Frontiers in global women's health最新文献

{"title":"Factors associated with sexually transmitted infections among reproductive age women in Ivory Coast: evidenced by 2021 Ivory Coast Demographic and Health Survey.","authors":"Gosa Mankelkl, Beletu Kinfe","doi":"10.3389/fgwh.2025.1490762","DOIUrl":"10.3389/fgwh.2025.1490762","url":null,"abstract":"<p><strong>Background: </strong>Globally, sexually transmitted infections (STIs) continue to be a major public health problem. STIs are a major cause of morbidity and mortality in many developing countries due to their effects on reproductive and child health and their role in spreading HIV infection. This study ' to determine the factors associated with STIs among women in Ivory Coast using data from the 2021 Ivory Coast Demographic and Health Survey (DHS).</p><p><strong>Methods: </strong>A total of 14,877 women from the 2021 Ivory Coast Demographic and Health Survey participated in this study. The Ivory Coast DHS employed a community-based cross-sectional study design for data collection. STATA version 14 was used for data extraction, recoding, descriptive analysis, and analytical analysis. Bivariable analysis was performed to identify factors for multivariable analysis. In the multivariable analysis, factors with a significance level of <i>P</i> < 0.05 were considered significant predictors of STIs among reproductive-age women. Finally, frequency, percentage, and odds ratios with a 95% confidence interval were reported.</p><p><strong>Result: </strong>This study includes a total weighted sample of 14,877 women from the 2021 Ivory Coast Demographic and Health Survey. The prevalence of STIs among reproductive-age women in the last 12 months was 6.82%, with a 95% CI (6.42, 7.23). The results of the multivariate analysis showed that among women, STIs were statistically and significantly associated with age range of 20-24 years [adjusted odds ratio (AOR): 1.558, 95% CI: (1.108, 2.359); <i>P</i> = 0.011], 25-29 years [AOR: 1.523, 95% CI: (1.089, 2.129); <i>P</i> = 0.014], and 30-34 years [AOR: 1.655, 95% CI: (1.191, 2.300); <i>P</i> = 0.003]; living in Denguele [AOR:2.138, 95% CI: (1.328, 3.439); <i>P</i> = 0.002], Montagnes [AOR: 2.930, 95% CI: (1.909, 4.497); <i>P</i> = 0.0001], and Zanzan [AOR: 2.330, 95% CI: (1.476, 3.679); <i>P</i> = 0.0001]; being married [AOR: 0.705, 95% CI: (0.520, 0.975); <i>P</i> = 0.034]; being Muslim [AOR: 0.785, 95% CI: (0.621, 0.993); <i>P</i> = 0.011]; listening to radio at least once a week [AOR: 1.524, 95% CI: (1.241, 1.871); <i>P</i> = 0.0001]; watching television less than once a week [AOR: 1.649, 95% CI: (1.156, 2.352); <i>P</i> = 0.006]; using the internet almost every day [AOR: 1.359, 95% CI: (1.081, 1.708); <i>P</i> = 0.008]; having a history of a terminated pregnancy [AOR: 1.170, 95% CI: (1.017, 1.376); <i>P</i> = 0.043]; using modern contraceptives [AOR: 1.213, 95% CI: (1.032,1.427); <i>P</i> = 0.0001]; and being tested for HIV [AOR: 1.342, 95% CI: (1.149, 1.569); <i>P</i> = 0.0001].</p><p><strong>Conclusion and recommendations: </strong>This study found that nearly seven out of a hundred reproductive-age women in Ivory Coast had sexually transmitted infections, influenced by factors such as age group, region, religion, marital status, media exposure (reading magazines, watching television, and using the inte","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1490762"},"PeriodicalIF":2.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095955","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":"Quality of life of women with urinary incontinence in the postpartum period: an integrative literature review.","authors":"Filipa Daniela Lopes, Carolina Henriques, Maria da Saudade Lopes, Isabel Margarida Mendes","doi":"10.3389/fgwh.2025.1562572","DOIUrl":"https://doi.org/10.3389/fgwh.2025.1562572","url":null,"abstract":"<p><p>Urinary incontinence (UI) during pregnancy and after childbirth can negatively impact women's lifestyles, health, and well-being. It is a common problem that is often normalized by both healthcare professionals and women. This integrative review examines the influence of UI on women's quality of life (QoL) during the postpartum period and identifies the main affected domains. It will also contribute to the discussion of the results of a primary study. Fourteen studies were included in this review, mainly from Brazil and Spain, with most using quantitative methods. The findings indicate that UI negatively affects the QoL of women during the postpartum period, with mixed