Reproductive Health最新文献

{"title":"Gender differences in infertility stress, coping and the ability to share feelings about infertility.","authors":"Angelika Szatmári, Ildikó Kovács, János Zádori, Boglárka Pataki, Miklós Zrínyi","doi":"10.1186/s12978-026-02343-8","DOIUrl":"10.1186/s12978-026-02343-8","url":null,"abstract":"<p><p>BACKGROUND: Infertility distress is a major concern for couples. The primary aim of this study was to predict ability to share feelings about infertility using the Fertility Problems Inventory (FPI) depression, anxiety and additional variables. METHODS: Randomly selected couples responded to paper-pencil instruments that measured ability to share feelings about infertility, fertility stress, coping, stress, anxiety and depression as key variables. Selected participants were adults diagnosed with infertility undergoing assisted reproductive treatment for at least 6 months in Hungary. Multiple linear regression analysis was applied to predict fertility related stress scores separately for female and male participants. RESULTS: A total of 94 couples participated. Employing Wilcoxon tests, a significant difference was identified in the use of emotional coping (females using more emotional coping compared to males) (z = -4.18, p < 0.001). No significant difference was found in the utilization of problem-solving coping. With regard to the ability to share feelings about infertility, no significant difference was identified in favor of either gender. With regard to the impact of treatment on everyday life, female respondents indicated a significantly greater effect (z = -2.67, p = 0.008). One-point increase in anxiety scores increased fertility distress by 0.83 and 1.25 points for women and men, respectively. One-year increase since infertility diagnosis was linked to a 1.61-point increase in fertility distress for males. For women, for every one-point increase in the perception of their inability to discuss personal issues with someone else, there was a five-fold increase in infertility-related distress. CONCLUSIONS: Stress, anxiety, and depression were linked to problem-solving in women, but were associated with emotional coping in men. Regression analysis showed a difference between women and men in predicting stress related to infertility. In women, the inability to talk about their feelings related to infertility was significantly negatively associated with fertility stress. However, in men, feelings related to infertility were not predictors of infertility stress. This result requires further research to clarify the reason for the difference. </p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13248470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779485","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":"Pre-pregnancy characteristics, medical conditions and prenatal support among pregnant women in same-sex relationships: a population-based cohort study.","authors":"Lisa Kogner, Anna Sara Oberg, Kenny A Rodriguez-Wallberg, Jonathan M Snowden, Anna Sandström","doi":"10.1186/s12978-026-02332-x","DOIUrl":"10.1186/s12978-026-02332-x","url":null,"abstract":"<p><p>BACKGROUND: Limited research exists on the obstetric risk profiles of women in same-sex relationships (WSSR) undergoing childbirth. METHODS: Population-based cohort study including deliveries in the Swedish Stockholm-Gotland regions, January 2008-June 2020. Linkage with national health and quality registers provided data on relationships status. Characteristics of WSSR were compared with those of women in different-sex relationships. RESULTS: Of the 289 979 included deliveries, 1 292 (0.45%) were to WSSR. Compared to women in different-sex relationships, WSSR were more likely to be older, nulliparous, of Swedish origin, and have higher educational attainment. Assisted reproduction was reported for 87.5% of WSSR, versus 7.2% in the comparison group. Smoking during pregnancy was less common for WSSR (1.2% vs. 3.8%). Adjusting for parity and age, WSSR were more likely to be overweight in early pregnancy (adjusted odds ratio [aOR] 1.47; 95% CI 1.30–1.67). Furthermore, they were more likely to have received support for fear of childbirth (12.2% vs. 9.7%; aOR 1.48 95% CI 1.14–1.91). Self-rated pre-pregnancy health and history of major medical conditions were largely similar across both groups, although WSSR were more likely to have been diagnosed with thyroid conditions, rheumatic diseases, gynecological conditions and psychiatric illnesses. CONCLUSIONS: When undergoing childbirth, WSSR more often presented with obstetric risk factors including higher age, nulliparity, and overweight. However, they were also more likely to have higher educational attainment and less likely to report smoking. Pre-pregnancy medical conditions were largely similar between groups. Even so, psychiatric disease and support for fear of childbirth were more common in WSSR, highlighting the need for targeted support during pregnancy. </p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729848","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":"Economic insecurity, access to menstrual materials, and sexual coercion: a qualitative study among adolescent schoolgirls in Ibadan, Nigeria.","authors":"Elizabeth L Frost, Elizabeth Reed, Shira Goldenberg, Angela R Bazzi, Olufunmilayo I Fawole, Mobolaji M Salawu, Omowumi O Okedare, Georgia L