Kassie Alemneh Tadesse, Tamir Tadesse Tarik, Bazezew Astewil Moges, Gebremichael Agnche, Gonete Daniel Asefa, Zegeye Alebachew Ferede
Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLOS Glob Public Health. 2025 Jun 24;5(6):e0004816. doi: 10.1371/journal.pgph.0004816. eCollection 2025.
Skin-to-skin contact (SSC) between newborns and mothers is crucial for reducing hypothermia complications and enhancing mother-baby bonding. This study aimed to examine the prevalence rates and risk factors for SSC in five East African countries. Data from the most recent Demographic and Health Surveys covering five East African countries from 2019 to 2023 were utilized for secondary data analysis. A total of 37,140 newborns were included in the weighted sample sizes. The factors contributing to SSC prevalence were assessed using a multilevel mixed-effects logistic regression model, with significance declared at p-values <0.05. Adjusted odds ratios (AOR) and confidence intervals (CI) were used for interpretation. In East Africa, nearly half of newborns did not receive SSC. Individual-level factors associated with SSC included: immediate breastfeeding (IBF) (AOR = 2.24, 95% CI: (1.86, 2.69)), primary education (AOR = 1.60, 95% CI: (1.24, 2.07)), more than four antenatal care visits (AOR = 2.15, 95% CI: (1.37, 3.36)), low birth weight (AOR = 1.35, 95% CI: (1.04, 1.76)), multiple births (AOR = 0.41, 95% CI: (0.24, 0.73)), and cesarean section deliveries (AOR = 0.26, 95% CI: (0.20, 0.34)). Community-level factors included rural residence (AOR = 0.63, 95% CI: (0.48, 0.82)), with significant country-level variations: Kenya (AOR = 2.45, 95% CI: (1.72, 3.49)), Mozambique (AOR = 1.21, 95% CI: (0.91, 1.62)), and Tanzania (AOR = 3.14, 95% CI: (2.29, 4.31)). The findings indicate a low prevalence of mother-newborn SSC in East African countries, with particularly high rates observed in Rwanda and lower rates in Madagascar. Policymakers and ministries of health should prioritize initiatives aimed at improving SSC, particularly for newborns and mothers with low educational levels, limited media exposure, and those living in rural areas, to enhance maternal and neonatal care during delivery.
新生儿与母亲之间的皮肤接触（SSC）对于减少体温过低并发症和加强母婴情感联结至关重要。本研究旨在调查东非五个国家中SSC的普及率及风险因素。利用了2019年至2023年覆盖东非五个国家的最新人口与健康调查数据进行二次数据分析。加权样本量中总共纳入了37140名新生儿。使用多级混合效应逻辑回归模型评估影响SSC普及率的因素，p值<0.05时具有统计学意义。采用调整后的优势比（AOR）和置信区间（CI）进行解读。在东非，近一半的新生儿未接受SSC。与SSC相关的个体层面因素包括：即时母乳喂养（IBF）（AOR = 2.24，95% CI：（1.86，2.69））、小学教育程度（AOR = 1.60，95% CI：（1.24，2.07））、产前检查超过四次（AOR = 2.15，95% CI：（1.37，3.36））、低出生体重（AOR = 1.35，95% CI：（1.04，1.76））、多胞胎（AOR = 0.41，95% CI：（0.24，0.73））以及剖宫产分娩（AOR = 0.26，95% CI：（0.20，0.34））。社区层面因素包括农村居住情况（AOR = 0.63，95% CI：（0.48，0.82）），国家层面存在显著差异：肯尼亚（AOR = 2.45，95% CI：（1.72，3.49））、莫桑比克（AOR = 1.21，95% CI：（0.91，1.62））和坦桑尼亚（AOR = 3.14，95% CI：（2.29，4.31））。研究结果表明，东非国家母婴SSC的普及率较低，在卢旺达观察到的普及率特别高，而在马达加斯加则较低。政策制定者和卫生部应优先开展旨在改善SSC的举措，特别是针对教育水平低、媒体曝光有限以及生活在农村地区的新生儿和母亲，以加强分娩期间的孕产妇和新生儿护理。
