Frontiers in global women's health最新文献

{"title":"Postpartum common mental disorders and its associated factors in eastern Ethiopia: a community-based cross-sectional study.","authors":"Dejene Tesfaye, Tadesse Misgana, Berhe Gebremichael, Daniel Alemu, Dawit Tamiru, Adisu Birhanu Weldesenbet, Mandaras Tariku, Merga Dheresa","doi":"10.3389/fgwh.2025.1484834","DOIUrl":"10.3389/fgwh.2025.1484834","url":null,"abstract":"<p><strong>Introduction: </strong>Common mental disorders (CMD) cause marked emotional distress and interfere with daily function among postpartum women. In addition, the negative attitude towards mental disorders and their treatments prevents the women from seeking mental healthcare. Very little is known about CMD among women, especially in the postpartum period. This study, therefore, aimed at assessing the prevalence of CMD and its associated factors among women in the postpartum period at Kersa and Haramaya Health and Demographic Surveillance Sites (HDSS) sites, in eastern Ethiopia, between 1 July 2021 and 28 February 2022.</p><p><strong>Methods: </strong>This study employed a community-based cross-sectional study design using a quantitative method and was conducted in Kersa and Haramaya HDSS among 1,016 postpartum women. A structured questionnaire was used to collect data through face-to-face interviews about the variables related to sociodemographic and economic, clinical, psychosocial, substance use, and obstetric complication characteristics. The CMD was assessed by using the Self-Reporting Questionnaire (SRQ-20). A bivariable and multivariable logistic regression analysis was performed. All the variables with a <i>p</i>-value <0.25 in bivariable logistic regression were taken to multivariable logistic regression. Variables with a <i>p</i>-value < 0.05 in the multivariable regression were declared statistically significant associations. The odds ratio (OR) and 95% confidence intervals (CI) were used to show the strength of the association.</p><p><strong>Result: </strong>The prevalence of postpartum CMD was 23.84% (95% CI: 21.21-26.47). Among pregnant women who had CMD, only 103 (27.7%) had CMD and persisted to the postpartum period. Poor social support [adjusted OR (aOR): 1.88, 95% CI: 1.28-2.74], wealth index in the first quantile (aOR: 1.59, 95% CI: 1.06-2.39), presence of obstetric complication (aOR: 7.74, 95% CI: 4.38-13.69), and cesarean delivery (aOR: 5.01, 95% CI: 1.14-22.13) were the factors that showed a statistically significant association with postpartum CMD.</p><p><strong>Conclusion: </strong>One in every four study participants had CMD, which was higher than in studies conducted in Ethiopia among postpartum women. Social support, wealth index, obstetric complications, and mode of delivery were the factors with statistically significant associations. Postpartum women may benefit from the early diagnosis and treatment of CMD at the community and the primary healthcare level, and the integration of mental healthcare into maternal health services.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1484834"},"PeriodicalIF":2.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thirty years after the Cairo declaration on population & development: have family planning measurements caught up?","authors":"Nour Horanieh, Alice Witt, Marieme Fall, Eloisa Montt-Maray, Lamiah Adamjee, Elizabeth Larson, Thais Gonzalez-Capella, Beniamino Cislaghi","doi":"10.3389/fgwh.2025.1548447","DOIUrl":"10.3389/fgwh.2025.1548447","url":null,"abstract":"<p><strong>Introduction: </strong>The 1994 International Conference on Population Development (ICPD) initiated the transition of family planning (FP) programmes from focusing on population control to promoting human rights and women's empowerment. The indicators used to measure success of FP programmes, however, continue to focus on estimating modern contraceptive uptake. Contraceptive Prevalence Rate (CPR) and unmet need are the main indicators used. We aim to assess the views of those working within the FP community from the Global North and South on the use of current indicators for FP programmes. While there have been calls for new measures, understanding the barriers to changing existing ones is essential for adopting and implanting these new measures.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 31 participants from five distinct groups; academics, NGO workers, government officials, funding agency workers and advocates. Participants were working in countries worldwide, including both the Global North and South; the latter were mostly based in Francophone West Africa. Interviews explored several themes including FP targets and indicators. We applied a thematic analysis.</p><p><strong>Results: </strong>Participants' views ranged from those who believed in the need to eradicate current indicators from FP programmes to those expressing contentment with current indicators and their benefit in measuring success. Most of the participants acknowledged the benefit of indicators in assessing progress or as a starting point, yet they identified multiple limitations to their use, including the possibility of implicit coercion, skewing training to focus on long-acting reversible contraceptives (LARCs) promotion, and prioritising modern contraceptive methods over natural ones. Some expressed anxiety that challenging the status quo could lead to funding cuts. Participants identified challenges in adopting new indicators and emphasised that funding for FP programs remains largely concentrated among international agencies based in the Global North, which results in maintaining certain traditional demographic approaches.