Frontiers in global women's health最新文献

{"title":"Estimating the impact of prenatal health care services on adverse pregnancy outcomes in Tanzania: a propensity score matching approach.","authors":"Magashi Joseph Ntegwa, Riccardo Pelizzo","doi":"10.3389/fgwh.2025.1589721","DOIUrl":"10.3389/fgwh.2025.1589721","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of adverse pregnancy outcomes remains one of the public issues that needs to be addressed in low- and middle-income countries (LMICs), including Tanzania. Despite evidence on the effectiveness of antenatal care (ANC) services in addressing adverse pregnancy outcomes, empirical studies are scarce. Therefore, this study aims to analyze the impact of ANC services on adverse pregnancy outcomes.</p><p><strong>Methods: </strong>This is a retrospective study that uses secondary data from the Tanzania Demographic and Health Survey for 2022. The impact of ANC services on adverse pregnancy outcomes was estimated using Propensity Score Matching (PSM), and the robustness of results was checked using doubly robust estimators.</p><p><strong>Results: </strong>Adequate ANC services utilization reduces adverse pregnancy outcomes in Tanzania. Specifically, adequate ANC services utilization reduces adverse pregnancy outcomes: 5.6%-8.2% (depending on the PSM approach used). Similarly, an adequate ANC package reduces adverse pregnancy outcomes: 6.3%-9.3% (depending on the PSM approach used).</p><p><strong>Conclusions: </strong>The prevalence of adverse pregnancy outcomes needs to be addressed through adherence to ANC services utilization. Despite the utilization of ANC services being influenced by social, economic, and demographic factors, it is important to ensure essential packages of services are delivered to a pregnant woman for better pregnancy outcomes, as our results show that ANC visits alone have no significant impact.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1589721"},"PeriodicalIF":2.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790934","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":"Na we go shine: women's wellbeing, agency, and health seeking behaviours in southeastern Nigeria.","authors":"Farah M C Shroff","doi":"10.3389/fgwh.2025.1550817","DOIUrl":"10.3389/fgwh.2025.1550817","url":null,"abstract":"<p><strong>Objectives: </strong>Peer-reviewed literature on southeastern Nigerian women's health status is scant. This participatory action research project explored mental and physical health status issues within a sample population of childbearing women in Cross River State.</p><p><strong>Methods: </strong>We conducted an initial study using the formal chieftaincy channels in villages and learned that those who expressed themselves were primarily men. We found that their concerns differed from those of women. We conducted this study in an attempt to hear from women about their health needs in the context of their lives. Local women carried out face-to-face interviews in their language with childbearing women in their community. We interviewed 70 women from ages 18-45 in 12 villages.</p><p><strong>Results/discussion: </strong>Most participants had their own farms and grew rice, cassava and yam to feed their families. The majority of participants had not completed elementary school and had given birth to an average of 6 children, 4 of whom survived. Most of the women who were included in this study walked 6-8 h per day to retrieve drinking water. Their young children and babies often accompanied their mothers on these journeys. Participants reported that they had suffered from malaria, diarrhea, anemia, hernia, waist pains, cough, eye problems and continuous headaches. Traditional healers were their first choice for treatment, partly because of physical and financial accessibility and partly because of cultural resonance and positive outcomes.</p><p><strong>Conclusion: </strong>Despite tremendous social, economic and political barriers, our participants generally reported a strong sense of well-being and had positive outlooks on their lives. We also interviewed 15 traditional healers to enhance the statements made by our female participants regarding their health-seeking behaviors.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1550817"},"PeriodicalIF":2.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790871","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":"Understanding premenstrual dysphoric disorder from a psychosomatic and a sensory perspective.","authors":"Ashita Arora, Sampurna Chakraborty, Rashmi Pandey","doi":"10.3389/fgwh.2025.1595083","DOIUrl":"10.3389/fgwh.2025.1595083","url":null,"abstract":"<p><strong>Aim: </strong>This mini-review aims to develop a multidimensional framework for Premenstrual Dysphoric Disorder (PMDD) that integrates the role of traumatic experiences, interoceptive awareness, and sensory processing sensitivity (SPS) in symptom development and maintenance.</p><p><strong>Background: </strong>PMDD is a complex disorder traditionally viewed through hormonal and mood-based lenses, but research shows that many women with PMDD experience significant emotional and physical symptoms that remain unexplained by these factors alone. Early-life trauma and interpersonal trauma may sensitize neural circuits, exacerbating symptom expression during hormonally sensitive periods.</p><p><strong>Method: </strong>A narrative synthesis of existing literature was conducted, focusing on the impact of trauma (particularly early-life and interpersonal trauma) on the hypothalamic-pituitary-adrenal (HPA) axis, sensory processing, and interoceptive awareness. The neurobiological interplay between these factors and hormonal fluctuations was examined.