Reproductive Health最新文献

{"title":"WASH facility adequacy and school attendance during menstruation among secondary school girls in Nasarawa West, Nigeria: a cross-sectional study.","authors":"Aishat Temitope Kasali, David Ishaleku, Benjamin Idoko, Stephen Olaide Aremu, Abdillahi Abdi Barkhadle","doi":"10.1186/s12978-026-02374-1","DOIUrl":"10.1186/s12978-026-02374-1","url":null,"abstract":"<p><strong>Background: </strong>Adequate Water, Sanitation, and Hygiene (WASH) facilities are essential for menstrual hygiene management (MHM) and school retention among adolescent girls. Many Nigerian schools lack such infrastructure, which has been associated with menstruation-related absenteeism and compromised menstrual wellbeing among adolescent girls. This study assessed WASH facility adequacy in secondary schools in Nasarawa West Senatorial Zone and examined associations with girls' school attendance during menstruation.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 1,250 female students across 25 secondary schools in Keffi, Nasarawa, and Kokona LGAs. WASH adequacy was assessed using a structured observational checklist, scoring 12 facility components (water availability, toilet conditions, privacy, lighting, handwashing facilities, and disposal systems). Student attendance during menstruation was assessed via structured questionnaire using a four-point frequency scale (always, sometimes, rarely, never), with absenteeism defined as reporting sometimes, rarely, or never attending during menstruation. Chi-square analyses with cluster-robust standard errors examined associations between WASH adequacy and menstruation-related absenteeism.</p><p><strong>Results: </strong>WASH conditions were critically inadequate, approximately 40% of schools had functional water sources, 28% had water available during assessment, and 16% had separate girls' toilets. Privacy features, handwashing facilities with soap, and covered disposal bins were each present in 16% of schools. No school provided private changing spaces, sanitary waste disposal systems, emergency sanitary supplies, or MHM education materials. Private schools scored marginally higher than public schools (1.2 ± 0.3 vs. 0.9 ± 0.3). Only 36.8% of students consistently attended school during menstruation. Absenteeism was strongly associated with inadequate WASH facilities (χ² = 48.3, p < 0.001), with pain or cramps (32%), lack of pads (23.2%), and fear of staining (19.2%) as the most frequently reported reasons.</p><p><strong>Conclusion: </strong>WASH facilities in Nasarawa West secondary schools are grossly inadequate and associated with menstruation-related absenteeism. Urgent interventions including improved water supply, private toilets, disposal systems, and access to menstrual materials are required to support girls' menstrual health and educational equity.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056348","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":"Training providers to improve access to emergency contraception in abortion ban states in the U.S.","authors":"Rachel Mundaden, Alejandra Alvarez, Yasaman Zia, Alison Comfort, Kristyn Brandi, Suzan Goodman, Cynthia C Harper","doi":"10.1186/s12978-026-02369-y","DOIUrl":"10.1186/s12978-026-02369-y","url":null,"abstract":"<p><strong>Background: </strong>Disparities in abortion and contraceptive care have intensified across the U.S. post-Dobbs, particularly in states with abortion bans and limited access to full-scope services. However, efforts to expand emergency contraception (EC) access and provider education have been limited. This study evaluated the impact of an evidence-based training on provider ability to offer the full range of EC methods.</p><p><strong>Methods: </strong>We developed and delivered a training intervention for providers, from 2022 to 2024, at 283 clinics in Texas, Oklahoma, and Indiana, all abortion restrictive states. Participants (N = 507) completed online surveys at baseline and three months post-intervention on clinical practices for EC levonorgestrel pills (LNG ECP), ulipristal acetate (UPA), copper intrauterine devices (IUDs), and levonorgestrel 52 mg IUDs (LNG IUD). We used generalized estimating equations to assess changes in provider attitudes, counseling, and availability of each type of EC.</p><p><strong>Results: </strong>Providers reporting that they strongly agreed that EC was safe increased across all methods, with the largest gains for UPA (58% to 78%; adjusted odds ratio [aOR 2.58], 95% confidence interval [CI] 1.37-4.89) copper IUDs (65% to 75%; aOR 1.76, 95% CI 1.03-3.00) and LNG IUDs (38% to 62%; aOR 2.71, 95% CI 1.91-3.83). More providers reported they included EC when counseling on contraception, with significant increases for IUDs for EC, from 61% to 77% for copper IUDs (aOR 2.39, 95% CI 1.38-4.13) and 44% to 64% for LNG IUDs (aOR 2.26, 95% CI 1.50-3.42). Counseling on pills was already high but increased further (LNG ECPs and UPA: 89% to 96%; aOR 2.78, 95% CI 1.87-4.15). Overall EC availability in clinic also improved, with LNG ECPs reaching universal availability (91% to 100%), and significant increases in UPA (67% to 79%; aOR 1.64, 95% CI 1.37-1.96) and IUDs (64% to 76%; aOR 1.77, 95% CI 1.07-2.91). Advance provision of EC pills increased modestly (28% to 34%; aOR: 1.40, 95% CI: 1.06-1.83).