Reproductive Health最新文献

{"title":"Menstrual health and health-related quality of life in Spain: a multicenter cross-sectional study.","authors":"Andrea García-Egea, Tomàs López-Jiménez, Carmen Rodríguez-Domínguez, Vinita Mahtani-Chugani, Uxune Apalategi-Gómez, Maria José Fernández-Domínguez, Cristina Martínez-Bueno, Sara Domínguez-Salas, Casandra Del Pilar González-Hernández, Maialen Berridi-Agirre, Macarena Chacón-Docampo, Jordi Baroja-Benlliure, Ana Isabel Arcos-Romero, María José González-Luis, Estíbaliz Gamboa-Moreno, Noemí López-Rey, Carme Valls-Llobet, Irene Gómez-Gómez, Celsa Perdiz-Álvarez, Mª Mercedes Vicente-Hernández, Alberto Armijo-Sánchez, Rosa Ostos-Serna, Emma Motrico, Anna Berenguera, Laura Medina-Perucha","doi":"10.1186/s12978-026-02401-1","DOIUrl":"10.1186/s12978-026-02401-1","url":null,"abstract":"<p><strong>Introduction: </strong>Menstrual health plays a crucial role in health-related quality of life (HRQoL). However, there is a gap addressing HRQoL in relation to broader aspects of menstrual health definition. This study aims to analyse the relationship between menstrual health and self-reported health-related quality of life in women and people who menstruate (PWM) ≥ 18 years in five regions of Spain (Andalusia, Basque Country, Canary Islands, Catalonia, and Galicia).</p><p><strong>Methods: </strong>A cross-sectional survey-based study with gender perspective was conducted. Thirty-two healthcare centres took part in the study across five regions of Spain between May and September 2023. Participants were women and PWM aged 18 or over with at least one menstruation in the last 6 months. Self-reported sociodemographic, menstrual health and HRQoL variables (using EQ-5D-5 L scale) were collected. Descriptive statistics and linear regression models were performed. EQ-VAS scale was employed to perform sensitivity analyses.</p><p><strong>Results: </strong>A total of 1,381 women and PWM were included (Mean age = 34.63, SD = 10.06). The mean of EQ-5D-5 L index was 0.88 (SD = 0.13) and EQ-VAS was 73.63 (SD = 22.60). Several menstrual health variables were significantly associated with lower HRQoL. The strongest associations were observed for high frequency of premenstrual symptoms (β= -0.144; 95%CI= -0.139 to -0.090), high impact of premenstrual symptoms (β= -0.071; 95%CI= -0.102 to -0.040), high impact on social participation during menstruation (β= -0.104; 95%CI= -0.128 to -0.080), moderate frequency of menstrual poverty (β= -0.054; 95%CI= -0.078 to -0.029) and menstrual pain intensity (β= -0.047; 95%CI= -0.068 to -0.025).</p><p><strong>Conclusions: </strong>These findings highlight the substantial impact of menstrual health on HRQoL, particularly in some EQ-5D-5 L domains (usual activities, anxiety/depression, and pain/discomfort). From a public health perspective, it is important to recognise menstrual health as a relevant component of overall well-being of women and PWM. Specifically paying greater attention to menstrual health relation to general pain, emotional health and participation in daily activities when designing health promotion and primary healthcare interventions.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397663","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":"Nonsteroidal anti-inflammatory drug resistance in dysmenorrhea: a study of prevalence, predictors, and alternative pain management among Nigerian female students.","authors":"Edidiong Orok, Blessing Aremu, Chidera Iheme, Hannah Odeleye, Ibukunoluwa Ola-Amuda, Oyinkansola Jogun-Omi, Deborah Yusuf, Precious Ometan, Akwaugo Iwuoha, Olajumoke Fehintola, Eniola Ariyo, Inimuvie Ekada, Idaraobong Usen","doi":"10.1186/s12978-026-02404-y","DOIUrl":"10.1186/s12978-026-02404-y","url":null,"abstract":"<p><strong>Background: </strong>Dysmenorrhea is a common gynaecological condition among young women, with non-steroidal anti-inflammatory drugs (NSAIDs) recommended as first-line therapy. However, a substantial proportion of women experience inadequate pain relief despite NSAID use. This study aimed to determine the prevalence of NSAID-resistant dysmenorrhea and to identify predictors as well as alternative pain management strategies among female undergraduate students at Afe Babalola University, Ado-Ekiti, Nigeria (ABUAD).</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted among 271 female undergraduate students of ABUAD. Data were collected using a structured, self-administered electronic questionnaire that assessed socio-demographic characteristics, menstrual history, dysmenorrhea severity, NSAID use, perceived effectiveness, and alternative pain management strategies. NSAID-resistant dysmenorrhea was operationally defined as persistent menstrual pain despite reported use of recommended NSAID dosages. Descriptive statistics were used to summarize data. Bivariate analyses were conducted using Chi-square, Fisher's exact, and Mann-Whitney U tests, as appropriate. Multivariate logistic regression was performed to identify independent predictors of NSAID resistance. Statistical significance was set at p ≤ 0.05.