Reproductive Health最新文献

{"title":"Editorial Expression Of Concern: Maternal fat free mass during pregnancy is associated with birth weight.","authors":"Yanxia Wang, Jie Mao, Wenling Wang, Jie Qiou, Lan Yang, Simin Chen","doi":"10.1186/s12978-024-01937-4","DOIUrl":"https://doi.org/10.1186/s12978-024-01937-4","url":null,"abstract":"","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"194"},"PeriodicalIF":3.6,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877865","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":"Optimizing screening practice for gestational diabetes mellitus in primary healthcare facilities in Tanzania: research protocol.","authors":"Amani Kikula, Nathanael Sirili, Kaushik Ramaiya, José L Peñalvo, Andrea B Pembe, Lenka Beňová","doi":"10.1186/s12978-024-01938-3","DOIUrl":"https://doi.org/10.1186/s12978-024-01938-3","url":null,"abstract":"<p><strong>Background: </strong>Tanzania, like most low- and middle-income countries, is facing an increasing prevalence of obesity in the general population, including among women of reproductive age. Excess weight pre-pregnancy is a risk factor for the onset of gestational diabetes mellitus (GDM), which is associated with several poor pregnancy outcomes. Screening for GDM, as a primary preventive measure, is not systematically done in Tanzania. This study aims to explore current practices of screening for GDM during routine antenatal care (ANC), estimate the prevalence of GDM among ANC users and compare the performance of two commonly used GDM screening algorithms. We will then explore the best ways for implementing a functional screening practice for GDM at primary level hospitals using perspectives of health care workers, health managers, and pregnant women.</p><p><strong>Methods: </strong>This will be an observational cross-sectional study design with sequential mixed-methods approach conducted in ANC clinics of two primary level hospitals: Kisarawe District Hospital in Coast region and Mbagala Rangi Tatu Hospital in Dar es Salaam region, Tanzania. Quantitative data will be collected to determine the current structural capacity and screening practices for GDM, the prevalence of GDM among ANC users, and the sensitivity and specificity of the two recommended screening algorithms. Qualitative data will be collected through key informant interviews with health managers and pregnant women and focus group discussions with healthcare workers to understand the rationale, challenges, possible solutions and benefits of the used screening algorithm. We will also explore the meaning of screening/diagnosis to pregnant women, and propose a functional GDM screening algorithm informed by users (i.e. pregnant women, health managers and care workers).</p><p><strong>Discussion: </strong>ANC is an entry point for pregnant women to access preventive services including screening for GDM. When done appropriately, GDM screening would reduce undesired outcomes attributed to GDM also beyond the pregnancy period. Through this study we will understand the bottlenecks and propose evidence to inform feasible ways to overcome them and establish a functional and standardized GDM screening service.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"193"},"PeriodicalIF":3.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872819","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":"Correction: Clinical features of patients with previous spontaneous rupture of ovarian endometrioma operated electively: a case-control study.","authors":"Zhiyue Gu, Xiaoyan Li, Yi Dai, Jinghua Shi, Yushi Wu, Chenyu Zhang, Qiutong Li, Hailan Yan, Jinhua Leng","doi":"10.1186/s12978-024-01939-2","DOIUrl":"https://doi.org/10.1186/s12978-024-01939-2","url":null,"abstract":"","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"192"},"PeriodicalIF":3.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865361","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":"Cultural and religious structures influencing the use of maternal health services in Nigeria: a focused ethnographic research.","authors":"Uchechi Clara Opara, Peace Njideka Iheanacho, Pammla Petrucka","doi":"10.1186/s12978-024-01933-8","DOIUrl":"https://doi.org/10.1186/s12978-024-01933-8","url":null,"abstract":"<p><strong>Background: </strong>Cultural and religious structures encompass a set pattern of values, beliefs, systems and practices that define a community's behaviour and identity. These structures influence women's health-seeking behaviour and access to maternal health services, predisposing women to preventable maternal health complications. However, most maternal health policies have focused on biomedical strategies, with limited attention to women's cultural challenges around childbirth. The overall aim of this paper is to provide a thick description and understanding of cultural and religious structures in Nigeria, their meaning and how they influence women's use of maternal health services.