Kayser","doi":"10.1186/s12978-026-02302-3","DOIUrl":"10.1186/s12978-026-02302-3","url":null,"abstract":"<p><p>BACKGROUND: Menstrual hygiene management (MHM) is a critical but often overlooked component of adolescent girls’ health. Limited access to financial resources for purchasing menstrual materials is a key barrier to adequate MHM. Few studies have examined how adolescent girls obtain materials, how economic insecurity may affect MHM, and whether this promotes reliance on male partners for financial means to purchase materials. Prior research has linked dependence on male partners for basic needs like food with increased risk of sexual coercion, yet little is known about whether dependence on male partners for menstrual materials carries similar risks. This study examined MHM among adolescent girls, focusing on how economic insecurity may drive girls’ reliance on male partners for menstrual materials and potential exposure to intimate partner violence (IPV). METHODS: We conducted one-on-one interviews with 38 adolescent girls ages 15–19 from eight schools in low-income communities of Ibadan, Nigeria. Data was gathered on menstrual hygiene practices, access to and affordability of menstrual materials, and how relationships with male partners influence access to menstrual materials. Conversational analysis was conducted using QInsights BV to identify key themes, patterns, and insights from textual data. RESULTS: A total of 38 adolescent girls were interviewed. Participants’ mean age was 16 years, half were currently in relationships, and 31% worked for an income alongside attending school. Emergent themes showed mothers typically provided menstrual materials or money to pay for materials. Participants also reported borrowing money from friends and relying on support from family members such as sisters, aunts, and grandmothers for menstrual materials. Some participants reported receiving money from male partners to purchase pads. Of these, several described being sexually pressured in exchange for financial support. CONCLUSIONS: Our research suggests limited access to menstrual materials may contribute to girls’ financial reliance on male partners, potentially increasing vulnerability to sexual coercion. Our study is among the first to qualitatively examine how menstrual health insecurity may foster financial dependence on male partners and, in turn, heighten vulnerability to sexual coercion. Future research and programs should address the intersection of MHM, reliance on male partners, and IPV. </p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717955","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":"Developing recommendations to improve the experience of unplanned pregnancy: results from a multiphase study.","authors":"Masoumeh Paiandeh, Roghaiyeh Nourizadeh, Esmat Mehrabi, Mojgan Mirghafourvand, Easa Mohammadi","doi":"10.1186/s12978-026-02324-x","DOIUrl":"10.1186/s12978-026-02324-x","url":null,"abstract":"<p><p>BACKGROUND: Unplanned pregnancy is considered one of the most important health, social, and economic challenges in the field of reproductive health, which can have multiple negative effects on women’s physical and psychological health and social relationships. This study aimed to develop interventions to improve the experience of women with unplanned pregnancy. METHODS: This study is part of a mixed-methods research with an exploratory sequential design. The study was conducted in two phases. In the first phase, a qualitative study was performed to clarify women’s perceptions and experiences of unplanned pregnancy from the perspective of the participants (13 women with unplanned pregnancies, three midwives, and one gynecologist) and to identify their perceived needs. The participants were selected using purposive sampling. The inclusion criteria were unplanned pregnant women aged 18–45 years old and without any diagnosed physical or mental disorders. Semi-structured interviews were analyzed using conventional content analysis following the steps proposed by Graneheim and Lundman. Then, through a literature review, the components of pregnancy experiences and related proposed interventions were identified. In the second phase, the data obtained from both the qualitative phase and the literature review of the first phase were integrated, and 38 initial interventions were developed. Subsequently, these interventions were evaluated through three Delphi rounds by 15 experts from the fields of midwifery, obstetrics, and reproductive health, selected based on their experience of at least 5 years, academic position, and professional expertise. RESULTS: Thirty-two interventions were agreed upon and grouped into four domains: (1) education, counseling, and awareness-raising (such as providing prenatal health education, nutritional guidance, and psychological counseling) (2), improving the quality of care (such as ensuring respectful and personalized care, and continuously monitoring maternal needs) (3), strengthening maternal–fetal attachment (such as encouragement to talk and interact with the fetus), and (4) family and social support (such as partner education package and virtual peer support). The experts scored the interventions according to feasibility and importance. CONCLUSION: The 32 interventions developed and refined through expert consensus can serve as an evidence-based framework to enhance the experience of unplanned pregnant women, especially