Reproductive Health最新文献

{"title":"Evaluating pregnancy outcomes in women with uterine fibroids treated with high-intensity focused ultrasound: insights from a single-institution study.","authors":"Min Zhao, Dan Wang, Yong Zhang, Ligang Wang","doi":"10.1186/s12978-024-01930-x","DOIUrl":"https://doi.org/10.1186/s12978-024-01930-x","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the safety and effectiveness of High-Intensity Focused Ultrasound (HIFU) ablation on pregnancy outcomes among women with uterine fibroids wishing to conceive, focusing specifically on short-term pregnancy outcomes immediately following HIFU treatment.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 210 women who underwent HIFU treatment (Group I) at our institution between January 2018 and December 2022 and subsequently conceived. Pregnancy outcomes were compared with two control groups: 510 patients who delivered vaginally (Group II) and 278 who underwent cesarean sections (Group III) during the same period. Statistical analyses included multivariable logistic regression to adjust for confounding factors. The study only considered outcomes related to the immediate pregnancy following HIFU treatment and did not include data on subsequent pregnancies or long-term effects.</p><p><strong>Results: </strong>The natural conception rate post-HIFU was 93.81% (197/210), with a miscarriage rate of 19.05% (40/210). Group I had significantly lower rates of gestational diabetes mellitus (8.24%) and precipitate labor (0%) compared to Group II but higher rates of mild anemia (31.18%) and adherent placenta (10.59%). Compared to Group III, Group I had lower rates of gestational diabetes mellitus (8.24% vs. 20.86%) and moderate anemia (4.71% vs. 16.55%) but a higher incidence of premature rupture of membranes (18.82%). Neonates in Group I had lower birth weights compared to Groups II and III (p < 0.05), with no cases of low birth weight in Group I. Multivariable analysis identified fibroid location as a predictor of preterm birth, while maternal age and mode of delivery influenced the risk of incomplete uterine rupture.</p><p><strong>Conclusion: </strong>HIFU ablation is a safe and effective fertility-preserving treatment for women with uterine fibroids, demonstrating favorable short-term pregnancy outcomes. It does not increase perinatal risks, but its impact on pregnancy duration and certain complications suggests that careful patient selection and management are crucial. Future studies should investigate the long-term effects of HIFU on subsequent pregnancies.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"184"},"PeriodicalIF":3.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854907","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":"Effect of early essential newborn care on breastfeeding and outcomes of mothers/newborns post-cesarean section: a randomized controlled trial in China.","authors":"Min Zhou, Jin-Yi Guo, Tai-Yang Li, Chun-Hua Zhou, Xiao-Qin Zhang, Wei Wei, Jie Zhou, Sharon R Redding, Yan-Qiong Ouyang, Hui-Jun Chen","doi":"10.1186/s12978-024-01932-9","DOIUrl":"https://doi.org/10.1186/s12978-024-01932-9","url":null,"abstract":"<p><strong>Background: </strong>The implementation of early essential newborn care (EENC) is important to maternal and neonatal health. However, few studies have conducted a complete procedure of EENC in cesarean section. This study aimed to systematically evaluate the effects of EENC during and after cesarean section.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted at a tertiary hospital in Wuhan, China. Full-term pregnant women who had no comorbidities and underwent elective cesarean section were recruited and received EENC intervention or routine health care. The Infant Breastfeeding Assessment Tool (IBFAT), the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), a questionnaire of the breastfeeding behavior, the Maternal Postnatal Attachment Scale (MPAS) and the Edinburgh Postnatal Depression Scale (EPDS) were used to collect data. The correlation between EENC implementation and breastfeeding, maternal-infant attachment, postpartum depression, and other maternal and neonatal outcomes was analyzed.</p><p><strong>Results: </strong>Mother-newborn pairs (N = 157) were enrolled in this study, 78 in the EENC group and 79 in the control group. A total of 155 (98.8%) were followed up at 14 days, 144 (91.7%) at 42 days, and 123 (78.3%) at 3 months. For the primary outcomes, generalized linear mixed model analysis showed that implementing EENC during cesarean section was beneficial for initiating breastfeeding (OR = 0.021), shortening the breastfeeding initiation time (β = - 45.321), improving the IBFAT scores (β = 2.740), and enhancing breastfeeding self-efficacy (β = 4.880). These effects were not influenced by time interaction. However, no difference was observed in the rate of exclusive breastfeeding between these two groups (P > 0.05). Implementing EENC during cesarean section significantly improved maternal-infant attachment (β = 9.668). Moreover, univariate analysis showed benefits of EENC in improving postpartum depression (P < 0.001) and decreasing maternal perinatal blood loss (P < 0.05).</p><p><strong>Conclusions: </strong>According to our small sample study, there is a trend of improvement in breastfeeding related behavior and maternal infant attachment in women who received EENC during cesarean deliveries. The effects of EENC on exclusive breastfeeding should be further explored in the future.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Register at www.chictr.org.cn , ChiCTR2300074760, retrospectively registration. Registration Date: August 15, 2023.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"183"},"PeriodicalIF":3.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847479","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":"Reasons for unsafe abortion in Iran after pronatalist policy changes: a qualitative study.","authors":"Arezoo Haseli, Nasrin Rahnejat, Dara Rasoal","doi":"10.1186/s12978-024-01929-4","DOIUrl":"https://doi.org/10.1186/s12978-024-01929-4","url":null,"abstract":"<p><strong>Background: </strong>In Iran, restrictive abortion laws have led to widespread unsafe abortions, posing significant health risks. The 2021 Family and Youth Protection Law further restricted access to reproductive health services in an effort to boost birth rates. The purpose of this qualitative study is to explore the reasons women sought abortions in an illegal context, based on their own experiences.</p><p><strong>Methods: </strong>This exploratory qualitative study involved in-depth interviews with 46 women in Kermanshah, Iran, between April and August 2024. All participants had experienced incomplete abortions after undergoing unsafe procedures. Data were analyzed using conventional content analysis and thematic analysis with MAXQDA 10 software to identify key themes in the women's experiences. To ensure the study's rigor, we applied Guba and Lincoln's criteria, including credibility, dependability, confirmability, and transferability.</p><p><strong>Results: </strong>Five main themes emerged from the interviews: economic hardship, pursuit of a prosperous life, unstable marital relationships, health and fertility issues, and cultural factors. Economic challenges, such as unemployment and lack of basic necessities, were the most frequently cited reasons for seeking unsafe abortions. Health issues, including unplanned pregnancies and fear of fetal anomalies, also played a significant role, alongside cultural stigmas related to age, illegitimacy, and gender preferences.</p><p><strong>Conclusion: </strong>This study sheds light on the multifaceted factors driving unsafe abortions in Iran following pronatalist policy changes. A holistic approach is recommended to address the interconnected economic, social, and cultural challenges that contribute to this issue. By implementing such comprehensive strategies, policymakers and stakeholders can work to reduce the prevalence of unsafe abortion practices and foster improved health and well-being for women.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"182"},"PeriodicalIF":3.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839120","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":"Inequality in modern contraceptive use and unmet need for contraception among women of reproductive age in Zambia. A trend and decomposition analysis 2007-2018.","authors":"Joseph Kazibwe, Felix Masiye, Marie Klingberg-Allvin, Björn Ekman, Jesper Sundewall","doi":"10.1186/s12978-024-01909-8","DOIUrl":"10.1186/s12978-024-01909-8","url":null,"abstract":"<p><strong>Background: </strong>Access to contraception can be a transformational intervention towards advancement of education, health, and freedom of choice. Countries have committed to improving access to contraception enshrined in the sustainable development goals (SDGs), indicator 3.7.1. Our study seeks to investigate the level of inequality in current use of modern contraception and unmet need for contraception among sexually active women of reproductive age in Zambia during 2007, 2013/14 and 2018 to inform family planning policy.</p><p><strong>Methods: </strong>We use three rounds of Zambia demographic and health survey datasets for the years 2007, 2013/14 and 2018, which are nationally representative surveys. We included a total of 19,973 sexually active women of reproductive age from 15 to 49 years living in Zambia. The level of inequality was assessed using concentration curves, and indices. The concentration indices were decomposed to identify the causes of the inequality.