</p><p><strong>Conclusion: </strong>This replicable training intervention was associated with increased provider counseling and clinic availability of EC. Remaining gaps to reach universal provision of EC methods highlight the need for ongoing initiatives to increase access, including in abortion ban states.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impacts of climate change on women's reproductive and sexual health: a systematic review.","authors":"Muayad Saud Albadrani","doi":"10.1186/s12978-026-02375-0","DOIUrl":"10.1186/s12978-026-02375-0","url":null,"abstract":"<p><strong>Background: </strong>Climate change is considered a substantial threat to women's health, particularly in their reproductive and sexual well-being. Several studies linked to changes in fertility rates, ovarian reserve, menopause timing, maternal and child health outcomes, and reproductive decision-making. While recent studies have suggested a correlation between climate variability and reproductive and sexual health outcomes, a comprehensive synthesis of existing research on this relationship is lacking.</p><p><strong>Aim: </strong>This study systematically reviews the available evidence on the association between climate change and women's reproductive and sexual health.</p><p><strong>Methods: </strong>A thorough search was conducted across Medline/PubMed, Scopus, Web of Science, and Cochrane Library databases up to May 2024. This review follows a registered protocol with the PROSPERO database (ID: CRD42024575251). Data were extracted using a standardized template, and quality evaluation was carried out using the Joanna Briggs Institute's Critical Appraisal Tools.</p><p><strong>Results: </strong>The search identified 3581 records, from which 12 observational studies were selected following screening. Most included studies were of moderate quality. Exposures were assessed using direct meteorological measures and subjective perceptions of climate change. The findings indicate that high temperatures are significantly associated with adverse outcomes. These include reduced ovarian reserve, lower fertility rates, and diminished reproductive decision-making. Extreme weather events were linked to negative social consequences like forced marriages, while specific regional climates were associated with premature menopause. Concerns about climate change also shape reproductive intentions, as eco-anxiety influences decisions to have smaller families. Conversely, higher latitude correlated with lower fertility rates.</p><p><strong>Conclusion: </strong>The review emphasizes the substantial adverse impacts of climate change, whether manifested through winter cold or rising temperatures, on women's reproductive and sexual health. Enhanced public health strategies and more longitudinal studies are needed to establish causality and address women's vulnerabilities in the face of escalating climate impact.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043492","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":"A silent link between stillbirth and maternal anaemia: evidence from the fifth round of the National Family Health Survey.","authors":"Mohammad Hammad, Mohammad Hifz Ur Rahman, Mohd Asfahan Nomani","doi":"10.1186/s12978-026-02378-x","DOIUrl":"10.1186/s12978-026-02378-x","url":null,"abstract":"<p><strong>Background: </strong>Stillbirth is a critical public health concern in India, with maternal anaemia being a significant contributing factor. Anaemia often resulting from a nutritional deficiciencies, has been linked to adverse pregnancy outcomes including stillbirth. This study aims to investigate the relationship between anaemia and the risk of stillbirth in India, incorporating data from the fifth wave of the National Family Health Survey.</p><p><strong>Methods: </strong>We utilized data from the fifth wave of the National Family Health Survey (NFHS) in India, utilizing information from 204,723 women 15-49 years of age who experienced a pregnancy in the five years preceding the survey. Calculations of stillbirth were performed via calendar data, which yielded reliable estimates. Descriptive statistics and results from bivariate analysis with chi-square tests have been reported to measure the prevalence. Furthermore, the study employed logistic regression to assess the relationship between stillbirth and maternal anaemia, adjusting for socioeconomic and maternal factors.