Reproductive Health最新文献

{"title":"Burden of uterine cancer in China from 1990 to 2021 and 15-year projection: a systematic analysis and comparison with global levels.","authors":"Zhan Lin, Mei Gan, Xiangping Wang, Zhonghua Su","doi":"10.1186/s12978-024-01882-2","DOIUrl":"https://doi.org/10.1186/s12978-024-01882-2","url":null,"abstract":"<p><strong>Objective: </strong>Uterine cancer (UC) is one of the prevalent malignancies in the female reproductive system. Estimating the burden trends of UC is crucial for developing effective prevention strategies at the national level. However, there has been no comprehensive analysis of the UC burden in China. We focused on the evaluation of the burden trends of UC in China over the past 32 years to provide a 15-year projection, comparing it with global levels.</p><p><strong>Methods: </strong>Data on incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were extracted from Global Burden of Disease (GBD) 2021 to describe the burden of UC in China. Joinpoint regression analysis was employed to describe the temporal trends of UC in China and globally over the past 32 years. A Bayesian age-period-cohort model was utilized to predict the trends of UC in the next 15 years. Spearman correlation analysis was used to compare the relationship between ASIR, ASPR, ASMR, ASDR, and SDI in UC in China and globally. Changes in ASMR and ASDR in UC caused by high BMI in China and globally from 1990 to 2021 were explored.</p><p><strong>Results: </strong>In 2021, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) of UC in China were 6.65, 46.52, 1.24, and 37.86 (per 100,000 population) respectively. Compared to 1990, the ASMR and ASDR decreased by 48.63% and 48.15% respectively, while the ASIR and ASPR increased by 17.79% and 37.67% respectively. Globally, the burden of UC followed a similar trend in China, with increasing ASIR and ASPR, and decreasing ASMR and ASDR, although the magnitude of increase and decrease was smaller than in China. Joinpoint regression analysis results showed an overall upward trend in ASIR and ASPR for both China and global UC, while an overall downward trend was observed in ASMR and ASDR. Age-specific analysis revealed that during the period from 1990 to 2021, the age groups with the highest incidence, prevalence, mortality, and DALYs for UC in China generally occurred at earlier ages compared to the global pattern. It is projected that over the next 15 years, the burden of UC in China will continue to increase at a higher rate than the global level. Spearman correlation analysis showed that ASIR and ASPR of UC in China and the world were significantly positively correlated with SDI (p < 0.05), and ASMR and ASDR were significantly negatively correlated with SDI (p < 0.001). High BMI is a risk factor affecting the mortality rate and DALYs of UC in both China and globally, with the increase in ASMR and ASDR due to high BMI being greater in China than globally.</p><p><strong>Conclusion: </strong>The incidence and prevalence burden of UC among Chinese and global women have shown an increasing trend over the past 32 years, while the mortality and DALYs have decreased. The projected burden of UC in China is ","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401109","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":"\"I managed to stand on my own. I saved my baby's life.\": qualitative analysis of birth experiences from women living with HIV in Cape Town, South Africa.","authors":"Alison Z Weber, Destry Jensen, Kira DiClemente-Bosco, Nokwazi Tsawe, Lucia Knight, Landon Myer, Jennifer A Pellowski","doi":"10.1186/s12978-024-01881-3","DOIUrl":"10.1186/s12978-024-01881-3","url":null,"abstract":"<p><strong>Background: </strong>There is growing recognition of obstetric violence in health facilities across the globe. With nearly one in three pregnant women living with HIV in South Africa, it is important to consider the influence of HIV status on birth experiences, including potential experience of obstetric violence as defined by the Respectful Maternity Care Charter. This qualitative analysis aims to understand the factors that shape birth experiences of women living with HIV, including experiences at the nexus of HIV status and obstetric violence, and how women react to these factors.</p><p><strong>Methods: </strong>Data were collected in a Midwife Obstetric Unit in Gugulethu, Cape Town, South Africa, through 26 in-depth interviews with women living with HIV at 6-8 weeks postpartum. Interviews included questions about labor and early motherhood, ART adherence, and social contexts. We combined template style thematic analysis and matrix analysis to refine themes and subthemes.