Reproductive Health最新文献

{"title":"Modern family planning method utilization and associated factors among women with disabilities in the Wolaita Zone, Ethiopia: a mixed methods study.","authors":"Kidist Wosene Cherkose, Mihiretu Alemayehu Arba, Fanose Yonas, Worku Mimani Minuta, Wakgari Binu Daga","doi":"10.1186/s12978-025-02125-8","DOIUrl":"10.1186/s12978-025-02125-8","url":null,"abstract":"<p><strong>Background: </strong>The utilization of modern family planning methods has improved maternal and child health and reduced population growth. However, modern family planning methods are utilized for only 10 percent of disabled women worldwide. In Ethiopia, the issue of family planning among women with disabilities has not been explicitly addressed or documented.</p><p><strong>Objective: </strong>To assess modern family planning method utilization and associated factors among women with disabilities in the Wolaita zone in Ethiopia, 2022.</p><p><strong>Method: </strong>A concurrent mixed study was employed. Quantitative data were collected from 332 women with disabilities by using a pretested structured questionnaire. Study participants were selected using a simple random sampling technique. The data were entered into Epi Data version 4.6 and subsequently exported to SPSS version 26.0 software. A logistic regression model was fitted to identify associated factors. A P value < 0.05 with a 95% confidence level was used to indicate statistical significance. Qualitative data were collected through individual in-depth interviews among 11 purposively selected study participants using interview-guided questions. Inductive thematic analysis was performed using open code software version 4.3. The findings were triangulated with the quantitative results and are presented in the text, table and chart.</p><p><strong>Results: </strong>Overall, 19.3% of women with disabilities utilized the modern family planning method. Being married (AOR=5.75, 95% CI=2.76-11.99), having good knowledge (AOR=5.25, 95% CI=2.36-11.68), and having a positive attitude (AOR=3.37, 95% CI=1.55-7.33) were significantly associated with hospital utilization. Information and communication problems, unfriendly health facility infrastructure, an unsupported services provision approach, undermining disable women, myths and misconceptions, and transportation-related issues were identified as barriers that hinder utilization.</p><p><strong>Conclusion: </strong>Theutilization of modern family planning methods among women with disabilities is low. Marital status, knowledge, and attitudes toward modern family planning were associated factors. It is crucial to address equity in the delivery of health care services, so a societal, attitudinal, and physical barrier must be addressed to increase the utilization of this method.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"175"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201040","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":"Intrauterine infusion of oil-based medium in women with recurrent implantation failure before frozen embryo transfer: a randomized clinical trial.","authors":"Qiuyan Huang, Fu Hang, LinIing Mo, Jun Yao, Xiaoqiong Luo, Hong Zhou, Li Fan, Sien Mo, Weimei Huang, Zhiwen Zhang, Jingya Yang, Man Li, Junli Wang, Aiping Qin","doi":"10.1186/s12978-025-02138-3","DOIUrl":"10.1186/s12978-025-02138-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Oil-based contrast medium in hysterosalpingography has been recommended as an approach to improve fertility in recent years. However, this approach has rarely been applied to patients with unknown recurrent implantation failure (RIF). This randomized clinical trial aimed to assess the effects of intrauterine oil-based contrast infusion on frozen embryo transfer (FET) prognosis and pregnancy outcomes among patients with unknown RIF.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This multicenter prospective randomized clinical trial was conducted between November 2019 and December 2022. A total of 224 patients with unknown RIF were randomized to the intrauterine oil-based medium infusion group or the control group at a 1:1 ratio. The oil-based contrast group was intrauterine infused with ethiodized poppy seed oil at a dose of 5 ml before FET, and the control group underwent only a standard FET. The primary outcome was the live birth rate (LBR). The secondary outcomes were implantation rate, clinical pregnancy rate (CPR), ongoing pregnancy rate (OPR), and early miscarriage rate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;One hundred patients completed intrauterine oil-based medium infusion followed by FET within 120 days. The intention-to-treat analysis demonstrated balanced baseline characteristics between groups. The oil-based medium group exhibited significantly higher CPR (56% vs. 37.4%, rate ratio (RR) 1.498, 95% CI 1.109-2.023, P = 0.007) and implantation rates (median 50% [interquartile