Reproductive Health最新文献

{"title":"The impact of a participatory learning and action intervention on unmet need for contraception: a cluster-randomized controlled trial in rural Bihar, India.","authors":"Mey-Ling Sommer, Lisa Bogler, S V Subramanian, Sebastian Vollmer","doi":"10.1186/s12978-025-02055-5","DOIUrl":"10.1186/s12978-025-02055-5","url":null,"abstract":"<p><strong>Background: </strong>Unmet need for contraception is a persistent issue in rural India. This work evaluates the impact of Gram Varta - a participatory learning and action intervention employed in women's self-help groups in rural Bihar, India - on women's contraceptive behavior and unmet need for contraception. Trained facilitators used an active and participatory communication approach in 20 group meetings to discuss health-related topics focusing on the improvement of communities' knowledge and practice related to health, nutrition, water, sanitation and hygiene. One of the meetings focused on family planning measures, the benefits of various measures, and a discussion on the availability of various means of contraception through the government health system. The intervention was also meant to increase women's empowerment.</p><p><strong>Methods: </strong>Gram Varta was evaluated in one district of Bihar, Madhepura, with a cluster-randomized controlled trial. We used a difference-in-differences model to estimate the intention-to-treat effect of Gram Varta on women's contraceptive behaviour and unmet need for contraception using a panel dataset with 972 observations collected in 2015 and 2016.</p><p><strong>Results: </strong>We find a statistically marginally significant increase in contraceptive use by 5.8 percentage points (95%-CI [0.00;0.12]) and a statistically significant reduction in unmet need for limiting childbirth by 7.2 percentage points (95%-CI [-0.14;0.00]) among women in treatment villages but no effect on spacing childbirth.</p><p><strong>Conclusions: </strong>There is indicative evidence that participatory learning and action intervention increased contraception use among women of reproductive age in rural India, but the effect on unmet need was inconsistent.</p><p><strong>Trial registration: </strong>The randomized controlled trial was registered with and a pre-analysis plan was submitted to 3ie before intervention roll-out. In addition, it was retrospectively registered in the AEA RCT Registry with the identification number AEARCTR-0004700 on September 16, 2019.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"121"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541986","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 struggle over caesarean section on maternal request: an ethical principles approach to Swedish media portrayal.","authors":"Mio Fredriksson, Magdalena Mattebo","doi":"10.1186/s12978-025-02057-3","DOIUrl":"10.1186/s12978-025-02057-3","url":null,"abstract":"","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"118"},"PeriodicalIF":3.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512445","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":"\"It's me who supports. How are you going to refuse to have a child?\": the social norms and gender dynamics of men's engagement in family planning practices in the Democratic Republic of the Congo.","authors":"Salomine Ekambi, Kathryn Sugg, Florence Mpata, Dédé Marachto Aliango, Peter J Winch","doi":"10.1186/s12978-025-02029-7","DOIUrl":"10.1186/s12978-025-02029-7","url":null,"abstract":"<p><strong>Background: </strong>In the Democratic Republic of the Congo (DRC), a disparity exists in the fertility desires of men and women, with men often expressing a desire for more children than their partners. This disconnect can be attributed to social and gender norms that influence discussions and decision-making regarding birth spacing, birth limiting, and the adoption of modern contraceptive methods. This qualitative study, through semi-structured interviews and focus group discussions, explored the social norms shaping perceptions, attitudes, and decision-making around family planning among men in the DRC.</p><p><strong>Methods: </strong>The study protocol was adapted from the 5-step process set forth in the Social Norms Exploration Tool (SNET). Data collection took place in the three provinces of Kasai Central, Lualaba, and Sankuru. This process was divided into three phases: a reference-group identification phase incorporating a short, quantitative questionnaire, an exploration of norms and attitudes with the population of interest (N = 317) - here married and unmarried men - and further exploration of social norms among the reference groups (N = 144) cited by men.</p><p><strong>Results: </strong>Social norms around family planning are contradictory and can be better understood by breaking down the concept of family planning into three categories of descriptive and injunctive norms: 1) the use of modern contraceptive methods, 2) birth spacing and family size, and 3) couple communication and decision-making. We found that while social norms oppose the use of modern contraceptive methods and advocate for larger family size, there is notable social support for birth spacing. Some men reported they would support their wives in learning about contraceptive methods if they were able to make the final decision. However, other men felt that allowing their wives to seek a method would undermine their authority or their virility.