</p><p><strong>Results: </strong>The prevalence of dysmenorrhea among participants was 70.8% (192/271). Of those with dysmenorrhea, 62.5% (120/192) reported NSAID use for pain management. Among NSAID users, 63 students were classified as having NSAID-resistant dysmenorrhea, representing 52.5% of NSAID users and 32.8% of all students with dysmenorrhea. Perceived delayed onset of NSAID action (adjusted odds ratio [AOR] = 16.91; 95% CI: 2.00-141.60; p = 0.009) and lower NSAID effectiveness scores (AOR = 0.72; 95% CI: 0.57-0.90; p = 0.004) were significant predictors of NSAID resistance. Common coping strategies among NSAID-resistant students included activities such as use of alternative medications (25.4%), NSAID dose escalation (23.8%), rest or sleep (6.3%), as well as medications including antispasmodics (31.7%), and herbal remedies (11.2%).</p><p><strong>Conclusion: </strong>NSAID-resistant dysmenorrhea is common among undergraduate students. Perceived delayed onset and reduced effectiveness of NSAIDs are key predictors of resistance and contribute to reliance on alternative and potentially unsafe coping strategies. These findings highlight the need for improved education on appropriate dysmenorrhea management, early identification of NSAID non-responders, and access to evidence-based alternative treatment options.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387963","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":"Understanding the implementation of specialist maternity services for pregnant women with FGM/C in Germany: a situation analysis applying normalization process theory.","authors":"Lisa Welcland, Marina A S Daniele, Isabel Runge, Lucia Rocca-Ihenacho, Christine McCourt","doi":"10.1186/s12978-026-02394-x","DOIUrl":"10.1186/s12978-026-02394-x","url":null,"abstract":"<p><strong>Background: </strong>Female Genital Mutilation/Cutting (FGM/C) comprises all procedures involving the partial or total removal of the external female genitalia or any other injury to the female genital organs for non-medical reasons. There are about 600.000 women in Europe estimated to live with the consequences of FGM/C, of whom about 104.000 are residing in Germany. Less is known about maternity service provision for affected women living in Germany. An exploratory case study was conducted to examine the implementation of specialist services for women with FGM/C in a German Maternity Unit. This publication reports findings from a situation analysis exploring how specialist services were embedded into routine care.</p><p><strong>Methods: </strong>Data was collected using a mixed-methods design. A retrospective data analysis of clinical records from women with FGM/C who gave birth between 2020 and 2023 was conducted. Qualitative data provided insights of maternal health professionals experiences working within a specialist service for women with FGM/C. The two datasets were analyzed separately and then interpreted together using Normalization Process Theory. This approach was chosen to understand the underlying mechanisms involved in implementing a complex intervention inside a real-life context.</p><p><strong>Results: </strong>Results revealed that services were operationalized by using a trauma-informed approach adopted to individual needs and recorded inside women's birth plans. Supportive mechanisms during the implementation were the presence of experienced colleagues, champions with sufficient position of authority in the service, an intrinsic motivation amongst staff, and accessible expert advice. Challenges were late midwifery contact, lack of time during consultations and fragmented postnatal care. Areas for further research could explore opportunities to address service fragmentation and focus on mechanisms to improve clinical coding.</p><p><strong>Conclusions: </strong>Specialist maternity services for women with FGM/C requires trauma-informed care, interprofessional collaboration and structural support. Systemic barriers such as fragmented care pathways, late access to midwifery care, and limited consultation time need to be further addressed to ensure equitable care in the long term. The best-practice model provides insights into the delivery of individualized maternity care for women affected by FGM/C and may inform the development of future models of care.</p><p><strong>Trial registration: </strong>DRKS00030704 (15.02.2024).