range, IQR 0-100%] vs. median 50% [IQR 0-50%], P = 0.010) compared to controls. However, no statistically significant differences were observed in LBR (39% vs. 27.1%, RR 1.439, 95% CI 0.969-2.138, P = 0.069) or OPR (40% vs. 27.1%, RR 1.476, 95% CI 0.997-2.168, P = 0.049), with the latter approaching borderline significance. Subgroup analyses revealed enhanced CPR specifically in RIF patients aged 35-39 years (P = 0.041) and with gonadotropin-releasing hormone agonist (GnRHa) pretreatment hormone replacement therapy (HRT) (GnRHa-HRT) endometrial preparation protocol (P = 0.008). However, no disparities were observed in the LBR and OPR. Within-group comparison of oil-based medium infusion protocols showed that GnRHa-HRT significantly improved reproductive outcomes versus HRT protocols, including LBR (52.2% vs. 26.1%, RR 1.894, 95% CI 1.035-3.466, P = 0.023), CPR (71.7% vs.39.1%, RR 1.983, 95% CI 1.198-3.283, P = 0.002), OPR(P = 0.047), and implantation rate(P = 0.021), which might be attributed to the thickening of the endometrium (P = 0.027).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Infusion with an oil-based medium did not increase the LBR in terms of FET prognosis among patients with unknown RIF. However, compared with HRT, an oil-based contrast agent combined with a GnRHa-HRT FET increased the endometrial thickness and the LBR. These findings suggest synergistic effects of dual interventions, proposing a potential personalized strategy for refractory RIF c","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"171"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201037","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":"Evaluating the implementation fidelity of national standards for adolescent- and youth-friendly sexual and reproductive health services in Tanzania: a descriptive cross-sectional survey.","authors":"Gerald Kihwele, Michael Nienga Mbele, Walter C Millanzi","doi":"10.1186/s12978-025-02118-7","DOIUrl":"10.1186/s12978-025-02118-7","url":null,"abstract":"<p><strong>Background: </strong>Adolescents and youth require age-appropriate, comprehensive sexuality education and health services to support healthy growth and development. This study evaluated the coverage and fidelity of implementation of the National Standards for Adolescent- and youth-friendly Sexual and Reproductive Health (SRH) Services across types of health facilities in Tanzania.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted from November,1st - 30th, 2022, in eleven purposely selected health facilities across three Tanzanian regions: Dar es Salaam, Dodoma, and Kigoma. Facilities were stratified by ownership (government versus faith-based) and type (Dispensary, Health Center, Hospital). Data were collected using an observation checklist adapted from the Tanzanian Ministry of Health and analyzed with an International Business Machine (IBM^®) Statistical Package for Social Sciences (SPSS™) version 26, and the findings are presented in frequencies (n) and percentages (%).</p><p><strong>Results: </strong>Of the 11 health facilities assessed, 9(82%) were government-owned and 2(18%) fatith-based; 3(27%) were Dispensaries, 55% (n = 6) Health Centers and 18% (n = 2) Hospitals. Findings revealed that all facilities (100%) offered adolescent- and youth-friendly SRH services. However, the average implementation fidelity of the National Standards of SRH services was 65%, of which none achieved full compliance with the National Standards. Health centers, including Tandale health center (73%), Kigogo health center (71%), Ujiji health center (67%), Baptist Council Designated Hospital, and Magomeni (60%) health center had the highest coverage and fidelity implementation of the adolescent-and youth-friendly SRH national standards, while Murufiti dispensary was the lowest (43%). Nevertheless, government-owned facilities achieved the highest coverage and fidelity in implementing adolescent- and youth-friendly SRH services compared to faith-based facilities.</p><p><strong>Conclusion: </strong>The study revealed suboptimal coverage and incomplete implementation fidelity of National Standards for adolescent- and youth-friendly SRH services in Tanzanian health facilities. Enhancing infrastructures, strengthening healthcare worker capacity, and improving access to SRH education and associated services are critical to advancing the quality and reach of these services across the country.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"173"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201007","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":"Toward consensus: a Delphi study on the core principles and indicators of respectful maternity care.","authors":"Ephrem Yohannes, Gonfa Moti, Eshetu E Chaka, Laura Gabriel, Nikki Tickle, Debra K Creedy, Carolyn Hastie","doi":"10.1186/s12978-025-02143-6","DOIUrl":"10.1186/s12978-025-02143-6","url":null,"abstract":"<p><strong>Background: </strong>The core principles and key indicators of Respectful Maternity Care (RMC), particularly in low-income settings, are under-researched. Validated core principles and indicators are crucial for measuring RMC, especially in contexts where workforce shortages, infrastructure gaps, and sociocultural factors impact the care. Thus, this study aimed to identify and validate the core principles and indicators of RMC in resource-limited settings.