</p><p><strong>Results: </strong>Our analysis shows that there was inequality in the current use of modern contraception across the years 2007, 2013/14 and 2018. The concentration curves showed that current use of modern contraception was higher among the wealthy than the poor. This pro-rich trend was consistent throughout the study period. Erreygers concentration Index (EI) values were 0.2046 in 2007, 0.1816 in 2013/14, and 0.1124 in 2018. The inequality in current use of modern contraception was significantly influenced by having access to contraceptive counselling, education level and being in a union (living with a partner). In addition, there was inequality in unmet need for contraception with concentration curves showing that unmet need for modern contraception was experienced more among the poor compared to the wealthy. Unmet need was thus pro poor. The EI values were - 0.0484 in 2007, - 0.0940 in 2013/14 and - 0.0427 in 2018. This inequality was significantly influenced by education, employment status, being in a union, and having health insurance.</p><p><strong>Conclusion: </strong>Inequality in modern contraceptive use and unmet need for contraception exists and has persisted over the years in Zambia. Such inequality can be addressed through a multipronged approach that includes encouraging women to visit health facilities, access to contraceptive counselling, and promoting formal education.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"181"},"PeriodicalIF":3.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802171","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":"Exploring the sexual and reproductive health knowledge, practices and needs of adolescents living with perinatally acquired HIV in Côte d'Ivoire: a qualitative study.","authors":"Clément Tisseron, Joël Djaha, Désiré Lucien Dahourou, Kouakou Kouadio, Patricia Nindjin, Marie-Sylvie N'Gbeche, Corinne Moh, François Eboua, Belinda Bouah, Eulalie Kanga, Muhammad Homayoon Manochehr, Marie-Hélène Doucet, Philippe Msellati, Julie Jesson, Valériane Leroy","doi":"10.1186/s12978-024-01919-6","DOIUrl":"10.1186/s12978-024-01919-6","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescents face unique challenges in accessing appropriate information and services regarding sexuality and reproductive health (SRH). This poor access can lead to sexual behaviours that could put them at risk of unintended pregnancies and sexually transmitted infections. Adolescents living with HIV (ALHIV) have specific SRH needs that remain unmet. We explored the SRH knowledge, practices and needs of ALHIV in Abidjan, Côte d'Ivoire.</p><p><strong>Methods: </strong>Between April and September 2023, a qualitative study using semi-structured individual interviews was conducted with nine male and nine female ALHIV without previous pregnancies, and eight ALHIV who became pregnant. All consented and were ALHIV acquired perinatally, aged 15-19 years, informed of their HIV status, and followed in three paediatric HIV care centres in Abidjan. participating in the paediatric IeDEA West African Cohort and enrolled in the ANRS12390 OPTIMISE-AO project aimed at improving HIV disclosure process and adherence to antiretroviral treatment. A focus group discussion was conducted with five peer-educators, aged 23-31 years, participating in the OPTIMISE-AO project to gather their perspectives on adolescent SRH. Interviews were conducted in French, and a thematic analysis was performed.</p><p><strong>Results: </strong>All participants expressed difficulty in talking about SRH with their parents or health professionals and turned to their friends for advice. All feared transmitting HIV. One-third of female participants reported having experienced non-consensual sex and sexual violence. Participants reported low levels of condom use, despite having good knowledge of its purpose. Reasons for not using condoms included difficulties in negotiating for girls, as well as having an undetectable viral load, which was seen by adolescents as a condition for waiving condom use. As hormonal contraceptives were subject to many negative beliefs justifying their non-use, alternative methods, such as emergency contraceptive pills or traditional plants, were used to prevent pregnancy.</p><p><strong>Conclusion: </strong>ALHIV reported unmet SRH needs, particularly in terms of accessing reliable information and appropriate support. Integrating SRH care into paediatric HIV care, organising SRH discussion groups led by peer-educators, and improving access to a range of contraceptives may address these needs to enhance SRH outcomes for ALHIV.