</p><p><strong>Results: </strong>Participants described a range of social and structural factors they felt influenced their birth experiences, including lack of resources and institutional policies. While some participants described positive interactions with healthcare providers, several described instances of obstetric violence, including being ignored and denied care. Nearly all participants, even those who described instances of obstetric violence, described themselves as strong and independent during their birth experiences. Participants reacted to birth experiences by shifting their family planning intentions, forming attitudes toward the health facility, and taking responsibility for their own and their babies' safety during birth.</p><p><strong>Conclusions: </strong>Narratives of negative birth experiences among some women living with HIV reveal a constellation of factors that produce obstetric violence, reflective of social hierarchies and networks of power relations. Participant accounts indicate the need for future research explicitly examining how structural vulnerability shapes birth experiences for women living with HIV in South Africa. These birth stories should also guide future intervention and advocacy work, sparking initiatives to advance compassionate maternity care across health facilities in South Africa, with relevance for other comparable settings.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392812","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":"Assessment of the impact an educational intervention on post-traumatic stress disorder and social cognitive theory constructs in women with sexual assault experience: a study protocol for a clinical trial.","authors":"Nasrin Vafaeinejad, Zahra Boroumandfar, Ashraf Kazemi, Hamid Nasiri Dehsorkhi, Sosan Sohrabi","doi":"10.1186/s12978-024-01866-2","DOIUrl":"10.1186/s12978-024-01866-2","url":null,"abstract":"<p><strong>Background: </strong>The high psychological burden of rape, together with complications such as pregnancy and chronic conditions, is associated with an increase in mental disorders. Social cognitive theory (SCT) is an important health theory that views behavior as dynamic and influenced by environmental, behavioral and individual factors. The aim of the present research is to determine the effect of an educational intervention on post-traumatic stress disorder and social cognitive theory constructs in women who have experienced sexual assault.</p><p><strong>Methods/design: </strong>This study is randomized, double-blind clinical trial research that will be conducted on 40 women with experience of sexual. In this research, by the intervention program based on social cognitive theory include\" awareness, self-efficacy, outcome expectations and environment. Written consent will be obtained from the participants to participate in the research. Participants in the intervention group will be taught about health, hygiene, psychology and stress reduction methods in group or individual sessions according to their preference in 6 sessions of 60 min each, one session per week. A post-test will be conducted for both groups.</p><p><strong>Discussion: </strong>This study provides comprehensive data on the effect of providing an educational intervention using the social cognition Theory. Social cognitive theory focuses on how patterns of behavior are learned and how they function in interaction between the individual and the environment. It seems that the use of this theory in designing the content of educational interventions can be useful and practical.</p><p><strong>Trial registration: </strong>The trial is prospectively recorded at the IRCT registry (Trial ID: IRCT20230926059526N1. Date recorded: 18/10/2023.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392813","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":"The reasons for and influences of unintended teenage pregnancy in Kericho county, Kenya: a qualitative study.","authors":"Rio Harada, Atsuko Imoto, Louisa Ndunyu, Ken Masuda","doi":"10.1186/s12978-024-01872-4","DOIUrl":"10.1186/s12978-024-01872-4","url":null,"abstract":"<p><strong>Background: </strong>Unintended teenage pregnancies are associated with greater health and socio-economic risks for teenage mothers and newborns. In Kenya, the government has declared a target for ending teenage pregnancy by 2030. However, the prevalence of teenage pregnancy has only decreased slightly, demonstrating the need for further efforts. Understanding teenage mothers' own experiences and perspectives is necessary to design appropriate interventions.</p><p><strong>Methods: </strong>A community-based qualitative study was conducted from March to May 2023. Two focus group discussions were conducted with community health volunteers and the mothers of teenage girls. Semi-structured interviews were conducted on the case histories of 19 teenage mothers and 18 key informants. Thematic analysis was subsequently performed using MAXQDA 2022.