</p><p><strong>Methods: </strong>Roper and Shapira's (2000) focused ethnography comprising 189 h of observation of nine women from the third trimester to deliveries. Using purposive and snowballing techniques, 21 in-depth interviews and two focus group discussions comprising 13 women, were conducted in two Nigerian primary healthcare facilities in rural and urban area of Kogi State. Data was analyzed using the steps described by Roper and Shapira.</p><p><strong>Results: </strong>Using the PEN-3 cultural model, nine themes were generated. Positive factor, such as the language of communication, existential factor, such as religion, and negative factors, such as the use of prayer houses and lack of women's autonomy, were either positive or negative enablers influencing women's use of maternal health services. Additionally, women's perceptions, such as their dependency on God and reliance on cultural norms were significant factors that influence the use of maternal health services. We also found that the use of herbal medicine was a negative enabler of women's access to facility care. At the same time, family support was also a positive and a negative nurturer that could influence how women use facility care. Finally, factors such as religion, Ibegwu, and male child syndrome were negative nurturers influencing women's contraceptive use.</p><p><strong>Conclusion: </strong>Cultural and religious structures are significant factors that could promote or limit women's use of maternal health services. Further studies are needed to understand culturally focused approaches to enhance women's use of maternal health services in Nigeria.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"188"},"PeriodicalIF":3.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854973","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":"Lessons from an intervention study on the sustainability of after-school comprehensive sexuality education in Zambia: the perspectives of teachers, health workers and guardians.","authors":"Joar Svanemyr, Joseph Mumba Zulu, Ecloss Munsaka, Ingvild Fossgard Sandøy","doi":"10.1186/s12978-024-01920-z","DOIUrl":"https://doi.org/10.1186/s12978-024-01920-z","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive sexuality education (CSE) has been introduced in many sub-Saharan African countries, but limited political interest and insufficient funding have resulted in many CSE initiatives being dependent on donor funding or non-governmental organisations (NGOs) supporting its implementation. This has created concerns about the sustainability of the programmes. The objective of this study was to explore factors affecting the sustainability of CSE delivered through a youth club organized after school hours in Zambia.</p><p><strong>Methods: </strong>We interviewed teachers and community health workers (CHWs) who had implemented CSE as part of an after-school youth club set up as part of a cluster randomized controlled trial. The trial evaluated the effectiveness of economic support for adolescent girls, CSE and community dialogue meetings on adolescent childbearing. Teachers and CHWs in 63 schools were trained to facilitate the CSE youth clubs, and they were given economic incentives during the trial´s two-year intervention period to organize meetings every fortnight. Two years after the external support for the youth clubs ended, we conducted qualitative interviews with the facilitators in 15 of the 63 schools, interviews with some head teachers, and focus group discussions with guardians of adolescent girls.</p><p><strong>Results: </strong>Whereas CHWs were generally supportive of teaching adolescents about contraception, some of the teachers stressed that abstinence was the most effective method to avoid pregnancy and diseases. The respondents' diverging points of view did not affect their willingness to continue teaching CSE, including contraception. However, the youth club meetings were only continued in a few schools after the external support period ended. This was attributed to transfers of trained teachers and a lack of training among the remaining staff; lapse of moral support, resources and incentives; limited involvement of the school management in the CSE initiative; and attention shifting to other projects.</p><p><strong>Conclusion: </strong>To ensure the sustainability of CSE initiatives for adolescents, emphasis should be placed on training several teachers in each school, and continued moral support and encouragement also appeared essential.</p><p><strong>Trial registration: </strong>ISRCTN (ISRCTN12727868).</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"191"},"PeriodicalIF":3.