UI causing greater discomfort despite stress UI being more frequent. The main affected domains are general health perception, physical functioning, daily life activities, psychological/emotional/mental and social aspects, and sexuality. Effective interventions should promote women's self-care and enhance their awareness and recognition of the problem. These interventions should go beyond physical aspects to address emotional and psychological dimensions, such as low self-esteem and self-image, secrecy, embarrassment, and reluctance to seek help. Nurse midwives have specialized skills and can work within multidisciplinary teams to improve the QoL of women with UI at a time of increased vulnerability.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1562572"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082514","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":"Intimate partner sexual violence and early resumption of sexual intercourse among married postpartum women in Ethiopia: a survival analysis using Performance Monitoring for Action data.","authors":"Eyob Tilahun Abeje, Fekade Demeke Bayou, Fekadeselassie Belege Getaneh, Lakew Asmare, Abel Endawkie, Alemu Gedefie, Amare Muche, Anissa Mohammed, Aznamariam Ayres, Dagnachew Melak","doi":"10.3389/fgwh.2025.1499316","DOIUrl":"https://doi.org/10.3389/fgwh.2025.1499316","url":null,"abstract":"<p><strong>Introduction: </strong>Many women worldwide resume sexual intercourse soon after childbirth, often before the recommended six-week recovery period. Early postpartum intercourse poses health risks, including infections and delayed healing. This study aims to assess the timing of resuming sexual intercourse and its predictors among postpartum women in Ethiopia using PMA data.</p><p><strong>Methods: </strong>The data was from the Performance Monitoring for Action (PMA) project, a cross-sectional design followed by cohort follow-up, employed to analyze the sociodemographic and reproductive characteristics of women aged 15-49. Pregnant women and those up to nine weeks postpartum at baseline were included in the study. Descriptive statistics and Cox proportional hazard model were used for analysis using R 4.4.1 software. Proportional hazard assumption was assessed using graphical and statistical tests. The model fitness was checked using martingale residual plot.</p><p><strong>Results: </strong>The study found that 29% of participants resumed sexual intercourse before the recommended 42 days postpartum, while 91% resumed by 68 days. The median survival time was 8 weeks (57 days). The hazard of early sexual resumption was 5.56 times higher among women who experienced intimate partner violence compared to those who did not.</p><p><strong>Discussion: </strong>Early sexual resumption among postpartum women in Ethiopia was high. Intimate Partner violence was a significant predictor of early sexual resumption. It is better to promote IPV prevention and postpartum couple counseling to support safe and consensual sexual resumption.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1499316"},"PeriodicalIF":2.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082508","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":"Exploration of fever characteristics in parturients under continuous temperature monitoring during labor analgesia and analysis of the impact on maternal and neonatal outcomes: an observational study.","authors":"Xia Li, Junli Ma","doi":"10.3389/fgwh.2025.1541227","DOIUrl":"10.3389/fgwh.2025.1541227","url":null,"abstract":"<p><strong>Objective: </strong>By continuous core temperature monitoring, this study aims to explore the patterns of fever in parturients receiving labor analgesia and analyze its impact on both the maternal and neonatal.</p><p><strong>Methods: </strong>Non-invasive temperature monitoring sensors (iThermonitor705) and labor analgesia temperature management system were used to collect temperature data from parturients. Based on the presence or absence of fever during the peripartum period, the subjects were divided into a fever group and a non-fever group. Maternal temperature data during the peripartum period, along with maternal and neonatal demographic and clinical characteristics, were collected.