Frontiers in global women's health最新文献

{"title":"Quest Narratives and Heroine Journeys: the road to freebirth and the joy of undisturbed physiological birth.","authors":"Gemma McKenzie","doi":"10.3389/fgwh.2024.1495914","DOIUrl":"10.3389/fgwh.2024.1495914","url":null,"abstract":"<p><p>Freebirth (intentionally giving birth without doctors or midwives present) is a taboo and stigmatised birthing decision. In this study, 16 women who had freebirthed their babies in the UK were interviewed, and the data was analysed using the voice-centred relational method (VCRM). This methodology produces a range of outputs, including I-Poetry. Previous scholars have noted the difficulty in presenting results from VCRM research and have devised varied and creative ways of subverting these obstacles. Uniquely, this article relies on the theories of Joseph Campbell, Arthur Frank, and Kim Hudson to present women's freebirth accounts as both Quest Narratives and Heroine Journeys. The article outlines the theoretical underpinnings of the Heroine's Journey and demonstrates its use with women's freebirth accounts as they pertain to the joy of undisturbed physiological birth.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"5 ","pages":"1495914"},"PeriodicalIF":2.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416382","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":"A holistic approach is needed for women with an inflammatory arthritis in the different phases around pregnancy; the results of the CAPRI study.","authors":"A J van Steensel-Boon, H M Wintjes, E Röder, H T W Smeele, L J C Kranenburg-van Koppen, R J E M Dolhain, L F Perez-Garcia","doi":"10.3389/fgwh.2024.1504095","DOIUrl":"10.3389/fgwh.2024.1504095","url":null,"abstract":"<p><strong>Introduction: </strong>Women with inflammatory arthritis (IA) face significant challenges throughout preconception, pregnancy, and postpartum phases, including concerns about disease management and medication safety. The Reproductive Rheumatology care pathway at Erasmus University Medical Center integrates specialized care from rheumatologists and specialized nurses to address both medical, nursing, practical and emotional needs during these phases. This study evaluates patient satisfaction, identifies unmet needs, and explores opportunities for enhancing support within this integrated care model.</p><p><strong>Methods: </strong>This was a cross-sectional study. We designed a customized questionnaire for women 18 years and older who were treated following the Reproductive Rheumatology care pathway and had given birth between 2019 and 2021. These women were invited to fill in the questionnaire. The survey assessed satisfaction with care, challenges experienced, and information needs across preconception, pregnancy, and postpartum phases. Descriptive statistics and paired <i>t</i>-tests were used for data analysis.</p><p><strong>Results: </strong>Participants reported high satisfaction with care, rating rheumatologists an average of 8.8/10 and specialized nurses 9.2/10. While 78.9% experienced no major issues, some faced problems such as managing disease flares and difficulties around conception. Information needs varied by phase: preconception needs focused on medication safety and fertility, while pregnancy and postpartum concerns included disease management and emotional support. Specialized nurses were pivotal in offering personalized care and practical advice.</p><p><strong>Conclusion: </strong>The integrated Reproductive Rheumatology care pathway effectively supports women with IA through their reproductive journey. Despite high satisfaction, improvements could be made in personalized care and addressing challenges related to confidence and help acceptance. Future research should investigate the long-term impact of such care pathways on reproductive outcomes and patient well-being.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"5 ","pages":"1504095"},"PeriodicalIF":2.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470163","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":"Fathers' perceptions of factors associated with the attainment of paternity leave: a qualitative study.","authors":"Naoyuki Mita, Yu Par Khin, Nobutoshi Nawa, Yui Yamaoka, Takeo Fujiwara","doi":"10.3389/fgwh.2024.1466227","DOIUrl":"10.3389/fgwh.2024.1466227","url":null,"abstract":"<p><strong>Background: </strong>A systematic review has reported that paternal involvement is beneficial in reducing social, behavioural and psychological problems in children. However, little research has investigated factors associated with the attainment of paternity leave.