</p><p><strong>Conclusions: </strong>To increase modern contraceptive uptake, interventions should address the underlying issues that contribute to non-adherence, addressing the three categories and their associated norms individually and engaging reference groups important to each, including healthcare providers, religious leaders, and male peer groups, in family planning programming.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"120"},"PeriodicalIF":3.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512443","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":"Design, implementation, and evaluation of a psychosocial intervention to improve mental health in pregnant adolescents: a mixed-methods protocol.","authors":"Setareh Yousefi, Simin Montazeri, Nahid Javadifar, Saeed Ghanbari","doi":"10.1186/s12978-025-02060-8","DOIUrl":"10.1186/s12978-025-02060-8","url":null,"abstract":"<p><strong>Background: </strong>Adolescent pregnancy remains a critical global health issue, with the World Health Organization reporting a prevalence of 10.3%. Pregnant adolescents aged 10 to 19 face elevated risks of mental health challenges, including depression, anxiety, and stress. Despite these vulnerabilities, there is a notable lack of effective psychosocial interventions, particularly in low- and middle-income countries. This study aims to develop and evaluate a culturally tailored psychosocial support intervention to improve mental health outcomes among pregnant adolescents in Iran.</p><p><strong>Methods: </strong>This mixed-methods study comprises three sequential phases. First, a qualitative study will explore the experiences and perceptions of pregnant adolescents regarding psychosocial support. Second, insights from the qualitative phase will inform the development of a targeted intervention, guided by expert consensus using the Nominal Group Technique. Third, a quantitative phase will assess the intervention's effectiveness through a randomized controlled trial involving 84 pregnant adolescents. Key outcomes will include levels of social support, anxiety, depression, and stress, measured using validated instruments. Data collection will involve semi-structured interviews, expert panels, and pre- and post-intervention assessments.</p><p><strong>Discussion: </strong>The study is expected to advance understanding of the psychosocial needs of pregnant adolescents and provide evidence for culturally sensitive interventions. The findings aim to inform clinical practice and health policy, contributing to improved mental health and overall well-being among this high-risk population.</p><p><strong>Trial registration: </strong>This study has been approved by the Ethics Committee of Ahvaz Jundishapur University of Medical Sciences (IR.AJUMS.REC.1402.140) and registered with the Iranian Registry of Clinical Trials on June 26, 2023 (IRCT20190129042544N1).</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"119"},"PeriodicalIF":3.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512444","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":"Correction: Delayed pregnancy disclosure, attributed social factors and implications for antenatal care initiation: a qualitative study among Ugandan women and their partners.","authors":"Hadija Nalubwama, Alison M El Ayadi, Cynthia C Harper, Josaphat Byamugisha, Dilys Walker, Alexander C Tsai, Blake Erhardt-Ohren, Umar Senoga, Paul J Krezanoski, Carol S Camlin, Alison B Comfort","doi":"10.1186/s12978-025-02062-6","DOIUrl":"10.1186/s12978-025-02062-6","url":null,"abstract":"","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"117"},"PeriodicalIF":3.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497956","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":"Relationships between inflammatory indicators, nutritional status, and metabolic status and female infertility.","authors":"Zhenwen Zhang, Liangyu Chen, Huihua Chen, Tingting Lin, Chen Gao, Lei Yang","doi":"10.1186/s12978-025-02059-1","DOIUrl":"10.1186/s12978-025-02059-1","url":null,"abstract":"<p><strong>Background: </strong>Infertility is a growing global challenge that affects millions of people, and various factors influence female reproductive health. This study examined the association between inflammatory indicators, nutritional status, metabolic conditions, and infertility.</p><p><strong>Methods: </strong>This cross-sectional study was part of the National Health and Nutrition Examination Survey (NHANES) and included women aged 18-45 years between 2013 and 2018. Weighted binary logistic regression was used to investigate independent relationships between inflammatory indicators, nutritional status, metabolic conditions, and infertility. Subsequently, a nomogram risk prediction model was developed along with subgroup analyses.</p><p><strong>Results: </strong>Among the 1,250 women analyzed, the overall infertility prevalence was 12.3%. Multivariate logistic regression analyses identified marital status, systemic immune inflammation index (SII), body mass index (BMI), nutritional risk index (NRI), and metabolic syndrome (MetS) as independent risk factors for infertility. A nomogram prediction model was constructed based on the independent risk factors, and the area under the ROC curve of the model was 0.703. The calibration and decision curves showed that the model had good calibration and net benefits. Based on the nomogram prediction model, the total risk scores for infertility were calculated and divided into tertiles. The infertility risk was 4.5% in tertile 1, 9.3% in tertile 2, and 22.1% in tertile 3. Both the crude and adjusted models and subgroup analyses confirmed this positive correlation.