Reproductive Health最新文献

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

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

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

{"title":"Public policies and their association with adolescent pregnancy in Southern Peru.","authors":"Emilio Jose Medrano-Sánchez, Lizabeth Lourdes Alanya-Pereyra, Freddy Ochoa-Tataje","doi":"10.1186/s12978-025-02131-w","DOIUrl":"10.1186/s12978-025-02131-w","url":null,"abstract":"<p><p>This study analyzed the association between public policies on adolescent pregnancy in a healthcare network in southern Peru, considering their alignment with Sustainable Development Goals (SDGs) 3, 4, and 5, which focus on health, education, and gender equality. The research was basic in nature, with a correlational quantitative approach and a non-experimental cross-sectional design. A structured survey with closed-ended Likert-scale questions was administered to 80 obstetrics professionals, selected through non-probabilistic convenience sampling. Instrument validity was established through expert judgment, and reliability was evaluated using Cronbach's Alpha coefficient, obtaining a value of 0.83, which indicated high internal consistency. The results obtained via ordinal logistic regression revealed that public policies were significantly associated with adolescent pregnancy (p = 0.000), with a Nagelkerke determination coefficient of 0.737, indicating that approximately 73.7% of the variance in adolescent pregnancy was associated with the level of policy implementation. It was concluded that public policies were linked to lower perceived levels of adolescent pregnancy in the healthcare network under study, recommending the optimization of sexual and reproductive health strategies to strengthen their implementation.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"172"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200647","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":"Comparison of sexual risk behaviors among Zambian adolescent girls and young women living with and without HIV.","authors":"Suzannah L Scanlon, Natalie A Blackburn, Jenny Beizer, Drosin M Mulenga, Laura Nyblade, Sarah T Roberts, Nachela Chelwa, Michael Mbizvo, Sujha Subramanian","doi":"10.1186/s12978-025-02147-2","DOIUrl":"10.1186/s12978-025-02147-2","url":null,"abstract":"<p><strong>Background: </strong>We sought to identify commonalities and variations in sexual risk behaviors between adolescent girls and young women living with and without human immunodeficiency virus (HIV) in Zambia. Our goal was to understand the specific needs of these populations to inform the design of interventions to support the sexual health by age group and HIV status.</p><p><strong>Methods: </strong>As a part of baseline survey Data collected for a cluster-randomized controlled, we surveyed a sample of 650 women aged 16-22 residing in Lusaka, Zambia between May and September 2021. We used bivariate statistical methods to determine whether sexual behavior and contraceptive use differed among participants living with and without HIV, by age group. Statistical significance was defined at P ≤ 0.10.</p><p><strong>Results: </strong>We found that among the younger participants (aged 16-18), those living with HIV were less likely to have ever had sex or be currently sexually active, and reported fewer casual and serious sexual partners in the last three months compared to those living without HIV. Among participants aged 19-22, we did not see a difference in sexual debut or number of casual sexual partners by HIV status. However, those living with HIV reported fewer recent serious sexual partners and were less likely to be currently having sex in this older age group. There was also evidence that those living with HIV in this older age group were more likely to be using condoms with sexual partners than their counterparts without HIV.</p><p><strong>Conclusions: </strong>Future HIV interventions should be tailored by age group and HIV status. For example, those living with HIV may require support to confidently engage in safe sexual relationships.</p><p><strong>Trial registration: </strong>This study was approved by both U.S. and Zambian Institutional Review Boards (RTI Institutional Review Board and RES Converge Zambia, respectively) and is registered on clinicaltrials.gov (NCT03995953).</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"174"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200989","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":"Safe spaces enhancing sexual and reproductive health for youth: a scoping review.","authors":"Salima Meherali, Yared Asmare Aynalem, Saba Nisa, Adeyinka G Ishola, Zohra Lassi","doi":"10.1186/s12978-025-02009-x","DOIUrl":"10.1186/s12978-025-02009-x","url":null,"abstract":"<p><strong>Introduction: </strong>Safe spaces play a crucial role in providing support for the sexual and reproductive health (SRH) of youth. As young individuals undergo significant physical and emotional changes, they often encounter challenges such as societal taboos and a lack of accessible information related to their SRH needs. This scoping review explores the existing literature on using safe spaces to offer a supportive environment for adolescents SRH to navigate these complexities.