</p><p><strong>Conclusion: </strong>Current indicators affect the understanding of success of FP programmes and influence how FP services translate on the ground. We provide international stakeholders' perspectives on the barriers to be overcome to support development of new indicators, including non-use of contraception as a success as long as it is a full, free and informed choice.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1548447"},"PeriodicalIF":2.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To operate or not to operate? The impact of surgical treatment on quality of life in women with ovarian endometriosis.","authors":"Emanuela Spagnolo, David Ramiro-Cortijo, Blanca Díaz Fuentes, María Suarez Vega, Lucía Calvillo-Fernández, Ana López, Alicia Hernández","doi":"10.3389/fgwh.2025.1606768","DOIUrl":"10.3389/fgwh.2025.1606768","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a chronic gynecological condition that impacts on women's health, reducing their quality of life. Ovarian endometriosis (OE) and deep endometriosis (DE) are the primary manifestations. While surgical intervention in OE is common, its effects on quality of life remain debated. This study aims to assess global health perception and quality of life in women with OE with and without surgery to inform targeted interventions strategies.</p><p><strong>Methods: </strong>This cross-sectional observational study was conducted at Hospital Universitario La Paz (Spain) and included women aged 25-55 diagnosed with OE, operated (OE-S) or not (OE-NS), as well as those with DE who had surgical resection. Women without endometriosis (control) was also included. Health-related quality of life was measured by SF-36, while pain perception, social support, and endometriosis-specific quality of life were assessed through validated instruments.</p><p><strong>Results: </strong>Regarding global health, physical and social functions, emotional role, body pain, and global mental health did not find difference between groups. However, women with DE and OE-NS had significantly lower physical role and global health scores compared to controls. Vitality and physical component scores were lower in DE, while pain sensitivity was higher in OE-NS and DE. Social support perception was reduced in women with OE compared to controls. Quality of life was significantly lower in DE and OE-NS groups, with OE-S showing intermediate scores. Psychological well-being and endometriosis-related support were significantly low across all endometriosis groups. Sexual and occupational functions were higher in OE- S than in OE- NS and DE. Reproductive function was impaired in OE- NS compared to controls, while menstrual characteristics were significantly altered in all endometriosis groups. OE- S exhibited intermediate health and quality of life patterns between control and DE groups, whereas OE- NS was more similar to DE.</p><p><strong>Conclusion: </strong>Psychological well-being and social support are reduced in all endometriosis groups, but surgical treatment in women with ovarian endometriosis preserve vitality, sexual, and occupational functions. A multidisciplinary approach is essential to improve quality of life in women with endometriosis.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1606768"},"PeriodicalIF":2.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive use and decision-making in Guéra, Chad: a mixed-methods study.","authors":"Vincent de Paul Allambademel, Mahamat Abdelaziz, Natalie Andrasko, Bongo Goumbo, Robert Madjigoto, Alexis Ngarmbatedjimal, Solal Noubadjim, Salomon Tamira, Theodora Varelis, Katchebe Vourbane, Sara E Casey","doi":"10.3389/fgwh.2025.1516757","DOIUrl":"10.3389/fgwh.2025.1516757","url":null,"abstract":"<p><strong>Background: </strong>Chad has one of the highest maternal mortality ratios in the world, and low modern contraceptive prevalence. Understanding the barriers and influences on women's decision-making around contraceptive use is critical to reducing the unmet contraceptive need, and thus maternal mortality.</p><p><strong>Methods: </strong>A mixed-methods study was conducted in three districts of Guéra province, Chad, including a longitudinal survey of women, focus group discussions with male and female users and non-users of modern contraceptives, and in-depth interviews with midwives, community health workers, and community leaders.</p><p><strong>Results: </strong>Survey participants showed increased knowledge of modern contraceptive methods, and 20.5% reported current modern contraceptive use at endline. Participants described multiple reasons for contraceptive non-use, including that it contradicts with their religious beliefs, community stigma and widespread misconceptions, particularly around long-acting reversible contraceptives. Husbands played a large role in a couple's contraceptive decision-making, as either a major facilitator or barrier depending on the individual.