</p><p><strong>Results: </strong>Stepwise logistic regression estimates revealed that women who have anaemia during pregnancy have a greater risk of stillbirth than non-anaemic women do, and this risk remains greater in the deduced models. We found that anaemic women have a stillbirth rate of 16.5 per 1000 total births, significantly higher than that of non-anaemic women (14.7 per 1000 total births).</p><p><strong>Conclusion: </strong>Our findings suggest that maternal anaemia increases the risk of stillbirth. Special attention is needed to reduce the prevalence of anaemia among women of reproductive age to decrease the burden of adverse pregnancy outcomes.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043516","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":"Experiences of women with disabilities accessing maternal and newborn health services in Mogadishu, Somalia.","authors":"Muna Jama, Naoko Kozuki, Mamothena Carol Mothupi","doi":"10.1186/s12978-026-02361-6","DOIUrl":"10.1186/s12978-026-02361-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite global commitments to inclusive and equitable maternal and newborn health (MNH) care, women with disabilities in fragile and conflict-affected settings remain overlooked. In Somalia, where maternal mortality is among the highest in the world, women with disabilities face systemic and structural barriers to accessing quality MNH services. This study examined experiences of and perspectives on equitable access to MNH care among women with disabilities in Mogadishu, Somalia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A qualitative descriptive study was conducted in Mogadishu between July and September 2024. We conducted in-depth interviews with women living with physical or visual impairments (n = 8) and with caregivers of women with hearing impairments or intellectual disabilities (n = 4). We also conducted key informant interviews with representatives of national disability organizations (n = 5). Interviews explored pregnancy and birth experiences, access to and quality of MNH services and recommendations for improvement. Data were analyzed using a primarily deductive thematic approach with inductive refinement, informed by Andersen's Behavioral Model of Health Services Use and Morgan's Gender Analysis Matrix to examine individual, facility and systemic-level determinants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At the individual level, women with disabilities faced intersecting challenges related to gender, disability, poverty, unemployment, limited education, and social stigma. These factors pressured them into early marriage and childbirth to secure future caregiving support and social approval. Gendered power relations and unequal access to resources left many women relying on family members for transportation, financial support, and communication with healthcare providers, reducing their autonomy in MNH decision-making. Facility-level barriers included inaccessible infrastructure such as lack of ramps or adjustable beds, poor provider communication especially for patients with hearing impairments or intellectual disabilities, and provider stigma questioning women with disabilities' right to motherhood. These experiences led many women with disabilities to avoid health facilities, relying instead on traditional birth attendants. Systemically, limited disability-inclusive MNH policy implementation, lack of data disaggregated by disability, and inadequate nationwide public awareness further compounded exclusion. Despite these constraints, women with disabilities identified free public health facilities and strong family and community support networks as key enabling factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These findings demonstrate urgent MNH care gaps for women with disabilities in Mogadishu, Somalia and provide evidence for action. Priorities include disability-inclusive infrastructure, provider training, accessible communication approaches, stronger disability-disaggregated data systems, and women with disabilities p","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148034690","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":"Correlates of antenatal care visits among expectant mothers in Malawi: application of generalised estimating equations and likelihood-based poisson and negative binomial mixed models.","authors":"Harry Chalistus Milala, Tsirizani Mwalimu Kaombe","doi":"10.1186/s12978-026-02372-3","DOIUrl":"10.1186/s12978-026-02372-3","url":null,"abstract":"<p><p>Despite recent improvements in antenatal care (ANC) coverage in sub-Saharan Africa, the timing and frequency of ANC visits remain inconsistent. This contributes