</p><p><strong>Methods: </strong>A three-round Delphi study was conducted. Maternity care professionals (midwives, educators, researchers, and obstetricians) based in Ethiopia (n = 33) were recruited via email through professional networks. Original peer-reviewed research published in English-language journals between 2010 and 2024 was reviewed and used to generate 75 initial indicators, which were securely uploaded to Qualtrics^® for digital distribution. The indicators were evaluated on a four-point Likert scale for importance, relevance, and clarity. Responses were analysed and reported back to the participants for round two. After analysing the second-round results, the final version was shared with the participants for the third round. The third round did not generate any new information or ideas. Participants were also invited to provide feedback and suggest additional core principles and indicators that they considered missing.</p><p><strong>Results: </strong>In the first round, 75 indicators were assessed. The Item-level Content Validity Indexes ranged from 0.66 to 1.00 for importance and relevance, and 0.90 to 1.00 for clarity. The Scale-level Content Validity Index was 0.94 for importance and relevance and 0.98 for clarity. Three indicators were eliminated in round one; 12 were merged, and three remained unchanged. Two new indicators were added to the items. Thirteen core principles of RMC were proposed, and ten were accepted. Sixty indicators aligned with the ten core principles of RMC were finalised for round two. After round two, 11 indicators were removed, leading to a final list of 49 indicators. The third round generated no further revisions to the questionnaire.</p><p><strong>Conclusion: </strong>The ten core principles and forty-nine indicators validated in this study provide a robust blueprint for the consistent implementation and monitoring of RMC. This validated framework also provides a timely, evidence-based response to the WHO's call for the most valid and responsive RMC indicators in clinical settings. Future research should assess the core principles and indicators' validity and reliability across diverse contexts.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"176"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200719","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":"Should patients undergo endometrioma surgery before IVF/ICSI? a retrospective study with propensity score matching.","authors":"Wumin Jin, Xia Chen, Xiaojing Lin, Zixuan Zheng, Qiuzi Shi, Linchai Zeng, Chang Liu, Xuefeng Huang, Yili Teng, Peipei Pan","doi":"10.1186/s12978-025-02141-8","DOIUrl":"10.1186/s12978-025-02141-8","url":null,"abstract":"<p><strong>Research question: </strong>Does surgical management of ovarian endometriomas improve in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI)?</p><p><strong>Design: </strong>This retrospective study analyzed 1,456 IVF/ICSI cycles from June 2017 to September 2022, comparing 530 control cycles with 926 endometriosis (EMS) cycles. The EMS group comprised pre-EMS (non-operated endometriomas, N = 272) and post-EMS (operated endometriomas, N = 654) subgroups. Propensity score matching (PSM) balanced female age, antral follicle count (AFC), body mass index (BMI), anti-Müllerian hormone (AMH), follicle stimulating hormone (FSH), and estradiol levels. Receiver operating characteristic (ROC) analyses identified potential predictors of high-quality D3 embryos and live birth.</p><p><strong>Results: </strong>After PSM, the EMS group showed significantly lower normal fertilization rates, D3 embryo rates, and ovarian sensitivity index (OSI) compared to the control group (P < 0.05), but comparable oocyte yield, fertilization outcomes, and embryo parameters. Subgroup analysis showed that advanced-stage post-EMS cases had fewer retrieved oocytes and embryos, along with lower OSI, than the pre-EMS group after PSM. LBRs were similar between the EMS and control groups, irrespective of prior endometrioma surgery. ROC analysis identified AMH (cutoff 1.17 ng/mL; AUC 0.703, 95% CI 0.654-0.752) and AFC (cutoff 7.5; AUC 0.670, 95% CI 0.621-0.720) as predictors of high-quality day-3 embryos in EMS patients. In post-EMS patients, AMH (cutoff value 1.175; AUC 0.703, 95% CI 0.647-0.759) and AFC (cutoff 6.5; AUC 0.667, 95% CI 0.608-0.725) were predictive. AMH, AFC, age, and endometrioma size did not predict live birth.