</p><p><strong>Conclusions: </strong>Inflammatory, nutritional, and metabolic factors are significantly associated with infertility in women. The reproductive capacity of women of childbearing age can be enhanced by reducing inflammation, optimizing nutrition, and managing metabolic conditions, thereby reducing the risk of infertility.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"116"},"PeriodicalIF":3.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497957","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 to sexual and reproductive health care faced by transgender and gender diverse people: a systematic review.","authors":"Connor Luke Allen, Luke Muschialli, Åsa Nihlén, Anna Coates, Lianne M Gonsalves","doi":"10.1186/s12978-025-02038-6","DOIUrl":"10.1186/s12978-025-02038-6","url":null,"abstract":"<p><strong>Background: </strong>Transgender (trans) and gender diverse people face significant obstacles when accessing sexual and reproductive health (SRH) services. This review aims to systematically identify and characterise the specific barriers to SRH barriers across a range of service domains.</p><p><strong>Methods: </strong>A systematic literature search was carried across MEDLINE, CINAHL, Embase, PsycInfo and Global Index Medicus for studies published up until Aug 17, 2023. We included qualitative, quantitative and mixed-methods studies that illustrated which barriers to SRH services trans and gender diverse people face. Relevant data were extracted and examined using an inductive approach by which organic themes emerged across the SRH service domains. Quality assessment was carried out using the Critical Appraisal Skill Programme (CASP) checklists.</p><p><strong>Findings: </strong>A total of 53 studies examining barriers to SRH services were deemed eligible for inclusion. This consisted of 20 studies relating to fertility care, two to abortion care, four to contraception, 15 to reproductive cancer screening, nine to antenatal, intrapartum and postnatal care and three spanning multiple domains of SRH. Eight studies were deemed to be moderate quality, the remaining 45 were high quality. 49 of the included studies were conducted exclusively in high-income countries. 40 studies were conducted from the perspectives of trans and gender diverse people, 10 from that of health providers whilst three incorporated both. Participants included for analysis ranged in age from 18 to 78 years. Domain specific and cross-cutting barriers were described throughout the included studies, including financial accessibility, lack of provider knowledge and education, limited information availability, systemic and interpersonal discrimination, cis-normative and gender biased health system practices and dysphoria associated with treatments and procedures.</p><p><strong>Interpretation: </strong>Trans and gender diverse people face substantial barriers to SRH services that prohibit them from fully exercising their reproductive rights. The evidence collated by this review demonstrates that whilst some barriers are shared with cisgender women, trans and gender diverse people face unique barriers to accessing SRH services. Both systems- and individual-level reform is necessary to improve not only gender responsiveness but also gender-inclusivity.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"115"},"PeriodicalIF":3.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497955","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":"Born Too Soon: learning from the past to accelerate action in the next decade.","authors":"Anna Gruending, Joy E Lawn, Amy Reid, Etienne V Langlois, Bo Jacobsson, Lori McDougall, Rajat Khosla, Zulfiqar A Bhutta, Ashok K Deorari, Lily Kak, Judith Robb-McCord, Nabila Zaka, Ditas Duque Decena, Helga Fogstad, Anshu Banerjee, Mary V Kinney, Queen Dube","doi":"10.1186/s12978-025-02044-8","DOIUrl":"10.1186/s12978-025-02044-8","url":null,"abstract":"<p><strong>Progress: </strong>This paper is a narrative review that takes stock of the progress in addressing preterm birth over the past decade - notably on policies, national plans, innovation, evidence, social mobilisation, and community engagement - to inform future progress on preterm birth. At the global policy level, many countries have strongly supported collective initiatives and resolutions on maternal and newborn health relevant to preterm birth in multilateral fora, most recently through a World Health Assembly resolution calling for a revival amongst the global community on stalled progress for maternal, newborn and child health. Following the adoption of other global plans, like the Every Newborn Action Plan and Strategies for Ending Preventable Maternal Mortality, most countries set corresponding national mortality and coverage targets, and many have national and subnational policies and plans for integrated maternal and newborn health. Adequate financing remains a challenge, and sexual and reproductive health and rights of women and girls are being challenged globally. There have been significant advances in evidence-based interventions for preterm birth prevention and care, reflected in updated World Health Organization guidelines on antenatal, intrapartum and postpartum care, and care for small and sick newborns. The past decade has also seen progress in social mobilisation and community engagement, particularly parent groups and healthcare professional organisations advocating on issues surrounding preterm birth.