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"180"},"PeriodicalIF":3.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786710","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":"HPV vaccine knowledge, attitude, and programme satisfaction among parents and caregivers of vaccine recipients in Ogun state Nigeria.","authors":"Tope Olubodun, Elijah Ayowole Ogunsola, Marcellina Olutomi Coker, Surajudeen Adekunle Olayinka, Waheed Àlàmú Elegbede, Joke Oluwatoyin Ojediran, Kofoworola B Olajide, Salimat Bola Sanni, Temitope Olawumi Oluwadare, Oluwaseun Temitope Inetagbo, Mobolanle Rasheedat Balogun, Onikepe Oluwadamilola Owolabi, Catherine Chidimma Anyadiegwu-Bello, Olukayode Abiodun Runsewe, Abiola Oluwatoyin Temitayo-Oboh, Tolulope Soyannwo, Oluwaseun Bisola Ogunsiji, Aduragbemi Banke-Thomas","doi":"10.1186/s12978-024-01913-y","DOIUrl":"10.1186/s12978-024-01913-y","url":null,"abstract":"<p><strong>Introduction: </strong>Human Papillomavirus is responsible for about 5% of the global cancer burden. In Nigeria, cervical cancer is the second most common cancer among women. The Federal Government of Nigeria and partners recently introduced Human Papillomavirus (HPV) vaccination into routine immunization beginning with 15 States and the Federal Capital Territory. This study assesses HPV vaccine knowledge, attitude and program satisfaction among parents and caregivers of vaccine recipients in Ogun State, Nigeria.</p><p><strong>Methods: </strong>This is a cross-sectional study with sample size of 1012 respondents, carried out during the 5-day HPV immunization campaign in all 20 Local Government Areas in Ogun State, Nigeria. Data was collected using interviewer-administered questionnaires. Univariate analysis was done using frequency tables and bivariate analysis using Chi-square test. Multivariate analysis was carried out to identify the determinants of knowledge of HPV, knowledge of cervical cancer and programme satisfaction.</p><p><strong>Results: </strong>All the respondents had heard of HPV vaccine and 67.5% had heard of cervical cancer. Eighty-two percent of the respondents heard of HPV vaccine for the first-time during the introduction programme. Eighty-two percent of respondents had good knowledge of HPV vaccine and 47.7% had good knowledge of cervical cancer. Forty-four percent of respondents heard about HPV vaccine via town/market announcers, 36.2% via radio, and 28.6% via social media. Common reasons respondents vaccinated their wards include, because there was a campaign (51.8%), to prevent cervical cancer (48.9%), and because it is free (38.3%). Twenty-nine percent were very satisfied with the HPV vaccination program and 63.2% were satisfied. All the respondents had positive attitude towards HPV vaccination, although 94.1% had heard messages discouraging people from vaccinating their wards. Respondents living in rural communities had higher odds of having good knowledge of HPV vaccine (aOR 2.232, 95% CI 1.527-3.263, p-value ≤ 0.001). Fathers with tertiary education were more likely to be satisfied with the programme (aOR 5.715, 95% CI 1.142-28.589, p-value = 0.034), CONCLUSION: Knowledge of HPV vaccination was high and was informed by the HPV vaccination introduction programme. Use of outreaches, awareness drives, and provision of free vaccines should be intensified to further promote HPV vaccine uptake in Nigeria.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"179"},"PeriodicalIF":3.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780850","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":"Improving the process of evaluating the quality of care in \"maternal near miss\" at hospital level: an action research study protocol.","authors":"Sedigheh Abdollahpour, Sanaz Mollazadeh, Shapour Badiee Avval, Talat Khadivzadeh","doi":"10.1186/s12978-024-01923-w","DOIUrl":"10.1186/s12978-024-01923-w","url":null,"abstract":"<p><strong>Background: </strong>The fifth Millennium Development Goal aims to improve maternal health by reducing maternal mortality by 75% from 1990 to 2015. Consequently, utilizing quality care indicators and performance evaluations is crucial for providing effective services. This study aimed to evaluate the quality of care for critically ill mothers in hospitals through action research.