</p><p><strong>Conclusion: </strong>Advanced-stage Endometriosis negatively impacts oocyte quantity and ovarian response, but endometrioma surgery may not improve these outcomes or LBRs. Following exclusion of malignancy, asymptomatic endometriosis patients with AMH ≤ 1.17 ng/mL or AFC ≤ 7 should not routinely undergo cystectomy.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"177"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200743","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":"Evaluating the implementation of post-abortion care in Shanghai using the RE-AIM framework: a qualitative study of provider perspectives.","authors":"Jingfen Zhu, Ming Hua, Qicong Tian, Ruiting Tan, Ning Fan, Sen Wang, Shu Li, Yongbin Yang","doi":"10.1186/s12978-025-02126-7","DOIUrl":"10.1186/s12978-025-02126-7","url":null,"abstract":"<p><strong>Background: </strong>Post-abortion Care (PAC) is a proven strategy to reduce the rate of repeat abortions and promote women's reproductive health. However, existing research has predominantly centered on patient perspectives and health outcome indicators, with limited insight into the barriers and facilitators encountered during the implementation of PAC services.</p><p><strong>Objective: </strong>To evaluate the current state and challenges of PAC services in Shanghai, providing references for future service improvements and broader promotion.</p><p><strong>Methods: </strong>Seven hospitals offering PAC services in Shanghai were selected through stratified sampling, and semi-structured interviews were conducted with service providers. The interview guideline was developed based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Data were analyzed using a combination of deductive and inductive analytical methods.</p><p><strong>Results: </strong>PAC services were highly accessible to patients within the study hospitals; however, lack of promotion and inadequate awareness among potential users were identified as major barriers to broader patient access. The services had a positive impact on post-abortion recovery and contraceptive adoption, while posing challenges to the efficient and equitable allocation of medical resources. Healthcare institutions and staff reported positive attitudes towards PAC services, but insufficient funds and manpower have limited the promotion and adoption of the project and also affected the work enthusiasm of providers. PAC services had standardized processes and were well-implemented. The lack of efficient follow-up methods was the main barrier to implementation. More policy support is needed to ensure the sustainability of the project.</p><p><strong>Conclusion: </strong>PAC services have proven feasible and effective in improving post-abortion contraceptive behaviors and protecting female reproductive health. The primary challenges are insufficient funds and difficulties in follow-up. These findings are expected to provide information for improving the quality of PAC services and promoting them as basic reproductive health services of the government in the future.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"167"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201055","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":"Trauma inquiry and response in sexual and reproductive health settings: collaborative learning among clinicians.","authors":"Megha Shankar, Kelsey B Loeliger, Emily Ager, Maud Arnal, Sara Johnson, Zoe Matticks, Emily Nakamura, Hannah Begna, Eleanor Bimla Schwarz","doi":"10.1186/s12978-025-02135-6","DOIUrl":"10.1186/s12978-025-02135-6","url":null,"abstract":"","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"164"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a clinical practice guideline for management of pregnancy in Iranian prisons: a study protocol.","authors":"Somayeh Alirezaei, Robab Latifnejad Roudsari, Hossein Ebrahimipour","doi":"10.1186/s12978-025-02153-4","DOIUrl":"10.1186/s12978-025-02153-4","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women in prisons encounter distinct challenges due to health, nutritional, and psychological limitations, which significantly affect maternal and fetal health outcomes. Although organizations like the World Health Organization have set standards for the care of incarcerated women, many prisons struggle to implement these standards effectively. This study aims to develop a clinical practice guideline for managing pregnancy in Iranian prisons, improving health outcomes for incarcerated women.</p><p><strong>Methods: </strong>This study will develop a clinical guideline for managing pregnancy in Iranian prisons, using the World Health Organization Handbook for Guideline Development. A multidisciplinary Guideline Development Group will be formed, comprising health professionals, prison staff, and legal advisors. Critical issues in pregnancy management within prisons will be identified and prioritized. A systematic review of existing literature will be conducted to gather scientific evidence, which will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Practical recommendations will be formulated based on the gathered evidence. A draft of the recommendations will be presented to stakeholders for feedback, and the recommendations will be refined based on the feedback received.