Clinical Epidemiology and Global Health最新文献

{"title":"Hospital inpatient in Indonesia: Does national health insurance matter?","authors":"Ratna Dwi Wulandari ,&nbsp;Agung Dwi Laksono ,&nbsp;Wahyu Pudji Nugraheni ,&nbsp;Tati Suryati ,&nbsp;Leny Latifah ,&nbsp;Diah Yunitawati ,&nbsp;Rofingatul Mubasyiroh ,&nbsp;Irfan Ardani ,&nbsp;Asep Kusnali ,&nbsp;Abdullah Saleh Alruwaili","doi":"10.1016/j.cegh.2025.102155","DOIUrl":"10.1016/j.cegh.2025.102155","url":null,"abstract":"<div><h3>Background</h3><div>Hospitals are the final gate in Indonesia's health service system. Furthermore, the government's strategy to pursue universal coverage through National Health Insurance (NHI) is anticipated to improve the public availability of healthcare services. The study aims to investigate the role of NHI in hospital inpatient care in Indonesia.</div></div><div><h3>Methods</h3><div>The analysis utilized data accessible via the 2023 National Socioeconomic Survey. This research used a cross-sectional design to investigate 1,223,377 individuals in total. Inpatient hospitalization was the outcome variable, while NHI membership was the exposure variable. As control variables, the research examined residence, age, gender, marital status, education, occupation, and wealth status. In the final phase of the investigation, multinomial logistic regression was utilized to assess the data.</div></div><div><h3>Results</h3><div>According to the investigation, the hospital admission rate in Indonesia in 2023 was 2.41 %. Currently, 72.5 % of the population consists of NHI members. Regarding NHI membership, people with NHI are 2.76 times more likely than those without it (95 % CI 2.66–2.86). Furthermore, the study reports that seven control variables were associated with hospital inpatients in Indonesia in 2023: residence, age, sex, marital status, education, employment, and wealth status.</div></div><div><h3>Conclusions</h3><div>The findings showed that NHI membership affects hospital inpatients in Indonesia. Membership in the NHI was associated with a nearly threefold increase in the likelihood of hospital inpatient care.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102155"},"PeriodicalIF":1.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The moderating impact of community-built environments on a behavior intervention program to increase health outcomes for insufficiently active adults","authors":"Natália Santos ,&nbsp;Adalberto A.S. Lopes ,&nbsp;Tânia Benedetti ,&nbsp;Cassiano R. Rech","doi":"10.1016/j.cegh.2025.102156","DOIUrl":"10.1016/j.cegh.2025.102156","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study is to verify if the benefits obtained in behavioral variables by intervention participants of the “Active Life Improving Health” (VAMOS) program were associated with access to places for physical activity and healthy eating.</div></div><div><h3>Methods</h3><div>Street network buffer areas of 500- and 1000-m were created around residences of VAMOS’ participants, healthy adults older than 18 years old (n = 125). Built environment's exposure variables were accounted for by the frequency of physical activity and healthy eating places in each buffer, and geo-referenced in Google Earth. Behavior variables focus on the primary health outcomes of VAMOS (i.e., sedentary behavior, moderate to vigorous physical activity, quality of life). Geospatial software was used to develop the walkability index in participants' census tracts.</div></div><div><h3>Results</h3><div>There are significant interactions (p &lt; 0.05) on how the presence of Leisure Public Spaces at 500-m decreased sedentary behaviors (p = 0.046) and waist circumference (p = 0.038) and increased physical activity levels (p = 0.001) in participants from baseline to the end of the program at 12 weeks. Walkability indices did not impact behavior change.</div></div><div><h3>Conclusions</h3><div>Having Leisure Public Spaces and food retailers that sell healthy foods within 500-m of participants can influence positive behavior change. Walkability levels did not directly impact behavior change, which could be a result of how participants perceive walkability in their communities, and what their threshold is for considering spaces unfit or unsafe for walking. Future studies should consider locations post-COVID and assess the perception of participants on how they move around their communities.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102156"},"PeriodicalIF":1.