</p><p><strong>Results: </strong>Trauma-related dysregulation of neural circuits-including the amygdala, insula, and prefrontal cortex-heightens vulnerability to premenstrual distress by disrupting sensory and emotional processing. Heightened sensory processing and altered interoceptive awareness further amplify symptom severity during the luteal phase.</p><p><strong>Conclusion: </strong>This trauma-informed sensory framework extends current understandings of PMDD beyond hormonal and mood-based models, highlighting the importance of assessing trauma history and sensory reactivity in clinical practice. Incorporating these factors may improve diagnostic accuracy and treatment outcomes.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1595083"},"PeriodicalIF":2.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12319025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786107","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 hypertensive disorders of pregnancy on maternal and perinatal outcomes in Ethiopia: an umbrella review of systematic reviews.","authors":"Teketel Ermias Geltore, Simegn Alemu, Tariku Laelago Ersado, Tamiru Beyene Uliso, Abebe Alemu Anshebo, Lakew Lafebo Foto","doi":"10.3389/fgwh.2025.1571052","DOIUrl":"10.3389/fgwh.2025.1571052","url":null,"abstract":"<p><strong>Background: </strong>Previous systematic reviews and meta-analyses have concentrated on the impacts of hypertensive disorders of pregnancy on maternal and perinatal outcomes in Ethiopia. Still, the evidence has often been inconsistent and inconclusive. Consequently, this study seeks to consolidate the findings regarding the effects of hypertensive disorders during pregnancy on maternal and perinatal outcomes in Ethiopia.</p><p><strong>Methods: </strong>PubMed, Science Direct, Google Scholar, Africa Journal Online, PsycINFO, Research4Life, and CINAHL from September 15 to 25, 2024. The quality of the methods was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. The estimates from the included studies were pooled and summarized using random-effects meta-analysis models.</p><p><strong>Results: </strong>We included five systematic reviews and meta-analyses (SRM) studies with a total of 621,146 pregnant women. The pooled prevalence of hypertensive disorders of pregnancy was 16.56% (95% CI: 13.15-20.02), with a heterogeneity index (I² = 94.17%, <i>P</i> = 0.00). Maternal age >35 years, (AOR = 2.29; 95% CI: 2.05, 2.94), previous history of preeclampsia, (AOR = 3.51; 95% CI: 2.26, 5.53), low birth weight (AOR = 2.18; 95% CI: 1.48, 3.01), and alcohol consumption (AOR = 1.84; 95% CI: 1.12, 2.46) were the risk factors and complications of hypertensive disorders of pregnancy.</p><p><strong>Conclusion: </strong>The higher rate of severe forms of HDP that are associated with significant maternal and perinatal complications is a major concern in Ethiopia. The risk of developing HDP is worse among women who have a history of preeclampsia, maternal age >35 years, alcohol consumption, and its complications, such as low birth weight.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024578548.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1571052"},"PeriodicalIF":2.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12319007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786106","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 policy in stagnation: addressing inequalities in the distribution of emergency obstetric and neonatal care in Ghana.","authors":"Ephraim Senkyire, Gloria Senkyire, Rullmann Twi Owusu, Ernestina Asiedua","doi":"10.3389/fgwh.2025.1614200","DOIUrl":"10.3389/fgwh.2025.1614200","url":null,"abstract":"<p><p>Maternal health has been a focal point of global attention since the 1980s, with initiatives like Safe Motherhood, Millennium Development and Sustainable Development Goals aiming to improve the well-being of women and infants worldwide. Despite these efforts, high maternal and neonatal mortality rates persist, particularly in middle-income countries, including Ghana, highlighting the need for urgent action. From 2000 to 2020, Ghana successfully halved its maternal mortality ratio from 499 to 263 deaths per 100,000 live births through various interventions and strategies, which is still higher than the global average. Emergency obstetric and neonatal care (EmONC) plays a vital role in preventing maternal and neonatal deaths, yet disparities in its distribution and delivery exist, particularly in Ghana. An evaluation of EmONC facilities in Ghana highlighted the challenges of infrastructure, human resources, logistics, and equipment in meeting the World Health Organisation standards for EmONC within national, regional, rural, and urban health facilities. This critical analysis paper aims to highlight these challenges and propose comprehensive solutions for improved delivery of EmONC services. Addressing these challenges requires comprehensive efforts to improve infrastructure, human resources, and supply chain logistic support. A two-pronged approach is recommended. One recommendation focuses on upgrading existing facilities and recruiting and retaining healthcare professionals in rural and underserved areas. The second recommendation calls for increasing the capability of delivery of EmONC by improving training efficiency and focusing on facilities missing only one or two of the seven key services required for basic emergency obstetric and newborn care.