</p><p><strong>Discussion: </strong>Overall, the study's findings suggest that participant awareness of modern contraceptive methods increased. Contraceptive use was more than twice as high as the provincial rate. Given the dominance of injectables within our sample, programs should explore introducing and scaling up community-based distribution of the self-injectable contraceptive (DMPA-SC). The findings highlight the need for more diverse and tailored stigma reduction interventions in the community to promote awareness and reduce misconceptions of modern contraceptives among key groups of people, including men, couples, and religious and other community leaders. Values clarification and attitude training should be considered for all cadres of providers to promote non-discrimination and equity in contraceptive service provision.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1516757"},"PeriodicalIF":2.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between mammography reports and women's age using retrospective data form a medical system.","authors":"Wen-Mi Chang, Yi-Chun Chen, I-Cheng Lu, Jen-Lung Chen, Hung-Yi Chuang","doi":"10.3389/fgwh.2025.1561669","DOIUrl":"10.3389/fgwh.2025.1561669","url":null,"abstract":"<p><strong>Objective: </strong>We explored the association of age, obesity and marital status with Breast Imaging Reporting and Data System (BI-RADS) category distribution in women, using retrospective mammography data from a medical system, as only a few studies have investigated this association.</p><p><strong>Materials and methods: </strong>This retrospective study collected the first left-lateral and right-lateral mammography data of 4,165 and 4,213 women from 2,011 to 2020 in a medical system, respectively, to be analyzed. We examined the association of age, body mass index (BMI), and marital status with BI-RADS categories using the Chi-square test and multinomial logistic regression.</p><p><strong>Results: </strong>The proportion of BI-RADS category 0 decreased with age, but the proportion of BI-RADS categories 4 and 5 increased with age. Women aged >69 years had a higher proportion of BI-RADS categories 4 and 5 [adjusted odds ratio (aOR) = 1.34 for left-lateral mammography and aOR = 1.29 for right-lateral mammography data] than women aged 45-69 years. Overweight was associated with the rate of the proportion of BI-RADS categories 4 and 5 of the left-lateral breast (aOR = 1.26, <i>p</i> < 0.05) but not with the right-lateral breast.</p><p><strong>Conclusions: </strong>Age >69 years, being overweight, and being separated/divorced/widowed were the factors associated with BI-RADS categories 4 and 5 of women who underwent mammography.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1561669"},"PeriodicalIF":2.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncovering the hidden implications of water scarcity for maternal health: a photovoice study in rural Malawi (Thyolo district).","authors":"Chiara Pittalis, Elizabeth Kogoya, Antonio Jaén Osuna, Christabel Kambala","doi":"10.3389/fgwh.2025.1588219","DOIUrl":"10.3389/fgwh.2025.1588219","url":null,"abstract":"<p><strong>Introduction: </strong>Access to clean water is essential for health, but in rural Malawi, water scarcity significantly threatens the health of postpartum women and their babies. Water is critical not only for hydration but also for hygiene, preventing infections, and promoting overall health, particularly during the postpartum period. Despite women's central role in water management within their households, they are seldom included in discussions about water access and management at the community level or within formal governance structures, where decisions are often made without their input. As climate change exacerbates water scarcity, addressing these challenges becomes increasingly urgent for maternal and child health.</p><p><strong>Goal & methods: </strong>This study aimed to create space for postpartum women to document and share their experiences with water scarcity and its implications through participatory photography. Eight women from rural communities in Thyolo District, Southern Malawi, were trained in photography and ethics. They captured images reflecting the challenges they faced with water access and maternal health. Through gallery walks and group discussions, photovoice allowed women to share the stories behind their images, providing deeper insight into the emotional, social and health implications of water insecurity. A phenomenological analysis was conducted to interpret the photographs and narratives.</p><p><strong>Results: </strong>The women's photographs and stories highlighted the multifaceted impact of water scarcity on health. They depicted not only the physical toll of water collection but also the emotional stress and heightened risk of infection due to inadequate sanitation. Through photovoice, the women conveyed a powerful narrative of vulnerability, resilience and frustration, revealing issues that are often invisible in traditional health research.</p><p><strong>Conclusion: </strong>Photovoice proved to be an effective tool for amplifying the voices of marginalized postpartum women, enabling them to highlight the urgent need for clean water access. This approach not only raised awareness of water-related health issues but also provided valuable insights into the lived realities of women in rural Malawi. As climate change continues to intensify water scarcity, these findings underscore the need for sustainable, community-driven solutions. The study offers a model for inclusive research on global health challenges, particularly in vulnerable communities.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1588219"},"PeriodicalIF":2.