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes and their associated factors among a cohort of children with wasting and severe wasting enrolled in the Integrated Child Development Services (ICDS) program in Sivakasi, Tamil Nadu, 2023-24","authors":"Sabarish Prabhu ,&nbsp;Srinivasan Ramalingam ,&nbsp;Sendhilkumar Muthappan ,&nbsp;Divya Saravanakumar ,&nbsp;Arshi Chawla ,&nbsp;Rizwan Suliankatchi Abdulkader","doi":"10.1016/j.cegh.2025.102145","DOIUrl":"10.1016/j.cegh.2025.102145","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to estimate the incidence of recovery and relapse over a four-month follow-up period among children aged 6–59 months diagnosed with wasting or severe wasting in the Srivilliputhur block of the Sivakasi Health Unit District, Tamil Nadu, during 2023–2024.</div></div><div><h3>Methods</h3><div>We conducted a prospective cohort study among children aged 6–59 months diagnosed with wasting or severe wasting in December 2023. We collected the data using structured questionnaires. Baseline assessments were conducted in December 2023 (T0), with monthly follow-ups until April 2024 (T4). To identify factors associated with recovery and relapse, we first conducted a univariate analysis, followed by a multivariable Poisson regression analysis. Pathways of recovery and relapse were visualized using a Sankey diagram, while Kaplan-Meier survival curves were plotted to illustrate recovery and relapse rates over time.</div></div><div><h3>Results</h3><div>A total of 78 children were enrolled, with a median age of 23 months. The incidence of recovery was 9.02 per 1000 person-days, while relapse incidence was 3.96 per 1000 person-days. The mean time to recovery was 77.5 days, whereas the mean time to relapse was 84.5 days. Factors influencing recovery included age, dietary preference, and caregiver occupation, with therapeutic diets playing a major role in improving outcomes.</div></div><div><h3>Conclusions</h3><div>This study highlights the critical need for targeted nutritional interventions and comprehensive care strategies to manage childhood wasting effectively. The findings underscore the importance of continuous monitoring and tailored approaches to enhance recovery rates and minimize relapse, ultimately contributing to improved child health and socio-economic development.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102145"},"PeriodicalIF":1.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic disparities in primary healthcare utilization in Eastern Indonesia","authors":"Ratna Dwi Wulandari ,&nbsp;Agung Dwi Laksono ,&nbsp;Zuardin Zuardin ,&nbsp;Nikmatur Rohmah ,&nbsp;Maznah Dahlui","doi":"10.1016/j.cegh.2025.102154","DOIUrl":"10.1016/j.cegh.2025.102154","url":null,"abstract":"<div><h3>Objectives</h3><div>Indonesia's eastern region is lagging in development, including the health sector, compared to other areas. The study aims to analyze socioeconomic disparities in primary healthcare utilization in eastern Indonesia.</div></div><div><h3>Methods</h3><div>The study analyzed raw data from the 2018 Indonesian Basic Health Survey. The poll collected 57,827 respondents using stratification and multistage random selection. Meanwhile, the research employed primary healthcare utilization as an outcome variable and socioeconomic status as an exposure variable. Moreover, the study controlled for nine variables: region, type of residence, age, gender, marital status, education level, work type, health insurance ownership, and time spent traveling to primary healthcare. In the final part of the analysis, the study employed binary logistic regression to examine the data.</div></div><div><h3>Results</h3><div>The results show that the poorer were 0.910 times less likely than the poorest to utilize primary healthcare (95 % CI 0.904–0.916). Individuals from a middle socioeconomic status were 0.877 times less likely than those from the poorest group to use primary healthcare (95 % CI 0.871–0.883). The richer were 0.821 times less likely than the most impoverished to utilize primary healthcare (95 % CI 0.815–0.828). The richest were 0.808 times less likely than the poorest to use primary healthcare (95 % 0.801–0.815).</div></div><div><h3>Conclusions</h3><div>Socioeconomic disparities existed in primary healthcare utilization in eastern Indonesia. For those living in poverty, this condition poses no financial obstacle to receiving primary healthcare services. This circumstance serves as an example of how well National Health Insurance policies, combined with Contribution Assistance for Recipients, work for low-income individuals.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102154"},"PeriodicalIF":1.