to increased pregnancy-related complications among mothers in the region. This study utilised Poisson and Negative Binomial mixed regression with maximum likelihood estimation and generalized estimating equations (GEE) to analyse the factors associated with ANC visits among mothers in Malawi. Secondary data for 7,125 mothers from the individual recode file of the 2024 Malawi Demographic and Health Survey were used. All the analyses were carried out using R software version 4.5.2. The results indicated substantial between-cluster variation of ANC visits, indicating higher chances of observing similar ANC outcomes for mothers staying in the same cluster. The likelihood-based estimation methods yielded efficient estimates with smaller standard errors, p-values, and narrower confidence intervals than the GEE. However, both methods produced estimates with similar directions and magnitudes. On average, mothers in Malawi attend four ANC visits during their pregnancies. Higher ANC attendance rates were observed among mothers aged 20 years and above, those with tertiary education, and those with educated husbands. Conversely, lower rates were found in mothers with at least five children, those from middle wealth households, and those exposed to newspapers. Using alternative statistical estimation methods can enhance the reliability of findings in public health research. The health policy interventions that can utilise shared community cultural values, norms and networks at cluster level, as well as spouse involvement may improve ANC programs in sub-Saharan Africa.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148034756","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":"\"There is a light that our wives had not seen before\": community perspectives on a gender-responsive maternal health intervention in Western Kenya.","authors":"Abiola Adeniyi, Violet Naanyu, Justus Ikemeri, Sheilah Chelagat, Anjellah Jumah, Anusu Kasaya, Lauren Y Maldonado, Jeffrey Bone, Michael Scanlon, Sammy Masibo, Laura Ruhl, Astrid Christoffersen-Deb, Julia Songok","doi":"10.1186/s12978-026-02338-5","DOIUrl":"10.1186/s12978-026-02338-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The Chamas for Change (Chamas) program is an innovative three-year community-based gender-responsive intervention in Western Kenya. During this period, the program provides peer support, microfinance initiatives, and health education to pregnant women. A randomized control trial demonstrated significant improvements in maternal and child health outcomes for program participants. This qualitative study explored community perceptions of the program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted 9 focus group discussions and 4 key informant interviews between November 2017 and June 2019. Participants (n = 75) were recruited from four sub-counties in Trans Nzoia County representing diverse rural, peri-urban, and urban settings. They included 26 pregnant women (pre-intervention), 19 Chamas women, 10 spouses, 16 CHPs, and 4 county public health nurses (post-intervention). We used purposive sampling to ensure representation across all four sub-counties where the intervention was deployed. We recruited women aged 18-45 years who had experienced pregnancy within the previous two years from each sub-county in Trans Nzoia County, capturing experiences across rural, peri-urban, and urban settings. This sampling strategy ensured comprehensive geographic representation within the intervention catchment area to understand how pregnancy experiences and gender dynamics varied across different community contexts. CHP and local leaders in each sub-county facilitated recruitment. Pre-intervention FGDs explored pregnancy experiences, gender-related barriers to care, and social support needs. Post-intervention, we examined Chamas program components, implementation, cultural acceptability, and perceived effects across individual, interpersonal, and community levels using the socio-ecological model (SEM). Data were analyzed thematically with ATLAS.ti&lt;sup&gt;®&lt;/sup&gt; version 23.4, organizing findings by SEM levels and participant type.