Socio-digital stratification and the threshold effects of digital inclusion on maternal health access in Somalia
Bibliographic Data
| ID | 21766321 |
|---|---|
| Authors | Abdirizak Mohamed Moumin (0009-0002-9453-4048, Amoud University, corresponding author), Abdalle Ali Yusuf (0009-0002-9076-388X, Amoud University), Khadar Mowlid Abdi (0009-0007-9987-7855, Amoud University), Abdirashid M Yousuf (0009-0008-1272-5566, Amoud University) |
| Year | 2026 |
| Volume | 19 |
| Issue | 1 |
| Pages | 2694167-2694167 |
| Publication date | 2026-12-31 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Global Health Action (JOURNAL) |
| Journal identifiers | ISSN: 1654-9716 • E-ISSN: 1654-9880 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/16549716.2026.2694167 |
| PMID | 42346984 |
| OpenAlex | W7165864514 |
| Language | EN |
| Citations received | 1 |
| References cited | 38 |
Background Maternal health utilization in fragile states is hindered by complex social and structural barriers.Objective This study examined socio-digital stratification and explored the threshold effects of digital inclusion on antenatal care (ANC) utilization in Somalia.Methods Using data from the 2020 Somalia Demographic and Health Survey (N = 8,940), we constructed a Digital Inclusion Index (0–3) and employed survey-adjusted logistic regression models to estimate the odds of achieving four or more ANC visits (ANC 4+).Results Only 8.4% of the women achieved the ANC 4+ threshold, with pronounced disparities between urban (14.0%) and rural/nomadic (5.5%) residents. Evidence consistent with a threshold effect was observed, whereby the initial transition from digital exclusion to basic connectivity (score = 1) was associated with the largest marginal gain in health seeking probability (OR = 1.55, p = 0.013). While mobile money penetration is high (85.2%), internet access remains deeply stratified by wealth (22.0% among the rich versus 1.0% among the poor). Interaction analysis suggests that digital inclusion complements but does not substitute for physical health infrastructure, partially mitigating distance-related barriers without eliminating the need for physical proximity to healthcare facilities.Conclusions Digital inclusion is a critical entry point for improving maternal health access in Somalia. Policies should prioritize universal basic connectivity and SMS-based interventions, while simultaneously addressing persistent physical and socioeconomic inequities
Digital divide · Digital health · Health care · Inclusion (mineral) · Logistic regression · Maternal health · Odds · Socioeconomic status · Universal design · Global Maternal and Child Health · ICT in Developing Communities · Mobile Health and mHealth Applications
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Impact of the digital divide in the age of Covid-19
Social and Structural Determinants of Health Inequities in Maternal Health
Determinants of financial inclusion and the digital divide among Somali women
The nexus between poverty and maternal healthcare utilization with a focus on antenatal care visits and choice of place of birth in Somaliland
Does women’s mobile phone ownership matter for health? Evidence from 15 countries
Socioeconomic Inequalities in Maternal Health Care Utilization and Delivery Channels in Nigeria
Mass media exposure and maternal healthcare utilization in South Asia
Can digital health technologies exacerbate the health gap? A clustering analysis of mothers’ opinions toward digitizing the maternal and child health handbook
Maternal health outcomes in the context of fragility
| Citations per year | 1 |
|---|---|
| Citation span | 2026 - 2026 (1) |
| Highly cited | No |