</p><p><strong>Objective: </strong>The objective of this study was to explore fathers' perceptions of the factors associated with taking paternity leave.</p><p><strong>Participants and setting: </strong>Overall, 21 in-depth interviews were conducted with fathers to obtain information on their perceptions of paternity leave. We also conducted key informant interviews with four supervisors at companies to understand their opinions on paternity leaves and ensure that the implications of this study are relevant at workplaces.</p><p><strong>Methods: </strong>Thematic analysis was adopted to analyse the data. Deductive coding was conducted based on previous studies on paternity leave, followed by inductive coding and modification of the initial codes. The final codes were organised based on the social-ecological model.</p><p><strong>Results: </strong>Themes associated with taking paternity leave included fathers' career aspirations, fathers' commitment to supporting infants or mothers, mothers' or infants' need for fathers' involvement, colleagues' outlook on paternity leaves, fathers' work schedules or responsibilities, support from relatives, paternity leave policies, and trends toward fathers' involvement. The supervisors mentioned themes related to paternity leave from the broader perspective of long-term effects and impact on the organisation.</p><p><strong>Conclusions: </strong>This study revealed fathers' perceptions regarding the factors associated with taking paternity leave. The results may provide useful information on how to create an environment in which fathers can easily take paternity leave.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"5 ","pages":"1466227"},"PeriodicalIF":2.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442980","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":"Utilization of partograph and associated factors among obstetric caregivers in Ethiopia: a systematic review and meta-analysis.","authors":"Mulat Ayele, Eyob Shitie Lake, Gizachew Yilak, Getinet Kumie, Biruk Beletew Abate, Alemu Birara Zemariam, Befkad Derese Tilahun","doi":"10.3389/fgwh.2025.1339685","DOIUrl":"10.3389/fgwh.2025.1339685","url":null,"abstract":"<p><strong>Introduction: </strong>Effective use of the partograph is crucial in identifying abnormal labor (prolonged and obstructed labor) and taking appropriate actions. However, in Ethiopia, the prevalence of obstructed labor is much higher at 11.8% and contributes to 14.4% of the total maternal deaths due to underutilization of the partograph by obstetric caregivers. Although a previous systematic review and meta-analysis (SRMA) had been conducted, they were not representative on a national level as they included a limited number of studies and did not evaluate the current prevalence of partograph utilization beyond July 2019. Since then, there have been inconsistent studies assessing the proportion of partograph utilization and its associated factors. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of partograph utilization and its associated factors in Ethiopia.</p><p><strong>Method: </strong>Comprehensive literature searches were conducted in PubMed, Google Scholar, and HINARI from 1 September 2013 to 23 October 2023. A random-effects model was used to estimate pooled prevalence and adjusted odds ratio. Stata (version 11.0) was used to analyze the data. Cochrane <i>I</i> ² statistics were computed to assess heterogeneity among studies. A subgroup analysis was done based on the study region to minimize underlying heterogeneity. Funnel plot and Eggers test were conducted to assess publication bias.</p><p><strong>Result: </strong>Overall, 661 articles were retrieved, and finally, 23 studies were included in this systematic review, including 7,649 participants. The pooled prevalence of partograph utilization was 54.92% (95% CI: 43.38-66.45). The subgroup analysis showed that partograph utilization was highest in the Dire Dawa region and lowest in the Amhara region. Factors such as partograph training [adjusted odds ratio (AOR) = 3.63, 95% CI: 2.57-5.25], good knowledge about partograph (AOR = 2.63, 95% CI: 1.62-4.26), a favorable attitude toward partograph (AOR = 1.95, 95% CI: 1.35-2.82), partograph availability (AOR = 0.89, 95% CI: 2.24-6.61), and being in the midwifery profession (AOR = 0.09, 95% CI: 1.78-5.25) were significantly associated with partograph utilization.</p><p><strong>Conclusion: </strong>The pooled prevalence of partograph utilization in Ethiopia was low. Partograph training, good knowledge about partograph, favorable attitude toward partograph, partograph availability in the health facility, and being in the midwifery profession were significantly associated with partograph utilization.