Reproductive Health最新文献

{"title":"Understanding contraceptive choice after discontinuing the contraceptive pill in Germany - a qualitative inquiry.","authors":"Jana Niemann, Lisa Glaum, Liane Schenk","doi":"10.1186/s12978-026-02416-8","DOIUrl":"10.1186/s12978-026-02416-8","url":null,"abstract":"<p><strong>Background: </strong>Contraception decision-making is a vital aspect of sexual and reproductive health, with individuals weighing various factors when choosing their current contraceptive methods. Method discontinuation is common and should not be viewed as an endpoint but rather as a starting point for selecting the next contraceptive option. However, there is a limited understanding of what former contraceptive pill users seek after discontinuation.</p><p><strong>Methods: </strong>This study examined the decision-making process and experiences of former oral contraceptive users (N = 19) who transitioned to alternative methods in Germany. We conducted a reflexive thematic analysis.</p><p><strong>Results: </strong>We generated five key themes shaping post-pill contraceptive decisions: (1) prioritization of efficacy and pregnancy prevention, with permanent methods offering psychological relief; (2) reliance on familiarity, particularly with condoms, as a default choice; (3) strong preference for hormone-free options due to concerns over side effects and bodily autonomy; (4) embodied aversion to invasive procedures, such as IUD insertion or complex surgeries; and (5) a growing emphasis on shared responsibility and gender equality in contraception, with calls for greater male involvement and accessible non-hormonal alternatives. These findings underscore the importance of individual experiences, bodily autonomy, and equitable contraceptive access in post-pill decision making.</p><p><strong>Conclusions: </strong>This study offers valuable insights into the complex nature of contraceptive decision-making, addressing considerations such as long-term health effects, bodily autonomy, and the need for improved contraceptive options.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562892","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":"Responding to the COVID-19 pandemic through global partnerships: the case of the HRP Alliance for research capacity strengthening.","authors":"Vanessa Brizuela, Mehr G Shah, Elizabeth Fine, Luis Bahamondes, Evelyn Gitau, Seni Kouanda, Pisake Lumbiganon, Thi Thuy Hanh Nguyen, Sarah Saleem, Kwasi Torpey, Anna Thorson","doi":"10.1186/s12978-026-02342-9","DOIUrl":"10.1186/s12978-026-02342-9","url":null,"abstract":"<p><strong>Background: </strong>The UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) has a mandate to lead in sexual and reproductive health and rights research and to support research capacity strengthening. Starting in 2016, it did so through supporting the latter through a large network of research institutions called the HRP Alliance. This commentary highlights the work of the HRP Alliance in response to the coronavirus disease (COVID-19) pandemic.</p><p><strong>Main body: </strong>The onset of the COVID-19 pandemic prompted the HRP Alliance to adapt the way they had been working. HRP Alliance research capacity strengthening hubs actively contributed to developing a research agenda based on WHO's research and development blueprint and country-specific needs. They also took on leading roles in developing, adapting to each country/setting, and implementing research projects aimed at understanding how the COVID-19 pandemic was affecting SRHR in different contexts and income settings. These studies provided opportunities for early career researchers and students to lead in project management, study implementation, training, and data analysis. Through a network of nimble research institutions, the HRP Alliance collaborated to generate evidence on the impact of COVID-19 on pregnancy, pregnancy outcomes, access to SRHR services, gender-based violence, and abortion care. The success of implementing these research response mechanisms and developing global networks of research and healthcare institutions, provided solid ground upon which to build SRHR research responses to future pandemics and other emerging diseases.</p><p><strong>Conclusion: </strong>Adequate readiness and response to global health emergencies require high quality and timely evidence generation. Global networks of research partner institutions, brought together through research capacity strengthening initiatives, can provide a fruitful platform ready and able to swiftly respond. However, inherent power imbalances and challenges to equitable partnerships need to be considered to ensure sustainable ways of working together.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 Suppl 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13417863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607164","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":"Advancing assisted reproductive technology in Africa: a narrative review on the promising role of molecular biology and molecular techniques.","authors":"Foster Kyei, Clement Napo, Collins Nabawo, Emmanuel Opoku Asante, Benjamin Nyarko, Isaac Kofi Adu, Cara Obenewaa Aidoo, Victoria Essien, Prince Amoah Barnie, Emmanuel Owusu Ansah, Kwadwo Fosu","doi":"10.1186/s12978-026-02410-0","DOIUrl":"https://doi.org/10.1186/s12978-026-02410-0","url":null,"abstract":"<p><p>Assisted Reproductive Technology (ART) has significantly improved fertility outcomes globally, yet its full potential remains underutilized. In Africa, persistent barriers including high costs, limited access, inadequate infrastructure, lack