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Pre-intervention participants described deep-rooted gender inequities and structural barriers to care that shaped pregnancy experiences. Our analysis revealed four key themes: (1) The \"heaviness\" and isolation of pregnancy shaped by gender roles, (2) Building individual skills and knowledge for pregnant and parenting women and their children, (3) Enhancing interpersonal support and family dynamics, and (4) Community-wide effects and challenges of implementing a gender-responsive program. Participants reported increased self-reliance, health knowledge, and financial skills at the individual level. Interpersonally, the program fostered improved family dynamics, communication, and shifts in gender roles. At the community level, it enhanced social cohesion and collective action, gaining widespread acceptance due to its cultural relevance. The program's microfinance component created participation barriers for the poorest women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The Chamas program's in","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006507","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":"\"Healthy bodies, healthy minds\": barriers and solutions to implementing a menstrual hygiene management program in South Sudan.","authors":"S Donya Razavi, Hanson Cummings, Jocelyne Labonté, Lydia Kapiriri, Salim Sohani","doi":"10.1186/s12978-026-02319-8","DOIUrl":"10.1186/s12978-026-02319-8","url":null,"abstract":"<p><strong>Background: </strong>Menstrual hygiene management (MHM) can be challenging for women and girls living in conflict-affected low- and middle-income countries, where access to menstrual products, soap, water, and private sanitation facilities is often limited. In response to these challenges, the Canadian Red Cross, in partnership with the South Sudan Red Crescent and the South Sudanese Government, implemented the Healthy Bodies Healthy Minds (HBHM) program from 2020-2023 to support MHM in South Sudan. Despite growing attention to MHM needs, few studies have examined the on-the-ground realities of implementing MHM programming in fragile settings. To address this gap, this study aimed to (i) describe the implementation of HBHM, (ii) identify barriers faced during implementation, (iii) identify potential solutions to overcome barriers, and (iv) understand the impact of the COVID-19 pandemic on program delivery.</p><p><strong>Methods: </strong>Data was collected through key informant interviews with individuals involved in program design and implementation and were analyzed via thematic analysis. A total of 14 respondents were interviewed.</p><p><strong>Results: </strong>Respondents identified several interrelated and compounding barriers, including resource constraints, logistical challenges, competing stakeholder interests/priorities, ongoing conflict, and climate change. To mitigate these barriers and improve the delivery of MHM programs, respondents recommended solutions and strategies such as extending implementation timelines, planning program activities around anticipated climate events, and strengthening inter-organizational collaboration. The COVID-19 pandemic introduced additional barriers, particularly by restricting the movement of people and goods. However, it also yielded unexpected benefits, notably expanding the project's reach beyond the target group of girls to the broader community.</p><p><strong>Conclusions: </strong>Implementation of the HBHM program was impacted by several interrelated and compounding factors including resource constraints and logistical challenges, protracted conflict, climate change, and COVID-19, however, collaboration between implementing partners and agility in the approach to program rollout supported enhanced program reach. International partnerships enabled community-level implementation, which proved especially effective for continued program implementation. Additionally, the shift to a more community-based model resulted in benefits to the broader community, offering another key insight that should be considered in the design of future MHM programs in South Sudan and similar contexts.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006492","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":"Initiation of immediate postpartum family planning and its determinants among women delivering in health facilities: a cross-sectional study.","authors":"Uhawenimana Thierry Claudien, Muhayimana Alice, Ndikumana Edouard, Mbabazi Eugenie, Nsengiyumva Richard, Murekezi Josephine","doi":"10.1186/s12978-026-02371-4","DOIUrl":"10.1186/s12978-026-02371-4","url":null,"abstract":"<p><strong>Introduction: </strong>The immediate postpartum period represents a critical yet underutilized opportunity to prevent unintended and closely spaced pregnancies, particularly in low- and middle-income countries. In Rwanda, despite high rates of facility-based delivery, initiation of contraception before hospital discharge remains suboptimal. Evidence on how sociodemographic characteristics, childbirth-related factors, male partner presence during childbirth, and health provider practices jointly determine immediate postpartum family planning (IPPFP) uptake is limited. This study assessed IPPFP uptake, examined male partner involvement, and identified associated factors.