A Retrospective Analysis of Adolescent Pregnancy and Child Mortality Cases in Kota Kinabalu, Sabah Introduction Under-five mortality remains a critical public health challenge, particularly among vulnerable and underserved populations. This study aimed to identify distinct socio-clinical profiles associated with under-five deaths in Kota Kinabalu from 2020 to 2024 and to compare risk patterns between adolescent and adult mothers using cluster analysis. Methods A retrospective analysis of district health records was conducted. A total of 818 under-five mortality cases were included, of which 55 involved adolescent mothers (10–19 years). K-means clustering was applied to maternal-socioeconomic and clinical variables to identify distinct profiles. The optimal number of clusters was determined using silhouette scores and stability testing. Associations between cluster membership and maternal-child health variables were evaluated using chi-square tests. Results Three clusters emerged. Cluster 2 represented the most vulnerable group, predominantly comprising non-citizen adolescent mothers with no formal education, household incomes below RM 1,000, and inadequate antenatal care. This cluster exhibited the highest rates of preterm births and preventable under-five deaths. Significant associations were identified between cluster membership and maternal age, citizenship status, education level, antenatal care, and birth outcomes. Under the death category, 61.7% of child deaths were classified as preventable, highlighting areas for intervention, while 38.3% were deemed not preventable. Conclusions Intersecting social disadvantages such as young maternal age, non-citizenship, low education, and poverty amplify risks for both mothers and children. Addressing these broader determinants through culturally sensitive, accessible maternal health services and targeted adolescent outreach is essential. Integrating cluster analysis into surveillance can enable early identification of high-risk groups and support equity-focused interventions to reduce preventable child mortality.

The coronavirus disease (COVID-19) pandemic has led to an alarming increase in domestic violence against women owing to lockdown measures and limited access to support services. This article provides insights into the global prevalence of domestic violence, barriers to seeking help, its impact on women and children, and the best practices implemented worldwide. Domestic violence encompasses various forms of abuse; many young women experience partner violence. Barriers to seeking help include fear, financial constraints, lack of awareness of available services, and distrust among stakeholders. The consequences of domestic violence affect the mental health of both mothers and children. Countries have increased shelter funding and developed innovative protocols to reach survivors and address this issue. However, the healthcare sector’s involvement in addressing domestic violence has been limited. This review advocates collaboration among healthcare institutions and government bodies. Key recommendations include utilizing telehealth services, implementing comprehensive training programs, establishing effective referral systems, enhancing health education, developing a domestic violence registry, improving the responses of law enforcement and justice systems through healthcare integration, promoting data sharing, and conducting further research. Healthcare systems should recognize domestic violence as a public health concern and detect, prevent, and intervene in cases to support survivors.

Elderly abuse and neglect are among the primary public health problems linked to global demographic changes in the population, impacting not only the well-being of the elderly but also the growth of the nation or economy. This article discusses the effects of elder abuse and neglect on population health from the national and international perspectives through a narrative review of previously published articles on the concept of aging, the prevalence of elderly abuse and neglect, its risk factors and effects, and finally measures, legal perspectives, and recommendations to curb it. Interventions in Malaysia and selected nations, including Indonesia, South Korea, the United States, Australia, and Hong Kong, are examined. This issue is important as the majority of countries are moving toward being elderly populations. Improving global surveillance and the monitoring of instances is essential to inform policy actions to prevent elder abuse. In addition, a thorough assessment of the identified risk factors for violence and steps to prevent violence is required.