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855069","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 relationship between delivery fear and childbirth experience with the level of adherence to the WHO recommendations for a positive childbirth experience in Iranian women: a cross-sectional study.","authors":"Fatemeh Shabani, Solmaz Ghanbari Homaie, Fatemeh Yousefi Tabaei, Maryam Montazeri, Fatemeh Raphi, Elnaz Lalezari, Mojgan Mirghafourvand","doi":"10.1186/s12978-024-01921-y","DOIUrl":"https://doi.org/10.1186/s12978-024-01921-y","url":null,"abstract":"<p><strong>Background: </strong>Childbirth experience is a unique event that involves psychological and physiological aspects influenced by social, environmental, organizational, and political factors. In 2018, the World Health Organization (WHO) introduced 56 recommendations for ensuring a positive childbirth experience at different stages of labor and delivery. Owing to the importance of implementing these guidelines, we have chosen to assess adherence to the WHO recommendations and their association with the fear and experience of childbirth.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on women hospitalized in the labor departments of the Al-Zahra and Taleghani Educational centers in Tabriz, Iran from 2023 to 2024. Sampling was performed via a convenience method, and data were collected via sociodemographic characteristics questionnaire, childbirth experience questionnaire.2 (CEQ.2), delivery fear scale (DFS), and the WHO recommendation checklist. The data were analyzed via Pearson correlation, independent t tests, one-way analysis of variance, and a general linear model (GLM).</p><p><strong>Results: </strong>The average adherence score to the WHO recommendations among the women studied was 36.4 (SD 9.3), out of a range of 0-56. There was a significant negative correlation between adherence to the recommendations and delivery fear (r = - 0.249; p < 0.001) and a significant positive correlation with childbirth experience (r = 0.414; p < 0.001). The GLM results, after adjusting for sociodemographic variables, revealed a significant increase in positive childbirth experience with increasing adherence score (B = 0.01; 95% CI 0.005 to 0.02, p = 0.001) and a nonsignificant association between delivery fear and adherence score (B = - 0.1; 95% CI - 0.4 to 0.04, p = 0.114).</p><p><strong>Conclusion: </strong>This study highlights the need to improve the implementation of WHO recommendations in educational and therapeutic centers and to consider various factors that affect the experience and fear of childbirth. Policymakers and medical center managers should place greater emphasis on training, monitor the complete implementation of the recommendations, and provide psychological and social support to pregnant women. This approach can help improve the childbirth experience, reduce delivery fear, and increase the preference for natural childbirth.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"189"},"PeriodicalIF":3.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855124","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":"Emergency contraceptive pill awareness in Bangladesh: missed opportunities in antenatal care and family welfare assistant visits.","authors":"Tasnim Ara, Shahnaj Sultana Sathi, Shafayatul Islam Shiblee, Sumaiya Nusrat Esha, Md Tazvir Amin, Md Mahabubur Rahman","doi":"10.1186/s12978-024-01922-x","DOIUrl":"https://doi.org/10.1186/s12978-024-01922-x","url":null,"abstract":"<p><strong>Background: </strong>Despite high coverage of antenatal care (ANC) and family welfare assistant (FWA) visits, emergency contraceptive pill (ECP) awareness is critically low in Bangladesh. We aim to investigate the missed opportunities in generating ECP awareness through ANC and FWA visit programs; and assess the missed opportunities and sociodemographic discrimination in receiving family planning (FP) counseling during ANC.</p><p><strong>Methods: </strong>We used data from the nationwide Bangladesh Demographic and Health Survey 2017-18. Sample includes 5012 reproductive-aged women who gave live birth in the last 3 years preceding the survey. We used mixed-effect multiple logistic regression considering women nested within clusters to conclude.</p><p><strong>Results: </strong>Nationally, 79% of women who gave live birth in the last 3 years preceding the survey were unaware of ECP. The estimated missed opportunities in generating ECP awareness was 59.5% in ANC, 0.9% in FWA visits, and 12.3% in both ANC and FWA visits. While FWA visit was not associated with ECP awareness, receiving FP counseling during ANC was significantly associated. About 88.4% of women remained unexposed to FP counseling through ANC during their last pregnancy. Missed opportunities in FP counseling during ANC was 80.4% of which 72% points were from qualified providers. The odds of missed opportunities was not associated with provider type, rather significantly increased among women with low education, lower parity, and poor socioeconomic status.</p><p><strong>Conclusions: </strong>This study highlights the fragile status of FP counseling during ANC and FWA visits in generating ECP awareness. A prominent provider bias is excluding women of the disadvantageous sociodemographic group from receiving FP counseling.