</p><p><strong>Polycrisis and vulnerability: </strong>There are, however, significant challenges that continue to hamper progress on preterm birth. Polycrisis - the interplay of overlapping economic, geopolitical, and environmental crises - compounds existing inequities, especially in places where health systems are already weak. Distinct and overlapping threats from conflict, climate change and the cost-of-living crisis present life-or-death challenges to those already facing extreme vulnerability, particularly women and girls, and small and sick newborns.</p><p><strong>Preterm birth: </strong>A MARKER OF MATERNAL AND NEONATAL HEALTH PROGRESS IN THE COMING DECADE: The detrimental impacts of preterm birth are felt along the life course and across generations. The success of countries and the global community in preventing preterm births and ensuring high-quality care for mothers and preterm babies serves as a critical measure of progress - or failure - in advancing global efforts to improve maternal and newborn health.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 Suppl 2","pages":"106"},"PeriodicalIF":3.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476527","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":"Born Too Soon: Care for small and sick newborns, evidence for investment and implementation.","authors":"Sarah Murless-Collins, Veronica Chinyere Ezeaka, Nahya Salim Masoud, Karen Walker, Natasha R Rhoda, William Keenan, Steve Wall, Zulfiqar A Bhutta, Pablo Duran, Olufunke Bolaji, Karen Edmond, Gagan Gupta, Joy E Lawn","doi":"10.1186/s12978-025-02032-y","DOIUrl":"10.1186/s12978-025-02032-y","url":null,"abstract":"<p><strong>Progress: </strong>Over the past decade, the world has made policy progress for newborns including the first global Sustainable Development Goal (SDG) target 3.2 (< 12 neonatal deaths per 1000 live births) and the Every Newborn Action Plan (ENAP). However, gaps remain for investment and action, especially for babies born too soon, too small, or who become sick. An estimated 20-30 million newborns have life-threatening conditions requiring hospital care each year. Annually, approximately 2.3 million newborns die during the neonatal period, the majority being preterm. A further 1 million newborn survivors are estimated to have long-term disabilities.</p><p><strong>Programmatic priorities: </strong>To achieve SDG 3.2 by 2030, we need to accelerate four-fold. The shift to 80% of births in health facilities creates opportunities for impact, for both maternal and newborn care. Increased coverage and quality of high-impact newborn interventions is urgently needed to reach SDG targets. Most neonatal deaths and disabilities are preventable through an evidence-based package for small and sick newborn care (SSNC), with greatest impact seen in preterm babies-particularly through respiratory support and kangaroo mother care-while placing families at the centre of care. SSNC scale-up requires addressing ten core components, defined by WHO/UNICEF, based on a health systems approach: political commitment and leadership; financing; human resources; appropriate infrastructure; equipment and commodities; robust data systems and use of data for action; referral systems; linkage with high-quality maternal care; family and community involvement; and post-discharge follow-up. Specific focus is required for fragile conflict settings, accounting for 25% global births but 39% global newborn deaths.</p><p><strong>Pivots: </strong>More ambitious investment in high-quality, family-centred care for vulnerable newborns can give a high return of between US$ 9-12 for every US$ 1 invested. Accelerating implementation requires diverse stakeholders, including political leaders, bureaucratic and technical leadership in country, professional societies, civil society, the private sector and importantly from families and communities. Cross-country collaboration and strengthening capacities of low- and middle-income countries to address gaps in newborn care are essential for innovations to reach high-burden, conflict-affected, and marginalised populations. Integrating newborn care follow-up into wider child and family care systems is crucial to ensure newborns not only survive but also thrive.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 Suppl 2","pages":"114"},"PeriodicalIF":3.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485729","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":"Born Too Soon: Priorities to improve the prevention and care of preterm birth.","authors":"Etienne V Langlois, Amy Reid, Joy E Lawn, Mary Kinney, Maria El Bizri, José M Belizán, Anna Gruending, Bo Jacobsson","doi":"10.1186/s12978-025-02069-z","DOIUrl":"10.1186/s12978-025-02069-z","url":null,"abstract":"","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 Suppl 2","pages":"110"},"PeriodicalIF":3.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485731","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}