal healthcare services in low- and middle-income countries: a scoping review of the literature. Matern Child Health J. 2025;29(6):741\u201366.","journal-title":"Matern Child Health J"},{"key":"27385_CR27","doi-asserted-by":"publisher","first-page":"1601","DOI":"10.1186\/s12913-024-12085-7","volume":"24","author":"AM Kassie","year":"2024","unstructured":"Kassie AM, Eakin E, Endalamaw A, Zewdie A, Wolka E, Assefa Y. Effective coverage of maternal and neonatal healthcare services in low- and middle-income countries: a scoping review. BMC Health Serv Res. 2024;24:1601.","journal-title":"BMC Health Serv Res"},{"key":"27385_CR28","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1186\/s12884-025-07505-3","volume":"25","author":"H Teka","year":"2025","unstructured":"Teka H, Ebrahim MM, Nardos R, Legesse AY, Berhe Y, Berhe H, Gebregziabher M, Kiros G-E. The impact of armed conflict on maternal morbidity and mortality at a teaching hospital in the Tigray region of Ethiopia: a pre-war and wartime comparative analysis. BMC Pregnancy Childbirth. 2025;25:389.","journal-title":"BMC Pregnancy Childbirth"},{"key":"27385_CR29","doi-asserted-by":"publisher","first-page":"117252","DOI":"10.1016\/j.socscimed.2024.117252","volume":"359","author":"M Schaub","year":"2024","unstructured":"Schaub M. Violent conflict and the demand for healthcare: how armed conflict reduces healthcare utilization. Soc Sci Med. 2024;359:117252.","journal-title":"Soc Sci Med"},{"key":"27385_CR30","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1186\/s13031-025-00708-7","volume":"19","author":"TY Headley","year":"2025","unstructured":"Headley TY, Wiley Shay C, Tozan Y. The impact of armed conflict on vaccination coverage: a systematic review of empirical evidence from 1985 to 2025. Confl Health. 2025;19:71.","journal-title":"Confl Health"},{"issue":"3","key":"27385_CR31","doi-asserted-by":"publisher","first-page":"27","DOI":"10.14302\/issn.2693-1176.ijgh-25-5729","volume":"2","author":"AK Ahawo","year":"2025","unstructured":"Ahawo AK, Essoh T-A, Adeyanju GC, Aplogan A, Ekouevi DK. The impact of public financing, economic growth, and corruption on immunization performance: evidence from 37 Sub-Saharan African countries. Int J Global Health. 2025;2(3):27\u201343. https:\/\/doi.org\/10.14302\/issn.2693-1176.ijgh-25-5729.","journal-title":"Int J Global Health"},{"key":"27385_CR32","doi-asserted-by":"publisher","unstructured":"Adeyanju GC, Betsch C. Vaccination decision-making among mothers of children 0\u201312 months old in Nigeria: a qualitative study. Hum Vaccines Immunotherapeutics. 2024;20(1). https:\/\/doi.org\/10.1080\/21645515.2024.2355709.","DOI":"10.1080\/21645515.2024.2355709"},{"key":"27385_CR33","doi-asserted-by":"publisher","first-page":"44146","DOI":"10.1038\/s41598-025-33121-4","volume":"15","author":"GC Adeyanju","year":"2025","unstructured":"Adeyanju GC. Immunisation decision-making and barriers to vaccine uptake among children under-5 in limited-resource settings. Sci Rep. 2025;15:44146. https:\/\/doi.org\/10.1038\/s41598-025-33121-4.","journal-title":"Sci Rep"},{"key":"27385_CR34","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1038\/s41541-022-00489-7","volume":"7","author":"GC Adeyanju","year":"2022","unstructured":"Adeyanju GC, Sprengholz P, Betsch C. Understanding drivers of vaccine hesitancy among pregnant women in Nigeria: a longitudinal study. npj Vaccines. 2022;7:96. https:\/\/doi.org\/10.1038\/s41541-022-00489-7.","journal-title":"npj Vaccines"},{"issue":"6","key":"27385_CR35","doi-asserted-by":"publisher","first-page":"e843","DOI":"10.1016\/S2214-109X(23)00152-3","volume":"11","author":"F Amberg","year":"2023","unstructured":"Amberg F, Chansa C, Niangaly H, Sankoh O, De Allegri M. Examining the relationship between armed conflict and coverage of maternal health services: evidence from Sub-Saharan Africa. Lancet Glob Health. 