Reproductive Health最新文献

{"title":"Adverse maternal and neonatal outcomes in Northern Sudan: the role of antenatal care and socioeconomic inequities in war.","authors":"Suodad Elhassan, Marwa Osman, Ayat Altaher, Reem Mohamedalhassan Ahmed Mohamed, Saja Salah, Swsan Elsharif, Elshimaa Yousif","doi":"10.1186/s12978-025-02129-4","DOIUrl":"https://doi.org/10.1186/s12978-025-02129-4","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization (WHO) has recommended increasing the minimum number of antenatal care (ANC) contacts from four to eight. High rates of maternal and neonatal complications and low ANC coverage are significant concerns in Sudan, especially after the war erupted. This study investigated the patterns of adverse maternal and neonatal outcomes and their correlation with ANC use and socioeconomic profile.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on 267 postpartum women using convenience sampling in three public hospitals and one private clinic in Merowe locality, Northern Sudan. Structured interviews were conducted to collect data on socioeconomic and maternal characteristics, ANC use, and adverse maternal and neonatal outcomes. Descriptive, bivariate, and multivariate analyses were performed using Statistical Package for Social Science (SPSS).</p><p><strong>Results: </strong>The perinatal death rate was 3.4%. Preterm delivery and neonatal ICU admission rates were 10.1% and 7.1%, respectively. Adverse maternal outcomes occurred in 26.2% of the cases, with gestational hypertension (7.5%) and dystocia (4.1%) being the most prevalent. Displaced women showed higher rates of eclampsia and preeclampsia (p value = 0.002). Predictors of adverse maternal outcomes were gravidity of more than five (Adjusted Odds Ratio 2.55; 95% CI 1.04-6.23), rural residence (AOR = 2.52; 95% CI 1.25-5.12), and history of adverse events (AOR = 3.15; 95% CI 1.67-5.92). Fewer than four ANC contacts were associated with more perinatal deaths (p value = 0.032), while ≥ 8 visits did not improve the outcomes.</p><p><strong>Conclusions: </strong>The rate of adverse maternal outcomes was high and was influenced by obstetric and socioeconomic profiles. Attending at least four ANC visits was significantly associated with better birth outcomes. Addressing the social determinants of health and implementing screening programs for high-risk women are recommended.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"186"},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlock the drivers of early ANC visits among pregnant women in Kasulu town council, Tanzania: an institutional cross-sectional study.","authors":"Winfrida Benedicto Lyoba, Chakupewa Joseph Mpambije, Joyce Donald Mwakatoga","doi":"10.1186/s12978-025-02162-3","DOIUrl":"https://doi.org/10.1186/s12978-025-02162-3","url":null,"abstract":"<p><strong>Background: </strong>Maternal and child mortality remains a global public health challenge. Thus, countries, including Tanzania, have adopted different cost-effective models, especially antenatal care (ANC) to improve maternal and child health (MCH). Despite the early timing of ANC visits having a great implication for ensuring improved MCH services, Tanzania has disproportionately experienced late ANC visits among pregnant women. This has entailed conducting an institutional-based study in Western Tanzania, Kasulu Town Council (KTC) to ascertain whether demographic socio-economic and maternal characteristics imply the persistence of late ANC visits using robust methods.</p><p><strong>Methods: </strong>An institutional cross-sectional study design was conducted in KTC, Kigoma Region using an embedded mixed-method approach from March-April 2020. Quantitative data was collected from 320 women with children aged 0-6 months attending postnatal services. A total of 40 participants were involved in the qualitative study through in-depth interviews with healthcare providers and focus group discussions held with pregnant women and women with children aged 0-6 months. Descriptive statistics and multivariate binary logistic regression were used to determine the characteristics associated with the timing of ANC visits among pregnant women. Furthermore, thematic analysis was used to generate themes triangulated with quantitative results.</p><p><strong>Results: </strong>Findings revealed that 32.2% of pregnant women attended ANC visits in the first trimester. Early ANC was associated with maternal age (AOR = 1.839, 95% Cl: 1.023, 3.303), being accompanied by a partner (AOR = 2.165, 95% Cl: 1.256, 3.733), and awareness of the danger signs (AOR = 2.079, 95% Cl: 1.172, 3.687) and parity (AOR = 2.164, 95% Cl: 1.091, 4.291). Little association was noted in the knowledge of ANC timing (AOR = 0.564, 95% Cl: 0.320, 994) and household income (AOR = 0.529, 95% Cl: 0.281, 0.995). Qualitative data indicated that low rate of early ANC initiation was attributed to a lack of support from partners and accompanied to ANC visits, insufficient knowledge of the timing of early ANC visits, and socio-cultural beliefs.