</p><p><strong>Findings: </strong>Four major reasons emerged for unintended teenage pregnancies: (1) lack of knowledge or awareness about the human reproductive system, (2) lack of knowledge about family planning (FP), (3) financial challenges, and (4) low access to FP. At the study site, cultural norms and stereotypes, such as \"infertility caused by FP,\" \"freedom of sex by promoting FP,\" and \"cultural taboos on having sex before marriage and talking about sexuality,\" were observed as barriers in promoting FP to teenagers. In addition, teenagers from low socio-economic backgrounds were found to be more vulnerable because they can be easily exploited by men who can afford to provide for some of their basic needs. Regarding the influences of unintended teenage pregnancy on teenage mothers' lives, the 19 cases were classified into four categories: (1) dropping out of school, (2) financial challenges, (3) changing relationships with parents, and (4) no major influence. Crucially, unintended teenage pregnancies negatively influenced most study participants. Continuing education, supportive parental attitudes, positive perceptions of the relationship with the child's father, and having future perspectives were identified as factors mitigating the negative influences.</p><p><strong>Conclusions: </strong>Strengthening culturally appropriate comprehensive sexuality education and the school re-entry policy with a supportive environment may prevent unintended teenage pregnancy and mitigate its negative influences. As financial challenges can be both a reason for and a negative influence of unintended teenage pregnancy, economic empowerment interventions are necessary.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392814","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":"Men's involvement in family planning programs: an exploratory study from Karachi, Pakistan.","authors":"Jawaria Mukhtar Ahmed, Farina Gul Abrejo, Xaher Gul, Sarah Saleem","doi":"10.1186/s12978-024-01875-1","DOIUrl":"10.1186/s12978-024-01875-1","url":null,"abstract":"<p><strong>Background: </strong>In Pakistan, family planning has traditionally been perceived as primarily a women's concern, resulting in the exclusion of men from relevant initiatives. This situation is further exacerbated by cultural and social barriers that hinder men's access to family planning services. This study addresses a significant research gap by assessing the extent of family planning service provision for men in urban areas of Karachi. It delves into the exploration of men's involvement in family planning service delivery, identifies existing gaps in services catering to men, records men's perceptions of accessibility and acceptability of these services, and ultimately offers recommendations to enhance men's involvement and strengthen service provision to better meet their needs.</p><p><strong>Methods: </strong>We employed a qualitative exploratory research design using semi-structured interviews to investigate perceptions regarding family planning service provision to men. This approach involved 25 interviews, comprising eight key informant interviews with stakeholders, eight with service providers, and nine in-depth interviews with married men.</p><p><strong>Results: </strong>This study highlights the limited engagement of men in family planning programs, primarily due to entrenched sociocultural norms that confine female healthcare providers to serving women, hindering men's involvement. While national and provincial policies endorse men's participation, they lack defined roles for male providers. Behavioral and information-sharing barriers at the community level discourage male healthcare providers from collaborating with females. Family planning programs, except for NGO-led vasectomy projects, fail to adequately address men's needs. Despite policy recognition, implementation remains inadequate. Bridging the men's involvement gap necessitates more male providers and improved contraceptive stigma combat training. Further research is vital to explore effective methods for involving men in community and service delivery in family planning.</p><p><strong>Conclusion: </strong>There is a need to change the perception that contraception is solely the responsibility of women, as men's participation in family planning in Karachi is limited. Engaging men can yield positive health and non-health outcomes. Culturally sensitive services, developed with community input using a couple-centered approach, are crucial for equitable family planning. Further research is needed to explore men's inclusion strategies in service provision and utilization.