Research Article
Public Health Burden and Statistical Determinants of Maternal and Child Mortality in Blue Nile State, Sudan:
A Secondary Data Analysis, 2010-2023
Alshaikh Ahmed Shokeralla*
,
Mohammed Ali Alshaib,
Waleid Alnour Daif
Issue:
Volume 2, Issue 3, June 2026
Pages:
59-73
Received:
20 June 2026
Accepted:
1 July 2026
Published:
27 July 2026
Abstract: Background: Blue Nile State is one of the most health-fragile regions in Sudan, characterised by recurrent conflict, population displacement, poverty, weak health infrastructure, and a high burden of preventable communicable diseases. Despite its public health importance, state-level statistical evidence on disease burden and determinants of maternal and child health outcomes remains limited. Objective: This study aimed to describe the public health burden in Blue Nile State during 2010-2023 and to identify key statistical determinants associated with maternal and child mortality using available secondary data. Methods: A secondary data analysis was conducted using publicly available reports and published studies from WHO, UNICEF, OCHA, the Sudan Central Bureau of Statistics, the Federal and State Ministries of Health, and peer-reviewed literature. Descriptive statistics, comparative analysis against national averages and SDG targets, chi-square tests, t-tests, time-trend analysis, and multiple linear regression were applied. Regression assumptions were evaluated using residual diagnostics, variance inflation factors (VIF), Durbin-Watson statistics, and influence diagnostics. Results: Blue Nile State showed substantially poorer health indicators than national averages. The maternal mortality ratio (MMR) was estimated at 412 per 100,000 live births compared with 295 nationally, while the under-five mortality rate (U5MR) reached 89.3 per 1,000 live births compared with 56.0 nationally. Malaria represented the dominant communicable disease burden (68 cases per 1,000 population). The multiple linear regression model identified poverty rate, distance to health facility, maternal education, vaccination coverage, and malaria prevalence as statistically significant determinants (R2 = 0.784; F = 68.32; p < 0.001). Conclusion: Poor health outcomes in Blue Nile State are associated with structural deprivation, geographic barriers, infectious disease burden, limited vaccination coverage, and conflict-related disruption of health services. A comprehensive multi-sector strategy is urgently needed.
Abstract: Background: Blue Nile State is one of the most health-fragile regions in Sudan, characterised by recurrent conflict, population displacement, poverty, weak health infrastructure, and a high burden of preventable communicable diseases. Despite its public health importance, state-level statistical evidence on disease burden and determinants of matern...
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Research Article
Vaccines to Prevent or Treatment to Recover: Immunisation Compliance Among Caregivers of Infants Aged 0–18 Months in Pager Cell, Northern Uganda
Abacha Omara Geoffrey*
Issue:
Volume 2, Issue 3, June 2026
Pages:
74-77
Received:
2 March 2026
Accepted:
16 March 2026
Published:
28 July 2026
DOI:
10.11648/j.mls.20260203.12
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Abstract: Routine childhood immunisation is a critical public health intervention for preventing vaccine-preventable diseases and reducing under-five mortality, yet adherence and completion remain sub-optimal in many low-resource settings, including Northern Uganda. This study examined immunisation adherence and compliance among mothers and caregivers of children aged 0–18 months in Pager Cell, Kitgum Municipality, using a P-factors analytical framework that considers provider and parental factors, procedures and practices, policy and programme influences, and political–contextual determinants. A cross-sectional analytical mixed-methods design was used, collecting data from 323 caregivers through structured questionnaires, child health card reviews, and key informant inputs. Quantitative data were analysed using descriptive statistics, while qualitative findings were thematically analysed within the P-factors framework. Results showed that full immunisation coverage was below national targets, with significant drop-out between early and later vaccine doses, influenced by caregiver knowledge and trust, health facility operational practices, programme implementation gaps, and broader political and infrastructural constraints. Overall, the findings demonstrate that immunisation adherence in Northern Uganda is shaped by interconnected individual providers and parental factors, health system procedure and practices, programme policy, and politico-contextual factors, highlighting the usefulness of the P-factors framework for understanding and improving routine immunisation performance in low-resource and post-conflict settings.
Abstract: Routine childhood immunisation is a critical public health intervention for preventing vaccine-preventable diseases and reducing under-five mortality, yet adherence and completion remain sub-optimal in many low-resource settings, including Northern Uganda. This study examined immunisation adherence and compliance among mothers and caregivers of chi...
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