Knowledge, Attitudes, and Reported Practice Indicators for Neonatal Jaundice Management Among Nurses in Mogadishu, Somalia: A Cross-Sectional Study

Abstract Background Neonatal jaundice is common in the first days of life, but severe hyperbilirubinemia can cause acute bilirubin encephalopathy, kernicterus, permanent neurological injury, and death. Nurses are central to early recognition, phototherapy care, monitoring, and referral, yet evidence on their preparedness in Somalia is scarce. We assessed nurses’ knowledge, attitudes, and reported practice indicators regarding neonatal jaundice in Mogadishu and examined associated factors. Methods We conducted a hospital-based descriptive cross-sectional survey among 133 nurses recruited purposively from three hospitals in Mogadishu between November 2025 and July 2026. A structured questionnaire collected sociodemographic characteristics and knowledge (eight scored items), attitude (five scored items), and practice items. Knowledge and attitude scores were classified as good, moderate, or poor. Data were analyzed in IBM SPSS Statistics using frequencies, Pearson chi-square tests, Spearman correlation, and exploratory binary logistic regression. Practice items were analyzed individually. Results Seventy-five nurses (56.4%) had good knowledge, 25 (18.8%) moderate, and 33 (24.8%) poor knowledge; 99 (74.4%) met the study-defined favorable-attitude threshold, 23 (17.3%) were in the moderate category, and 11 (8.3%) in the poor category. Knowledge was associated with age group (p = 0.040), education, professional rank, and work unit (each p < 0.001). Attitude was associated with age, marital status, education, rank, work unit, and experience. Knowledge and attitude scores were positively correlated (Spearman rho = 0.643, p < 0.001). In exploratory adjusted models, degree-or-higher education (OR 10.84, 95% CI 1.11–105.69), staff/senior-staff rank (OR 4.02, 1.07–15.02), and NICU employment (OR 3.55, 1.34–9.44) were associated with good knowledge, while staff/senior-staff rank (OR 5.65, 1.50–21.23) and NICU employment (OR 17.11, 4.82–60.76) were associated with good attitude. Most nurses (89.5%) had cared for jaundiced neonates and 88.0% assessed jaundice by observing skin and sclera; 51.1% selected providing eye care during phototherapy and 70.7% identified overheating as a phototherapy complication. Conclusions Just over half of the nurses had good knowledge and about three-quarters met the study-defined favorable-attitude threshold, with important gaps in knowledge of causes and risk factors. Knowledge and attitudes were higher among nurses with degree-level education, higher rank, and NICU experience. Competency-based training, protocol support, and clinical audit are needed, and future studies should use a validated practice instrument combined with direct observation.