</p><p><strong>Methods: </strong>This review adhered to Arksey and O'Malley's scoping review framework method. A comprehensive search was conducted across Medline, EMBASE, CINAHL, and Scopus for studies published between January 2013 and December 2023. It focused on youth aged 15 to < 25 years, including primary studies and grey literature in English from diverse global contexts, excluding non-English studies and scoping/systematic reviews. The screening was done using Covidence software by two independent reviewers. Data were extracted and analyzed using descriptive statistics and narrative synthesis to summarize the findings.</p><p><strong>Results: </strong>Schools emerged as the most common safe spaces (37 studies), effectively increasing condom use, SRH knowledge, and service utilization. Community-based initiatives (e.g., youth clubs and outreach programs) were critical in reducing stigma and fostering positive SRH attitudes. At the same time, digital platforms demonstrated the potential to address high-risk behaviours and unplanned pregnancies. Interventions included educational sessions, resource distribution, counseling, and peer support. While most studies reported positive outcomes, the evidence for long-term efficacy and sustainability was limited.</p><p><strong>Conclusion: </strong>Safe spaces hold significant potential to improve youth SRH outcomes by fostering informed decision-making and reducing risky behaviors. However, the effectiveness of interventions should be critically evaluated, with more emphasis on innovative, digital approaches and long-term impact. Tailored, inclusive, and sustainable strategies are essential to address the diverse needs of youth globally.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"168"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200593","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":"'Our rights, Our lives, Our future': evaluation of a 5-year multi-country programme to enhance sexuality education in sub-Saharan Africa.","authors":"Maryse Kok, Hannah Kabelka, Tasneem Kakal, Joseph M Zulu, Laure Moukam, Patricia Machawira, Ygainnia Hamandawana, Mariëlle Le Mat","doi":"10.1186/s12978-025-02096-w","DOIUrl":"10.1186/s12978-025-02096-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;School-based sexuality education is instrumental in promoting health and well-being of adolescents and young people. While countries across sub-Saharan Africa have made significant progress in improving adolescents' and young people's sexual and reproductive health and rights, school-based sexuality education policy, curriculum development and implementation need further advancement. This paper aims to contribute to enhancing the effectiveness and sustainability of sexuality education programmes, by sharing lessons learned from the mixed-methods evaluation of the 'Our rights, Our lives, Our future' programme across 33 countries in sub-Saharan Africa (2018-2022).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The evaluation employed mixed methods. It started with a review of 35 programme documents, after which ten qualitative country case studies and 15 regional and global-level interviews with key stakeholders were conducted. The case studies were conducted in Botswana, Burundi, Cameroon, Côte d'Ivoire, Eswatini, Gabon, Malawi, Nigeria, Uganda and Zambia. They included a total of 34 focus groups discussions with adolescents, teachers and parents; 76 key informant interviews; and nine stakeholder learning sessions. Data from each method were triangulated and synthesised based on an evaluation framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Findings show that the programme made a substantial contribution to keeping sexuality education on the political agenda in a context of growing opposition. The programme's support to national governments also led to significant progress in the development and adoption of sexuality education curricula. In many settings, the delivery of sexuality education was hampered by limited competencies and sometimes negative attitudes of teachers, and a lack of support in the school and community environment, including a lack of support from parents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Continued efforts are needed for supporting sexuality education policy processes and sustainable implementation in sub-Saharan Africa. There is a need for collaborative advocacy and countering opposition. Improving the quality of sexuality education delivered in schools also requires continuous attention. Such efforts need the engagement of multiple stakeholders, including adolescents