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372721","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":"Clinical characteristics and treatment during preconception and perinatal period of infertile women with non-classical 21-hydroxylase deficiency.","authors":"Xuejiao Cui, Ping Li","doi":"10.1186/s12978-024-01874-2","DOIUrl":"10.1186/s12978-024-01874-2","url":null,"abstract":"<p><strong>Objective: </strong>A single-center observational study to determine the clinical characteristics and therapeutic dose adjustments in women of reproductive age with infertility and non-classical 21-hydroxylase deficiency (NC-21OHD).</p><p><strong>Design: </strong>A retrospective analysis of 20 women of reproductive age who were diagnosed with NC-21OHD during an infertility evaluation at Shengjing Hospital of China Medical University from January 2013 to May 2024 was performed. The clinical manifestations, auxiliary examinations, adjustment of glucocorticoid (GC) treatment during preconception and perinatal period, and pregnancy outcomes were analyzed.</p><p><strong>Results: </strong>14 of 16 patients (87.5%) had inappropriately elevated progesterone levels during the follicular phase. The average levels of 17α-hydroxyprogesterone, testosterone, androstenedione, and dehydroepiandrosterone sulfate in the follicular phase were also significantly increased. All 20 infertile patients received GC treatment before preparing for pregnancy. During the follow-up, six of 20 patients had seven conceptions. three patients had spontaneous abortions in the first trimester and four patients delivered babies (4/20). Three patients had a GC dose that was maintained throughout pregnancy and one had an increase in the GC dose starting in the second trimester. Of the remaining 16 patients, seven are still trying to conceive and nine had discontinued treatment.</p><p><strong>Conclusions: </strong>An abnormal increase in the follicular phase progesterone level is the most common serologic marker for NC-21OHD among infertile women. Ovulation can be restored after GC treatment, but the proportion of successful conceptions remains low. The dose of GCs in most pregnant women remained unchanged throughout pregnancy.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361949","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":"Influence of socio-contextual factors on the link between traditional and new media use, and young people's sexual risk behaviour in Sub-Saharan Africa: a secondary data analysis.","authors":"Helen Uche Okoye, Elizabeth Saewyc","doi":"10.1186/s12978-024-01868-0","DOIUrl":"10.1186/s12978-024-01868-0","url":null,"abstract":"<p><strong>Background: </strong>Traditional and new media use links to young people's sexual risk behaviour. The social contexts of young people's daily lives that influence media use and sexual risk behaviour are often investigated as independent causal mechanisms. We examined the link between media use and young people's sexual risk behaviour, considering the intersecting socio-contextual factors in Sub-Saharan Africa.</p><p><strong>Methods: </strong>Age-adjusted bivariate logistic regression models tested the association between traditional media (TV, radio, and newspapers), and new media (mobile phone and online) use and sexual risk behaviour using the Demographic and Health Surveys from six Sub-Saharan African countries among unmarried sexually active youths, aged 15-24 years. Multivariate logistic regression models ascertained the media sources that had an additional influence on young people's sexual risk behaviour, after accounting for socio-contextual factors, and knowledge about HIV and other sexually transmitted infections.</p><p><strong>Results: </strong>Socio-contextual factors attenuated the association between media use and young people's sexual risk behaviour in many countries. However, those who did not have access to new and traditional media were more likely to use unreliable contraceptive methods or not use contraception. Adolescents in Nigeria who did not own phones were 89% more likely to use unreliable contraceptive methods or not use any methods [(AOR = 1.89 (1.40-2.56), p < .001)], those in Angola who did not read newspapers had higher odds of not using contraception or used unreliable methods [(aOR = 1.65 (1.26-2.15), p < .001)]. Young people in Angola (aOR = 0.68 (0.56-0.83), p < .001), Cameroon [(aOR = 0.66 (0.51-0.84), p < .001)], Nigeria [(aOR = 0.72 (0.56-0.93), p = .01)], and South Africa [(aOR = 0.69 (0.49-0.98), p = .03)] who did not own phones were less likely to have 2 or more sexual partners compared to those who owned phones. Lack of internet access in Mali was associated with lower odds of having 2 or more sexual partners (aOR = 0.45 (0.29-0.70), p < .001). Traditional media use was significantly associated with transactional sex in many countries.