{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:09:35Z","timestamp":1784182175164,"version":"3.55.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"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>Background<\/jats:title>\n                    <jats:p>Maternal mortality remains a critical global health challenge, particularly in fragile settings. The continuum of maternal healthcare\u2014comprising antenatal care (ANC), skilled birth attendance (SBA), and postnatal care (PNC)\u2014is essential for reducing preventable deaths. In Somalia, with a maternal mortality ratio of approximately 563 per 100,000 live births, evidence on completion of the continuum of care remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the completion of the maternal healthcare continuum and its determinants among women who gave birth in the past year in Mogadishu, Somalia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A community-based cross-sectional study was conducted among 422 women of reproductive age in Mogadishu including Internally displaced people (IDPs). Data were collected using structured interviewer-administered questionnaires. Completion of the continuum of care was defined as receipt of at least four antenatal care visits (ANC\u2009\u2265\u20094), facility delivery, and postnatal care within 48\u2005h after delivery. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall,\n                      <jats:bold>18.2%<\/jats:bold>\n                      of women completed the maternal health continuum. In the multivariable analysis, maternal education remained a strong predictor, with significantly lower odds among women with primary (AOR\u2009=\u20090.10; 95% CI: 0.02\u20130.43), secondary (AOR\u2009=\u20090.21; 95% CI: 0.05\u20130.86), and no formal education (AOR\u2009=\u20090.12; 95% CI: 0.02\u20130.56) compared to those with higher education. Husband's education was also significant, as women whose partners had no formal education (AOR\u2009=\u20090.14; 95% CI: 0.03\u20130.58) or primary education (AOR\u2009=\u20090.22; 95% CI: 0.05\u20130.95) had reduced odds of completion. Higher household income (\u2265300 USD) (AOR\u2009=\u20093.61; 95% CI: 1.28\u201310.14) and gravidity (4\u20137 pregnancies) (AOR\u2009=\u20095.08; 95% CI: 1.17\u201322.09) were positively associated with completion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Although only\n                      <jats:bold>18.2%<\/jats:bold>\n                      of women in Mogadishu completed the maternal healthcare continuum, substantial inequities persist. Socioeconomic status, maternal and partner education, and reproductive history significantly influence care completion. Strengthening maternal health programs through targeted education, economic support, and integrated service delivery is essential to improve equitable access and continuity of care in fragile settings.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fgwh.2026.1801598","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:37:35Z","timestamp":1784180255000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Complete continuum of maternal health care and Its determinants among women who gave birth in the past year in Mogadishu, Somalia"],"prefix":"10.3389","volume":"7","author":[{"given":"Sharmake Gaiye","family":"Bashir","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]},{"name":"Center for Health Research and Innovation, Somali National University","place":["Mogadishu, Somalia"]},{"name":"Faculty of Health Science, Salaam University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hibo Hassan","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumaya Abdi","family":"Ali","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muna Mohamed","family":"hassan","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdiqani abdiqaadir","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amina Adan","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yakub Burhan","family":"Abdullahi","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]},{"name":"Center for Health Research and Innovation, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuf Hared","family":"Abdi","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]},{"name":"Center for Health Research and Innovation, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiba Abdi","family":"Salad","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Sharif","family":"Abdi","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]},{"name":"Center for Health Research and Innovation, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naima Ibrahim","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]},{"name":"Center for Health Research and Innovation, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuradin Abdullahi Sheikh","family":"Rashid","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]},{"name":"Center for Health Research and Innovation, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Abdinasir","family":"Abdulle","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]},{"name":"Center for Health Research and Innovation, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gallad Dahir","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Public Health, Faculty of Graduate Studies and Research Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e0305780","DOI":"10.1371\/JOURNAL.PONE.0305780","article-title":"The continuum of care for maternal health in Africa: a systematic review and meta-analysis","volume":"19","author":"Ahmed","year":"2024","journal-title":"PLoS One"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e0293479","DOI":"10.1371\/JOURNAL.PONE.0293479","article-title":"Proximate and distant determinants of maternal and neonatal mortality in the postnatal period: a scoping review of data from low- and middle-income countries","volume":"18","author":"Izulla","year":"2023","journal-title":"PLoS One"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e17559","DOI":"10.1016\/J.HELIYON.2023.E17559","article-title":"Effectiveness of a continuum of care in maternal health services on the reduction of maternal and neonatal mortality: systematic review and meta-analysis","volume":"9","author":"Zelka","year":"2023","journal-title":"Heliyon"},{"key":"B4","doi-asserted-by":"publisher","first-page":"869552","DOI":"10.3389\/FGWH.2022.869552","article-title":"Pooled prevalence and determinants of completion of maternity continuum of care in sub-saharan Africa: a multi-country analysis of recent demographic and health surveys","volume":"3","author":"Hunie Asratie","year":"2022","journal-title":"Front Glob Womens Health"},{"key":"B5","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1186\/S12911-023-02305-1","article-title":"Predicting the drop out from the maternal, newborn and child healthcare continuum in three east African community countries: application of machine learning models","volume":"23","author":"Mlandu","year":"2023","journal-title":"BMC Med Inform Decis Mak"},{"key":"B6","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/S12884-023-05372-4","article-title":"Coverage-level