</p><p><strong>Results: </strong>Among the parturients receiving labor analgesia, 25.9% (43/166) developed a fever during the peripartum period. Of these, 25.6% (11/43) experienced their first fever after delivery, all occurring within 2 h after delivery. Compared to the non-fever group, the fever group had longer durations of the first stage of labor, total labor duration, and epidural analgesia. Additionally, the fever group had a higher rate of meconium-stained amniotic fluid (grade III), used more analgesics, and had a higher rate of antibiotic use. However, no significant differences in adverse maternal and neonatal outcomes were observed between the two groups.</p><p><strong>Conclusion: </strong>Fever can occur not only during labor but also for the first time after delivery. Although fever during the peripartum period increases the rate of maternal exposure to antibiotics, there were no significant differences in maternal or neonatal outcomes between the two groups.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1541227"},"PeriodicalIF":2.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029918","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":"Epidemiology of second trimester induced abortion in Ethiopia: a systematic review and meta-analysis.","authors":"Mesfin Abebe, Tsion Mulat Tebeje, Nebiha Yimer, Tesfaye Temesgen, Getnet Melaku, Habtamu Endashaw Hareru","doi":"10.3389/fgwh.2025.1452114","DOIUrl":"https://doi.org/10.3389/fgwh.2025.1452114","url":null,"abstract":"<p><strong>Background: </strong>Second-trimester induced abortion refers to the termination of a pregnancy occurring between 13 and 28 weeks of gestation in Africa. These abortions are particularly concerning due to the heightened risk of complications and maternal mortality. In Ethiopia, there is a lack of nationally representative data regarding the magnitude and associated factors of second-trimester induced abortions. This systematic review and meta-analysis aimed to ascertain the pooled magnitude and identify the factors associated with second-trimester induced abortions in Ethiopia.</p><p><strong>Methods: </strong>The PRISMA guidelines were used to review and report this study. A systematic literature search was conducted to identify relevant articles from online databases, including PubMed/MEDLINE, Web of Science, Google Scholar, and Ethiopian University online repositories. Data were extracted using an Excel data extraction format, and analysis was performed using Stata version 17. A meta-analysis was conducted using a random-effects model, and subgroup analysis was performed based on the year of publication and sample size to identify the source of heterogeneity. To determine publication bias, a funnel plot, and Egger's regression test were conducted.</p><p><strong>Results: </strong>In this review, a total of ten articles encompassing 4,466 participants were analyzed. The pooled prevalence of second-trimester induced abortion in Ethiopia was found to be 29.10% (95% CI: 19.96-38.24; <i>I</i>² = 97.84, <i>P</i> < 0.000). Delay in confirming pregnancy (POR = 4.33, 95% CI: 2.25, 8.32), nature of the menstrual cycle (POR = 0.32, 95% CI: 0.18, 0.56), residence (POR = 0.38, 95% CI: 0.30, 0.49), and pregnancy intention (POR = 0.28, 95% CI: 0.18, 0.42) were significantly associated with second-trimester induced abortion.</p><p><strong>Conclusions: </strong>The magnitude of induced second-trimester abortions in Ethiopia is significantly higher than global data. This meta-analysis identifies factors associated with second-trimester abortions, including delayed pregnancy confirmation, irregular menstrual cycles, rural residency, and unplanned pregnancies. The findings highlight the urgent need for targeted interventions to address these factors and decrease the incidence of second-trimester abortions. Encouraging early pregnancy testing and confirmation to reduce delays, raising awareness about the importance of regular menstrual cycles and seeking medical advice for irregularities, improving healthcare services in rural areas to reduce disparities, and strengthening family planning and counseling services can help mitigate unplanned pregnancies and induced abortions.</p><p><strong>Systematic review registration: </strong>PROSPERO (CRD42022383559).</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1452114"},"PeriodicalIF":2.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032177","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 impact of a home visiting program on the care environment of Brazilian adolescent mothers - an descriptive exploratory study.","authors":"Letícia Aparecida da Silva, Luciola Demery Siqueira, Larayne Gallo Farias Oliveira, Euripedes Constantino Miguel Filho, Guilherme Vanoni Polanczyk, Lislaine Aparecida Fracolli","doi":"10.3389/fgwh.2025.1530351","DOIUrl":"https://doi.org/10.3389/fgwh.2025.1530351","url":null,"abstract":"<p><strong>Background: </strong>There is evidence of a link between the environment and child development (CD) in early childhood, justifying the importance of studying the characteristics of the environment in order to understand it and thus intervene in CD.