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/, identifier (CRD42023475818).</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1339685"},"PeriodicalIF":2.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392607","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":"Respectful maternity care and associated factors among mothers who gave birth at public health institutions in Debre Tabor town, Northwest Ethiopia: a mixed-methods study.","authors":"Tadesse Ayana Fentie, Abayneh Aklilu Solomon, Mihretu Molla Enyew, Meseret Mekuriaw Beyene, Ayalew Kassie Melese, Alamirew Enyew Belay, Gebrie Getu Alemu","doi":"10.3389/fgwh.2025.1513906","DOIUrl":"10.3389/fgwh.2025.1513906","url":null,"abstract":"<p><strong>Background: </strong>Respectful maternity care is care organized for and provided to all women in a manner that maintains their dignity, privacy, and confidentiality, ensures freedom from harm and mistreatment, and enables informed choice and continuous support during labor and childbirth. However, in many healthcare settings in Ethiopia, the standard practice of respectful obstetric care is not the norm, and a significant proportion of health professionals view patients merely as cases and do not show compassion.</p><p><strong>Objectives: </strong>To assess respectful maternity care and associated factors among mothers who gave birth at public health institutions in Debre Tabor town, Northwest Ethiopia from December 1, 2023, to January 30, 2024.</p><p><strong>Methods: </strong>An institution-based cross-sectional study was conducted using qualitative and quantitative data collection methods. Three hundred seventy participants were selected for quantitative analysis using systematic random sampling, while eight were chosen for the qualitative study through purposive sampling. The quantitative data were coded and entered into Epi Data version 4.6, then exported to the Statistical Package for the Social Sciences (SPSS) version 25 for analysis. A multivariable logistic regression analysis was performed to identify factors associated with the outcome variable. Adjusted odds ratios with 95% confidence intervals were computed to determine the significance level. Thematic analysis was used for the qualitative data.</p><p><strong>Results: </strong>The proportion of respectful maternity care was 34.1% (95%CI: 29.4, 39.2) cesarean delivery [AOR = 3.45, 95%CI: 1.60, 7.42]. Daytime delivery [AOR = 3.14, 95%CI: (1.59, 6.18)] and less than or equal to 1 day stay in a healthcare facility [AOR = 3.03, 95%CI: (1.51, 6.08)] were positively associated with respectful maternity care. Inadequate equipment and supplies, shortage of staffing, and lack of accountability were barriers to providing respectful maternity care.</p><p><strong>Conclusions: </strong>The proportion of respectful maternity care was low. Therefore, health institutions and other stakeholders should support and strengthen monitoring and evaluation mechanisms for maternal and neonatal healthcare providers and enhance education and constant support for women during their pregnancy and childbirth. Additionally, adequate access to basic equipment and supplies should be given due attention to ensure respectful maternity care.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1513906"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366938","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":"Urinary human papillomavirus DNA as an indicator of gynaecological infection in young women in <i>Schistosoma</i> and HIV endemic South Africa.","authors":"P Pillay, H N Galappaththi-Arachchige, M Taylor, B Roald, E F Kjetland","doi":"10.3389/fgwh.2024.1436064","DOIUrl":"10.3389/fgwh.2024.1436064","url":null,"abstract":"<p><strong>Background: </strong>Globally, Africa has the highest HIV, cervical cancer and schistosomiasis prevalence. Female Genital Schistosomiasis (FGS) is hypothesized to be associated with HIV and cervical atypia. Young women aged 15 and above, constituting almost 3 million of the South African population, have limited health care access and are at risk for this triad of diseases. Urinary HPV DNA analysis is a non-invasive sampling method that can assist in evaluating risk among this population. This study compared the analysis of HPV DNA in urine and cervico-vaginal lavage (CVL) samples to cytology Pap smear, <i>Schistosoma</i> microscopy and HIV results.</p><p><strong>Methods: </strong>In this cross-sectional study, 235 young women aged 16 years and older from rural high schools in KwaZulu-Natal participated. HPV DNA analysis was done in urine and CVL samples. Pap smears were analysed for squamous cell atypia and urine microscopy was used for the identification of <i>Schistosoma</i> ova.