</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382721","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":"Gender norms and responsibility for preconception health improvement: challenges and recommendations for action from the 2024 UK preconception EMCR network conference.","authors":"Merissa Elizabeth Hickman, Manjiri Khare, Danielle Schoenaker, Madeleine Benton, Emma H Cassinelli, Kriss Fearon, Stephanie J Hanley, Shivali Lakhani, Catherine Stewart, Michael Daly","doi":"10.1186/s12978-026-02402-0","DOIUrl":"10.1186/s12978-026-02402-0","url":null,"abstract":"<p><p>Preconception health improvement is vital for maternal and child health, yet societal perceptions about who holds responsibility for this remain underexplored. We conducted a hybrid workshop at the 2024 UK Preconception Early-Mid Career Researcher (EMCR) Network conference, attended by academics, health professionals and members of the public (N = 60). Small-group discussions on responsibility for preconception health improvement were audio-recorded and transcribed alongside notes from online whiteboards and paper-based flipcharts. Using framework analysis, we applied a deductive coding framework derived from the workshop questions. Attendees felt a disproportionate burden of responsibility for preconception health improvement was placed on women, reflecting deeply entrenched gendered norms within research, healthcare and broader societal structures. Attendees' recommendations centred around (i) society, community and culture, (ii) education and early awareness, (iii) considerations for future research, and (iv) systems-level and policy solutions. These findings provide valuable insights for developing equitable public health strategies and research agendas relating to preconception health.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362124","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 empowerment and experience of marital control in sub-Saharan Africa.","authors":"Richard Gyan Aboagye, Augustus Osborne, Joshua Okyere, Mainprice Akuoko Essuman, Yaa Boahemaa Gyasi Aderoju, Blessing Jaka Akombi-Inyang, Bright Opoku Ahinkorah","doi":"10.1186/s12978-026-02376-z","DOIUrl":"10.1186/s12978-026-02376-z","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined the association between women's empowerment (social independence, decision-making, and attitudes to violence) and experience of marital control in sub-Saharan Africa.</p><p><strong>Methods: </strong>A weighted sample of 82,208 was extracted from the most recent Demographic and Health Surveys conducted in 19 countries in sub-Saharan Africa. We used multinomial and multivariable binary logistic regression analyses to examine the association between the dimensions of women's empowerment and marital control. All the analyses were conducted using Stata 17.0.</p><p><strong>Results: </strong>Women with high attitudes to violence (adjusted relative risk ratio [aRRR] = 0.72, 95% CI = 0.68, 0.77) were less likely to experience medium marital control than those with low attitudes to violence. Women with medium (aRRR = 0.80, 95% CI = 0.74, 0.86) and high (aRRR = 0.49; 95% CI = 0.46, 0.52) attitudes to violence were less likely to experience high marital control. Women with high social independence were less likely to experience medium and high levels of marital control. Women with medium decision-making capacity were less likely to experience medium marital control. Additionally, women with medium and high decision-making capacity had a reduced likelihood of experiencing high marital control. Partner alcohol consumption, women's exposure to interparental violence, place of residence, wealth index, women's age, and media exposure were the covariates associated with marital control.</p><p><strong>Conclusion: </strong>This study highlights an association between women's empowerment and marital control. It emphasises the importance of prioritising women's empowerment initiatives to address controlling behaviour by spouses. Governments in sub-Saharan Africa, especially in Eastern African countries, should focus on providing women with quality education and skills development programmes to enhance their economic independence and decision-making capacity.