</p><p><strong>Objectives: </strong>To describe the changes in the environment of families who participated in the Young Caring Mothers Programme (YCMP).</p><p><strong>Method: </strong>This is an exploratory, descriptive study focusing on the home environment of adolescent mothers and their babies supported by the YCMP, derived from the randomised controlled clinical trial \"The effect of the Young Pregnant Women Visitation Program on child development: a pilot study\" (registered at clinicaltrial.gov; identifier: NCT02807818).</p><p><strong>Sample: </strong>80 pregnant adolescents, 40 in the intervention group (IG) and 40 in the control group (CG).</p><p><strong>Instrument: </strong>IT-HOME inventory.</p><p><strong>Results: </strong>At 6 and 12 months, both groups showed a tendency for the median to increase, although this increase was more pronounced in the IG. From 12 to 24 months, both groups showed a tendency for the median to decrease, with a more marked decrease in the CG, which reached values lower than those previously observed. No significant differences were found between the groups in the overall IT-HOME scores, but it was found that the relationship between maternal schooling and the score on the subscales emotional and verbal responsibility of the caregiver was greater in the control group (4. 5 points more) in mothers with less schooling (primary school) than in mothers with the same schooling in the control group (<i>p</i> = 0.02), this satisfactory result was obtained in the 6 and 24 month measurements, in the latter the intervention group scored 3 points higher than the control group (<i>p</i> = 0.05).</p><p><strong>Discussion: </strong>The results show a small impact of the YCMP on the quality of the \"environment\" of the families supported, but the impact is on a dimension of the environment that is very important for child development: responsive relationships of the mother with low schooling and high vulnerability.</p><p><strong>Conclusions: </strong>The YCMP can have an impact on the care environment of children under 3 years of age in families with high social vulnerability.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1530351"},"PeriodicalIF":2.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054472","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":"Healthcare providers' readiness to screen for intimate partner violence in obstetrics and gynecology units in Amhara regional state referral hospitals, Ethiopia: validation and cross-sectional survey using the DVHCPSS tool.","authors":"Kidist Ayalew Abebe, Tirusew Nigussie Kebede, Birhan Tsegaw Taye, Mulualem Silesh, Mesfin Tadese, Moges Sisay Chekol, Tesfanesh Lemma Demisse, Betel Bogale Workineh, Abayneh Akililu Solomon, Bayew Kelkay Rade, Getie Lake Aynalem","doi":"10.3389/fgwh.2025.1408703","DOIUrl":"https://doi.org/10.3389/fgwh.2025.1408703","url":null,"abstract":"<p><strong>Introduction: </strong>Intimate partner violence (IPV) is most prevalent among women of reproductive age and can have lifelong consequences. Screening within healthcare settings represents a promising first step toward addressing IPV, with healthcare providers playing a central role in this response. A lack of healthcare provider readiness to screen for IPV may leave victims vulnerable to continued physical, psychological, sexual, and reproductive health problems. This study aimed to assess the readiness of healthcare providers to screen for IPV and to identify factors affecting screening practices in obstetrics and gynecology units of referral hospitals in Amhara regional state, Ethiopia.</p><p><strong>Methods: </strong>An institution-based cross-sectional study was conducted between 9 January and 4 February 2023. A simple random sampling technique was employed to select study participants. A pilot study was conducted to assess the reliability and construct validity of the tool, and data were collected using a self-administered questionnaire. The data were entered into EPI-Data version 4.6 and analyzed using STATA version 14. Bivariable and multivariable logistic regression models were applied to identify associated factors.