2023;11(6):e843\u201353.","journal-title":"Lancet Glob Health"},{"key":"27385_CR36","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s41256-022-00261-3","volume":"7","author":"GC Adeyanju","year":"2022","unstructured":"Adeyanju GC, Betsch C, Adamu AA, et al. Examining enablers of vaccine hesitancy toward routine childhood and adolescent vaccination in Malawi. Glob Health Res Policy. 2022b;7:28. https:\/\/doi.org\/10.1186\/s41256-022-00261-3.","journal-title":"Glob Health Res Policy"},{"key":"27385_CR37","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.3390\/vaccines9111231","volume":"9","author":"GC Adeyanju","year":"2021","unstructured":"Adeyanju GC, Sprengholz P, Betsch C, Essoh T-A. Caregivers\u2019 willingness to vaccinate their children against childhood diseases and human papillomavirus: a cross-sectional study on vaccine hesitancy in Malawi. Vaccines. 2021;9:1231. https:\/\/doi.org\/10.3390\/vaccines9111231.","journal-title":"Vaccines"},{"issue":"1","key":"27385_CR38","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1186\/s12889-023-15855-w","volume":"23","author":"TA Essoh","year":"2023","unstructured":"Essoh TA, Adeyanju GC, Adamu AA, Tall H, Aplogan A, Tabu C. Exploring the factors contributing to low vaccination uptake for nationally recommended routine childhood and adolescent vaccines in Kenya. BMC Public Health. 2023;23(1):912. https:\/\/doi.org\/10.1186\/s12889-023-15855-w.","journal-title":"BMC Public Health"},{"issue":"5","key":"27385_CR39","doi-asserted-by":"publisher","first-page":"489","DOI":"10.3390\/vaccines12050489","volume":"12","author":"GC Adeyanju","year":"2024","unstructured":"Adeyanju GC, Essoh T-A, Sidibe AR, Kyesi F, Aina M. Human Papillomavirus vaccination acceleration and introduction in Sub-Saharan Africa: a multi-country cohort analysis. Vaccines. 2024;12(5):489. https:\/\/doi.org\/10.3390\/vaccines12050489.","journal-title":"Vaccines"},{"issue":"5","key":"27385_CR40","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1080\/14760584.2021.1899819","volume":"20","author":"AA Adamu","year":"2021","unstructured":"Adamu AA, Essoh TA, Adeyanju GC, Jalo RI, Saleh Y, Aplogan A, Wiysonge CS. Drivers of hesitancy towards recommended childhood vaccines in African settings: a scoping review of literature from Kenya, Malawi and Ethiopia. Expert Rev Vaccines. 2021;20(5):611\u201321. https:\/\/doi.org\/10.1080\/14760584.2021.1899819.","journal-title":"Expert Rev Vaccines"},{"key":"27385_CR41","doi-asserted-by":"publisher","unstructured":"Adeyanju GC, Korn. Lars. Paediatrics health outcomes in Sub-Saharan Africa: a multi-country assessment of antecedence of childhood vaccination decision-making. medRxiv Preprint. 2026;13. https:\/\/doi.org\/10.64898\/2026.03.12.26348244.","DOI":"10.64898\/2026.03.12.26348244"},{"issue":"2","key":"27385_CR42","doi-asserted-by":"publisher","first-page":"57","DOI":"10.47305\/JLIA2020057a","volume":"6","author":"GC Adeyanju","year":"2020","unstructured":"Adeyanju GC. Gender-based violence as an instrument of warfare in armed conflicts. J Lib Int Affairs. 2020;6(2):57\u201370. https:\/\/doi.org\/10.47305\/JLIA2020057a.","journal-title":"J Lib Int Affairs"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12889-026-27385-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-026-27385-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-026-27385-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:15:33Z","timestamp":1781648133000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12889-026-27385-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,17]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["27385"],"URL":"https:\/\/doi.org\/10.1186\/s12889-026-27385-2","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,17]]},"assertion":[{"value":"13 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the tenets of the Declaration of Helsinki and the protocol was approved by the Nigeria National Health Research Ethics Committee (reference number: NHREC\/01\/01\/2007-14\/01\/2024). Written informed consent was obtained from all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1274"}}