</p><p><strong>Conclusion: </strong>Results confirmed that early ANC visit in KTC is low. Revealed associated factors act as a bridge to improve maternal and newborn health and contribute to achieving Sustainable Development Goal no 3, which targets maternal mortality of less than 70 deaths per 100,000 live births and neonatal mortality of 12 per 1000 live births by 2030. Proposed integrated interventions can potentially ensure that women, regardless of pregnancy status, are encouraged to receive early ANC utilisation during the first trimester to receive antenatal care before delivery to improve maternal and newborn health.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"187"},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the issues of women's empowerment and fertility in Bangladesh.","authors":"Shanjida Chowdhury, Md Aminul Haque","doi":"10.1186/s12978-025-02065-3","DOIUrl":"https://doi.org/10.1186/s12978-025-02065-3","url":null,"abstract":"<p><strong>Background: </strong>Traditional cultural norms in Bangladesh often restrict women's autonomy to decide and voice their opinions regarding fertility. This study tried to understand how Bangladeshi women's perceptions, views, and experiences regarding women's empowerment (WE) influence their total number of children, desired number of children, birth spacing, and gender preferences.</p><p><strong>Methods: </strong>A qualitative research design was used to investigate the impact of WE on fertility in Dhaka City. The study conducted seven focus group discussions (FGDs) and twenty-nine in-depth interviews (IDIs) with 93 married women aged 15-49 years. A purposive sampling technique was used to select the study participants, and thematic analysis was conducted to identify key patterns and insights.</p><p><strong>Results: </strong>The results show that higher levels of Women's empowerment were associated with a preference for smaller family sizes and delayed childbearing. Empowered women exhibit greater self-confidence and independence in expressing opinions and making decisions in both household and societal settings. Economic empowerment enhances women's bargaining power and decision-making capabilities regarding the timing and number of children. However, the prevalent preference for sons still significantly impacts these choices.</p><p><strong>Conclusion: </strong>The study identified significant sociocultural barriers, including family pressure, gender preference, lack of critical consciousness, and misconceptions about contraceptives that hinder WE toward fertility decisions. Addressing these enduring cultural and societal barriers requires immediate and thorough interventions focused on economic, psychological, and sociocultural empowerment. Increasing autonomy in fertility decision-making is crucial for achieving more equitable reproductive health outcomes.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"185"},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness and predictors of knowledge about sexually transmitted diseases among early adolescents in koforidua, ghana: a mixed-methods study.","authors":"Richard Ofori, Mary Sefa Boampong, Andrew Nketsia Arthur, Dorcas Sekyi, Seth Christopher Yaw Appiah","doi":"10.1186/s12978-025-02070-6","DOIUrl":"https://doi.org/10.1186/s12978-025-02070-6","url":null,"abstract":"<p><strong>Background: </strong>This study explores the awareness and predictors of knowledge regarding sexually transmitted diseases among early adolescents (ages 11-15) in the Koforidua Municipality.</p><p><strong>Methods: </strong>The study was designed as convergent parallel mixed-methods research hinged on an analytical cross-sectional and descriptive phenomenological design. In all, 373 adolescents were surveyed, obtaining varied insights across different demographic groups, with an additional 10 interviews conducted for qualitative analysis. Quantitative data were analyzed using descriptive statistics and multilevel logistic regression, while the qualitative data were thematically analyzed.</p><p><strong>Results: </strong>Two-thirds (67.3%) of early adolescents reported awareness of STDs. 134(53.4%) out of the 251 early adolescents who were aware of STDs opted to test for them. HIV (M = 1.33, SD = 0.699), and Gonorrhea (M = 1.55, SD = 0.827) were the most commonly recognized infections but misconceptions about Syphilis (M = 1.94, SD = 0.929), Chlamydia (M = 2.49, SD = 0.778), Genital wart (M = 2.35, SD = 0.854) and Hepatitis (M = 2.36, SD = 0.755) as types of STDs were dominant. Early adolescents in Junior High School -JHS1 (AOR 0.307 (95.0% CI 0.111-0.847 p = 0.023), JHS 2 (AOR 0.201 (95.0% CI 0.070-0.579 p = 0.003), JHS 3 (AOR 0.134 (95.0% CI 0.043-0.414 p = 0.00) were less likely to know STDs compared to those in primary six. Early adolescents who had never dated (AOR 0.705 (95.0% CI 0.423-1.173 p = 0.014) were also less likely to know about STDs compared to those who had ever dated.</p><p><strong>Conclusion: </strong>The findings highlight the need for the Ghana Education Service to integrate comprehensive sexual health education into primary and junior high school curricula to improve STD knowledge among early adolescents.