Background Mother-newborn skin-to-skin contact (SSC) involves placing the naked infant on the mother's bare chest within the first hour of birth and is crucial for thermoregulation, bonding, breastfeeding initiation, and promoting neonatal health. This study examined the prevalence, and factors associated with SSC in Afghanistan.

Methods Data from the Afghanistan Multiple Indicator Cluster Survey (MICS) 2022-23 were used and analysed from ever-married women, aged 15-49 years, who delivered a live infant in the past 2 years. The outcome was SSC, placing the naked infant on the mother's bare chest and initiating breastfeeding within the first hour of birth. Adjusted odds ratios [AOR: (95%CI)] of factors associated with SSC were obtained by a logistic regression model.

Results Of 11,992 women, 32.9% practiced SSC. The likelihood of SSC was greater in women with primary [1.38 (1.14-1.68)] and secondary or higher [1.29 (1.06-1.57)] education, in women who had access to media [1.36 (1.11-1.65)], and those who owned mobile phones [1.27 (1.11-1.45)]. The likelihood of SSC was lower in women who delivered at home [0.26 (0.21-0.33)], those who delivered at private clinics or hospitals [0.50 (0.41-0.61)], and those with cesarean section [0.12 (0.08-0.17)]. Women living in rural areas, and women with deliveries conducted by traditional birth attendants/community healthcare workers and by relatives/others had lower odds of SSC [0.76 (0.63-0.92), 0.37 (0.27-0.53), 0.45 (0.33-0.59), respectively].

Conclusion The low prevalence of SSC in Afghanistan highlights the need for targeted health interventions. Efforts should focus on improving access to public clinics and hospitals, enhancing education, training of healthcare providers, and leveraging media and mobile phone access to promote SSC. Interventions should prioritize rural women and women who have undergone cesarean sections to increase SSC rates and improve neonatal health outcomes.