</p><p><strong>Methods/design: </strong>This study involves action research utilizing reform cycles, including focus group meetings with the head of the midwifery office, maternity hospital officials, gynecologists, and midwives from Mashhad University of Medical Sciences. Following a severe morbidity incident resulting in maternal death, a hospital meeting will convene to investigate the root causes. This committee will review the hospital records from the mother's admission to discharge to identify necessary preventive measures against malpractice. Sampling is purposeful. Sample size will be determined by data saturation. The project's final results, along with participant feedback, will inform the planning of the second action research cycle, which will encompass planning, implementation, observation, and reflection. The final report will be submitted to officials for approval, and the number of invitees for subsequent meetings will be based on study findings, facilitating discussion and decision-making for ongoing processes. Ultimately, the final care quality assessment process will be prepared for presentation.</p><p><strong>Discussion: </strong>In many birth blocks, women experiencing severe complications from pregnancy and childbirth face similar health issues. Quality care is essential for global strategies aimed at eliminating avoidable deaths. Ethical code IR.MUMS.NURSE.REC. 1402.024.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"178"},"PeriodicalIF":3.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780868","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":"INSIGHT-2: mechanistic studies into pregnancy complications and their impact on maternal and child health-study protocol.","authors":"Carlotta Valensin, Emilie J M Côté, Daniela Pereira-Carvalho, Rachael A Gardner, Glen Nishku, Caitlin L Giles, Carolyn Gill, Anna Brockbank, Lisa Story, Andrew H Shennan, Natalie Suff, Deena L Gibbons, Rachel M Tribe","doi":"10.1186/s12978-024-01911-0","DOIUrl":"10.1186/s12978-024-01911-0","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy and early childhood cohorts provide a framework for investigating the complex interplay between early-life exposures and health outcomes, thereby informing prevention strategies and interventions to improve maternal and child health. In this paper, we outline the objectives, methodologies and expected contributions of INSIGHT-2, a comprehensive cohort study dedicated to advancing our understanding of pregnancy and pregnancy complications towards improving the health and well-being of mothers and their offspring.</p><p><strong>Methods: </strong>Over the course of 5 years, the study aims to establish a diverse cohort of 1700 pregnant women and to follow up their children up to 2 years of age. Recruitment targets participants with healthy pregnancies, preexisting conditions, and/or risk factors for pregnancy complications or later child health problems. Clinical and lifestyle data and a range of biological samples will be collected, providing a comprehensive resource for biomarker investigations and cross-sectional analyses. It is anticipated that the cohort will continue beyond this initial 5-year plan.</p><p><strong>Discussion: </strong>By gathering a wide range of biological samples and using diverse analytical techniques, this study supports broad participation, potential replication and collaboration across various sites. The extensive collection of longitudinal data and samples not only facilitates current investigations but also establishes a biobank for future research. The exploration of pre-pregnancy and pregnancy factors that may contribute to disease processes and impact fetal well-being and future health will provide a comprehensive picture of disease mechanisms in both mothers and children, facilitating the identification of biomarkers for the prediction, diagnosis, and management of pregnancy complications. Additionally, our diverse population allows for the capture of various pregnancy complications and outcomes, enhancing external validity and addressing health disparities. This comprehensive design ultimately aims to improve maternal and child health outcomes by providing a valuable longitudinal study of the relationships among the in utero environment, pregnancy management, and long-term maternal and child health, ensuring that findings are relevant and beneficial to a broader population.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"177"},"PeriodicalIF":3.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751478","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":"Nego-feminism as a strategy to improve access to abortion in sub-saharan Africa.","authors":"Lalique Browne, Irmine Fleury Ayihounton, Thomas Druetz","doi":"10.1186/s12978-024-01914-x","DOIUrl":"10.1186/s12978-024-01914-x","url":null,"abstract":"<p><strong>Background: </strong>Abortion is partially legal in 48 of 54 countries in Sub-Saharan Africa (SSA); however, abortion laws are generally weakly implemented, and evidence suggests that extending abortion rights does not necessarily improve abortion access.