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"184"},"PeriodicalIF":3.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implications of digital fertility tracking for clinical care: a qualitative systematic review.","authors":"Kathryn Sheridan Clay, Tori Ford, Rosa Mackay, Sabrina Keating, Sue Ziebland, John Powell","doi":"10.1186/s12978-025-02083-1","DOIUrl":"https://doi.org/10.1186/s12978-025-02083-1","url":null,"abstract":"<p><p>Research on the use of digital health interventions for the management of infertility is still emerging and remains understudied. This review syntheses cross-domain qualitative research on the use of digital fertility trackers. We identified 29 papers and thematic analysis found that these tools are most frequently used alongside, but also sometimes in place of clinical care. The research shows that they pose significant disruption to patient-provider relationships and the broader fertility industry and may place patients at risk when developed without a strong research or medical base, or if used incorrectly. More work is needed on the impact of these tools on care pathways, and to provide guidance on differentiating evidence-based platforms from low quality trackers to safeguard patients and improve fertility treatment outcomes.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"183"},"PeriodicalIF":3.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The burden of infertility in north-eastern Democratic Republic of Congo, a high-fertility region: a cross-sectional study.","authors":"Mike-Antoine Maindo Alongo, Noël Labama Otuli, Jean-Jeannot Juakali Sihakiyolo, Salomon Batina Agasa, Sarah Missimbu Mayindu, Bienvenu Antony Ilongosi, Louise Bamawa Bahaisi, Katenga Bosunga","doi":"10.1186/s12978-025-02111-0","DOIUrl":"10.1186/s12978-025-02111-0","url":null,"abstract":"<p><strong>Background: </strong>Infertility affects millions of couples worldwide and regions with high fertility rates are the most affected. This study aims to determine the proportion of infertile couples during gynecological consultations in Kisangani, identify the aetiological factors involved, and assess the responsibility of partners.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in seven health facilities in Kisangani, following a two-month campaign of free gynecological consultations in 2023. The ratios were subjected to Pearson's chi-square test or Exact Fisher with a significance level of p < 0.05. The data was analysed using Epi Info™ software version 7.2.2.6.</p><p><strong>Results: </strong>Of the 1,434 female patients who consulted for a gynecological problem, 697 (48.61%) were infertile, predominantly secondary (78.78%) with a mean duration of 3.43 ± 2.79 years. Among the female reproductive system factors involved in infertility, ovarian factors was identified among 43.21% of cases, tubal factors among 64.63% of cases and uterine factors among 19.69% of cases. Polycystic ovarian syndrome (PCOS) was found to be associated with primary infertility, while bilateral obstruction and bilateral hydrosalpinx were associated with secondary infertility. Bacterial vaginosis was identified in 53.54% of patients, while 43.4% exhibited antisperm antibodies. A positive diagnosis for Chlamydia trachomatis was associated with secondary infertility. Among males, 44.55% of them had a sperm abnormality wich was in association to primary infertility. Oligospermia was the most prevalent semen abnormality (21.03%) and associated to primary infertility. Regarding partner responsibility, women was solely responsible in 25.23% of cases and men in 18.16%. Both partners were responsible in 29.06% of cases and in 27.53% of cases, the cause of infertility remained unexplained.</p><p><strong>Conclusion: </strong>Infertility represents a significant public health concern in Kisangani, with approximately one-quarter of cases remaining unexplained. Given the high prevalence of bacterial vaginosis and anti-sperm antibodies, it is imperative to conduct studies to ascertain whether there is a correlation between these factors and unexplained infertility.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"182"},"PeriodicalIF":3.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of maternal and child health services in Tanzanian primary healthcare: a 2021-2022 star rating review.","authors":"Erick S Kinyenje, Martin M Degeh, Joseph C Hokororo, Syabo M Mwaisengela, Ruth R Ngowi, Omary A Nassoro, Chrisogone J German, Radenta P Bahegwa, Yohanes S Msigwa, Atuganile Musyani, Laura E Marandu, Michael Habtu, Jennifer T Mbise, Habibu Ismail, Janeth Masuma, Faraja Msemwa, Joanita Muruve, Saturini Manangwa, Daudi Msasi, Jimmy Mbelwa, Athman Pembe, Ahmad M Makuwani, Ntuli A Kapologwe, Tumaini J Nagu, Eliudi S Eliakimu","doi":"10.1186/s12978-025-02105-y","DOIUrl":"10.1186/s12978-025-02105-y","url":null,"abstract":"<p><strong>Background: </strong>Tanzania faces high maternal and infant mortality rates, yet key service quality metrics remain underexamined, limiting targeted improvements. Star Rating Assessment (SRA), introduced in 2015, aims to improve primary health care (PHC) quality, including maternal and child health (MCH) services. This study analyses SRA data to assess the prevalence of PHC quality in MCH and its associated factors.