in communities with legal restrictions on abortion. These findings offer practical guidance for policymakers on how to train healthcare providers to deliver individualized care and holistic support that addresses the diverse needs of women. Additionally, healthcare systems should prioritize the development and dissemination of educational materials that cover the comprehensive topics identified in this study. </p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699658","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":"Socioeconomic and demographic differentials in unintended pregnancies, abortion, and contraceptive use in Spain: insights from the 2018 Fertility Survey.","authors":"Marta Seiz, Xiana Bueno, Evgeniya Borisova","doi":"10.1186/s12978-026-02329-6","DOIUrl":"10.1186/s12978-026-02329-6","url":null,"abstract":"<p><p>BACKGROUND: There is growing interest in the social stratification of demographic trends, including those related to reproductive outcomes. One issue that has received little attention in recent years in the case of Spain is the relationship between individuals’ social position and unintended pregnancies, abortion, and contraceptive use. METHOD: We present descriptive statistics and estimate predicted probabilities from logistic regression models using a nationally representative sample of 14,556 women from the 2018 Spanish Fertility Survey. RESULTS: Results show that unintended pregnancies are more common among socially vulnerable women—those with a lower level of education, migrant background (not born in Spain), unstable partnership histories, or experience of employment instability. Abortions are also more prevalent within these groups. In contrast, women with higher socioeconomic status are more likely to avoid unintended pregnancies through more consistent contraceptive use. CONCLUSION: These findings highlight persistent social inequalities in reproductive health outcomes in Spain, suggesting the need for policy interventions that include educational programs on family planning and expand accessibility to reproductive health services particularly for the most vulnerable populations. </p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691730","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":"Evidence on prevalence of caesarean sections and factors influencing uptake in Ghana: a scoping review.","authors":"Stella Mahama, Louisa Lawrie, Jamini Dimri, Mairead Black","doi":"10.1186/s12978-026-02317-w","DOIUrl":"10.1186/s12978-026-02317-w","url":null,"abstract":"<p><p>BACKGROUND: Ghana’s caesarean section (CS) rate has increased from 16% in 2017 to 21% in 2022 which matches the global CS rate (Ghana Demographic and Health Survey 2022) (Ghana Health Service 2016 Annual REport. 2017). Given that the World Health Organisation (WHO) recommends a range of 10% to 15% per live birth, Ghana, as of 2017, joined other countries that have exceeded this range (WHO Statement on Caesarean Section Rates. 2015) (Journal of Public Health (Germany) 25(5):557–64, 2017). This review set out to explore the prevalence of CS across regions of Ghana and to understand influences on CS uptake. METHODS: The Joanna Briggs Institute methodological guidelines for scoping reviews were followed, and the review was reported in line with the Preferred Reporting Items for Systematic and Meta-Analyses extension for scoping reviews (PRISMA-ScR). Literature searches were conducted in MEDLINE, PsycINFO, EMBASE, Web of Science and CINAHL (EBSCO). The review included primary qualitative, quantitative, mixed methods studies, systematic reviews, scoping reviews, and grey literature. Narrative synthesis was used to present CS prevalence. The Theoretical Domains Framework (TDF) was used to assess factors influencing CS uptake. RESULTS: Substantial variation in CS uptake is evident across Ghana regions, ranging from 15.7% (Menoufia Medical Journal 35, 2022) to 26% (BMC Pregnancy and Childbirth 19(1), 2019) in the Northern and 6.6% (BMC Pregnancy and Childbirth 18(1), 2018) to 40.6% (Texila International Journal of Public Health 11(2), 2023) across the Southern sector. Quantitative factors such as maternal age (older women), free maternal healthcare policy, and high household socio-economic status were among the specific factors influencing CS uptake in Ghana (Pan African Medical Journal 29, 2018), (BMC Pregnancy Childbirth 21(1), 2021), (BMC Pregnancy Childbirth 22(1), 2022), (Health Services Insights 2024), (Glob J Health Sci 6(4):9–21, 2014). Despite this, and several reports on clinical and demographic factors associated with CS uptake, there is very little in-depth evidence published on the nature of the barriers and facilitators to CS uptake; thus, future qualitative research is warranted. CONCLUSION: The review found variation in CS prevalence across regions of Ghana, ranging from 6.6% to 40.6%. The reason for this variation is not well understood. The limited evidence demonstrating potential influences on CS uptake in Ghana is mainly quantitative. Hence, we recommend further qualitative research with a range of stakeholders to better understand in-depth contextual issues influencing CS uptake in Ghana. </p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676286","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":"Development of a food security assessment tool for prenatal care in pregnant women: a mixed-method