of awareness, and sociocultural and ethical concerns impedes its utility. This review explores the promising role of molecular biology and advanced molecular techniques in overcoming these challenges and advancing ART on the continent. Techniques such as preimplantation genetic testing (PGT), non-invasive prenatal testing (NIPT), CRISPR/Cas9 gene editing, mitochondrial replacement therapy (MRT), and single-cell RNA sequencing offer opportunities to enhance embryo selection, minimize genetic and epigenetic risks, and improve pregnancy success rates. Furthermore, innovations like biomarker discovery, liquid biopsy, and genomic screening can personalize treatment strategies and improve reproductive outcomes. We also provide a narrative on the progress made in expanding ART services, improving affordability through low-cost protocols, and building local expertise through training and collaborations. While challenges persist, especially in regulation and access to ART, the integration of molecular innovations in a phased manner has the potential to transform ART if implemented within appropriate infrastructural, ethical, and policy frameworks. This review underscores the need for sustained investment, policy reform, and interdisciplinary collaboration to bridge existing gaps and ensure that ART technologies are accessible, safe, and effective for all individuals and couples affected by infertility in the region.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224828","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":"Challenges in accessing family planning, contraceptive and abortion services, and sexually transmitted infections care during the COVID-19 pandemic in Italy: a mixed method study.","authors":"Simone Garzon, Alessia Savoldi, Maddalena Cordioli, Ranieri Poli, Igor Toskin, Moazzam Ali, Stefano Uccella, Massimo Mirandola","doi":"10.1186/s12978-026-02341-w","DOIUrl":"10.1186/s12978-026-02341-w","url":null,"abstract":"<p><strong>Background: </strong>The Coronavirus Disease 2019 (COVID-19) pandemic disrupted the capacity of healthcare systems. This study aimed to provide a better understanding of the impact of the COVID-19 pandemic on sexual and reproductive healthcare (SRH) services.</p><p><strong>Methods: </strong>We conducted a mixed-method cross-sectional study at the SRH services of the tertiary care university hospital of Verona, Veneto region, Italy. Questionnaires based on WHO validated tools were administered to all consecutive clients once per month for 11 months (December 2021 to November 2022) to assess SRH services availability and readiness. In-depth interviews (IDIs) have been used to understand participants' perspectives.</p><p><strong>Results: </strong>The questionnaire was completed by 100 clients (average age 35.34 years; sexually transmitted infection care service: n=49; abortion service: n=24, family planning and contraception service: n=16, and anti-violence service: n=11). All SRH services continued to operate without a shortage of supplies, although some facilities had relocation of staff and a location change. IDIs involved 25 clients at the abortion and family planning services, and 5 clients at the sexually transmitted infection care service. Most clients self-referred to SRH services and sought information online, which was described as helpful, clear, and informative. Remote consultation was the primary access method, allowing planning for in-person attendance after initial triage. This approach was appreciated and considered time-saving and facilitating. Slight delays or longer than anticipated waits were reported by some clients, although mainly in the initial pandemic phase. The relocation of facilities and the restriction of supportive persons were significant barriers to some SRH services. The risk of COVID-19 was perceived as low or less relevant than the reason for accessing SRH care, and it did not limit the decision to access.</p><p><strong>Conclusions: </strong>Results of the present study reflect the importance of maintaining SRH services for clients during health emergencies. Expanding pre-existing remote services and innovations in SRH care delivery had a key role and were appreciated by clients. Telemedicine for initial triage or online consultations and prescriptions should be implemented in regular practice or predisposed for rapid implementation in emergencies, along with ensuring up-to-date information, particularly online.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 Suppl 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13417862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550248","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":"Stakeholders' views on comprehensive sexuality education in Sierra Leone: a critical theory analysis.","authors":"Regina Mamidy Yillah, Anais Bash-Taqi, O'bai Conteh, Augustus Osborne","doi":"10.1186/s12978-026-02418-6","DOIUrl":"10.1186/s12978-026-02418-6","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive Sexuality Education is crucial for equipping young people with the knowledge and skills necessary to make informed decisions about their sexual health and well-being. We explored stakeholders' perspectives on Comprehensive Sexuality Education in Sierra Leone through a critical theory lens, emphasising the power structures, economic conditions, and cultural norms that shape educational realities. Specifically, we asked how power relations, gender norms, economic vulnerability, and institutional authority shape stakeholders' perceptions and implementation of Comprehensive Sexuality Education.