{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T05:53:27Z","timestamp":1775714007723,"version":"3.50.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Glob. Women\u2019s Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>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\u2009=\u20090.12, 95% CI: 0.09\u20130.16). Socioeconomically, mothers from the richest households were 75% more likely to practice SSC than those from the poorest households (AOR\u2009=\u20091.75, 95% CI: 1.17\u20132.61). Maternal healthcare decision-making capacity was a critical factor: the odds of SSC were significantly lower when the husband decided on healthcare alone (AOR\u2009=\u20090.42, 95% CI: 0.30\u20130.58) 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\u2009=\u20091.88, 95% CI: 1.05\u20133.37). The null model showed a high intraclass correlation coefficient (ICC\u2009=\u200951.7%), justifying the multilevel approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fgwh.2026.1717086","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T05:21:19Z","timestamp":1775712079000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":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"],"prefix":"10.3389","volume":"7","author":[{"given":"Awo Mohamed","family":"Kahie","sequence":"first","affiliation":[{"name":"School of Postgraduate Studies and Research, Amoud University","place":["Borama, Somalia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suhaib Mohamed","family":"Kahie","sequence":"additional","affiliation":[{"name":"School of Postgraduate Studies and Research, Amoud University","place":["Borama, Somalia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nura Mohamed","family":"Omer","sequence":"additional","affiliation":[{"name":"College of Health Sciences, School of Medicine and Surgery, Amoud University","place":["Borama, Somalia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdirahman","family":"Omer Ali","sequence":"additional","affiliation":[{"name":"School of Postgraduate Studies and Research, Amoud University","place":["Borama, Somalia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nima","family":"Muhammad","sequence":"additional","affiliation":[{"name":"College of Health Sciences, School of Medicine and Surgery, Amoud University","place":["Borama, 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