study.","authors":"Maryam Bagheri, Fatemeh Mohammadi-Nasrabadi, Jila Sadighi, Fazlollah Ahmadi, Mahdi Akbarzadeh, Minoor Lamyian","doi":"10.1186/s12978-026-02323-y","DOIUrl":"10.1186/s12978-026-02323-y","url":null,"abstract":"<p><p>BACKGROUND: Women have more complex nutritional needs due to menstrual cycles, pregnancy, and breastfeeding. They are the most vulnerable group in terms of household food insecurity. Until now, public tools used to assess the food security of pregnant women. This study aims to develop and validate a food security assessment tool specifically for pregnant women to integrate into antenatal care in the health system. METHODS: A sequential-exploratory mixed-method design was implemented. In the qualitative phase, 23 in-depth semi-structured interviews with 17 pregnant women and 6 food security experts were analysed using conventional content analysis to define the concept and dimensions of food security during pregnancy. Based on these findings and a structured instrument-development framework, an initial item pool was generated and evaluated through face validity, content validity, item analysis, and construct validity assessments. Exploratory factor analysis (EFA) was conducted with a sample of 300 pregnant women, followed by confirmatory factor analysis (CFA) in an independent sample of 150 women. Reliability (Cronbach’s alpha, ICC), responsiveness, feasibility, and known-group validity were also examined. RESULTS: EFA supported a two-factor structure explaining 63.9% of the variance. CFA demonstrated acceptable model fit (χ².df = 1.71, CFI = 0.953, IFI = 0.953, RMSEA = 0.069). The final 20-item Pregnancy Food Security Questionnaire (Pregnancy-FSQ) exhibited excellent internal consistency (α = 0.965) and test–retest reliability (ICC = 0.999). Known-group validity was confirmed through significant score differences across maternal education, household income, occupation, and place of residence (p < 0.001). The tool showed minimal nonresponse, required approximately 15 min to complete, and demonstrated adequate responsiveness to socio-demographic disparities associated with food insecurity. CONCLUSIONS: The Pregnancy-FSQ is a valid, reliable, and feasible instrument specifically designed to assess food security among pregnant women. Its integration into routine antenatal care can support early identification of food-insecure pregnant women and indirectly highlight food-insecure households, facilitating timely interventions. </p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663062","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":"Development and validation of the person-centered postnatal care scale for low- and middle-income countries.","authors":"Patience A Afulani, Anthony Gerald Akanlu, Hawa Malechi, Moro Ali, Osamuedeme J Odiase, Jaffer Okiring, Beryl Ogolla, Joyceline Kinyua, Linnet Ongeri, Özge Tunçalp, Raymond A Aborigo","doi":"10.1186/s12978-026-02330-z","DOIUrl":"10.1186/s12978-026-02330-z","url":null,"abstract":"<p><p>BACKGROUND: High-quality postnatal care (PNC), including Person-centered postnatal care (PCPNC), is essential to achieving optimal maternal and neonatal outcomes. PCPNC refers to postnatal care that is respectful of and responsive to postpartum women’s preferences, needs, and values. While interest in person-centered care across the reproductive health continuum has increased, there are no validated tools to comprehensively measure PCPNC. This study aimed to develop and validate a tool to comprehensively measure PCPNC that is relevant to the experiences of women in low- and middle-income countries (LMICs). METHODS: The adaptation and validation process included a literature review to define the construct and develop the scale items. This was followed by expert reviews with maternal health experts, healthcare providers, and women with past postnatal care experience to assess content validity. We then conducted cognitive interviews with postpartum women to ensure the questions were relevant, clear, and understandable. We iteratively revised the questions at each stage and surveyed 268 postpartum women (who gave birth within the last six months) in the Upper East Region of Ghana for initial analysis. We then analyzed the data, which informed additional edits to the questions. The final questions were administered in a survey to 1,394 women in Ghana and Kenya who had received postnatal care within 12 weeks postpartum. Psychometric analysis was employed for item reduction and to assess construct and criterion validity, as well as internal consistency reliability. RESULTS: Following iterative factor analysis, we developed a 38-item PCPNC scale. The 38 items load onto one dominant factor, with three factors having eigenvalues greater than one and a Cronbach’s alpha of 0.93. We grouped the items into three conceptual domains, representing the “dignity and respect,” “communication and autonomy,” and “responsive and supportive care” subscales, each of which has a Cronbach’s alpha > 0.7. PCPNC scores are associated with satisfaction with PNC and intent to receive PNC in the same health facility in the future, suggesting good criterion validity. CONCLUSIONS: The PCPNC scale is a valid and reliable tool for measuring respectful and responsive PNC, and will thus facilitate efforts to monitor and improve the experiences of mothers and their babies during