</p><p><strong>Results: </strong>Urinary schistosomiasis was reported in 49 (20.9%) and HIV detected in 49 (20.4%). Urinary and CVL HPV DNA was found in 147 (62.6%) and 177 (75.3%) respectively. Any atypia was detected cytologically among 173 (73.6%). The following associations were found using the Pearson Chi-Square and a Likelihood Ratio test: (a) between HIV positive status and urinary HPV DNA positive cases on both the urine (<i>X</i> ² = 5.007; <i>p</i>-value = 0.025) and (<i>X</i> ² = 4.264; <i>p</i>-value = 0.039) and between HIV positive status and CVL HPV DNA tests respectively (<i>X</i> ² = 5.165; <i>p</i>-value = 0.023) and (<i>X</i> ² = 4.321; <i>p</i>-value = 0.015), and (b) among urine HPV DNA and the CVL HPV DNA tests, where (<i>X</i> ² = 52.966; <i>p</i>-value = 0.001) and (<i>X</i> ² = 50.716; <i>p</i>-value = 0.001). Urine HPV DNA showed a sensitivity of 75.7% and specificity of 77.6% relative to the CVL HPV DNA. There was no statistical association between urinary schistosomiasis and HPV or with any atypia.</p><p><strong>Conclusion: </strong>Urine has the potential of being optimized as an alternative and possibly more acceptable sample for HPV detection among young adolescent populations at risk in comparison to CVL samples. An integrated targeted intervention incorporating <i>Schistosoma</i> in addition to HPV and HIV testing needs consideration among young women in this age group from endemic areas.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"5 ","pages":"1436064"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366937","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":"Motivations regarding continuing or terminating pregnancy in women with high-risk pregnancies: a scoping review.","authors":"Mónica Antunes, Ana Galhanas, Ana Lúcia Vitorino, Sara Palma, Ana Frias","doi":"10.3389/fgwh.2025.1517669","DOIUrl":"10.3389/fgwh.2025.1517669","url":null,"abstract":"<p><strong>Background: </strong>The decisions of women with high-risk pregnancies to continue or terminate a pregnancy are complex and influenced by various factors. This scoping review synthesises the qualitative literature on the underlying motivations influencing these decisions.</p><p><strong>Aim: </strong>This analysis explores the underlying motivations that influence women's decisions regarding the continuation or termination of pregnancy, considering the challenges and dilemmas this population faces.</p><p><strong>Methods: </strong>This review was conducted following the Joanna Briggs Institute's methodology. No date restrictions were applied to the search. Titles and abstracts were screened to select original studies, and cross-checking was performed to avoid case overlap. We included studies that focused on the factors influencing women's decisions to either continue or terminate pregnancies when complications arose.</p><p><strong>Results: </strong>Eighteen studies involving women from different countries and cultural contexts were included. The review identifies four main themes driving these decisions: health considerations, religious convictions, social and political factors and ethical and moral dilemmas. Each theme interlinks to form a complex web of influences that significantly shape women's choices, illustrating how deeply personal, societal, and ethical contexts converge in these critical decisions. Significant emotional and cognitive factors, particularly hope, also play a crucial role. The findings highlight the complexity of the decision-making process and provide a deeper understanding of the personal, social, and spiritual dimensions involved.</p><p><strong>Conclusions: </strong>Multiple factors shape the complex decisions of women with high-risk pregnancies. Understanding these motivations is crucial to providing appropriate support and counselling. This review underscores the need for healthcare professionals to be aware of the diversity of factors involved and to adopt an individualized and context-sensitive approach in their practice, guiding their future actions.