</p><p><strong>Objective: </strong>Reflecting on the implementation challenges faced by the laws extending rights to abortion in SSA, and enriching this approach by considering complementary avenues to overcome barriers in access to abortion.</p><p><strong>Argument: </strong>Reproductive justice is a theory that emphasizes the importance of contexts and different levels of societal forces in shaping reproductive freedom. From a reproductive justice perspective, we suggest that the successful implementation of abortion laws is hampered by discrepancies between legal frameworks and socio-cultural contexts in many SSA countries. In many SSA contexts, the legalization of abortion has not been accompanied by a modification of socio-cultural contexts regarding abortion. Until these contexts are more receptive to abortion, implementation issues may persist and access to abortion may remain hindered. Since increasing social acceptability of abortion can be a lengthy process, exploring complementary strategies to improve abortion access can be beneficial. Nego-feminism, an African feminist theory rooted in African values of negotiation and relationships, may be an effective strategy to navigate societal forces to improve abortion access, in the meantime, until greater acceptability and enforcement of abortion laws. An illustration of this promising strategy can be found in abortion accompaniment models such as MAMA network which provide safe access to medication abortion in the informal sector.</p><p><strong>Conclusion: </strong>Nego-feminism could potentially improve access to abortion in legally and socially restricted settings. However, the continued fight for the legalization of abortion is essential, while using nego-feminism as a complement.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"175"},"PeriodicalIF":3.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740289","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":"Age at first menstruation and clinical breast cancer screening utilization: insights from the 2021 Côte d'Ivoire demographic and health survey.","authors":"Joshua Okyere, Castro Ayebeng, Sylvia Ahinee Adjedu, Kwamena Sekyi Dickson","doi":"10.1186/s12978-024-01915-w","DOIUrl":"10.1186/s12978-024-01915-w","url":null,"abstract":"<p><strong>Background: </strong>There is a strong evidence showing that women who start menstruation early are at a greater risk of developing breast cancer. Recognizing that women will seek breast cancer screening when they have a high perceived risk, we hypothesized that women who experienced early menarche will be more likely to utilize clinical breast examination (CBE). Hence, we aimed to investigate the association between age at first menstruation and women's utilization of CBE in Côte d'Ivoire.</p><p><strong>Methods: </strong>We used data from the 2021 Côte d'Ivoire demographic and health survey. A sample of 14,685 women was used for the analysis. A descriptive analysis, as well as bivariate and multivariate logistic regression models were computed in STATA version 18. Adjusted odds ratio (AOR) and a 95% confidence interval was used to present the result.</p><p><strong>Results: </strong>CBE utilization was 17.4%. Women who had their first menstruation before attaining 15 years were significantly less likely to utilize CBE services [AOR = 0.89; 95% CI 0.81-0.99]. A significantly higher utilization of CBE was found among those with primary [AOR = 1.48, 95% CI 1.29-1.70], secondary [AOR = 2.96, 95% CI 2.59-3.38], and higher education [AOR = 4.35, 95% CI 3.50-5.40] compared to those with no formal education. Increasing likelihood of CBE utilization was observed as age increased. Rural residence was associated with lower odds of CBE utilization (AOR = 0.84, 95% CI 0.74-0.95]. Increasing wealth status was associated with higher odds of CBE utilization with those in the richest households having the highest odds compared to women in the poorest household [AOR = 2.11, 95% CI 1.69-2.64].</p><p><strong>Conclusion: </strong>Utilization of CBE is low among women of reproductive age in Côte d'Ivoire. We conclude that even though existing literature has established early age at first menstruation as a strong risk factor for breast cancer, CBE utilization is significantly low among those who had early menarche. Going forward, it is necessary for Côte d'Ivoire's health Ministry to intensify breast cancer awareness in the country. Such awareness campaigns must emphasize age at menarche as a risk factor so as to motivate women with a history of early menstruation to utilize CBE.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"176"},"PeriodicalIF":3.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740275","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}