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship stigma negatively impacts the relationship quality of trans women.","authors":"Emily S Schuler, Pilar C Sharp, Omotayo N Fasan, Araya J McNeal, Tae-Young Zajkowski, Vinita Saxena, Audrey Xu, Bow Suprasert, Sean Arayasirikul, Alexander J Marr, Kelly D Taylor, Willi McFarland, Erin C Wilson","doi":"10.3389/fgwh.2025.1533060","DOIUrl":"10.3389/fgwh.2025.1533060","url":null,"abstract":"<p><strong>Background: </strong>Trans women face negative health outcomes due to multiple types of anti-trans stigma. Relationship stigma, or when people experience stigma because their romantic partnerships are devalued by society, can negatively impact experiences in relationships of trans women. Relationships and their quality are important predictors of wellness across populations, but little is known about relationship quality for trans women. This study was conducted to determine whether relationship stigma is associated with relationship quality for trans women with main partners.</p><p><strong>Methods: </strong>This is a secondary analysis of data from 89 trans women with main partners enrolled in the 2020 Partners Study, an online, interviewer-administered, cross-sectional survey of trans women in the San Francisco Bay Area. Multivariate logistic was used to test for an association between relationship stigma and relationship quality among trans women with main partners.</p><p><strong>Results: </strong>The trans women surveyed were White (29.2%), Latinx (24.7%), or multiracial (23.6%), with the majority having never been married (65.2%). Those who often felt they must hide their partnerships had significantly lower odds of reporting satisfaction with intimacy and closeness in their relationships [odds ratio (OR): 0.07; 95% confidence interval (CI): 0.01-0.68, <i>p</i> = 0.02] and of reporting satisfaction with their overall relationship (OR: 0.02; 95% CI: 0.02-0.34, <i>p</i> < 0.01). Those whose families were not supportive of their partnerships had significantly lower odds of reporting relationship satisfaction, intimacy, and closeness with their main partners (OR: 0.08; 95% CI: 0.01-0.85, <i>p</i> = 0.04) and of reporting satisfaction with their overall relationship (OR: 0.08; 95% CI: 0.00, 0.51, <i>p</i> = 0.01).</p><p><strong>Conclusions: </strong>Relationship stigma was negatively associated with relationship quality for trans women with main partners in this study. Stigma from family also had a significant negative impact on relationship quality, suggesting the important influence of family on trans women's relationships. Efforts to boost family support may foster intimacy and improve relationship satisfaction for trans women in main partnerships.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1533060"},"PeriodicalIF":2.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the low uptake of LARC in Ethiopia: an analysis of individual-level predisposing and enabling factors.","authors":"Mintesnot T Teni, Travis Loux, Ness Sandoval, Anne Sebert Kuhlmann","doi":"10.3389/fgwh.2025.1547891","DOIUrl":"10.3389/fgwh.2025.1547891","url":null,"abstract":"<p><strong>Introduction: </strong>According to the 2019 Ethiopian Demographic and Health Survey (EDHS) only 11% of married reproductive-age women in Ethiopia use long-acting reversible contraceptives (LARCs). This study aimed to identify individual characteristics associated with LARC uptake compared to short-acting contraceptives, traditional and barrier methods, and non-contraceptive use.</p><p><strong>Methods: </strong>Data from the 2019 Performance Monitoring for Action (PMA) Ethiopia survey (<i>n</i> = 8,182) were used to run multilevel logistic regression models. The sample includes sexually active reproductive-age women (15-49 years). Independent variables were grouped into predisposing and enabling factors guided by the Andersen Behavioral Model of Health Services.</p><p><strong>Results: </strong>LARC uptake in this study was 9.7%. Older, single, nulliparous, and Muslim women had lower LARC use than non-contraceptive and traditional/barrier method use. When compared to short-acting method use, low LARC use was associated with smaller household size and no exposure to family planning information. When compared to all other groups, contraceptive autonomy was associated with higher LARC uptake. Younger women and women living in rural areas were less likely to use IUDs than implants.</p><p><strong>Discussion: </strong>Policymakers could use these findings to tailor interventions to specific populations with low LARC uptake. Training providers on counseling and LARC eligibility could help improve LARC uptake among populations, including less-empowered women. Involving religious leaders in contraceptive health education has the potential to increase LARC use.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1547891"},"PeriodicalIF":2.