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"186"},"PeriodicalIF":3.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854900","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":"Effects of pre-pregnancy body mass index on cardiometabolic biomarkers in pregnant emirati women.","authors":"Lolowa A Almekhaini, Shamsa A Awar, Taoufik Zoubeidi, Sania Al Hamad, Javed Yasin, Junu V George, Maha Khaled, Nehaya Qasem, Fatima Bahwan, Hassib Narchi, Elhadi H Aburawi","doi":"10.1186/s12978-024-01940-9","DOIUrl":"https://doi.org/10.1186/s12978-024-01940-9","url":null,"abstract":"<p><strong>Background: </strong>To study effect of pregnancy on obese women's maternal cardiometabolic biomarkers as a signature for maternal morbidity and complications.</p><p><strong>Methods: </strong>This cross-sectional cohort study involved pregnant Emirati women who had regular menstrual cycles and had normal blood pressure. Pre-pregnancy body mass index was calculated using height and weight measurements recorded within three months before current pregnancy. Average systolic and diastolic blood pressure measurements were calculated from each visit. Blood samples were collected randomly once and following cardiometabolic biomarkers were measured.</p><p><strong>Results: </strong>We enrolled 178 pregnant women, with a mean age ± standard deviation of cohort was 29.9 ± 4.97 years and Pre-pregnancy body mass index 28.11 ± 6.58 kg/m2. None of blood pressure measurements or biomarkers serum concentrations were statistically different across Pre-pregnancy body mass index groups except for soluble intercellular cytoadhesive molecule-1levels which were the highest in underweight women. Pregnant women with pre-gestational obesity had higher systolic and diastolic blood pressure levels compared to women with normal or overweight. All variables were statistically significantly different by trimesters except systolic blood pressure, random blood glucose, lipoprotein-A, and high-sensitivity C-Reactive Protein. After adjusting, in a multivariate linear regression model, for maternal age, trimester of pregnancy, education level, parity and smoking, none of biomarkers or blood pressure were found to be significantly associated with Pre-pregnancy body mass index. In a multivariate linear regression model adjusting for maternal age, Pre-pregnancy body mass index, education level, parity and smoking, gamma-glutamyl transferase, total cholesterol, high density lipoprotein, low-density lipoprotein, triglycerides, apolipoprotein A & B, interleukin-6, tumor necrosis factor-alpha and insulin-like growth factor-1 concentrations remained significantly associated with advancing trimester of pregnancy. There was a significant interaction between Pre-pregnancy body mass index and trimester of pregnancy for serum gamma-glutamyl transferase and soluble intercellular cytoadhesive molecule-1concentration.</p><p><strong>Conclusion: </strong>This study emphasizes how pregnancy has a significant impact on cardiometabolic markers in obese women, indicating both hyperlipidemic status of pregnancy and diabetogenic tendency in obese patients who are not diabetics. These findings may suggest that pregnancy in obese patients increases risk of developing metabolic syndrome in future, therefore more attention is recommended of pregnant obese women and further study of establishing specific cardiometabolic biomarkers screening program.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"185"},"PeriodicalIF":3.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854896","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":"Exploring women's sexual and reproductive health needs in Zabol's suburbs, Iran: a qualitative study.","authors":"Maryam Koochakzai, Zahra Behboodi Moghadam, Shahla Faal Siahkal, Mehrbanoo Amirshahi, Elham Ebrahimi","doi":"10.1186/s12978-024-01934-7","DOIUrl":"https://doi.org/10.1186/s12978-024-01934-7","url":null,"abstract":"<p><strong>Background: </strong>Suburban populations in developing countries are affected by poor environmental conditions affecting their ongoing health. Given the low reproductive health indicators of women residing in the suburbs of eastern Iran, planning to improve their health by assessing the needs of the target group through qualitative research is essential. The present study seeks to elucidate the views of women living in the suburbs of Zabol, Iran, regarding sexual and reproductive health needs.</p><p><strong>Methods: </strong>This qualitative study was conducted in healthcare centers in the suburbs of Zabol in 2023. The sample comprised 22 women, including 16 women of reproductive age (age 15-49 years) living in the suburbs and six key informants (service providers and people who were in close contact with these women). The sample was selected purposively with maximum variation. Data were collected through semi-structured, in-depth, individual interviews, which continued until data saturation was reached. The data were then analyzed using conventional content analysis.