and predictors of maternity continuum of care in Nigeria: implications for maternal, newborn and child health programming","volume":"23","author":"Oyedele","year":"2023","journal-title":"BMC Pregnancy Childbirth"},{"key":"B7","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1186\/S12939-023-02047-6","article-title":"Evaluating equity across the continuum of care for maternal health services: analysis of national health surveys from 25 sub-saharan African countries","volume":"22","author":"Bobo","year":"2023","journal-title":"Int J Equity Health"},{"key":"B8","doi-asserted-by":"publisher","first-page":"11786329231214607","DOI":"10.1177\/11786329231214607","article-title":"Completion of the maternal health care continuum\u2014barriers and facilitators among pregnant women in jimma zone, southwest Ethiopia: a prospective study","volume":"16","author":"Kitila","year":"2023","journal-title":"Health Serv Insights"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e0003641","DOI":"10.1371\/JOURNAL.PGPH.0003641","article-title":"Determinants of dropout from the maternal continuum of care in Ethiopia, multilevel analysis of the 2016 demographic and health survey","volume":"4","author":"Kebede","year":"2024","journal-title":"PLOS Global Public Health"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e0305234","DOI":"10.1371\/JOURNAL.PONE.0305234","article-title":"Health system strengthening in fragile and conflict-affected states: a review of systematic reviews","volume":"19","author":"Bogale","year":"2024","journal-title":"PLoS One"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/S12939-025-02486-3","article-title":"Universal health coverage in fragile and conflict-affected states: insights from Somalia","volume":"24","author":"Nikoloski","year":"2025","journal-title":"Int J Equity Health"},{"key":"B12","doi-asserted-by":"publisher","first-page":"26334941251403814","DOI":"10.1177\/26334941251403814","article-title":"Accessibility and barriers to maternal health services for adolescents in sub-Saharan Africa: a scoping review","volume":"19","author":"Muchemwa","year":"2025","journal-title":"Ther Adv Reprod Health"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1192473","DOI":"10.3389\/fgwh.2023.1192473","article-title":"Provision and utilization of maternal health services during the COVID-19 pandemic in 16 hospitals in sub-Saharan Africa","volume":"4","author":"Semaan","year":"2023","journal-title":"Front Glob Womens Health"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e0004102","DOI":"10.1371\/JOURNAL.PGPH.0004102","article-title":"Level of completion of maternity continuum of care among ever-married women: an analysis of Somalia\u2019s health and demographic survey 2020","volume":"5","author":"Mohamed","year":"2025","journal-title":"PLOS Global Public Health"},{"key":"B15","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/S13031-021-00382-5","article-title":"Lockdowns, lives and livelihoods: the impact of COVID-19 and public health responses to conflict affected populations\u2014a remote qualitative study in Baidoa and Mogadishu, Somalia","volume":"15","author":"Braam","year":"2021","journal-title":"Confl Health"},{"key":"B16","year":""},{"key":"B17","doi-asserted-by":"publisher","first-page":"04180","DOI":"10.7189\/JOGH.14.04180","article-title":"Utilisation and associated socio-demographic factors related to the maternal continuum of care in sub-Saharan Africa: a systematic review and meta-analysis","volume":"14","author":"Kassa","year":"2024","journal-title":"J Glob Health"},{"key":"B18","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1186\/S12884-022-04757-1","article-title":"Coverage and factors associated with completion of continuum of care for maternal health in sub-Saharan Africa: a multicountry analysis","volume":"22","author":"Alem","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"B19","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1186\/S12939-023-02015-0","article-title":"Wealth-based inequality in the continuum of maternal health service utilisation in 16 sub-Saharan African countries","volume":"22","author":"Asefa","year":"2023","journal-title":"Int J Equity Health"},{"key":"B20","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1186\/S12884-024-06998-8","article-title":"Effect of pregnancy intention on completion of maternity continuum of care in sub-Saharan Africa: systematic review and meta-analysis","volume":"24","author":"Mekonnen","year":"2024","journal-title":"BMC Pregnancy Childbirth"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1394","DOI":"10.1186\/S12913-022-08693-W","article-title":"Continuum of care for maternal, newborn, and child health in 17 sub-Saharan African countries","volume":"22","author":"Seidu","year":"2022","journal-title":"BMC Health Serv Res"},{"key":"B22","doi-asserted-by":"publisher","first-page":"14174","DOI":"10.1038\/s41598-025-85998-w","article-title":"Family structure factors influencing modern contraceptive use in Cameroon based on analysis of 2018\u20132019 demographic and health survey data","volume":"15","author":"Amadou","year":"2025","journal-title":"Sci Rep"},{"key":"B23","doi-asserted-by":"publisher","first-page":"3354","DOI":"10.1186\/S12889-025-24495-1","article-title":"Perinatal mortality rate and associated risk factors in Mogadishu, Somalia: a hospital-based cross-sectional study","volume":"25","author":"Hussein","year":"2025","journal-title":"BMC Public Health"},{"key":"B24","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/1742-4755-9-32","article-title":"Determinants of male involvement in maternal and child health services in sub-Saharan Africa: a review","volume":"9","author":"Ditekemena","year":"2012","journal-title":"Reprod Health"},{"key":"B25","doi-asserted-by":"publisher","first-page":"670239","DOI":"10.3389\/FPUBH.2021.670239","article-title":"A qualitative endline evaluation study of male engagement in promoting reproductive, maternal, newborn, and child health services in rural Kenya","volume":"9","author":"Lusambili","year":"2021","journal-title":"Front Public Health"},{"key":"B26","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1186\/S12884-018-1763-8","article-title":"Ending preventable maternal mortality: phase II of a multi-step process to develop a monitoring framework, 2016\u20132030","volume":"18","author":"Jolivet","year":"2018","journal-title":"BMC Pregnancy Childbirth"}],"container-title":["Frontiers in Global Women's Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgwh.2026.1801598\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:37:36Z","timestamp":1784180256000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgwh.2026.1801598\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,16]]},"references-count":26,"alternative-id":["10.3389\/fgwh.2026.1801598"],"URL":"https:\/\/doi.org\/10.3389\/fgwh.2026.1801598","relation":{},"ISSN":["2673-5059"],"issn-type":[{"value":"2673-5059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,16]]},"article-number":"1801598"}}