</p><p><strong>Conclusions: </strong>Media use is linked to sexual risk behaviour among young people in Sub-Saharan Africa. Socioeconomic inequalities, levels of globalization, as well as rural-urban disparities in access to media, underscore the need to deliver tailored and targeted sexual risk reduction interventions to young people using both traditional and new media.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352747","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":"Opportunities for improving abortion care: a key stakeholder analysis of best practices for addressing the needs of transgender, nonbinary, and gender expansive people seeking abortions.","authors":"Aliza J Barnett, Subasri Narasimhan, Sophie A Hartwig, Anna Newton-Levinson","doi":"10.1186/s12978-024-01863-5","DOIUrl":"https://doi.org/10.1186/s12978-024-01863-5","url":null,"abstract":"<p><strong>Objectives: </strong>Transgender, nonbinary, and gender expansive (TGE) persons experience pregnancies and have abortions, yet abortion care remains rooted in a gender binary, often centering the needs, experiences, and challenges of cisgender women. Despite guidance supporting gender-affirming sexual and reproductive healthcare (SRH), barriers for TGE people seeking abortions persist. We conducted an exploratory case study with key informants to understand their perception of TGE abortion seekers' needs with specific considerations for those in restrictive abortion settings.</p><p><strong>Methods: </strong>Qualitative interviews focused on gender-affirming care and abortion provision were conducted with U.S.-based key informant clinicians (n = 4) who could provide powerful insights into gaps and experiences faced by TGE individuals. Participants were eligible if they currently or previously provided abortions and had experience practicing gender-affirming care. Interviews focused on informants' perceptions of TGE patients' needs when seeking abortions.</p><p><strong>Results: </strong>Findings highlight the unique barriers TGE patients face when seeking abortions, including lack of provider knowledge, in-clinic stigmatization, and gender marginalization. It is notable that key informants who practiced in abortion-protective political environments have greater access to resources to implement gender-affirming care than those in restrictive contexts. Results are summarized in a clinical recommendations document which provides an accessible starting point for clinicians to begin building gender-inclusive abortion spaces.</p><p><strong>Conclusions: </strong>It is necessary to further understand barriers facing TGE abortion seekers and integrate recommendations and emerging evidence into abortion practice. This study contributes to a growing knowledge base which emphasizes the need for inclusive abortion spaces and highlights key considerations for improving access and quality for TGE abortions seekers.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352748","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":"Telemedicine for the provision of medication abortion to pregnant people at up to twelve weeks of pregnancy: a systematic literature review and meta-analysis","authors":"Leonardo Cely-Andrade, Karen Cárdenas-Garzón, Luis Carlos Enríquez-Santander, Biani Saavedra-Avendano, Guillermo Antonio Ortiz Avendaño","doi":"10.1186/s12978-024-01864-4","DOIUrl":"https://doi.org/10.1186/s12978-024-01864-4","url":null,"abstract":"Telemedicine represents an important strategy to facilitate access to medication abortion (MAB) procedures, reduces distance barriers and expands coverage to underserved communities. The aim is evaluating the self-managed MAB (provided through telemedicine as the sole intervention or in comparison to in-person care) in pregnant people at up to 12 weeks of pregnancy. A literature search was conducted using electronic databases: MEDLINE, Embase, Cochrane (Central Register of Controlled Trials and Database of Systematic Reviews), LILACS, SciELO, and Google Scholar. The search was based on the Population, Intervention, Comparison, Outcome, and Study Design (PICOS) framework, and was not restricted to any years of publication, and studies could be published in English or Spanish. Study screening and selection, risk of bias assessment, and data extraction were performed by peer reviewers. Risk of bias was evaluated with RoB 2.0 and ROBIS-I. A narrative and descriptive synthesis of the results was conducted. Meta-analyses with random-effects models were performed using Review Manager version 5.4 to calculate pooled risk differences, along with their individual 95% confidence intervals. The rate of evidence certainty was based on GRADE recommendations. 