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of health-related quality of life among patients of rheumatoid arthritis in Rawalpindi: A cross-sectional study","authors":"Muhammad Amer ,&nbsp;Saleh Ahmed ,&nbsp;Muhammad Akhlaq ,&nbsp;Hoorain Bibi ,&nbsp;Ishmal ,&nbsp;Muhammad Ishfaq ,&nbsp;Muhammad Nouman Arshad ,&nbsp;Simrah Rehman Malik ,&nbsp;Ali Ahmed","doi":"10.1016/j.cegh.2025.102151","DOIUrl":"10.1016/j.cegh.2025.102151","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Rheumatoid arthritis (RA) is a chronic inflammatory disorder that significantly impairs patients' health-related quality of life (HRQoL). Early diagnosis and improved disease management can alleviate a patient and country's financial burden. The study aimed to evaluate the HRQoL of RA patients in Rawalpindi to highlight its debilitating nature in the national context.</div></div><div><h3>Methods</h3><div>This cross-sectional study evaluates the HRQoL of RA patients in Rawalpindi using the EuroQol 5D (EQ-5D) scale. The study involved 400 participants from the outpatient department of Benazir Bhutto Hospital, primarily middle-aged women, assessing various domains of health, including mobility, self-care, usual activities, pain, and depression.</div></div><div><h3>Results</h3><div>A significant decrease in HRQoL was observed in RA patients, influenced by the duration and severity of the disease (p-value = 0.00). The mean EQ-5D index score was 0.4 ± 0.4, while the mean VAS score was 54.7 ± 16.5. Most participants (43 %) experienced moderate disease intensity, with diabetes (27.8 %) and high blood pressure (20 %) being common comorbidities. Pain and physical impairments significantly impacted daily activities and emotional well-being, with 23.5 % of patients reporting moderate problems in multiple dimensions of the EQ-5D scale.</div></div><div><h3>Conclusion</h3><div>RA has a profound impact on the HRQoL of patients in Rawalpindi. The effect is significantly associated with disease severity and duration, highlighting the need for comprehensive management strategies like early disease diagnosis and prompt treatment to improve the quality of life for RA patients.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102151"},"PeriodicalIF":1.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features and mortality risk factors in hospitalized heart failure patient during the COVID-19 pandemic: A South Korea national emergency department study","authors":"Soo Young An ,&nbsp;Jong Sun Ok ,&nbsp;Sung Hea Kim","doi":"10.1016/j.cegh.2025.102144","DOIUrl":"10.1016/j.cegh.2025.102144","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate changes in clinical characteristics and mortality-related risk factors among patients with acute and chronic heart failure (HF) admitted to emergency department (ED) in South Korea before and during the coronavirus disease 2019 (COVID-19) pandemic.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted using data from the National Emergency Department Information System (NEDIS) covering January to December 2020. Adults aged ≥20 years diagnosed with HF and presenting to EDs nationwide were included. Of the 240,828 HF-related ED visits, 79,212 hospitalized patients were selected for detailed analysis.</div></div><div><h3>Results</h3><div>During the pandemic period, there was a 13.7 % decline in HF-related ED visits and a 6.0 % reduction in subsequent hospital admission. Despite this decrease, delays in ED presentation following symptom onset, ED length of stay, and total hospitalization duration all increased. In-hospital mortality rose by 11.5 %. Dyspnea was the most common presenting symptom (53.8 %). Multivariable logistic regression identified older age, female sex, and altered mental status at ED arrival as independent predictors of in-hospital mortality.</div></div><div><h3>Conclusions</h3><div>The COVID-19 pandemic was associated with decreased ED utilization by HF patients but increased in-hospital mortality and delays in care. These findings highlight the urgent need for adaptive healthcare strategies to manage chronic cardiovascular condition during global health crises.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102144"},"PeriodicalIF":1.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decomposition of socioeconomic inequalities in smoking status in Indonesia: a decade of widening gaps","authors":"Wahyu Pudji Nugraheni ,&nbsp;Bunga A. Paramashanti ,&nbsp;Sinta Dewi Lestyoningrum ,&nbsp;Dea Anita Ariani Kurniasih ,&nbsp;Haerawati Idris","doi":"10.1016/j.cegh.2025.102147","DOIUrl":"10.1016/j.cegh.2025.102147","url":null,"abstract":"<div><h3>Background</h3><div>Tobacco consumption persists as a significant global health issue. In Indonesia, smoking rates have changed little despite various policies, potentially due to underlying socioeconomic disparities. This study provides the first comparative assessment of socioeconomic inequalities in smoking behavior in Indonesia over ten years.