</p><p><strong>Methods: </strong>A qualitative research design was employed, utilising purposive sampling to capture diverse viewpoints from 127 key informant interviews and 61 focus group discussions involving 366 participants across 11 schools in various provinces. Focus group discussions were conducted in sex-disaggregated groups so that male and female students' perspectives were captured equally. Data analysis incorporated deductive and inductive thematic analysis, revealing how social norms, economic factors, and power relations affect educational practices and policies.</p><p><strong>Results: </strong>Our findings reveal that educational authorities in Sierra Leone often adopt a conservative approach to Comprehensive Sexuality Education, prioritising traditional frameworks over comprehensive, reality-based instruction. While stakeholders recognise the importance of sexual and reproductive health education, there is widespread concern that practical methods, such as condom demonstrations, could encourage inappropriate behaviours. Gender dynamics play a crucial role, with a disproportionate focus on female students, who are seen as responsible for managing sexual risks, thereby marginalising male students and perpetuating traditional gender roles. Additionally, economic conditions complicate Comprehensive Sexuality Education implementation, as financial hardships influence students' sexual decision-making, often leading to risky behaviours. The successful implementation of Comprehensive Sexuality Education depends on teacher training, community engagement, societal attitudes, and policy support, but societal stigmas surrounding sexual health discussions remain significant barriers, underscoring the need for initiatives that foster open dialogue.</p><p><strong>Conclusion: </strong>Our study underscores the need for a transformative approach to Comprehensive Sexuality Education in Sierra Leone that addresses power dynamics, gender disparities, and economic influences, ultimately fostering a more equitable and effective educational environment for all students.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196231","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 dynamics of family planning and abortion services during COVID-19: perspectives from healthcare providers and clients in Burkina Faso.","authors":"Eunice Nahyuha Chomi, Marie Gisèle Donessouné, Armel Sogo, Armando Humberto Seuc, Gabriela Garcia Camacho, Ali Moazzam, Seni Kouanda","doi":"10.1186/s12978-026-02340-x","DOIUrl":"10.1186/s12978-026-02340-x","url":null,"abstract":"<p><strong>Background: </strong>The novel SARS-CoV-2 (COVID-19) led to an unprecedented increase in demand on health systems to care for people infected, necessitating the allocation of significant resources, especially medical resources, towards the response. This, compounded by the restrictions on movement led to disruptions in the provision of essential services, including sexual and reproductive health (SRH) services. This study assessed the effects of the COVID-19 pandemic on demand, utilisation and delivery of family planning and abortion services in Burkina Faso.</p><p><strong>Methods: </strong>The study used a mixed method, cross-sectional panel survey to collect data at two time points in eight health facilities in Ouagadogou and Bobo Dioulasso. Data was collected using in-depth interviews (IDI) and focus group discussion (FGDs) with women, their male partners, and healthcare providers and health facility availability and readiness assessments.</p><p><strong>Results: </strong>Demand for family planning services declined during the lockdown period due to movement restrictions, fear of infection and of being quarantined if found to be infected. Despite no direct demand for abortion services, healthcare providers reported increased unintended pregnancies and demand for treatment of complications of abortion, suggesting recourse to unsafe abortions. At least 30% of facilities experienced partial disruption in delivery of services, including staff shortages, supply chain challenges and reduced outpatient volumes. Health facility readiness scores remained moderate, implying existing constraints worsened by the pandemic.</p><p><strong>Conclusions: </strong>COVID-19 response and containment measures indirectly affected demand, delivery and utilisation of family planning and abortion services in Burkina Faso, by increasing the existing barriers for women and girls. Strengthening health system resilience, community-based service delivery and communication strategies is essential to ensure uninterrupted access during health emergencies.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 Suppl 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13417866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550270","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":"Use of prescription medications potentially harmful during pregnancy among women of reproductive age by pregnancy status and contraceptive use in the United States, 2009-2020.","authors":"Dima M Qato, Katharine Ozenberger, Qingrong Li, Irving Steinberg","doi":"10.1186/s12978-026-02409-7","DOIUrl":"10.1186/s12978-026-02409-7","url":null,"abstract":"<p><strong>Background: </strong>Despite recent changes in the labeling of safety risks for prescription medications during pregnancy, information on the use of prescription medications potentially harmful or teratogenic among women of reproductive age is not known. In this study, we examine trends in the use of prescription medications potentially harmful during pregnancy based on pregnancy status and the use of contraceptives in the U.S.