</p><p><strong>Methods: </strong>The study was conducted in the maternity units of Muhima District Hospital and King Faisal Hospital in Kigali, Rwanda. Quantitative data were collected from 480 women aged ≥ 18 years within 96 h postpartum. Qualitative in-depth interviews were conducted with five male partners to explore perspectives on postpartum contraceptive decision-making. Immediate postpartum family planning was defined as self-reported initiation of a modern contraceptive method before discharge. Quantitative data were analyzed using descriptive statistics, chi-square tests, and regression analysis, and qualitative data were analyzed thematically to complement quantitative findings.</p><p><strong>Results: </strong>Overall, 60.6% (291/480) of women initiated a contraceptive method before discharge, with intrauterine devices being the most commonly chosen method (33.7%). Male partners were present during childbirth for 48.3% of women; however, partner presence was not significantly associated with IPPFP uptake (χ² = 1.409, p = 0.262). Qualitative findings from a small exploratory sample suggest that contraceptive decisions were largely made during pregnancy, driven by considerations such as maternal health, parity, and household economic capacity, rather than male partners' physical presence at childbirth.</p><p><strong>Conclusions: </strong>IPPFP uptake in these two urban Rwandan hospitals was moderate. Initiation of contraception before discharge was associated with selected sociodemographic and obstetric characteristics, although these associations were based on unadjusted analyses. Male partner presence during childbirth was not statistically associated with IPPFP uptake, and qualitative findings suggest that contraceptive decisions are often made earlier in pregnancy. Strengthening postpartum counseling and clinical assessment may improve informed decision-making. However, findings should be interpreted in light of the study's limited scope and design.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006571","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":"Developing and evaluating the effectiveness of a web-based application to improve the mental health of infertile women: a multi-phase study protocol.","authors":"Fatemeh Aliasghari, Kobra Hamdi, Zeinab Mohammadzadeh, Somayeh Abdolalipour, Mojgan Mirghafourvand","doi":"10.1186/s12978-026-02362-5","DOIUrl":"10.1186/s12978-026-02362-5","url":null,"abstract":"<p><strong>Introduction: </strong>Infertility is a chronic bio-psycho-social condition associated with substantial psychological distress, particularly among women. High rates of anxiety, depression, reduced quality of life, low self-efficacy, and impaired resilience have been widely reported, while access to psychological support remains limited due to financial, social, and stigma-related barriers. Web-based mental health interventions offer a promising, accessible, and cost-effective approach to address these unmet needs. This study aims to develop and evaluate the effectiveness of a user-centered, web-based psychoeducational and supportive application designed to improve the mental health of infertile women.</p><p><strong>Methods: </strong>This developmental-applied study will be conducted in three phases. Phase 1 involves a comprehensive needs assessment through systematic literature reviews and qualitative interviews with infertile women and multidisciplinary experts to identify educational and supportive mental health needs. Phase 2 focuses on the design and development of a web-based application using user-centered design principles, incorporating evidence-based psychoeducational content, interactive exercises, and supportive resources targeting depression, anxiety, stress, quality of life, infertility self-efficacy, and resilience. Phase 3 will evaluate the application through a randomized controlled clinical trial conducted in infertility clinics affiliated with Tabriz University of Medical Sciences. Eligible infertile women will be randomly assigned to either the intervention group, receiving access to the application for six weeks, or a control group receiving routine care. Outcomes will be assessed using validated instruments, including Depression, (Anxiety and Stress Scale - 21) DASS-21, (Fertility Quality of life) FertiQoL, Infertility Self-Efficacy Scale, Connor-Davidson Resilience Scale, and the Questionnaire for User Interaction Satisfaction. Linear mixed models will be applied to compare post-intervention outcomes between groups.</p><p><strong>Discussion: </strong>This study contributes to the growing body of evidence supporting the role of digital mental health interventions in reproductive medicine and highlights the potential of technology-driven, patient-centered approaches to improve psychological outcomes in infertile women.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006554","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}