Evidence map›Paper›PMID 41764511›Full record

ArticleConflict and health2026

Caregivers´ qualitative insights on trust, resilience and vaccination attitudes shaping child health in conflict-affected Northeast Nigeria.

Liliana Abreu, Pia Schrage, Gbadebo Collins Adeyanju, Rabiu Ibrahim Jalo, Aisha Aliyu Abulfathi, Musa Muhammad Bello, Aminatu Ayaba Kwaku, Muhammad Ibrahim Jalo, Ahmad Mahmud, Max Schaub

Abstract read
In one paragraph

Article in Conflict and health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Liliana AbreuDepartment of Politics and Public Administration, University of Konstanz, Konstanz, Germany. liliana.abreu@uni-konstanz.de.
Pia SchrageMedia and Communication Science and Centre for Empirical Research in Economics and Behavioral Science (CEREB), University of Erfurt, Erfurt, Germany.
Gbadebo Collins AdeyanjuMedia and Communication Science and Centre for Empirical Research in Economics and Behavioral Science (CEREB), University of Erfurt, Erfurt, Germany.
Rabiu Ibrahim JaloBayero University & Aminu Kano Teaching Hospital, Kano, Nigeria.
Aisha Aliyu AbulfathiUniversity of Maiduguri, Maiduguri, Nigeria.
Musa Muhammad BelloBayero University & Aminu Kano Teaching Hospital, Kano, Nigeria.
Aminatu Ayaba KwakuAminu Kano Teaching Hospital, Kano, Nigeria.
Muhammad Ibrahim JaloWomen and Children Hospital Damaturu, Damaturu, Nigeria.
Ahmad MahmudModibbo Adama University, Yola, Nigeria.
Max SchaubWZB Berlin Social Science Center, Berlin, & University of Hamburg, Hamburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNortheast Nigeria, particularly the conflict-affected Borno, Yobe and Adamawa (BAY) states, has some of the highest under-five mortality rates in the world. Armed conflict, damaged health infrastructure and systemic poverty have significantly reduced access to healthcare. This study explores how health-seeking behaviour among caregivers of children under five intersects with trust in health systems, exposure to violence and vaccine hesitancy.

methodsA qualitative study was conducted using nine focus group discussions (FGDs) with 72 caregivers living in conflict-affected communities in the BAY states. Participants were purposively selected, and discussions explored barriers to accessing healthcare, trust in health systems, the impact of conflict on health-seeking behaviour and perceptions of childhood vaccinations. Data were analysed thematically using a conventional content analysis approach, allowing codes and themes to emerge inductively.

resultsHealth-seeking behaviour was shaped by a complex interplay of poverty, dysfunctional health infrastructure and profound mistrust of governmental institutions, all of which were exacerbated by prolonged exposure to violence. Patriarchal norms played a central role in decision-making processes, often limiting women's autonomy when it came to accessing care. Vaccine hesitancy was influenced by misinformation, knowledge gaps and limited community engagement. However, caregivers with access to reliable information sources, such as community networks and local media, showed more positive attitudes towards immunisation.

conclusionsEfforts to improve maternal and child health in conflict-affected regions must prioritise trust-building, strengthening the health system in a culturally sensitive way and implementing targeted communication strategies. Leveraging community engagement and resilience is essential to reducing barriers to care and address vaccine hesitancy in fragile contexts.

Indexed as

Armed conflictChild mortalityHealth-seeking behaviorNortheast NigeriaQualitative researchTrustVaccine hesitancy

Identifiers

PMID41764511
PMCPMC13049947

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.