</p><p><strong>Methods: </strong>Data for this cross-sectional study were collected from November 2021 to March 2022 across 10 regions. The tool used included 12 MCH-related indicators, each comprising specific criteria. Facilities scoring ≥ 80% across these criteria were considered to meet MCH quality standards, which was the primary study outcome. A descriptive analysis of indicator performance was conducted, followed by multivariate logistic regression to assess characteristics associated with achieving the quality standard. Results are reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of 2,583 facilities assessed: 2,189 dispensaries (84.7%), 303 health centres (11.7%), and 91 district-level hospitals (3.5%). Only 280(10.8%) met the MCH quality standards. Maternal audit and review practices aligned with guidelines in 2,057 facilities (79.6%). Moderate adherence was observed for family planning guidelines (48.3%), accurate partogram completion (47.9%), and immunisation standards (46.3%). Major gaps included cervical cancer screening, offered by 199 facilities (7.7%), and essential obstetric medicines, available in 424 facilities (16.4%). Among 394 hospitals and health centres, only 60(15.2%) offered postnatal and essential newborn care with dedicated neonatal and Kangaroo Mother Care spaces. Compliance was higher in public, rural, and higher-level facilities. Nurse availability, functional management, and quality improvement teams were key predictors of MCH quality.</p><p><strong>Conclusion: </strong>The quality of MCH services in Tanzania varies widely by facility type, ownership, nurse staffing, and management functionality. Targeted improvements in cervical cancer screening, emergency obstetric care, and newborn care are essential to raise overall MCH service standards.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"180"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the childbearing decision-making process in mothers of children with autism spectrum disorder and designing and validation of a childbearing program: A study protocol.","authors":"Mahla Salarfard, Talat Khadivzadeh, Javad Moghri, Kobra Mirzakhani","doi":"10.1186/s12978-025-02142-7","DOIUrl":"10.1186/s12978-025-02142-7","url":null,"abstract":"<p><strong>Background: </strong>One of the most important demographic challenges in the world over the last three decades has been the significant decline in fertility rates. Fertility decision making is one of the major events in a couple's life and can be a complex process, especially for families who have a child with a history of a multifactorial disease, such as autism spectrum disorder. Therefore, the present study will be aim to discover the childbearing decision-making process in mothers of children with autism spectrum disorder and design and validate a childbearing program for this mothers.</p><p><strong>Methods: </strong>The present study will be conducted in three phases. In the first stage, a qualitative research will be conducted using the Strauss and Corbin grounded theory approach. In this study, the main participants are mothers who have at least one autistic child, who meet the inclusion criteria for the study. In the first phase, sampling will be done with purposive and theoretical method. The date will be gathered through semi-structured in-depth interviews, field notes, and observations of individual interactions. The Strauss and Corbin 2015 approach will be used to analyze the data. MAXQDA 2020 software will be used for managing the process of data analysis. In the second phase of the present study, a program using a logic model will be designed to support decision-making regarding childbearing among mothers of children with autism. Finally, validation of the developed program will be achieved by using the nominal group technique with a panel of experts during the third phase.</p><p><strong>Discussion: </strong>In this research, as a result of the needs, challenges and problems of mothers of children with autism spectrum disorder in the context of their decision to have children, a supportive program will be presented using a logical model that is suitable for policy makers, planners and service providers to be implemented in the socio-cultural context of the study.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"178"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-ethical and legal issues regarding surrogacy in Ghana: a qualitative study.","authors":"Rosaline Akangah, Amanda Debuo Der, Promise Emmanuel Sefogah, John Ganle","doi":"10.1186/s12978-025-02007-z","DOIUrl":"10.1186/s12978-025-02007-z","url":null,"abstract":"<p><strong>Introduction: </strong>Surrogacy has recently emerged as a crucial fertility treatment solution due to the development of in-vitro fertilization (IVF). There are however a number of socio-ethical and legal issues, including parental rights, children's basic human rights, and abuse of women, most notably surrogate exploitation. In Ghana, these socio-ethical issues have not been well studied. This study aimed to explore the socio-ethical and legal issues regarding surrogacy in Ghana.