Frontiers in global women's health最新文献

{"title":"Epidemiology, risk factors, maternal and perinatal outcomes of uterine rupture: a 7-year retrospective study from a Moroccan tertiary hospital.","authors":"Hanane Houmaid, Hafssa Naji, Myriem Sali, Karam Harou, Bouchra Fakhir, Lahcen Boukhanni, Hamid Asmouki, Abderraouf Soummani","doi":"10.3389/fgwh.2026.1814132","DOIUrl":"10.3389/fgwh.2026.1814132","url":null,"abstract":"<p><strong>Background: </strong>Uterine rupture (UR) is a rare but life-threatening obstetric emergency associated with high maternal and perinatal morbidity and mortality, particularly in low-resource settings. Delayed diagnosis and management significantly worsen outcomes. This study aimed to describe the epidemiological characteristics, risk factors, management, and maternal and perinatal outcomes of uterine rupture, with particular emphasis on distinguishing neglected from non-neglected cases.</p><p><strong>Methods: </strong>A retrospective descriptive study was conducted at Mohammed VI University Hospital, Marrakesh, Morocco, between January 2017 and December 2024. All confirmed cases of uterine rupture were included. Demographic, obstetric, clinical, and surgical data were collected from medical records. Maternal and perinatal outcomes were compared according to uterine scar status and delay in management.</p><p><strong>Results: </strong>Among 115,121 deliveries, 74 cases of uterine rupture were identified, corresponding to an incidence of 0.06%. Rupture occurred in unscarred uteri in 57% of cases and in scarred uteri in 43%. Inadequate or absent antenatal care was reported in 81% of patients. Hysterectomy was required in 23% of cases, predominantly in neglected ruptures. Maternal mortality was 1.4%, while perinatal mortality reached 35.1%, occurring mainly in neglected and unscarred uterine ruptures.</p><p><strong>Conclusion: </strong>Uterine rupture remains a severe and largely preventable obstetric emergency in low-resource settings. Strengthening antenatal care, eliminating harmful obstetric practices, and ensuring timely referrals and intervention are essential to reduce preventable morbidity and mortality.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1814132"},"PeriodicalIF":2.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681345","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":"Postpartum family planning education during prenatal care: a cross-sectional study using descriptive statistics in Barrero, Dominican Republic.","authors":"Alexandra Van Cleave, Olivia Anne Foley, April Mabie, Caron Gray, Jason Beste, Michelle María Jiménez de Tavárez","doi":"10.3389/fgwh.2026.1804322","DOIUrl":"10.3389/fgwh.2026.1804322","url":null,"abstract":"<p><strong>Introduction: </strong>Barrero, Dominican Republic is a globally underrepresented area in research as no prior studies have been completed regarding women's health in this community. One important area of women's health is prenatal care as education is delivered to women that can impact the rest of their lives. The goal of this research project was to describe postpartum family planning information received during prenatal care for women in Barrero, Dominican Republic and create a database for this community regarding the prenatal care experience.</p><p><strong>Methods: </strong>A cross-sectional study consisting of a 28-question subset was administered in Barrero, a semi-rural, semi-urban community. 121 mothers, aged 18-50, with children 0-12 years old living in Barrero were surveyed in February 2025. Descriptive rates were reported as frequency (%).</p><p><strong>Results: </strong>Of the 216 pregnancies reported by 121 surveyed mothers, a postpartum family planning discussion occurred for 82% of women during prenatal care. Notably, of 92 women using contraception at the time of survey administration, 43.5% utilized tubal ligation as their primary method to avoid pregnancy. Other methods reported included oral contraception (21.7%), arm implant (17.4%), injections (15.2%), and only 1.1% reported using condoms.</p><p><strong>Conclusion: </strong>Comprehensive knowledge regarding contraception options is essential for women to make a personalized family planning decision. Future research projects should investigate if causal relationship exists between postpartum family planning education discussions and future contraception utilization. These projects could then shape provider education regarding postpartum family planning conversations.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1804322"},"PeriodicalIF":2.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681376","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":"Diversity in human fertility in India beyond age 30: an index based temporal study.","authors":"Brijesh P Singh, Ravi Kant Maurya, Anuj Singh","doi":"10.3389/fgwh.2026.1882364","DOIUrl":"10.3389/fgwh.2026.1882364","url":null,"abstract":"<p><strong>Introduction: </strong>Fertility patterns among women aged 30 years and above have undergone substantial changes in India, reflecting the country's ongoing demographic transition. However, evidence on the diversity and distribution of age-specific fertility across states and urban-rural settings remains limited.</p><p><strong>Method: </strong>The study examines the diversity-index using age-specific fertility rates (ASFR) among women aged 30-49 years across 16 major Indian states and the Union Territory of Delhi, with particular focus on urban-rural differentials over five rounds of the National Family Health Survey (NFHS) from 1992-93 to 2019-21.</p><p><strong>Results: </strong>Regional and temporal variations in fertility diversity were evident across India. Southern and western states indicates the lower diversity indices, representing more concentrated fertility patterns, whereas northern and eastern states, particularly Bihar, Uttar Pradesh, and Rajasthan, showed greater fertility heterogeneity. