Reproductive Health最新文献

{"title":"Magnitude, determinants, and complications of short inter pregnancy intervals among pregnant mothers in Ethiopia: a systematic review and meta-analysis.","authors":"Gizachew Yilak, Biruk Beletew Abate, Alemu Birara Zemariam, Addis Wondmagegn Alamaw, Eyob Shitie Lake, Mulat Ayele, Alemayehu Sayih Belay, Befkad Derese Tilahun","doi":"10.1186/s12978-024-01893-z","DOIUrl":"10.1186/s12978-024-01893-z","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal and child mortality remains a major public health concern in Ethiopia. Improving the practice of short inter-pregnancy intervals is a key strategy to reduce neonatal and maternal mortality. Several primary studies conducted in Ethiopia have revealed the practice short inter-pregnancy interval. However, inconsistencies among these studies have been observed, and no review has been conducted to report the combined magnitude, determinants, and complications. Therefore, this review aims to estimate the national magnitude, determinants, and complications of short inter-pregnancy intervals among pregnant mothers in Ethiopia.</p><p><strong>Methods: </strong>Following the PRISMA standards, we systematically reviewed and meta-analyzed articles from PubMed, Cochrane Library, and Google Scholar that investigated the magnitude, determinants, and complications of a short inter-pregnancy interval. The Q and I² tests were used to assess heterogeneity across studies. We utilized a weighted inverse variance random effects model to evaluate the national magnitude and effect size of linked covariates. To examine publication bias, we employed a funnel plot and Egger's regression test. A sensitivity analysis was also performed to determine the impact of the studies.</p><p><strong>Results: </strong>The analysis included a total of twenty-six studies. The pooled magnitude of a short inter-pregnancy interval in Ethiopia was found to be 44.054% (95% CI 32.735-55.372; I² = 100%; P < 0.001). no formal education (AOR = 1.889; 95% CI 1.261-2.517; I² = 3.42%; P = 0.41), never used contraceptive methods (AOR = 3.38; 95% CI 2.41-4.35; I² = 44.9%; P = 0.027), breastfeeding duration of less than 24 months (AOR = 6.69; 95% CI 4.77-8.52; I² = 95.5%; P = 0.00), having a preceding female child (AOR = 1.45; 95% CI 0.88-2.015; I² = 16.4%; P = 0.301), and experiencing fetal complication (AOR = 3.55; 95% CI 1.986-5.122; I² = 0%; P = 0.482).</p><p><strong>Conclusion: </strong>A substantial number of women in Ethiopia continue to have a short inter-pregnancy interval. To address this issue, it is crucial to focus on empowering women through education and raising awareness about the importance of spacing pregnancies adequately. Efforts should be made to improve breastfeeding practices, promoting the recommended duration of at least 24 months.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"168"},"PeriodicalIF":3.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682623","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":"Who actualizes postpartum contraceptive intentions? A trajectory cluster analysis.","authors":"Michelle L O'Brien, Aasli Abdi Nur","doi":"10.1186/s12978-024-01899-7","DOIUrl":"10.1186/s12978-024-01899-7","url":null,"abstract":"<p><p>Contraceptive intention is an important woman-centered indicator for family planning. Yet, few studies have examined the determinants of women or couples actualizing their contraceptive intentions. We leverage panel data from the Performance Monitoring for Action (PMA) survey in Ethiopia to examine these dynamics among a pregnancy cohort, over the first year postpartum. Using cluster analysis on intent-to-use trajectories, we find distinct patterns across wealth categories, education levels, and regions. Additionally, we find that receiving family planning counseling in both antenatal and postnatal care visits led to a higher likelihood of intending to use. However, counseling did not increase the odds of actualization. We argue that examining actualization through model-based approaches like cluster analysis generates better insight into woman-centered contraceptive demand and provides stronger evidence for strengthening postpartum family planning interventions, than quantifying contraceptive use alone. Modeling postpartum actualization trajectories can shed light on the barriers to women's and couple's reproductive autonomy and inform future investments in both upstream development of better contraceptive methods and downstream implementation.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"169"},"PeriodicalIF":3.