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1517669"},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257483","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":"Comparison of the lower genital tract microbiome composition in patients with benign gynecological disease.","authors":"Yonghui Shi, Jun Li, Jinjing Xie, Tianye Yang, Qiongyan Ma, Hua Chen, Wenwei Guo","doi":"10.3389/fgwh.2025.1507907","DOIUrl":"10.3389/fgwh.2025.1507907","url":null,"abstract":"<p><strong>Objective: </strong>Lower genital tract microbiome dysbiosis has been associated with several gynecological diseases. However, the differences in microbiome composition among patients with several gynecological diseases, such as endometrial polyps and uterine myoma, are poorly understood. Studying the lower genital tract microbiome composition in patients with benign gynecological diseases could provide new insights for interpreting the complex interplay between the microbiome and pathogenesis and finding new targets for preventive measures.</p><p><strong>Methods: </strong>A total of 16 patients with endometrial polyps (EPs), 11 patients with uterine myoma (UM), 6 patients with ovarian cysts (OC) and 36 healthy women (HWs) were recruited for this study. Samples were obtained from vaginal secretions. The DNA was isolated from the samples, and the V3-V4 regions were amplified. The sequencing libraries were generated and sequenced on an Illumina NovaSeq 6000 platform.</p><p><strong>Results: </strong>Firmicutes, Actinobacteria and Bacteroidota were the most common phyla in all four groups, whereas OC presented the highest abundance of Firmicutes and the lowest abundance of Bacteroidota. At the genus level, <i>Lactobacillus</i> in the OC group was significantly greater than that in the HW group, and <i>Atopobium</i> in the UM group was significantly lower than that in the HW group. The abundance of <i>Gardnerella</i> was greater in the UM group than in the EP group, and the abundance of <i>Streptococcus</i> was greater in the EP group. The richness and evenness of the microbiome were generally consistent among the HW, EP, UM, and OC groups. Principal component analysis (PCA), principal coordinate analysis (PCoA) and nonmetric multidimensional scaling (NMDS) revealed no distinct separation trends among the four groups. According to ANOSIM, there was no significant difference in community structure among the four groups.</p><p><strong>Conclusions: </strong>A nonsignificant result was obtained from the microbiome diversity comparison among the different groups. However, we demonstrated that the OC group had a greater abundance of <i>Lactobacillus</i> and that the UM group had a lower abundance of <i>Atopobium,</i> which might contribute to the occurrence of diseases, providing new clues for preventive measures.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1507907"},"PeriodicalIF":2.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257480","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":"Like mother like daughter, the role of low human capital in intergenerational cycles of disadvantage: the Pune Maternal Nutrition Study.","authors":"Akanksha A Marphatia, Jonathan C K Wells, Alice M Reid, Aboli Bhalerao, Chittaranjan S Yajnik","doi":"10.3389/fgwh.2024.1174646","DOIUrl":"10.3389/fgwh.2024.1174646","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal nutrition promotes maternal and child health. However, most interventions to address undernutrition are only implemented once pregnancy is known, and cannot address broader risk factors preceding conception. Poverty and socio-economic status are considered systemic risk factors, but both economic growth and cash transfers have had limited success improving undernutrition. Another generic risk factor is low human capital, referring to inadequate skills, knowledge and autonomy, and represented by traits such as low educational attainment and women's early marriage. Few studies have evaluated whether maternal human and socio-economic capital at conception are independently associated with maternal and offspring outcomes.</p><p><strong>Methods: </strong>Using data on 651 mother-child dyads from the prospective Pune Maternal Nutrition Study in rural India, composite markers were generated of \"maternal human capital\" using maternal marriage age and maternal and husband's education, and 'socio-economic capital' using household wealth and caste. Linear and logistic regression models investigated associations of maternal low/mid human capital, relative to high capital, with her own nutrition and offspring size at birth, postnatal growth, education, age at marriage and reproduction, and cardiometabolic risk at 18 years. Models controlled for socio-economic capital, maternal age and parity.</p><p><strong>Results: </strong>Independent of socio-economic capital, and relative to high maternal human capital, low human capital was associated with shorter maternal stature, lower adiposity and folate deficiency but higher vitamin B₁₂ status. In offspring, low maternal human capital was reflected in shorter gestation, smaller birth head girth, being breastfed for longer, poor postnatal growth, less schooling, lower fat mass and insulin secretion at 18 years. Daughters married and had children at an early age.