21 articles published between 2011 and 2022 met the inclusion criteria. Among them, 20 were observational studies, and 1 was a randomized clinical trial. Regarding the risk of bias, 5 studies had a serious risk, 15 had a moderate risk, and 1 had an undetermined risk. In terms of the type of intervention, 7 compared telemedicine to standard care. The meta-analysis of effectiveness revealed no statistically significant differences between the two modalities of care (RD = 0.01; 95%CI 0.00, 0.02). Our meta-analyses show that there were no significant differences in the occurrence of adverse events or in patient satisfaction when comparing the two methods of healthcare delivery. Telemedicine is an effective and viable alternative for MAB, similar to standard care. The occurrence of complications was low in both forms of healthcare delivery. Telemedicine services are an opportunity to expand access to safe abortion services. Globally, unsafe abortion causes 47,000 deaths and 5 million sexual and reproductive dysfunctions in young pregnant people due to complications of the procedure. This practice is related to barriers to accessing safe abortion services secondary to health system limitations and inequities in the distribution of resources. Telemedicine has proven to be an efficient care alternative to reduce distancing gaps, decrease waiting time and rationalize the costs derived from the procedure. Consequently, several health systems in the world use this model with differences in treatment schemes, weeks of gestation, pregnancy confirmation methods and measurement of reported outcomes. For this reason, evaluating the effectiveness and safety of self-managed medication abortion (MAB) by telemedicine is a sup","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252991","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":"Socioecologies in shaping migrants and refugee youths’ sexual and reproductive health and rights: a participatory action research study","authors":"Michaels Aibangbee, Sowbhagya Micheal, Pranee Liamputtong, Rashmi Pithavadian, Syeda Zakia Hossain, Elias Mpofu, Tinashe Dune","doi":"10.1186/s12978-024-01879-x","DOIUrl":"https://doi.org/10.1186/s12978-024-01879-x","url":null,"abstract":"This study explores socioecological factors facilitating the sexual and reproductive health and rights (SRHR) experiences of migrant and refugee youth (MRY) in Greater Western Sydney, Australia. MRY may be at higher risk for poorer SRH outcomes due to cultural, linguistic, and systemic barriers. Using participatory action research, 17 focus groups were conducted with 87 MRY aged 15–29 from diverse cultural backgrounds. Data were analysed thematically, using socioecological framework. Key facilitators of MRY's SRHR were identified at the microsystem and exosystem levels, including (1) Peer dynamics and support, with friends serving as trusted confidants and sources of advice; (2) Safety and contraceptive choices, highlighting the importance of access to contraception and STI prevention; and (3) Digital platforms for SRHR information access, with online resources filling knowledge gaps. Findings suggest the need for SRHR interventions to leverage peer support networks, expand access to contraceptive options, and develop culturally appropriate digital resources for MRY. Further research is needed to identify and enhance facilitators across all socioecological levels to comprehensively support MRY's SRHR needs. Migrants and refugee youth often struggle to access sexual and reproductive health information and services in their new countries. This study is an attempt to understand what helps young migrants and refugee maintain their sexual and reproductive health and rights in Greater Western Sydney, Australia. Our aim was to identify the positive factors in their environment that make it easier for them to access and use sexual health resources. We talked to 87 migrants and refugee youth aged 15–29 from various cultural backgrounds, conducting 17 group discussions about their experiences with sexual health. Our main results show three important factors that help these young people. The results were, that (1) Many young people trust their friends for advice and information about sexual health, (2) Having choices about contraception and ways to prevent sexually transmitted infections was important, and (3) The internet, especially social media and search engines, is a major source of sexual health information for young people. Understanding these helpful factors can guide better support for young migrants and refugees. It shows sexual health programs need to use peer support in sexual health programs, make sure young people can easily access contraception and protection and create trustworthy online resources about sexual health that are culturally appropriate. Our findings show more research is needed to find other ways to support young migrants and refugees with their sexual and reproductive health. This will help create better health services and education programs for these young people.","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252958","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}