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688473","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, attitudes and perceptions to physical activity among pregnant women in Ibadan, Nigeria and the associated factors: a mixed method study.","authors":"Favour Suberu, Ikeola A Adeoye","doi":"10.1186/s12978-024-01903-0","DOIUrl":"10.1186/s12978-024-01903-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Physical activity has several health benefits during pregnancy. However, it remains low among pregnant women because of various barriers. This study assessed the attitude, perception, barriers to physical activity during pregnancy and the associated factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;We conducted a cross-sectional study using a sequential explanatory mixed method among 465 pregnant women attending antenatal care from four healthcare facilities in Ibadan, Nigeria. Data was collected using a pretested interviewer-administered questionnaire, and we conducted four focus group discussions. Using the Barriers to Physical Activity during Pregnancy Scale questionnaire, we assessed the barriers based on the socioecological theory. The explanatory variables included sociodemographic characteristics, obstetric factors, past obstetric history and physical activity-related issues. Data were analysed using univariate and bivariate methods (independent T-tests and ANOVA), and multiple linear regression was at 5% significance. We applied thematic content analysis to qualitative data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age of the participants was 29.22 + 5.01 years. The mean ± SD of the total physical activity barrier score (PABS) was 85.35 ± 22.82. The PABS for the subscales were intrapersonal barriers (34.46 ± 8.79), non-pregnancy intrapersonal barriers (14.47 ± 5.67), and interpersonal barriers (11.67 ± 4.25), environmental, political and organisational barriers (24.766 ± 8.82). The significant relationships between the total score of physical activity barriers and religion (p &lt; 0.030), education (p &lt; 0.000), complaints in pregnancy (p &lt; 0.043), antenatal admission in the hospital (p &lt; 0.004), physical activity advice (p &lt; 0.018), pre-pregnancy physical activity (p &lt; 0.000). Factors associated with physical activity barrier score were maternal education: adjusted β: - 15.26, 95% CI: - 27.83; - 2.69; p = 0.017, antenatal admission adjusted β: 12.20, 95% CI 3.74; 20.67, p = 0.005 pre-pregnancy physical activity: adjusted β: - 12.27, 95% CI - 1.6.5; - 7.99, p = 0.001. Significant themes that emerged in the perception of pregnant women towards physical activity are understanding physical activity, personal experience of physical activity, barriers experienced by pregnant women, the role of support, perceived benefits, and information from health care workers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study showed that pregnant women attending antenatal clinics in Ibadan, Nigeria, face various barriers to physical activity during pregnancy. Using the socioecological framework, the most commonly reported barriers by our respondents were intrapersonal and environmental barriers. Sociodemographic characteristics, pre-pregnancy physical activity, and antenatal admission were significant factors associated with the total barrier scores of respondents. Healthcare professionals should be trained in promoting physical activity during","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"166"},"PeriodicalIF":3.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668763","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":"Trends and inequalities in modern contraceptive use among women in Sierra Leone, 2008-2019.","authors":"Augustus Osborne, Camilla Bangura, Bright Opoku Ahinkorah","doi":"10.1186/s12978-024-01900-3","DOIUrl":"10.1186/s12978-024-01900-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite the known benefits of modern contraceptives in preventing unwanted pregnancies and reducing unsafe abortions, their use remains low among women of reproductive age in several sub-Saharan African countries, including Sierra Leone. This study investigated the inequalities in modern contraceptive use among women in Sierra Leone based on data from 2008 to 2019.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used data from the Sierra Leone Demographic Health Survey data rounds (2008, 2013, and 2019). The World Health Organization's Health Equity Assessment Toolkit (WHO's HEAT) software was used to calculate both simple measures; Difference (D) and Ratio (R) and complex measures of inequality: Population Attributable Risk (PAR) and Population Attributable Fraction (PAF). The inequality assessment was done for five stratifiers: age, economic status, level of education, place of residence, and sub-national province.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study found that the prevalence of modern contraceptive use among women in Sierra Leone increased from 6.7% in 2008 to 20.9% in 2019. There was an increase in age-related inequality from a Difference of 5.9 percentage points in 2008 to 7.0 percentage points in 2019. PAF decreased from 5.7% in 2008 to 1.6% in 2019, indicating that the national average of modern contraceptive use would have increased by 5.7% in 2008 and 1.6% in 2019 in the absence of age-related inequalities. For economic status, the Difference decreased from 14.9 percentage points in 2008 to 9.9 percentage points in 2019. PAF decreased from 166.3% in 2008 to 23.3% in 2019, indicating that the national average of modern contraceptive use would have increased by 166.3% in 2008 and 23.3% in 2019 in the absence of economic-related inequalities. For education, the Difference decreased from 15.1 percentage points in 2008 to 12.4 percentage points in 2019. The PAF shows that the national average of modern contraceptive use would have reduced from 189.8%  in 2008 to 39.5% in 2019, in the absence of education-related inequality. With respect to place of residence, the Difference decreased from 10.4 percentage points in 2008 to 7.6 percentage points in 2019, and PAF decreased from 111.2% in 2008 to 23.0% in 2019. The decline in PAF indicates that the national average of modern contraceptive use would have increased by 111.2% in 2008 and 23.0% in 2019 without residence-related inequality. Provincial-related inequality decreased from a Difference of 15.5% in 2008 to 8.5% in 2019. The PAF results showed a decrease in inequality from 176.3% in 2008 to 16.7% in 2019, indicating that province would contribute 176.3% and 16.7% in 2008 and 2019 respectively to the national average of modern contraceptive use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The use of modern contraceptives among women of reproductive age in Sierra Leone increased between 2008 and 2019 reflecting positive progress in reproductive health initiatives and access to ","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"167"},"PeriodicalIF":3.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676545","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":"Adherence to and predictors of iron-folate acid supplementation among pregnant women in a pastoral population in Ghana: a community-based cross-sectional study.","authors":"Yula Salifu, Yaa Nyarko Agyeman, Joseph Lasong","doi":"10.1186/s12978-024-01877-z","DOIUrl":"10.1186/s12978-024-01877-z","url":null,"abstract":"<p><strong>Background: </strong>Iron-Folate Acid Supplementation (IFAS) interventions have been recognized globally as key in reducing the burden of anemia among pregnant women. However, adherence to and determinants of IFAS remain indistinct, as it is the main constraint with supplementation therapy, particularly among minority populations. Hence, this study sought to determine the adherence to and predictors of IFAS among nomadic Fulani pregnant women in the West Gonja Municipality of Ghana.</p><p><strong>Methods: </strong>A community-based cross-sectional design was employed to involve 130 respondents between February to July, 2022 in the West Gonja Municipality of Ghana. Fulani pregnant women aged 15-49 years, possessing maternal and child health record book and were given iron-folate supplements within 16 weeks and resided within the study area ≥ 6 months before/during the data collection period were included in the study. Multivariable logistic regression was used to determine independent predictors of IFAS using SPSS version 25.0 (p ≤ 0.05 deemed statistically significant across all models). ResultsUptake of and adherence to IFAS was 47.7% and 35.5% respectively. Major barriers to IFAS uptake were forgetfulness (25.7%) and unavailability (20.0%). About 65.4% of the respondents revealed poor knowledge of IFAS. Spousal occupation (AOR = 0.17, p = 0.010), spousal income (AOR = 4.125, p = 0.050) and knowledge on IFAS (AOR = 0.259, p = 0.039) were predictors of IFAS.</p><p><strong>Conclusions: </strong>Poor adherence to and knowledge on IFAS were noted in the study and highlighted as a grave public health concern. Thus, nutrition and antenatal educational programs should give necessary attention to adherence to IFAS during pregnancy, particularly among nomadic and other vulnerable and minority populations to limit the burden of illnesses.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"165"},"PeriodicalIF":3.