PNC. </p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663042","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":"Downplaying reality: is the UN population fund forgetting population growth and family planning?","authors":"Frank Götmark, Chukwuedozie Ajaero, Mohammad Mainul Islam, Rhoda Mundi, Nebechukwu H Ugwu, Malte Andersson","doi":"10.1186/s12978-026-02292-2","DOIUrl":"10.1186/s12978-026-02292-2","url":null,"abstract":"<p><p>BACKGROUND: The global population is projected by the UN Population Division to continue growing by over 2 billion, from 8.1 in 2024 to 10.3 in 2084, aggravating climate change and biodiversity loss, raising risks of poverty and starvation, and impairing reproductive health in many developing countries, especially in Africa. OBJECTIVE: Evaluation of the population policy of a major international actor in reproductive health, the United Nations Population Fund (UNFPA), and presentation of alternative and complementary policy addressing population growth, high fertility rates and unmet need for family planning in African and other countries. ARGUMENT: Original research and reviews show that family planning (FP) programs help reduce unsustainably high fertility and population growth. Historically birth control has seen grave mistakes, but most FP programs were voluntary and successful. Yet the United Nations Population Fund (UNFPA) leadership criticizes such programs, avoids emphasizing the need for fertility decline in Africa and elsewhere, and averts important facts about population growth. Instead, the leadership assumes that sexual and reproductive health and rights (SRHR) fully solve related problems. While SRHR contributes to public health, voluntary FP programs in several African countries with serious undernourishment have helped increase contraceptive use and slow population growth. Many African countries face problems from strong population growth and wish to lower fertility by family planning. The US government has now cut most of its previously large international aid, with tragic health consequences. The new situation should encourage African and other high-fertility countries to invest in own population programs that reduce dependency on uncertain foreign donors. CONCLUSION: Voluntary family planning programs can increase contraceptive use, slow population growth, and improve the life of children, women and men. UNFPA leadership should endorse such FP programs and, in particular, re-adopt its historic mandate of improving human welfare by ameliorating rapid population growth. </p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654647","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":"Husbands' knowledge of women's reproductive rights and its associated factors in Gacho Baba District, Southern Ethiopia, 2023: a rights-based approach to male engagement.","authors":"Kinde Kibe, Wubshet Estifanos, Genet Asefa, Addisalem Haile, Arega Abebe Lonsako, Aster Dure","doi":"10.1186/s12978-026-02310-3","DOIUrl":"10.1186/s12978-026-02310-3","url":null,"abstract":"<p><p>BACKGROUND: Husbands’ knowledge of women’s reproductive health rights is a key determinant of rights-based maternal health care, particularly in rural settings where men strongly influence household decision-making. Poor awareness of women’s autonomy, informed choice, and access to services can delay care-seeking, reduce service utilization, and worsen maternal outcomes. In Ethiopia, no prior study has examined husbands’ knowledge of women’s reproductive rights in rural areas, including the present study setting. Therefore, this study aimed to assess husbands’ knowledge of women’s reproductive rights and its associated factors in Gacho Baba District, Gamo Zone, Southern Ethiopia. METHODS: A community-based cross-sectional study was conducted from April 1 to 30, 2023. A total of 613 participants were selected using systematic random sampling. Data were collected using an interviewer-administered questionnaire, entered into EpiData version 3.1, and exported to SPSS version 26 for analysis. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with knowledge of women’s reproductive rights. The strength of association was reported using adjusted odds ratios (AOR) with 95% confidence intervals (CI), and statistical significance was set at p < 0.05. RESULTS: The knowledge of women’s reproductive rights among husbands was 36.5% (95% CI: 32.7–40.3). Attending reproductive health services with wives (AOR = 3.07, 95% CI: 2.14–4.43), discussing reproductive health issues with spouses (AOR = 2.10, 95% CI: 1.02–4.31), and exposure to mass media (AOR = 4.60, 95% CI: 1.97–10.65) were significantly associated with better knowledge. CONCLUSIONS: These findings highlights that knowledge of women’s reproductive rights among rural husbands remains low, indicating a significant gender based knowledge gap. Accompanying wives to reproductive health services, engaging in spousal discussions on reproductive health issues, and exposure to mass media were positively associated with husbands’ knowledge. Strengthening male involvement in reproductive health services, promoting open spousal communication, and expanding targeted mass media interventions tailored to rural contexts are recommended to enhance husbands’ knowledge and support for women’s reproductive rights. </p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654636","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}