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine-learning algorithm to predict home delivery after antenatal care visit among reproductive age women in East Africa.","authors":"Agmasie Damtew Walle, Shimels Derso Kebede, Jibril Bashir Adem, Daniel Niguse Mamo","doi":"10.3389/fgwh.2025.1461475","DOIUrl":"10.3389/fgwh.2025.1461475","url":null,"abstract":"<p><strong>Background: </strong>Maternal and child health remains a global public health issue, particularly in low- and middle-income countries where maternal and child mortality are extremely high. The World Health Organization estimates that close to 287,000 women die annually due to pregnancy and childbirth complications, and the majority of these deaths occur where skilled birth attendants are not readily available. Reducing the prevalence of home delivery is a key strategy for lowering the maternal mortality rate. Although several studies have explored home delivery and antenatal care (ANC) utilization independently, limited evidence exists on predicting home delivery after ANC visits using machine-learning approaches in East Africa.</p><p><strong>Methods: </strong>This study utilized a community-based, cross-sectional design with data from the most recent Demographic and Health Surveys conducted between 2011 and 2021 in 12 countries in East Africa countries. A total weighted sample of 44,123 women was analyzed using Python version 3.11. Nine supervised machine-learning algorithms were applied, following Yufeng Guo's steps for supervised learning. The random forest (RF) model, selected as the best-performing algorithm, was used to predict home delivery after ANC visits. A SHapley Additive exPlanations analysis was conducted to identify key predictors influencing home delivery decisions.</p><p><strong>Results: </strong>Home delivery after ANC visits was most prevalent in Malawi (17.88%), Uganda (15.38%), and Kenya (11.3%), and was low in Comoros (2.38%). Living in rural areas and late ANC initiation (second trimester) increased the likelihood of home delivery. In contrast, factors such as higher household income, husband's level of primary and secondary education, contraceptive use, shorter birth intervals, absence of distance-related barriers to healthcare, and attending more than four ANC visits were associated with a lower likelihood of home delivery.</p><p><strong>Conclusion: </strong>The study demonstrates that home delivery after ANC visits was high. The RF machine-learning algorithm effectively predicts home delivery. To reduce home deliveries, efforts should improve early ANC initiation, enhance healthcare quality, and expand facility-based services. Policymakers should prioritize increasing health facility accessibility, promoting media-based health education, and addressing financial barriers for women with low incomes. Strengthening these areas is crucial for improving maternal and neonatal health outcomes in East Africa.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1461475"},"PeriodicalIF":2.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstetric violence: perspectives from mothers, midwives, and obstetricians.","authors":"Zaira Reyes-Amargant, Concepció Fuentes-Pumarola, Marta Roqueta-Vall-Llosera, Josep Garre-Olmo, David Ballester-Ferrando, Carolina Rascón-Hernán","doi":"10.3389/fgwh.2025.1609632","DOIUrl":"10.3389/fgwh.2025.1609632","url":null,"abstract":"<p><strong>Background: </strong>According to the World Health Organization (WHO), the majority of the 140 million annual births occur without complications. Women desire a positive birth experience based on respectful care, clear information, and emotional support, which enables them to make informed decisions and maintain control over their reproductive process. However, many women experience disrespectful or abusive treatment during obstetric care, with lasting consequences for both their physical and mental health. This study explores the factors that influence respectful maternal care and the phenomenon of obstetric violence, as perceived by mothers, midwives, and obstetricians.</p><p><strong>Methodology: </strong>A qualitative study using a phenomenological approach was conducted in eight public and private hospitals in the Girona Health Region (Catalonia, Spain) between 2021 and 2022. In-depth interviews were conducted with eight mothers and eight healthcare professionals (midwives and obstetricians) selected through purposive sampling. The interviews were transcribed verbatim and analysed using thematic analysis to identify meaningful units and key themes.</p><p><strong>Results: </strong>The narratives collected allowed for the identification of key elements of non-respectful maternal care. A lack of information during pregnancy and childbirth emerged as a central concern for both mothers and professionals, affecting their sense of control and satisfaction. Poor communication with healthcare providers, particularly with anaesthesiologists and obstetricians, was perceived as a barrier to quality care. Mothers reported experiences of disrespect, the absence of informed consent for procedures such as episiotomies, and paternalistic treatment. Obstetricians showed resistance to the term \"obstetric violence,\" while midwives recognized it as practices and attitudes that negatively affect the maternal experience.</p><p><strong>Conclusions: </strong>The discrepancy between professional perspectives and mothers' experiences highlights the urgent need for transformation in obstetric care. It is crucial to promote a care model based on evidence, effective communication, and respect for women's rights. Incorporating a gender perspective into healthcare training and strengthening public policies to ensure respectful obstetric care are essential measures to improve the quality of care and prevent obstetric violence.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1609632"},"PeriodicalIF":2.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}