</p><p><strong>Method: </strong>A phenomenological qualitative study was conducted. A total of 13 participants comprising couples undergoing fertility treatments, surrogates, fertility specialists, lawyers, and bioethicists were selected using a combination of purposive and snowball sampling. Data were collected via in-depth interviews. In-depth interviews were tape-recorded and transcribed verbatim. A thematic content analysis approach was used to analyse the data and results were presented using quotes.</p><p><strong>Results: </strong>The results suggest that couples will resort to surrogacy when all treatments have failed. This decision is however influenced by age, economic status, family and societal pressure. Surrogates are both altruistically and monetarily motivated to enter into surrogacy arrangements. However, surrogacy practice in Ghana is marred with numerous ethical issues including lack of informed consent, exploitation, abuse, issues of compensation and maltreatment of surrogates. These issues are compounded by a weak legal and regulatory framework which is unable to address uncertainties and abuse.</p><p><strong>Conclusion: </strong>Even though surrogacy has come to address infertility issues in infertile couple, it is faced with ethical issues and weak legal system. Specific legislation on Assisted Reproductive Technologies (ARTs) and surrogacy is urgently needed to address the uncertainties in the practice, protect the rights of surrogates, and minimize abuse. Clinical Trial Number Not applicable.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"181"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disability status and socioeconomic related inequality in receiving quality antenatal care in nine low- and middle-income countries: A multilevel analysis.","authors":"Ebisa Turi, Lisa Gold, Ha N D Le, Hasheem Mannan, Eric H Y Lau, Julie Abimanyi-Ochom","doi":"10.1186/s12978-025-02075-1","DOIUrl":"10.1186/s12978-025-02075-1","url":null,"abstract":"<p><strong>Background: </strong>Quality of antenatal care (ANC) is a cornerstone to achieving progress in maternal and child health. ANC quality has not been fully explored among women with disability (WwD). We assess socioeconomic inequalities in utilization of quality ANC among reproductive aged women with and without disability.</p><p><strong>Methods: </strong>This study utilized Demographic and Health Survey (DHS), which is population-based survey conducted nine low-and middle-income countries (LMICs): Mauritania (2019-21), Rwanda (2019-20), South Africa (2016), Mali (2018), Senegal (2019), and Uganda (2016), Cambodia (2021-22), Pakistan (2017-18), and Timor-Leste (2016). Disability status was measured by the Washington Group Short Set questionnaires (WG-SS) and quality of ANC was measured by a validated tool (ANCq), constructed from seven aspects of quality ANC: number of ANC, timely initiation, blood pressure measurement, blood and urine samples taken, and minimum of two doses of tetanus toxoid immunization. Wealth-related inequality in utilization of quality ANC was measured by concentration indices. Mixed-effects logistic regression fitted, and result presented in Adjusted odds ratio (AOR) with 95% confidence interval (CI).</p><p><strong>Results: </strong>One in seven women (14.0%) had at least some difficulty in at least one domain of function. While most participants (90.3%) had at least one ANC visit, high-quality ANC was received by only 42.6% with 38.8% among WwD. Five out of seven aspects of ANCq were lower among WwD compared to WwoD. The overall receipt of high-quality ANC is pro-rich (CCI 0.27, 95% CI: 0.26-0.29), however the inequality among WwD and WwoD differs across countries. Coverage of high-quality antenatal care varied between countries, from 78.5% in Cambodia to 30.9% in Mali. The odds of receiving high-quality ANC were lower among WwD (AOR = 0.88, 95% CI: 0.83-0.94), higher for wealthier households (AOR = 2.16: 95% CI: 1.94-2.41) richest compared to poorest quintile) and lower for women facing significant barriers to healthcare (AOR = 0.76, 95% CI: 0.72-0.80).</p><p><strong>Conclusions: </strong>Despite high initial ANC visit, a significant portion of women, particularly WwD, received lower quality ANC than recommended. These findings highlight the disadvantages faced by WwD, who have fewer ANC visits and substandard care when services are available. Regional disparities demonstrate the need for region-specific strategies. Reducing barriers to healthcare access, particularly for disadvantaged populations, are crucial steps towards achieving equitable maternal health outcomes across LMICs and achievement of SDG3.1 by 2030.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"179"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}