</p><p><strong>Discussion: </strong>Separating maternal human and socio-economic capital is important for identifying the aspects which are most relevant for future interventions. Low maternal human capital, independent of socio-economic capital, was a systemic risk factor contributing to an intergenerational cycle of disadvantage, perpetuated through undernutrition, low education and daughters' early marriage and reproduction. Future interventions should target maternal and child human capital. Increasing education and delaying girls' marriage may lead to sustained intergenerational improvements across Sustainable Development Goals 1 to 5, relating to poverty, hunger, health, education and gender equality.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"5 ","pages":"1174646"},"PeriodicalIF":2.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123944","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":"Experiences of midwifery students and graduates in Somalia: evidence from qualitative data.","authors":"Hawa Abdullahi, Asia Mohamed Mohamud, Maryan Abdulkadir Ahmed, Mohamed Ahmed Omar, Abdirisak A Dalmar, Hannah Tappis, Shatha Elnakib","doi":"10.3389/fgwh.2024.1480914","DOIUrl":"10.3389/fgwh.2024.1480914","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Midwives play an important role in maternal and newborn care, yet are in short supply globally. The shortage in midwives is particularly acute in sub-Saharan African countries, many of which are conflict-affected. Midwives face many challenges that impact their workforce participation and retention, and these challenges are often compounded in conflict settings. Somalia ranks among the countries with the highest maternal mortality rate, with an estimated shortage of 20,000 midwives compared to the WHO recommended standard. Yet, limited research has explored the lived experience of midwives in conflict. This qualitative study seeks to explore the experiences, plans, and aspirations of midwifery students and recent graduates from nine midwifery schools in Somalia and to understand how the safety and security situation impacts their educational experience and willingness to join the profession.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a sub-study embedded within a broader prospective multi-cohort study of midwifery students and early career midwives conducted in 2023 and which will continue until 2025. We invited graduates and students in their final year from eight schools in Mogadishu and one school in Galgadud to participate in the study. This study draws on findings from five focus group discussions conducted with midwifery students and graduates who were included in the parent cohort study, for a total sample size of 33 students and graduates. We conducted thematic analysis using a combination of inductive and deductive coding.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our data illustrates powerful motivation among midwifery students and graduates to join the profession. Motivation was mostly intrinsic, with participants describing their desire to help the mother-baby dyad and to reduce maternal mortality in their communities as the predominant driving force for joining the profession. Yet, participants cited several barriers to entering the workforce, including harmful gender norms that prioritize women's domestic roles over professional aspirations and societal mistrust toward young midwives. Participants stated that their age and gender undermined them professionally and noted the community's preference for older midwives and traditional birth attendants. Safety and security significantly impacted participants' acceptance of job placement in remote areas and students' ability to attend school regularly. In terms of perceived preparedness, graduates felt well prepared for their role but identified gaps in abortion care, neonatal resuscitation, and usage of basic ultrasound.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The challenges faced by midwifery students and newly graduated midwives have direct implications for the health outcomes of mothers and infants in conflict-affected settings. The recurring themes of inadequate training, security risks, and restrictive gender norms require holistic and systematic interventions that a","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"5 ","pages":"1480914"},"PeriodicalIF":2.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082511","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}