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1614200"},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777065","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 importance of promoting positive childbirth experiences for women: a perspective paper.","authors":"Sigfridur Inga Karlsdottir, Nicky Leap","doi":"10.3389/fgwh.2025.1599249","DOIUrl":"10.3389/fgwh.2025.1599249","url":null,"abstract":"<p><p>Childbirth can be a profound and transformative experience, one that embodies complex emotional challenges. Childbirth experiences can have profound and lasting consequences, both positive and negative, shaping a woman's physical, emotional, and psychological well-being. A positive childbirth experience often fosters feelings of empowerment and birth may carry a sense of accomplishment and strength into motherhood. This can enhance bonding with the baby, reduce the likelihood of postpartum depression, and contribute to an overall positive transition into parenting. Supportive environments, effective pain management, and respectful care from healthcare providers play critical roles in creating such experiences. In contrast, a negative childbirth experience can have significant adverse effects. Negative childbirth experiences caused by, for example, a lack of control, disrespectful treatment, or traumatic events during childbirth may lead to feelings of failure, fear, or even post-traumatic stress disorder. These can undermine maternal self-esteem, strain relationships, and hinder the mother-baby bond. Addressing both women's positive and negative childbirth experiences requires providing compassionate, individualised care, fostering open communication, and ensuring that all women feel heard, valued, and supported throughout their childbirth journey. When planning care for women and their families through the childbirth process, it is crucial for health care providers to understand women's perspectives and know how to maximise the likelihood of a positive childbirth experience. This paper explores the significant impact of a positive childbirth experience on a woman's life. It offers perspectives on the importance of recognising and measuring women's childbirth experiences in the ongoing development of maternity service provision.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1599249"},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762556","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":"Low birth weight and associated factors in rural population of Rajasthan, India.","authors":"Ramesh Kumar Sangwan, Ramesh Kumar Huda, Mukti Khetan, Parul Gazta, Pankaj Kumar, Bontha V Babu","doi":"10.3389/fgwh.2025.1587991","DOIUrl":"10.3389/fgwh.2025.1587991","url":null,"abstract":"<p><strong>Background: </strong>Low Birth Weight (LBW) significantly affects childhood survival, with the socio-demographic characteristics (maternal age, child's gender, education, maternal diseases and others) contributing to it. The study aims to identify social determinants contributing to LBW, which can further be useful in developing local interventions to rectify the problem in an Indian rural context.</p><p><strong>Methodology: </strong>The cross-sectional study was conducted in the Jalore district of Rajasthan, India. A total of 92 delivery cases, including LBW (<i>n</i> = 46) and cases with normal birth weight (<i>n</i> = 46), became part of the research. A pre-tested questionnaire collected information from study participant groups enumerating deliveries from selected Primary Health Centres (PHCs) related to LBW and non-LBW deliveries in a 1:1 ratio.</p><p><strong>Results: </strong>The study recorded a total of 1,251 deliveries, of which 63 resulted in the LBW (<2,500 grams), nine were premature, 12 were twin births, and 361 were normal weight deliveries (≥2,500 grams). LBW was prevalent in underprivileged communities within nuclear families, having an average birth weight of 2.12 kilograms. Reduced meal frequency (1-2 times a day) for women is also linked to higher LBW risk.</p><p><strong>Conclusion: </strong>Many factors, like complications during pregnancy, awareness of pregnancy planning, and nutritional intake, are associated with the likelihood of LBW occurrences. Many maternal risk factors for LBW are modifiable through early detection by imparting education and awareness to pregnant women in their first trimester. The findings emphasize the significance of targeted interventions and awareness programs to address specific risk factors and improve birth outcomes in rural Indian communities.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1587991"},"PeriodicalIF":2.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12307435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755265","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":"Global, regional, and national burden of diabetes in women of childbearing age, 1990-2021: a systematic analysis from the global burden of disease study 2021.","authors":"Zhifeng Guo, Wangquan Ji, Mengqing Yan, Xianan Zou, Teng Chen, Fanghui Bai, Yu Wu, Zhe Guo, Linlin Song","doi":"10.3389/fgwh.2025.1528661","DOIUrl":"10.3389/fgwh.2025.1528661","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes may have long-term adverse health effects on both women of childbearing age (WCBA) and their future generations. The objective of this study is to provide up-to-date epidemiologic information on the global burden of diabetes in WCBA to inform the development of targeted public health policies.</p><p><strong>Methods: </strong>The data on the burden of diabetes among WCBA from 1990 to 2021 at the global, regional, and national levels were extracted from the Global Burden of Disease 2021 database. The estimated annual percentage change (EAPC) and Bayesian age-period-cohort models were used to assess and predict time burden trends. The slope index and concentration index were used to assess health inequalities associated with the sociodemographic index (SDI).