</p><p><strong>Result: </strong>From 409 study participants, 46.5% [95% confidence interval (CI): 42-51] were ready to screen for IPV among reproductive-aged women. Being male [adjusted odds ratio (AOR) = 1.64, 95% CI: 1.03-2.61], trained in IPV (AOR = 2.84, 95% CI: 1.64-4.94), favorable attitude toward IPV screening (AOR = 2.21, 95% CI: 1.42-3.44), good knowledge of IPV (AOR = 2.23, 95% CI: 1.42-3.50), and availability of IPV guidelines in their working area (AOR = 1.74, 95% CI: 1.07-2.81) were found to be significantly associated factors with healthcare providers' readiness to screen for IPV.</p><p><strong>Conclusion: </strong>In this study, fewer than half of the healthcare providers were found to be ready to screen for IPV. Factors that significantly influenced their readiness included the availability of training on IPV, positive attitudes toward IPV screening, adequate knowledge about IPV, and access to IPV screening guidelines within their work environment.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1408703"},"PeriodicalIF":2.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993746","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 ripple effect: impacts of climate change on menstrual health and paths to resilience.","authors":"Arundati Muralidharan, Marije Broekhuijsen, Lady Lisondra, Aeka Guru, Jacquelyn Haver, Sidra Irfan","doi":"10.3389/fgwh.2025.1569046","DOIUrl":"https://doi.org/10.3389/fgwh.2025.1569046","url":null,"abstract":"<p><p>Girls and women face greater threats and severe ramifications from climate change, with studies consistently finding that women experience more health risks from climate change than men do. Climate change endangers girls and women's sexual and reproductive health and rights, including their menstrual health and hygiene practices. However, menstrual health and hygiene is rarely discussed in the context of climate change. We scoped the existing evidence to describe the interlinkages between climate change and menstrual health and hygiene, and outline services that anticipate, respond to, cope with, recover from, adapt to or transform in response to climate related events, trends and disturbances. Specifically, we describe how climate change disrupts access to essential menstrual health and hygiene information, products and services, impacts menstrual disorders and the menstrual cycle, and intensifies existing inequalities. Recommendations for improvement include climate resilient menstrual health and hygiene services encompassing access to menstrual products and materials, impartment of knowledge and skills, access to climate resilient facilities and services, social support, and policy actions.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1569046"},"PeriodicalIF":2.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054474","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":"Reasons for maternal near-miss in Bahir Dar city administration, northwest Ethiopia: a qualitative interview approach using socio-ecological model.","authors":"Yinager Workineh, Getu Degu Alene, Gedefaw Abeje Fekadu","doi":"10.3389/fgwh.2025.1535379","DOIUrl":"https://doi.org/10.3389/fgwh.2025.1535379","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal near-miss means the experience of a woman who encounters complications of pregnancy, childbirth, or within 42 days of termination but survives. Maternal near-miss is common in developing nations like Ethiopia. Exploring healthcare system risk factors and opportunities informs policy, but understanding the complex contributors to maternal near-miss remains limited in the Ethiopian context. Therefore, this study aims to explore reasons using a socio-ecological model in Bahir Dar City, Ethiopia, 2023.</p><p><strong>Methods: </strong>A phenomenological study was conducted in the rural part of Bahir Dar city administration, northwest Ethiopia, from September 28th-December 10th, 2023. In-depth interviewees were women who experienced maternal near-miss. Key informants included husbands, women development army leaders, health extension workers, obstetric care providers, and health office holders. Participants were purposively selected until information saturation was reached, after interviewing twenty-five individuals. Data were collected using open-ended interview guides, with audio recordings and field notes. Verbatim transcription was conducted after each interview, and contextual translation was used to translate Amharic transcripts into English. Findings were made trustworthy through data triangulation, member checks, clear descriptions, and contextual translation. Data were analyzed using the framework analysis technique with Open Code 4.03, and results were reported within each theme.