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668762","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":"Modern contraceptive utilization among street beggar women in the Sidama region of Ethiopia using bayesian model approach.","authors":"Buzuneh Tasfa Marine, Mihiret Genene Zewde","doi":"10.1186/s12978-024-01905-y","DOIUrl":"10.1186/s12978-024-01905-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Contraceptive methods are techniques used to prevent pregnancy during sexual intercourse. The primary goal of contraception is to inhibit the fertilization of an egg by sperm or to prevent the implantation of a fertilized egg in the uterus. Unwanted pregnancy is a major challenge for street beggar women. Due to limited use of modern contraception, unwanted pregnancy and STDs are key issues faced by this population. This study aims to assess modern contraceptive utilization and explore factors influencing contraceptive choices among street beggar women in the Sidama region, Ethiopia by using Bayesian logistic approaches.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional quantitative study was conducted on reproductive-aged (15-49) street beggar women in the Sidama Region. Data was collected using a pre-tested, structured interview questionnaire in the local language from each town in the Sidama region. Descriptive and inferential statistics were used to analyze the data using STATA version 17. A Bayesian logistic approach, with Markov Chain Monte Carlo methods, was used to model the association between modern contraceptive utilization and independent variables, allowing for estimation of model parameters and credible intervals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;The study found that 38.9% of street women in the Sidama region used modern contraceptives, primarily implants and injections. Bayesian logistic regression identified key factors influencing contraceptive use including, women aged 25-34 (AOR: 2.69 (95% CI: 1.57, 4.26)), married women (AOR: 4.91 (95% CI: 2.67, 8.51)), Widowed women (AOR: 2.81 (95% CI: 1.49)) and educated women (AOR: 2.16 (95% CI: 1.48, 3.01)) were more likely to use contraceptives. In contrast, those living on the street (AOR: 0.12 (95% CI: 0.05, 0.27)), with no history of pregnancy (AOR: 0.07 (95% CI: 0.02, 0.16)), and no sexual activity in the last six months (AOR: 0.11 (95% CI: 0.01, 0.03)), had lower usage rates. Additionally, women whose only job was begging (AOR: 0.43 (95% CI: 0.13, 0.92)) and those lacking health advice (AOR: 0.25 (95% CI: 0.07, 0.59)) also showed reduced utilization. Lack of discussion about contraceptives with partners (AOR: 0.18 (95% CI: 0.08, 0.33)) and no women's approval (AOR: 0.18 (95% CI: 0.08, 0.33)) further contributed to lower usage. Conversely, good knowledge of modern contraceptives was positively associated with utilization (AOR: 2.33 (95% CI: 1.44, 3.64)).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The findings of this study identified several factors significantly associated with modern contraceptive use among street beggar women in the Sidama region, including age, marital status, Education level, disability, Job in addition to begging, Current living situation, history of sexual assault/rape, History of pregnancy after street life, discussion of modern contraception with a sexual partner, Advice from a health professional, Sexual activity in the last six months","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"163"},"PeriodicalIF":3.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668765","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":"Intimate partner violence in the context of infertility: voices from women seeking assisted reproductive technology treatment and clinicians' perspectives.","authors":"Yu Fu, Xueqi Sun, Kailibinuer Kayimu, Gong Chen, Yuanyuan Wang, Fan Yang","doi":"10.1186/s12978-024-01906-x","DOIUrl":"10.1186/s12978-024-01906-x","url":null,"abstract":"<p><strong>Background: </strong>The interplay between infertility and intimate partner violence (IPV) is a pressing global health issue, yet qualitative evidence on this phenomenon is limited. In order to measure and prevent IPV, it is pivotal to explore and integrate perceptions and experiences from those women with infertility themselves on IPV definition and its phenomenal manifestations in the context of infertility.</p><p><strong>Methods: </strong>This study is undertaken as part of a year-long ethnographic research based at a reproductive medicine center in Beijing, China from July 2022 to July 2023. Individual interviews with women attending ART outpatient clinics and with clinicians involved in infertility treatment were conducted. Grounded Theory methodology was used to guide data analysis, which entailed a three-step analytical approach.