Published in PLOS One on 2026-07-15, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. HealthSignal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Abdeta Muktar Ahmed, Mohamed Abdilahi Ahmed, Abdulkadir Mohammed Nuh, Hamse Khalif Hassan
Source: PLOS One • DOI 10.1371/journal.pone.0353778
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Maternal mortality remains a major global health challenge, disproportionately affecting low- and middle-income countries. Despite international efforts, nearly 95% of maternal deaths occur in these regions, with Sub-Saharan Africa bearing the highest burden. Limited knowledge of obstetric danger signs is a key factor contributing to delays in seeking care, which in turn increases the risk of preventable maternal complications. Evidence on maternal awareness in Somaliland is scarce.
This study aimed to assess the level of knowledge of obstetric danger signs and associated factors among pregnant women attending antenatal care in Hargeisa, Somaliland.
A facility-based cross-sectional study was conducted from July 2 to August 4, 2022, among pregnant women attending antenatal care services. A total of 222 participants were selected using a systematic random sampling technique from eight maternal and child health centers. Data were collected through face-to-face interviews using a pretested and structured questionnaire and analyzed with SPSS version 25. Bivariate and multivariate logistic regression was carried out.
About 35.6% had a good knowledge specifically about pregnancy related obstetric danger signs. Only 57 women (25.7%) demonstrated overall good knowledge of obstetric danger signs across pregnancy, childbirth, and the postpartum periods. Knowledge was highest for vaginal bleeding (65% − 67%), while less visible complications such as convulsions and blurred vision were less frequently mentioned. Multivariate analysis revealed that secondary level education or higher (AOR = 3.6, 95% CI: 1.8–7.3), access to and usage of media (AOR = 2.6, 95% CI: 1.2–5.6), and institutional delivery (AOR = 3.4, 95% CI: 1.6–7.2), were significant predictors of knowledge.
Maternal knowledge of obstetric danger signs in Hargeisa was low. Targeted health education, broader use of mass media, and promoting institutional delivery are critical strategies to improve and reduce preventable maternal mortality.
Background
Maternal mortality remains a pressing global issue. In 2023, more than 700 women lost their lives to pregnancy-related and childbirth-related avoidable causes every day, or roughly one woman every two minutes [1]. Despite international efforts to address it, maternal mortality is still a serious global health concern. The startling truth is that the majority of maternal fatalities are avoidable and result from severe health disparities that occur both within and between nations and worldwide. These disparities are significant. Nearly 95% of all maternal deaths take place in low- and middle-income nations, with Sub-Saharan Africa bearing the highest risk, accounting for 70% of all maternal deaths. The 2030 United Nations Sustainable Development Goal (SDG), which aims to lower the rate of maternal fatalities to fewer than 70 per 100,000 live births, is still significantly above the current global rate of maternal deaths (223 per 100,000 live births) [2–3].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Abdeta Muktar Ahmed, Mohamed Abdilahi Ahmed, Abdulkadir Mohammed Nuh, Hamse Khalif Hassan. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by HealthSignal. The researchers are the authors of the source study, not members of HealthSignal’s staff.
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