</p><p><strong>Results: </strong>The data analysis yielded seven categories (gender-based violence, psychological problems, women's lack of empowerment, barriers to equity in sexual and reproductive health, support seeking, sexual issues, and pregnancy, childbirth, and postpartum care needs) and 24 subcategories. The results revealed that suburban women did not have adequate information or knowledge about their sexual and reproductive health or the available services, and most of them suggested that they required training.</p><p><strong>Conclusion: </strong>Women living in the suburbs of Zabol were faced with challenges in their sexual and reproductive health and well-being. It is crucial to provide these women with sexual and reproductive health education and services that are accessible and suitable to their conditions by targeted interventions aiming to improve their health and well-being. The findings of the current study can serve as a basis for future health policymaking, planning, and research by providing evidence and strengthening the body of knowledge about this domain of health.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"190"},"PeriodicalIF":3.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855068","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":"Barriers to advancing the sexual and reproductive health agenda in Latin America: a qualitative study of key informants' perspectives.","authors":"Juan Pedro Alonso, Cintia Cejas, Mabel Berrueta, Paula Vazquez, Gabriela Perrotta, Sandra Formia, Sofía Pirsch, Jamile Ballivian, Denise Zavala, Analía López, María Belizán","doi":"10.1186/s12978-024-01927-6","DOIUrl":"https://doi.org/10.1186/s12978-024-01927-6","url":null,"abstract":"<p><strong>Background: </strong>The effective attainment of sexual, reproductive, and maternal health and rights (SRMHR) requires a holistic life-course approach. This approach should address disparities in healthcare access and rights, guarantee the delivery of high-quality care devoid of discrimination, and underscore rigorous accountability mechanisms throughout the implementation process. Latin American and Caribbean (LAC) countries face significant disparities in SRMHR within and between nations. Vulnerable populations, such as indigenous communities, Afro-descendants, LGBTQI + population, persons with disabilities, older adults, and migrants, often endure discrimination and stigmatization, severely impacting their access to healthcare and health rights. This paper presents the findings from the qualitative component of a broader mixed-methods scoping study aimed at establishing a priority research agenda to address healthcare gaps affecting the SRMHR of vulnerable populations. The qualitative component focused on identifying key challenges hindering progress in SRMHR and access to health services for these populations in the LAC region, drawing on the perspectives of key informants at both regional and national levels.</p><p><strong>Methods: </strong>Qualitative research approach employing semi-structured interviews with key informants. A purposive sample comprised of stakeholders from relevant regional organizations and local stakeholders in selected countries (Argentina, Colombia, Peru, Mexico, Guatemala, Jamaica, and Guyana), encompassing government representatives, civil organizations, and academia. A rapid content thematic analysis was conducted to analyze the data obtained from the interviews.</p><p><strong>Results: </strong>We interviewed 27 key informants in SRMHR, six at a regional level and 21 at a country level. The region faces barriers around establishing and sustaining agency agendas, such as a lack of political will, political instability, and opposition from civil society groups regarding SRMHR agendas. Policy implementation presents difficulties due to insufficient and unstable funding, weaknesses in sexual and reproductive health programs, unequal policy implementation in federal countries, and the absence of evidence-based policies. The lack of high-quality data and quality indicators poses obstacles, leading to limitations in evidence generation. Access to SRMHR services faces barriers such as the low-quality provision of services, discrepancies between legislation and effective access, insufficient healthcare resources, and resistance from certain healthcare providers.</p><p><strong>Conclusion: </strong>Addressing these multifaceted challenges will be crucial in advancing the agenda of sexual, reproductive, and maternal health rights and ensuring effective access to health services for the most vulnerable populations in the LAC region.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"187"},"PeriodicalIF":3.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854929","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}