</p><p><strong>Methods: </strong>We conducted a repeated cross-sectional analysis using five cycles of the National Health and Nutrition Examination Survey (NHANES), 2009-2010 through 2017-2020. Our sample included women aged 20-44 years who reported prescription medication use in the past 30 days. Medications were classified using Micromedex into three fetal risk categories: (1) contraindicated during pregnancy, (2) fetal harm has been demonstrated, and (3) may cause fetal harm. We estimated weighted prevalence of any prescription medication use and use of ≥ 1 potentially harmful medication by pregnancy status (pregnant vs. non-pregnant) and contraceptive use among non-pregnant women. Trends were examined overall, by fetal risk severity, therapeutic class, and specific medications.</p><p><strong>Results: </strong>Among pregnant women aged 20-44 years, the prevalence of any prescription medication use increased from 28.5% to 37.1% (P<0.05) between 2009 and 2014 and 2015-2020, respectively, while no significant change was observed among non-pregnant women, regardless of contraceptive use. Use of at least one potentially harmful medication remained common among pregnant women (14.6% to 14.5%) and among non-pregnant women, including those not using contraceptives (27.4% to 27.1%). Importantly, the use of two or more potentially harmful medications increased among pregnant women from 1.5% to 5.0% (P<0.05). Antidepressants were the most frequently used potentially harmful medications across women of reproductive age; among pregnant women, antidepressant use increased from 2.6% to 7.1% (P = 0.12), driven largely by sertraline use, which increased from 0% to 5.4%.</p><p><strong>Conclusions: </strong>Prescription medications with potential fetal risk are commonly used among women of reproductive age, including pregnant and non-pregnant women who are not using contraceptives, especially antidepressants. These findings highlight the need for continued monitoring of maternal mental health treatment and increased awareness of medication safety during pregnancy.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456566","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":"Women's contraceptive knowledge, attitudes, and practices in Algeria, Morocco, and Tunisia: a scoping review.","authors":"Sabrine Chengane, Roa Sabra, Angel M Foster","doi":"10.1186/s12978-026-02398-7","DOIUrl":"10.1186/s12978-026-02398-7","url":null,"abstract":"<p><strong>Background: </strong>Although Algeria, Morocco, and Tunisia have made significant progress in family planning and remain committed to achieving socio-economic and sustainable development goals, recent years have seen a decline in contraceptive use and a rise in unmet contraceptive need.</p><p><strong>Aim: </strong>Our review aimed to explore available information and identify gaps in the literature on family planning in Algeria, Morocco, and Tunisia by synthesising published literature on women's contraceptive knowledge, attitudes, and practices in these three countries.</p><p><strong>Methods: </strong>Our review followed the framework outlined by Arksey and O'Malley [1] and revised by Levac and colleagues [2]. We conducted a comprehensive search of Medline (Ovid), Embase (Ovid), CINAHL (EBSCOhost), and Web of Science, a supplementary search in Google Scholar, and a hand search of ASJP, CAIRN.info, EMHJ, and La Tunisie Médicale. We included literature in Arabic, English, and French published between January 1990 and September 2024, focusing on women's contraceptive knowledge, attitudes, and practices in the Maghrib.</p><p><strong>Results: </strong>We identified 671 articles from the databases and 70 reports from the supplementary and hand searches. After removing duplicates, conducting initial screens, and retrieving full texts we ultimately included 63 sources in our review. Existing literature revealed that, although contraceptive knowledge has increased over the past decades, gaps in knowledge and misinformation persist. Additionally, fear of side effects and rumours contribute to negative attitudes toward contraception. Through this review, we observed that specific contraceptive methods promoted by early family planning programmes, and the strategies used to promote them, may have had a lasting impact on contraceptive practices, even decades later.</p><p><strong>Conclusion: </strong>Our review highlights the importance of exploring changes in knowledge and attitudes and the factors that influence them, as well as women's lived experiences with contraceptive use and access to services. This knowledge can provide more contextually relevant evidence to inform effective family planning policies and interventions.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456557","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":"Association between maternal and neonatal outcomes and psychosocial risk levels in pregnant women: a convergent parallel mixed methods study protocol.","authors":"Sahar Rouhzendeh, Mahnaz Shahnazi, Fatemeh Abbasalizadeh, Mojgan Mirghafourvand","doi":"10.1186/s12978-026-02405-x","DOIUrl":"10.1186/s12978-026-02405-x","url":null,"abstract":"<p><strong>Background: </strong>Perinatal psychosocial health has gained significant attention due to its impact on maternal and neonatal health outcomes. Elevated rates of mental health disorders during pregnancy and the initial postpartum year, particularly pronounced in low- and middle-income countries (LMICs), have been consistently linked to women's heightened exposure to psychosocial risk factors. In response to this evidence, the current investigation is designed to evaluate psychosocial risk status among pregnant women and to explore its associations with both maternal and neonatal outcomes, employing a convergent mixed-methods design.