</p><p><strong>Results: </strong>In 2021, approximately 79.04 million WCBA aged 15-49 years were living with diabetes, resulting in approximately 7.82 million disability-adjusted life years (DALYs). From 1990 to 2021, the age-standardized prevalence rate (ASPR) increased from 1960.8 to 3942.2 per 100,000 WCBA, with an EAPC of 2.25%. The ASPR and age-standardized DALY rate were highest in the low-middle SDI region, at 4,107.0 and 472.3 per 100,000, respectively. DALYs and deaths are concentrated in low SDI countries. By 2040, the global burden of diabetes in WCBA will increase further.</p><p><strong>Conclusion: </strong>The global burden of diabetes among WCBA has increased over the past three decades. This burden is concentrated in low- and middle-income countries. Diabetes care policies for WCBA urgently need to be improved and popularized.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1528661"},"PeriodicalIF":2.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746352","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":"Illuminating birth: exploring the impact of birthing environment lighting on labor.","authors":"Shenhav Albo, Orli Dahan, Omer Horovitz, David Peleg, Inbar Ben-Shachar, Yael Sciaky-Tamir","doi":"10.3389/fgwh.2025.1599885","DOIUrl":"10.3389/fgwh.2025.1599885","url":null,"abstract":"<p><strong>Introduction: </strong>Numerous factors influence the birth experience and outcomes, both positively and negatively. We aimed to investigate the relationship between the birth room environment and light condition during birth and their effects on birth method, perineal health, and birth experience.</p><p><strong>Method: </strong>A longitudinal cohort study was conducted in a medical center in Northern Israel. Participants completed self-report questionnaires during the third trimester of their pregnancy and again 72 h post-birth (T1 and T2, <i>n</i> = 126). Initially sociodemographic data and reproductive history were collected, as well as preparation and plans for birth. Data about birth outcomes and birth complications were gathered from electronic records. Perception of the birth environment and the state of consciousness during birth (T2) was assessed using a valid questionnaire that includes 36 statements indicating the state of flow.</p><p><strong>Results: </strong>Our study demonstrated a significant positive correlation between birth type and birth room light conditions. Vaginal births predominantly occured under dim light (86.36% vs. 68.3%). Moreover, a negative correlation was observed between perineal tears and dim light levels (<i>p</i> = 0.0033). Regarding maternal mental state during birth, dimmer lighting correlated with heightened experiences of Unambiguous feedback flow state (<i>p</i> = 0.003).</p><p><strong>Discussion: </strong>Dim light was correlated with higher rates of vaginal birth, fewer perineal tears, and enhanced maternal immersion during birth. Although promising, these associations are correlational and require further exploration. Our findings suggest that the birth room is not merely a physical setting but a dynamic environment where sensory cues and psychological states interact.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1599885"},"PeriodicalIF":2.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746353","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":"Multifactorial drivers of engagement in sex work among Ethiopian women: a multinomial logistic regression approach.","authors":"Dawit Sekata Duressa, Lemessa Negeri Debel, Saro Abdella Abrahim","doi":"10.3389/fgwh.2025.1512560","DOIUrl":"10.3389/fgwh.2025.1512560","url":null,"abstract":"<p><strong>Background: </strong>Understanding the multifactorial drivers of female sex workers' (FSWs) engagement in Ethiopia is essential for designing effective public health interventions. While economic drivers are often emphasized, the roles of family, social, and geographic contexts remain underexplored.</p><p><strong>Methods: </strong>We analyzed data from a cross-sectional bio-behavioral survey of 6,085 FSWs across 16 Ethiopian urban centers conducted from December 2019 to April 2020. Multinomial logistic regression was used to assess associations between primary motivations for engaging in sex work-categorized as economic, family-related, combined economic-family, or social/behavioral-and socio-demographic, behavioral, and health-related factors.</p><p><strong>Results: </strong>Economic reasons were most common (41.7%), followed by family-related (22.7%), combined economic-family (21.0%), and social/behavioral (14.6%) motivations. Geographic variation was evident: FSWs in Addis Ababa, the capital in central Ethiopia, had lower odds of reporting family-related reasons (AOR = 0.52) than those in Adama, another central commercial city. FSWs in Dessie-Kombolcha, in northeastern Ethiopia, were more likely to report social or behavioral motivations (AOR = 2.02). Age, education, marital status, income, and healthcare access were also significant predictors. Women aged 35-59 were less likely to cite family (AOR = 0.50) or social motivations (AOR = 0.55), while those with secondary education were more likely to report family-related reasons (AOR = 1.54). Limited healthcare access and early initiation into sex work were associated with non-economic drivers.</p><p><strong>Conclusion: </strong>FSWs' engagement is influenced by intersecting economic, familial, and geographic factors. Tailored interventions should consider age, location, and service accessibility. The cross-sectional design limits causal interpretation.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1512560"},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735862","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}