and young people themselves. Sexuality education in schools promotes the health and well-being of adolescents and young people. Countries in sub-Saharan Africa have made significant progress in improving adolescents' and young people's sexual and reproductive health and rights. However, it is known that sexuality education in schools needs to be improved. This paper aims to contribute to more effective and sustainable sexuality education programmes, by sharing lessons learned from the evaluation of the 'Our rights, Our lives, Our future' programme (2018-2022). This programme supported 33 countries in sub-Saharan Africa in the promotion of sexuality e","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"169"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200612","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":"Technology-facilitated abuse as a risk factor for STI and pregnancy in early adulthood: evidence from latine adolescents in California.","authors":"Miriam Hartmann, Marie Stoner, Carmen Guadalupe Ramirez, Erica N Browne, Alondra Jaime-Aguilar, Danielle Rodriguez, Nivedita L Bhushan, Mary Kate Shapley-Quinn, Marissa Raymond-Flesch, Alexandra Minnis","doi":"10.1186/s12978-025-02128-5","DOIUrl":"10.1186/s12978-025-02128-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Background Technology-facilitated abuse (TFA) has emerged as a significant form of violence against adolescents and young adults (AYA). However, evidence is limited regarding the prevalence of forms of TFA among AYA and how TFA from partners influences other outcomes related to AYA sexual health and wellbeing. The aim of this study was to examine the prevalence of TFA exposure among AYA in an agricultural region in the United States, to identify associated risk factors, and assess its relationship to later sexual, mental, and violence-related health outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We analyzed data from a prospective cohort study of eighth graders from Salinas, California followed over eight years. Pregnancy and sexually transmitted infection (STI) testing were conducted in emerging adulthood (~age 20). TFA was measured using a 6-item scale of Cyber Dating. Log-binomial models were used to estimate risk ratios (RR) and 95% confidence intervals (CIs) for the associations between any TFA in early and middle adolescence (~ages 13-15) with sexual health, mental health and violence outcomes in emerging adulthood.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 373 participants with follow-up data, the median age of participants at baseline was 13.7 years (interquartile range (IQR) 13.4, 14) and the majority were female (56.0%, n=216), Latine (95.9%, n=370) and had at least one parent or grandparent from Mexico (88.9%, n=343). Over the entire study period in early adolescence, 41.7% (n=161) of participants reported ever having TFA experiences but the percentage was roughly 20% at any one visit. The most reported TFA type was a partner repeatedly contacting the participant via some form of technology to see where they were/who they were with. Exposure to TFA in early or middle adolescence was associated with a higher likelihood of pregnancy before age 20 (RR 1.71; 95% CI 1.02, 2. 84) and an STI diagnosis in emerging adulthood (RR 2.22; 95% CI 1.19, 4.16) in adjusted models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;TFA was relatively common among AYA throughout adolescence and into emerging adulthood. TFA was associated with teen pregnancy and STI acquisition. Further work is needed to understand mechanisms for this relationship and to integrate TFA into existing intimate partner violence prevention programming and reduce the negative effects of TFA on sexual and reproductive health. Technology is increasingly being used as a tool for abuse in relationships, especially among teenagers and young adults. This study looked at how common technology-facilitated abuse (TFA) is among adolescents and young adults in an agricultural region of California. We also explored how experiencing this type of abuse in early and middle adolescence (around ages 13-15) might affect reproductive health outcomes later in early adulthood.We followed a group of young people from their early teenage years into adulthood, checking in with them over eight ","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"166"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200705","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":"Impact of COVID-19 pandemic on family planning and sexual transmitted infection services in Thailand: results from WHO survey.","authors":"Jen Sothornwit, Pisake Lumbiganon, Nampet Jampathong, Somporn Rungreangkulkij, Netchanok Kaewjanta, Caron Kim, Moazzam Ali","doi":"10.1186/s12978-025-02092-0","DOIUrl":"10.1186/s12978-025-02092-0","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 pandemic has put tremendous burden on health services. Only limited evidence, however, is available to identify the impact of COVID-19 on sexual and reproductive health (SRH). This world health organization (WHO)-led research sought to evaluate health systems focusing on SRH in Brazil, Burkina Faso, China, Ghana, Italy, Pakistan, Thailand, and the United Kingdom.