</p><p><strong>Methods/design: </strong>A convergent parallel mixed‑methods design will be employed for this investigation. The quantitative strand comprises a prospective cohort study that will enroll 260 pregnant women at 12-14 weeks of gestation. Based on their ANRQ‑R total scores, participants will be divided into two groups: those scoring 23 or above (high‑risk) will form the exposed cohort, while those scoring below 23 (low‑risk) will constitute the non‑exposed cohort. Both groups will be followed prospectively until six weeks postpartum. At enrolment, a sociodemographic and obstetric characteristics form will be completed. A second data collection point at 31-34 weeks of gestation will involve administration of the Wijma Delivery Expectancy/Experience Questionnaire (W‑DEQ, version A), the Edinburgh Postnatal Depression Scale (EPDS), and the Pregnancy Experience Scale (PES). Postnatally, within six weeks after birth, the following instruments will be administered: a Maternal and Neonatal Outcomes Checklist, the EPDS, the Childbirth Experience Questionnaire version 2.0 (CEQ‑2), the Postpartum Specific Anxiety Scale Research Short‑Form, the Barkin Index of Maternal Functioning (BIMF), and a measure of Breastfeeding Self‑Efficacy. Running concurrently with the quantitative follow‑up, the qualitative phase will recruit participants through purposive sampling from both high‑ and low‑risk groups. Data will be generated via in‑depth, semi‑structured individual interviews using open‑ended questions, allowing for rich exploration of participants' experiences. Finally, the findings from both the qualitative and quantitative strands will be integrated in the discussion section.</p><p><strong>Discussion: </strong>Identifying psychosocially vulnerable mothers before the onset of mental health disorders during pregnancy, coupled with a deep understanding of the maternal and neonatal outcomes of these risk factors, can provide a roadmap for designing a healthcare system that preemptively safeguards maternal mental health. Furthermore, this approach can contribute to reducing healthcare system costs through timely screening, early intervention, and the effective management of psychosocial conditions.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423410","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":"When policy meets practice: enacting WHO global standards for adolescent reproductive health services in Uganda.","authors":"Susan Asiimwe, Kristien Michielsen, Viola Nilah Nyakato","doi":"10.1186/s12978-026-02408-8","DOIUrl":"10.1186/s12978-026-02408-8","url":null,"abstract":"<p><strong>Background: </strong>Adolescent pregnancy remains a major public health concern in sub-Saharan Africa. In Uganda, about one in four girls becomes pregnant before age 19, a rate unchanged for more than a decade. Although national adolescent reproductive health policies broadly align with the World Health Organization Global Standards for Quality Health Care Services for Adolescents, important implementation gaps persist. This study examined how these standards are enacted in routine health facility and school settings.</p><p><strong>Methods: </strong>A qualitative study was conducted in eight public health facilities and eight secondary schools in south-western Uganda. Data were collected through structured observations and exit interviews with 80 adolescent girls aged 15-19 years and 20 accompanying caregivers. Health-facility findings were organised using the eight World Health Organization Global Standards, while school observations were assessed against national school health and teenage pregnancy guidelines and interpreted alongside the World Health Organization framework. Data were analysed thematically in NVivo using Braun and Clarke's framework, with Street-Level Bureaucracy theory informing interpretation of how standards were enacted in practice.</p><p><strong>Results: </strong>Implementation was partial and uneven across both settings. Some facilities provided respectful and confidential care, while others had stock-outs of essential commodities, reported out-of-pocket purchases, limited adolescent-friendly spaces, and judgemental or dismissive treatment, particularly toward unmarried adolescents. School-based reproductive health activities were largely abstinence-oriented and often donor-dependent, with weak curriculum integration, referral systems, monitoring, and evaluation. Community engagement and adolescent participation were limited in both settings. Several donor-supported activities became inactive after funding ended because they had not been absorbed into routine institutional systems. The findings indicated alignment in policy intent but weak embedding of adolescent-responsive components in routine institutional systems.</p><p><strong>Conclusion: </strong>Uganda's adolescent reproductive health policy framework is broadly aligned with World Health Organization Global Standards, but implementation remains uneven because adolescent-responsive components are not sufficiently institutionalised within routine financing, supervision, school programming, data use, and accountability systems. Closing this gap requires embedding adolescent-responsive services in routine institutional systems and strengthening adolescent-specific supervision and accountability.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412510","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}