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148339794","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":"Trial trustworthiness assessment: commentary on the Cochrane 2025 systematic review on calcium supplementation during pregnancy.","authors":"Maria Regina Torloni, Gabriela Cormick, Alvaro Nagib Atallah","doi":"10.1186/s12978-026-02395-w","DOIUrl":"10.1186/s12978-026-02395-w","url":null,"abstract":"<p><strong>Background: </strong>Hypertensive disorders of pregnancy remain a major cause of maternal and perinatal morbidity and mortality worldwide. Calcium supplementation during pregnancy is recommended by guidelines and the World Health Organization to prevent preeclampsia largely based on successive versions of a Cochrane systematic review (SR). However, the 2025 update of this SR reported that calcium supplementation may result in little to no reduction in preeclampsia risk, a conclusion that diverges from all previous versions. This change was driven primarily by the exclusion from meta-analyses of several previously included trials due to concerns about study trustworthiness.</p><p><strong>Discussion: </strong>We critically examine trustworthiness assessments in the 2025 SR and identify inconsistencies in how criteria were interpreted and applied across trials. Using two trials as illustrative examples, we show that concerns related to ethics and effect size were applied inconsistently. We further demonstrate that the same trials were deemed trustworthy and included in another Cochrane SR updated in 2024, on calcium supplementation during pregnancy for related outcomes. Sensitivity analyses illustrate how the inclusion of these two excluded trials would significantly change the pooled effect estimates for preeclampsia in the 2025 SR. We argue that reliance on unvalidated trial trustworthiness assessment tools risks subjective exclusion of evidence, potentially impacting guidelines and policies. We recommend that the review authors reassess all trials excluded from the meta-analyses due to trustworthiness issues and conduct sensitivity analyses to transparently assess their impact on the 2025 SR conclusions and related policy recommendations.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353370","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":"Reproductive health care experiences and rights of displaced Afghan women, and intersecting factors influencing outcomes: a scoping review.","authors":"Donya Eghrari, Nilab Hamidi, Nicola Creagh, Anna Ziersch, Lucio Naccarella","doi":"10.1186/s12978-026-02396-9","DOIUrl":"10.1186/s12978-026-02396-9","url":null,"abstract":"<p><strong>Background: </strong>Forcibly displaced Afghan women face a high risk of poor reproductive outcomes from preexisting and post-settlement inequalities intensified by displacement and inadequate culturally responsive care. Understanding Afghan women's pre- and post-settlement reproductive issues and experiences, across periods of political and social transition, can highlight needs and improve reproductive outcomes.</p><p><strong>Objective: </strong>This scoping review provides a synthesis of the prevalent reproductive health issues among externally displaced Afghan women residing in humanitarian or resettlement settings. It describes the factors impacting reproductive issues and outcomes as well as interventions employed to address gaps.</p><p><strong>Methods: </strong>We conducted a search of the Medline (OVID)/EMBASE, CINAHL, Web of Science, Scopus, and Global Health (OVID/CABI) databases from 2000 to 2024 to identify full-text studies in any language reporting on matters related to or influencing the reproductive health of externally displaced Afghan women. Systematic and other reviews and studies focusing merely on sexual health were excluded. We used thematic synthesis with an inductive approach to analyse and report the findings.</p><p><strong>Results: </strong>Forty-two studies from eight countries were included in the data extraction. Reproductive health issues, and factors influencing reproductive outcomes, varied across humanitarian and resettlement settings, with some overlap. Reproductive health topics broadly related to family planning and maternal and neonatal outcomes. Facilitators and barriers to reproductive outcomes included linguistic and reproductive literacy, finances, cultural and religious norms, social connections, legal status, communication with health professionals, and justice in service provision. Reproductive outcomes were worse in humanitarian settings than in resettlement countries. However, despite better service availability in resettlement settings, navigating and accessing services is hindered by personal, cultural, and structural barriers.</p><p><strong>Conclusion: </strong>Advancing Afghan women's reproductive rights requires a multidimensional strategy that prioritises women's autonomy. This necessitates a deeper understanding of the reproductive issues women experience, and the intersecting factors influencing their reproductive decision-making and service access. Drawing upon the synthesis of findings, we advocate for (a) routine collection of disaggregated reproductive data by country of origin, migration status, and other critical data such as literacy levels; (b) codesigned, culturally safe care models; (c) reproductive and health literacy programs; (d) gender-transformative education and interventions that include men and boys; and (e) workforce training and preparedness.