</p><p><strong>Results: </strong>A total of 37 women and five clinicians were interviewed. Incomplete conceptualization of IPV and high mental stress among patients were evident. IPV against women with infertility has been shown to be a specific and severe form of IPV. The phenomenal manifestation of IPV in the context of infertility often takes the form of psychological abuse, including stonewalling, threats of divorce, and non-compliance with ART treatment.</p><p><strong>Conclusion: </strong>The study revealed that the burden of fertility disproportionately falls on women, often intensified by the involvement of other family and cultural norms, exacerbating gender inequalities and IPV risks. Findings from this study calls for an immediate and comprehensive response in healthcare practice. IPV screening, health education, and structural interventions should be introduced to prevent and mitigate this issue.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"164"},"PeriodicalIF":3.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668764","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":"How does chronic endometritis influence pregnancy outcomes in endometriosis associated infertility? A retrospective cohort study.","authors":"Shunhe Lin, Xi Xie, Yishan Chen, Zhenna Wang, Jinna Zhang, Chaobin Liu, Guan Lin, Yi Wang, Yuyan Guo","doi":"10.1186/s12978-024-01897-9","DOIUrl":"10.1186/s12978-024-01897-9","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis (EMS) and chronic endometritis (CE) frequently coexist. This study aimed to examine the impact of CE on reproductive outcomes in patients with EMS.</p><p><strong>Methods: </strong>We enrolled 685 patients with endometriosis-associated infertility from January 2018 to December 2020. The patients were divided into CE (318) and non-CE (367) groups. A subset of 123 clinically pregnant women from the CE group and 369 from the non-CE group was selected for detailed comparison. Pregnancy and delivery data were meticulously collected from hospital records and through telephone interviews.</p><p><strong>Results: </strong>CE was diagnosed in 46.42% of EMS patients. Higher pregnancy rates were observed in patients with Endometriosis Fertility Index (EFI) scores of 7-10. EMS patients with CE had increased risks of placenta previa (13.01%), gestational hypertension (5.69%), and cesarean sections (59.34%).</p><p><strong>Conclusions: </strong>CE, which is prevalent among EMS patients, is linked to increased risks of pregnancy complications, including placenta previa, gestational hypertension, and cesarean delivery. Although combined hysteroscopy and laparoscopy improve pregnancy rates, they demand careful management of these complications.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"162"},"PeriodicalIF":3.6,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626683","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":"Fertility awareness, perceived factors and approaches to improve contraceptive uptake among sexually active adolescent girls in Phalombe, Malawi: a mixed-methods study.","authors":"Precious L Hajison, Felistas Mpachika-Mfipa, Lerato Pitso, Lumbani Tshotetsi, Chancy Skenard Chimatiro","doi":"10.1186/s12978-024-01904-z","DOIUrl":"10.1186/s12978-024-01904-z","url":null,"abstract":"<p><strong>Background: </strong>Healthcare practitioners and policymakers in Sub-Saharan Africa face a significant health challenge due to the insufficient fertility awareness and other perceived health outcomes in contraceptive use among adolescent girls. This has resulted in a rise in unplanned pregnancies and other adverse fertility-related health consequences for adolescent girls in Malawi. Consequently, this research examines fertility awareness, perceived factors, and strategies in contraceptive adoption among adolescent girls in Malawi's Phalombe district.</p><p><strong>Methods: </strong>The study utilized a mixed-methods approach, with the quantitative component employing structured questionnaires administered in person to collect data from school-going adolescent girls in three traditional authorities in Phalombe district, Malawi. The research employed multivariate logistic regression analysis, and its findings were corroborated with qualitative data obtained through focus group discussions involving adolescent girls in the same environment.