</div></div><div><h3>Objective</h3><div>To quantify socioeconomic inequality in smoking status in Indonesia and determine the contribution of different factors to this inequality.</div></div><div><h3>Methods</h3><div>We utilized two nationally representative surveys from Indonesia, conducted in 2013 (Basic Health Research) and 2023 (Indonesia Health Survey). The sample was individuals aged &gt;15 years. Socioeconomic inequality was measured using the concentration curve and the Wagstaff-normalised concentration index. We applied concentration index decomposition to determine the relative contributions of demographic, socioeconomic, and health-related factors.</div></div><div><h3>Results</h3><div>The concentration indices for smoking were −0.060 (p &lt; 0.001) in 2013 and -0.089 (p &lt; 0.001) in 2023, indicating a pro-poor concentration of smoking that widened over time. The decomposition analysis revealed that household socioeconomic status and education level were key factors explaining the pro-poor inequalities in smoking status in Indonesia in both 2013 and 2023. Additionally, occupation type contributed to the inequality in 2013, while insurance ownership emerged as a contributing factor in 2023.</div></div><div><h3>Conclusion</h3><div>There is an increase in socioeconomic inequalities in smoking behavior in Indonesia from 2013 to 2023. Tobacco control efforts should prioritize equity by enhancing health education, expanding culturally tailored cessation support, adopting innovative motivation tools to support quitting, and integrating cessation services into the national health insurance system.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102147"},"PeriodicalIF":2.3,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental stress, psychological well-being and sleep quality of mothers of neonates hospitalized in the Neonatal Intensive Care Unit of a tertiary care hospital in North India: a cross-sectional study","authors":"Pragati Jha ,&nbsp;Shalini Tripathi ,&nbsp;Sujita Kumar Kar","doi":"10.1016/j.cegh.2025.102139","DOIUrl":"10.1016/j.cegh.2025.102139","url":null,"abstract":"<div><h3>Background</h3><div>Mothers of sick neonates in the neonatal intensive care unit (NICU) face significant stress, negatively impacting their sleep quality and overall well-being, which can affect their child's development.</div></div><div><h3>Aim</h3><div>This study evaluated the psychological well-being of these mothers, focusing on subjective well-being, maternal stress, sleep quality, and associated factors. We also explored the relationships among these variables.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted on mothers of neonates admitted to the NICU for at least 24 h at a tertiary care hospital, with an estimated sample size of 109. Instruments for evaluation included the WHO Five Well-Being Index (WHO-5), the Parental Stressor Scale, and a single-item sleep quality scale, alongside a socio-demographic questionnaire.</div></div><div><h3>Results</h3><div>The average scores were: WHO well-being score 62.06 ± 20.04 out of 100, parental stress score 47.06 ± 11.11 out of 90, and sleep quality score 7.02 ± 2.21 out of 10. Significant correlations were found: a positive correlation (r = 0.43) between the WHO well-being index and sleep quality, and negative correlations between parental stress and both the WHO well-being index (r = −0.45) and sleep quality (r = −0.37). Parental stress was also negatively correlated with education, family support, quality of spousal relationships, and the number of prenatal visits.</div></div><div><h3>Conclusion</h3><div>The study highlights the poor state of well-being, more stress, and poor sleep quality among mothers of NICU neonates. The correlations found suggest that enhancing family support and spousal relationships may improve psychological well-being and sleep quality in this population.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102139"},"PeriodicalIF":2.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil-lymphocyte ratio as a point-of-care marker for predicting bacterial etiology in pediatric community-acquired Pneumonia: A comparative analysis with C -reactive protein","authors":"Maya Lakshmanan,&nbsp;Sandeep Kumar,&nbsp;Sowmya Shashidhara,&nbsp;Pushpa Kini,&nbsp;Shrikiran Aroor,&nbsp;Suneel Mundkur,&nbsp;Ramesh Bhat Y,&nbsp;Karen Moras","doi":"10.1016/j.cegh.2025.102148","DOIUrl":"10.1016/j.cegh.2025.102148","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the role of NLR in predicting bacterial etiology in pediatric community acquired pneumonia and compare its diagnostic performance with CRP.