</p><p><strong>Methods: </strong>The study was conducted in Thailand on two levels using a mixed-methods design: 1) Individual level included in-depth interviews and focus group discussions with clients (and their partners, where applicable) and healthcare providers (HCPs) to investigate service perceptions and obstacles to SRH service utilization; 2) health facility level, a quantitative evaluation of health facility preparedness for SRH service provision was performed using an adapted version of the WHO Service Availability and Readiness Assessment (SARA) tool. The data was collected at two timepoints, baseline and endline, at time intervals of 9 months.</p><p><strong>Results: </strong>Almost all SRH services were maintained with some shortage of supply such as medications for safe abortion during the first few months. Both providers and clients perceived that all SRH services should be maintained. Some clients were concerned about fear of getting COVID-19 infection while visiting the facility. Some clients switched from short-acting to long-acting contraceptive methods. At the endline, this affect was less obvious since a large proportion of clients were familiar with the pandemic and already received vaccination. The Centre for COVID-19 Situation Administration (CCSA) was established to update COVID-19 pandemic situation, new government policy and intervention to reduce fake news. Telemedicine was used to reduce avoidable appointments. For postpartum women, appointment tended to be more individualized. For those who required pregnancy protection, contraceptive methods were offered to clients before discharge from the hospital. A follow-up visit was performed using both telemedicine and in-person visit at the hospital. For those required medications such as antibiotics for STI, home delivery to clients was provided.</p><p><strong>Conclusions: </strong>This study demonstrated that COVID-19 pandemic had some but non-significant effect on SRH services. The two major referral hospitals in Northeast, Thailand had service readiness to provide SRH services during the COVID-19 pandemic and pandemic recovery.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 Suppl 3","pages":"165"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200728","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":"Accessibility of sexual and reproductive health services among women with motor disabilities in low- and middle-income countries in Africa: a systematic review.","authors":"Firdaous Zekaoui, Houssine Boufettal, Rachid Aboutaieb, Samy Housbane","doi":"10.1186/s12978-025-02117-8","DOIUrl":"10.1186/s12978-025-02117-8","url":null,"abstract":"<p><strong>Background: </strong>Access to sexual and reproductive health (SRH) services is recognized as a fundamental human right and a core priority within global health agendas, particularly under the Sustainable Development Goals (SDGs). Despite significant legal advances such as the Convention on the Rights of Persons with Disabilities women with motor disabilities continue to face persistent marginalization, especially in low- and middle-income African countries. This systematic review aims to identify the barriers and facilitating factors influencing their access to SRH services.</p><p><strong>Methods: </strong>Following PRISMA guidelines and registered with PROSPERO (CRD42024555816), this review adopted a Population, Concept, Context (PCC) search strategy. Studies published between 2001 and 2024 in English and French were retrieved from major electronic databases and grey literature sources. Data extraction and methodological assessment were conducted independently by multiple reviewers. A narrative synthesis was used for qualitative findings and a descriptive approach for quantitative data.</p><p><strong>Results: </strong>Twenty-eight studies covering eleven African countries were included. The main barriers identified were grouped into five categories: physical and logistical constraints, social and attitudinal barriers, institutional limitations, economic hardships, and informational and communication barriers. Key facilitating factors included healthcare provider training, infrastructure adaptation, community mobilization, and the development of inclusive public health policies.</p><p><strong>Conclusion: </strong>This review highlights the urgent need to embed disability inclusion within national SRH policies and to promote multisectoral strategies that address the systemic inequalities limiting access for women with motor disabilities.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"170"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201034","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}