</p><p><strong>Results: </strong>The majority of adolescent females were unaware that their fertile period occurs in the middle of their menstrual cycle, indicating a lack of knowledge regarding their reproductive health. The study examined data from 102 sexually active adolescent females in the quantitative component and 72 adolescent girls in the qualitative component. For the quantitative strand, participants' ages ranged from 13 to 19 years, with a mean age of 16.5 and a standard deviation of 1.5. In the qualitative portion, the study conducted interviews with adolescent females aged between 10 and 19 years, with a median age of 15 years. Services that were not tailored to youth needs served as barriers to contraceptive use. Factors that facilitated contraceptive use included a preference for receiving contraceptives from peers, which was associated with a higher probability of usage (AOR: 4.80, 95% CI 1.31-17.32). Moreover, adolescent females who were identified as Catholic (AOR: 14.01, 95% CI 2.50-78.47) or belonged to other Christian denominations (AOR: 5.85, 95% CI 1.20-28.25) exhibited a greater likelihood of using contraceptives compared to their Muslim counterparts. The focus group discussions suggested making contraceptives available in educational institutions, analogous to the distribution of iron supplements.</p><p><strong>Conclusion: </strong>Adolescent girls in the Phalombe district seemingly have low awareness and knowledge of their fertility, which may lead to unintended pregnancies. Adolescent girls are unable to access modern contraceptives, and there is a need for youth-friendly structures when delivering contraceptive services. Additionally, participants indicated that community midwives and health surveillance assistants should provide contraceptives within the communities to reduce distance.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"161"},"PeriodicalIF":3.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626576","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":"Gynecological health care services utilization and violence among female sex workers in Togo in 2021.","authors":"Alexandra M Bitty-Anderson, Akila W Bakoubayi, Fifonsi A Gbeasor-Komlanvi, Arnold J Sadio, Patrick A Coffie, Didier K Ekouevi","doi":"10.1186/s12978-024-01887-x","DOIUrl":"10.1186/s12978-024-01887-x","url":null,"abstract":"<p><strong>Background: </strong>Female Sex Workers (FSW) in Sub Saharan Africa face multiple challenges increasing their vulnerability to poor health, particularly poor sexual and reproductive (SRH) health outcomes and violence. The aim of this study was to assess the use of gynecology health care services and factors associated with its use as well as experiences of violence among FSW in Togo.</p><p><strong>Method: </strong>A cross-sectional study was carried out in 2021 among FSW in two cities of Togo. A snowball sampling method was used and initial seeds were identified in each site in collaboration with FSW non-governmental organizations. A logistic regression was performed to identify factors associated with the use of a SRH service and violence.</p><p><strong>Results: </strong>A total of 447 FSW with a median age of 30 [IQR: (24-38)] participated in this study and 43.4% of them had reached at least secondary school. Among them, 29.1% reported having been to a gynecological consultation over the previous year. Factors associated with a gynecological consultation included: living in the Lomé capital city (aOR = 0.35, 95%CI 0.22-0.54), and an experience of condom breakage or slippage (aOR = 2.00; 95%CI 1.19-2.64). The majority reported at least one lifetime pregnancy (87.9%), 39.8% reported ever having an unintended pregnancy and 67.6% of them ever had an abortion. Finally, 61.1% indicated being victims of physical, sexual, or emotional violence in the previous six months. Sex workers living in Lomé (aOR = 1.78; 95%CI 1.16-2.73); a history of abortion (aOR = 1.53; 95%CI 1.03-2.31) and having more than 15 clients per week (aOR = 4.87; 95% CI 1.99-11.94), were more likely to experience violence.</p><p><strong>Conclusion: </strong>There is an under-utilization of health care services among FSW in Togo in addition to overall poor sexual and reproductive health outcomes with a high prevalence of gender-based violence. Those results highlight the importance of continued advocacy for the integration of SRH care with HIV prevention services geared toward FSW as well as a holistic approach to SRH care with innovative ways to prevent violence.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"21 1","pages":"160"},"PeriodicalIF":3.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626589","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}