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148339731","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":"Contraceptive use, adherence, and perceptions among women aged 18-45 years in Czechia: a 2019 cross-sectional quota-based online survey.","authors":"Vladimír Dvořák, Vladimír Dvořák, Ľudovít Paulis, Radovan Pilka","doi":"10.1186/s12978-026-02390-1","DOIUrl":"10.1186/s12978-026-02390-1","url":null,"abstract":"<p><strong>Background: </strong>Unintended pregnancies remain common globally, underscoring the need to understand real-world contraceptive behaviors and their determinants to optimize counseling and public health planning. In Czechia, robust evidence on contraceptive method mix and perceptions has been limited.</p><p><strong>Methods: </strong>We analyzed a cross-sectional online survey conducted in September 2019, among women aged 18-45 years (n = 1501) irrespective of current contraception usage. The survey used quota sampling for age, education, household income/size, and region; no weighting was applied. We analyzed prior and current contraceptive use, emergency contraception, drivers and barriers to method choice, pill adherence, and information sources. Age-group differences (18-24, 25-34, 35-45 years) were tested with Cochran-Armitage test for trend (categorical) and ANOVA (continuous).</p><p><strong>Results: </strong>This survey provides a detailed age-stratified picture of contraceptive experience, current use, and perceptions among women aged 18-45 years in Czechia. One-third reported no current method (33%, 95% CI [31%, 35%]) and the current method mix concentrated on short-acting methods (oral contraception [OC] 38% [36%, 41%] and barrier methods 14% [12%, 16%]). Intrauterine device (IUD) use was comparatively low overall (hormonal 4.7% [3.6%, 5.7%]; non-hormonal 3.5% [2.6%, 4.5%]) but increased with age (hormonal 2.5%→2.9%→7.4%, p < 0.001; non-hormonal 0.9%→3.6%→4.8%, p < 0.01), while barrier use declined (22%→14%→10%, p < 0.001). Among current OC users, 37% reported forgetting at least one pill in the preceding 3 months. Younger women had the highest missed-pill rates among OC users, greater concern after a missed pill, and more frequent recent emergency contraception use. The major source of information were various internet-based sources combined, while gynecologists were the main single source of information (73%, [70%, 75%]), followed by internet search engines specifically (44%, [42%, 47%]). While the relevance of gynecologist increased with age, the relevance of internet search engines declined.</p><p><strong>Conclusions: </strong>Contraceptive use was dominated by short-acting methods, with low but age-increasing IUD uptake. Younger women more frequently reported at least one missed OC pill, greater concern after missed pills, and more frequent recent emergency contraception use. Interpretation should consider mainly the use of non-probability quota sampling, the absence of weighting, and reliance on self-reported questionnaire data.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148332574","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":"Barriers and facilitators to sexual and reproductive health services among adolescents and young adults in Sidama region, Ethiopia: a qualitative study.","authors":"Melaku Birhanu Alemu, Jaya Ar Dantas, Zohra S Lassi, Richard Norman, Gavin Pereira, Gizachew A Tessema","doi":"10.1186/s12978-026-02400-2","DOIUrl":"10.1186/s12978-026-02400-2","url":null,"abstract":"<p><strong>Background: </strong>Adolescents and young adults (AYAs) in Ethiopia face multiple challenges in accessing sexual and reproductive health (SRH) services. Understanding the barriers and facilitators to SRH service uptake is essential for designing tailored interventions. Therefore, this study aimed to explore barriers and facilitators to SRH service uptake from the perspectives of AYAs and stakeholders in southern Ethiopia.</p><p><strong>Methods: </strong>We conducted a qualitative study in the Sidama region, Southern Ethiopia using focus group discussions (FGDs) with AYAs recruited from schools, communities, and a non-governmental organisation. A supplemental FGD was conducted with government officials, clinicians and SRH experts to capture stakeholder perspectives. The FGD was conducted in the national language (Amharic), which was then transcribed and translated into English for analysis. A thematic content analysis was used to present emerging themes in the FGDs. A ranking of barriers and facilitators was conducted to identify the most influential factors for SRH service uptake. NVivo 15 was used for data management and organisation for the thematic analysis.