</div></div><div><h3>Methods</h3><div>This retrospective analytical study was conducted in a tertiary care center in South India. The clinico-laboratory data of children with pneumonia were reviewed. The diagnostic performance was evaluated using appropriate statistical methods.</div></div><div><h3>Results</h3><div>Among 514 children with community-acquired pneumonia, 398 were included. Bacterial pneumonia was diagnosed in 250 (62.8 %) children. The median NLR among children with bacterial pneumonia was 3.3 (2.18, 5.7) compared to 1.3 (0.685, 2.595) among children with non-bacterial pneumonia [p &lt; 0.001]. A CRP cut-off value of 31.5 mg/L had a sensitivity of 85.2 % and a specificity of 93.2 %, respectively [AUC 0.923; 95 % CI (0.895, 0.952); p &lt; 0.001]. The positive and negative predictive values of CRP to predict bacterial pneumonia were 95.52 % and 78.86 %, respectively, while the positive and negative likelihood ratios were 12.61 (6.92, 22.99) and 0.16 (0.12, 0.21), respectively. An NLR cut-off of 1.74 had a sensitivity of 87.6 % and a specificity of 62.8 %, respectively [AUC 0.78, 95 % CI (0.729, 0.831); p &lt; 0.001]. The positive and negative predictive values of NLR to predict bacterial pneumonia were 79.93 % and 75 %, respectively, while the positive and negative likelihood ratios were 2.36 (1.90, 2.92) and 0.19 (0.14, 0.28), respectively. Bayesian reasoning on positive NLR shifted the post-test probability of bacterial pneumonia to 79.9 %.</div></div><div><h3>Conclusion</h3><div>NLR has moderate specificity and should be viewed primarily as a sensitive, accessible, and rapid screening or triage tool, especially useful in resource-limited settings.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102148"},"PeriodicalIF":2.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of contraceptive morbidity: Associated factors, and its role in further contraceptive utilization – An analytical cross-sectional study from the field practice area of a medical college in Sikkim, India","authors":"Aeleesha Rai,&nbsp;Binu Upreti,&nbsp;Deepika Gurung","doi":"10.1016/j.cegh.2025.102122","DOIUrl":"10.1016/j.cegh.2025.102122","url":null,"abstract":"<div><h3>Background</h3><div>The term “Contraceptive Morbidity\" was coined by the WHO to describe conditions resulting from the use of contraceptive methods such as menstrual irregularities, weight gain, disturbances of appetite, headache, lower abdominal pain, acne, mood swings, decreased libido, dermatitis, uterine perforation etc. The study aimed to examine the role of such contraceptive morbidity in further contraceptive use and to identify the factors associated with contraceptive morbidity.</div></div><div><h3>Materials and methods</h3><div>The present study is a community-based cross-sectional observational epidemiological study conducted over 1 year from July 2022 to July 2023. The study included 410 female partners of eligible couples who were “ever users\" of contraceptives. A pre-designed and pre-tested questionnaire was the study tool. Probability proportional to size sampling was applied to distribute the sample into urban and rural areas. Participants were selected using systematic random sampling. With the help of ASHAs (Accredited Social Health Activists), these individuals were located and data was collected through house-to-house visits.</div></div><div><h3>Result</h3><div>The prevalence of contraceptive morbidity was found to be higher among 31–35 years old, Hindu, unemployed women, from Other Backward Class (OBC), belonging to middle socioeconomic status and lower educational level and having irregular menstrual cycle, and having 1–2 children. Women who received counselling were less likely to report experiencing contraceptive morbidity. On chi-square analysis statistically significant associations were found between age, educational level, occupation, socioeconomic status, reproductive history, and counselling with contraceptive morbidity. 30 % of participants switched their contraceptive method, and 32 % discontinued the method due to contraceptive morbidity. Among those who discontinued, 72 % experienced unintended pregnancies, with 52 % resulting in live births.</div></div><div><h3>Conclusion</h3><div>The discontinuation of contraceptive methods as a result of contraceptive morbidities contributes largely to the unmet need of contraception among women. The findings underscore the importance of improving contraceptive counselling and follow-up care to address contraceptive morbidities and thus reduce the unmet need for contraception among women.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102122"},"PeriodicalIF":1.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}