</p><p><strong>Status: </strong>This study is currently ongoing.</p><p><strong>Conclusion: </strong>This study aspires to create a practical guideline that will improve the care and management of pregnant women in prisons, effectively addressing the unique challenges they face and enhancing incarcerated pregnant women's maternal and fetal health outcomes.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"163"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192726","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":"Evaluating health system barriers to sexual and reproductive health service delivery during the COVID-19 pandemic in China: a mixed-methods study.","authors":"Hanxiyue Zhang, Hao Wang, Xizhuo Xie, Angela Y Xiao, Moazzam Ali, Caron Kim, Grace H M Kapustianyk, Kun Tang","doi":"10.1186/s12978-025-02093-z","DOIUrl":"10.1186/s12978-025-02093-z","url":null,"abstract":"<p><strong>Background: </strong>The disruption of sexual and reproductive health (SRH) services emerged as a key issue during the early COVID-19 outbreak. We aimed to assess the availability of SRH services in China during the COVID-19 pandemic.</p><p><strong>Methods: </strong>The study is part of a larger cross-country study on the impact of COVID-19 pandemic on health system. A cross-sectional panel survey design with two data collection points was used to capture changes in SRH service availability as a result of the COVID-19 pandemic. We developed a questionnaire to assess the readiness and resilience of China's health system. We conducted 109 in-depth interviews with healthcare providers, clients, and their partners in seven purposively selected health facilities in Wuhan, Beijing, and Changsha between November 2020 and December 2022. An adapted grounded theory and thematic analysis approach were applied to analyze the interview data. Direct quotes and findings from the coding and categorization process were used to develop the results.</p><p><strong>Results: </strong>The quantitative data showed that family planning, including contraception, and safe abortion services were completely or partially disrupted by the COVID-19 pandemic. The effects were greater at baseline. The disruption of services can be attributed to both supply-side and demand-side factors. Facilities responded to the pandemic's adverse impact on essential health services in multiple ways, most commonly through telemedicine, task shifting/role delegation, and triaging, to prioritize resource allocation. Three major themes emerged from the qualitative data: (1) barriers to SRH service delivery, (2) barriers to access and utilization of SRH services, and (3) resilient innovations in response to COVID-19. Service providers experienced barriers in providing SRH services to women during the pandemic. Women also faced numerous barriers and challenges to accessing SRH services, including lockdowns and mobility restrictions, lack of access to information, and limited access to SRH products. Most participants expressed support for the further expansion of telehealth strategies to improve access to SRH resources.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic negatively impacted SRH service provision and utilization in China. Our findings highlight the challenges of SRH service delivery during the COVID-19 pandemic and can be used to guide policy development and enhance service provision in alignment with societal needs. These findings underscore the importance of strengthening health systems by supporting telehealth expansion, tailoring provider-client communication, addressing the gender-specific needs of female providers, and leveraging community engagement to sustain essential SRH services during future crises.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 Suppl 3","pages":"162"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125817","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":"Network meta-analysis of episiotomy approaches: comparing routine, restrictive, and non-episiotomy strategies and their effects on maternal and neonatal outcomes in primiparous patients.","authors":"Mahmoud Shaaban Abdelgalil, Basma Ehab Amer, Elsayed Eldesouky, Moaz Yasser Darwish, Elsayed Farag, Attia Mohamed, Mohammed Ali, Alaa Abdelsalam, Zeinab Yousef Hashem, Esraa Elsayed, Reem M Elsapagh, Marwa M Badawy, Mohamed Abd-ElGawad, Almandouh H Bosilah","doi":"10.1186/s12978-025-02132-9","DOIUrl":"10.1186/s12978-025-02132-9","url":null,"abstract":"","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"161"},"PeriodicalIF":3.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075885","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}