</p><p><strong>Results: </strong>Nine FGDs were conducted with 56 AYAs and seven experts, with each FGD comprising 6-8 participants. We identified four major themes: 1) health system and policy environment, 2) service access and delivery, 3) user experience and outcomes, and 4) sociocultural and economic determinants. Participants ranked service quality, cost, and privacy higher in their influence on determining SRH service uptake. Stigma, religious beliefs, poverty, and urban migration were also identified as barriers to SRH service access among AYAs.</p><p><strong>Conclusions: </strong>SRH service uptake among AYAs was shaped by their interconnected health system and policy environment; service access and delivery; user experiences and outcomes, and sociocultural and economic determinants. Barriers and facilitators from service access and delivery theme such as service quality, privacy and health system factors such as cost emerged as the most influential drivers shaping service uptake. Policy and programme efforts should consider improving service quality, strengthening confidentiality, and reducing financial barriers. The findings may also inform future quantitative research examining AYAs' preferences for SRH service.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318800","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":"Determinants of precancerous cervical lesions among women screened for cervical cancer at Debre Markos town public health facilities, Ethiopia.","authors":"Yehualashet Belayneh, Aysheshim Asnake Abneh, Asmamaw Mengist, Tadele Derbew Kassie, Yilkal Tafere","doi":"10.1186/s12978-026-02399-6","DOIUrl":"10.1186/s12978-026-02399-6","url":null,"abstract":"<p><strong>Background: </strong>The potential for precancerous cervical lesions to develop into cervical cancer over time is a significant public health concern in low and middle-income countries, including Ethiopia. The Ethiopian government is supporting the prevention of cervical cancer by acetic acid screening and vaccinations. However, the determinants of precancerous cervical lesions were not well studied. Therefore, this study aimed to identify determinants of pre-cancerous cervical lesions among women screened for cervical cancer at Debre Markos town public health institution, Ethiopia, 2025.</p><p><strong>Methods: </strong>An institution-based unmatched case-control study was conducted among 340 women (85 cases and 255 controls) who underwent cervical cancer screening. Cases were selected consecutively, and controls were selected using systematic random sampling. Data were collected through a structured interviewer-administered questionnaire and chart review. Data were entered using Epi-Data Version 4.6 and then transferred to STATA 15 for analysis. Descriptive statistical analysis computed frequencies and presented them with texts and tables. To determine the factors linked to precancerous cervical lesions, this study used bivariate logistic regression analysis (P < 0.25), multivariable logistic regression (P < 0.05), and odds ratios with 95% Confidence Interval (CIs). The Hosmer-Lemeshow goodness-of-fit test was used to evaluate the model's fitness.</p><p><strong>Result: </strong>A total of 85 cases and 255 controls were included in this study, resulting in a 100% response rate. Age above 40 years adjusted odds ratio (AOR): 2.99 (1.03-8.90), rural residence AOR = 3.69 (1.46-9.36), Live alone AOR = 4.86 (2.05-11.5), history of STIs AOR = 5.3 (2.12-13.3), genital mutilation AOR = 5.98 (2.37-15.08), early initiated sexual intercourse AOR = 3.47 (1.27-9.5), having HIV positive AOR = 7.04 (2.75-17.9), and having two or more lifetime sexual partners AOR = 6.87 (2.74-17.2) were determinants of precancerous cervical lesion.</p><p><strong>Conclusions: </strong>This study highlights the importance of behavioural, biological, and socio-cultural factors in the development of precancerous cervical lesions among women in Ethiopia. HIV infection, history of sexually transmitted infections, multiple sexual partners, and female genital mutilation were identified as key determinants requiring targeted prevention and screening interventions. Strengthening integrated cervical cancer screening services may improve early detection and reduce the burden of cervical cancer in Ethiopia.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318803","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}