</p><p><strong>Results: </strong>Based on the Socio-Ecological Model, risk factors, protective factors, and strategies emerged from in-depth and key informant interviews. Individual-level reasons included poor knowledge, trust in traditional practices, and lack of decision-making power. Family-level contributors included male dominance, negligence, and disagreement. Organizational-level reasons encompassed non-compassionate care, resource scarcity, consultation delays, and lack of privacy. Community-level contributors included rumors, conflicts, transportation barriers, and harmful cultural practices. Public policy-level reasons were a lack of cascading protocols or guidelines and lengthy referral bureaucracy. Protective factors against maternal near-miss were identified at various levels, including self-care, acceptance of instruction, adaptation to modern healthcare, family trust-relationship, exempted services, mentorship, a three-tier healthcare system, and enhanced community engagement.</p><p><strong>Conclusion: </strong>Maternal near-miss was determined by complex contributors and opportunities at intrapersonal, interpersonal, organizational, community, and policy-level. We recommend addressing risk factors and utilizing potential opportunities to prevent maternal near-miss.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1535379"},"PeriodicalIF":2.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052209","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":"Spatial disparities and determinants of modern contraceptive use among reproductive age women in Ethiopia: application of multilevel spatial analysis.","authors":"Bisrategebriel Tesfaye Muchie, Ashenafi Abate Woya, Awoke Seyoum Tegegne, Maru Zewdu Kassie, Muluhabt Alene Assfaw, Wondaya Fenta Zewdia","doi":"10.3389/fgwh.2025.1505789","DOIUrl":"https://doi.org/10.3389/fgwh.2025.1505789","url":null,"abstract":"<p><strong>Background: </strong>Contraception aims to prevent unintended pregnancies, significantly impacting maternal and infant mortality in sub-Saharan Africa, especially in Ethiopia. This study investigates factors influencing modern contraceptive use among reproductive-age women in Ethiopia.</p><p><strong>Methods: </strong>We analyzed the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) dataset, which includes 8,196 weighted samples of women and girls aged 15-49. Data management utilized STATA version 17, R version 4.2.2, and Arc GIS 10.8 for mapping. We employed multilevel and spatial analyses to identify determinants.</p><p><strong>Results: </strong>Only 26% of the women used modern contraceptives, with notable spatial clustering (Global Moran's Index = 0.237776, <i>p</i> < 0.001). Hotspots were identified in Benishangul-Gumuz; Gambela; Southern Nations, Nationalities, and Peoples' Region (SNNPR); and eastern Oromia. Being in the 25-34 age group [adjusted hazard ratio (AHR) = 1.346, 95% CI: 1.143, 1.585]; having a higher [adjusted odds ratio (AOR) = 1.919, 95% CI: 1.380, 2.669], secondary (AOR = 1.554, 95% CI: 1.261, 1.914), or primary education level (AOR: 1.3514, 95% CI: 1.1624, 1.5712); being married (AOR = 25.953, 95% CI: 20.397, 32.942); and higher community wealth (AOR = 1.497, 95% CI: 1.114, 2.011) were positively associated with contraceptive usage, whereas being aged 35-49 (AOR = 0.538, 95% CI: 0.446, 0.649), having three or more children (AOR = 0.634, 95% CI: 0.460, 0.872), and living in the Somali region (AOR = 0.114, 95% CI: 0.045, 0.2882) were negatively associated with contraceptive usage. The best-fitting model included individual, community, and spatial variables, with an intra-class correlation coefficient indicating that 15.57% of the variability in contraceptive use was due to cluster differences.</p><p><strong>Conclusions: </strong>Modern contraceptive use among Ethiopian women is low and varies by cluster. Factors positively associated include age of 25-34, education, marital status, and community wealth. Conversely, women aged 35-49, those with three or more children, and those in the Somali region showed lower usage. Community-level interventions are necessary to improve modern contraceptive adoption.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1505789"},"PeriodicalIF":2.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052210","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}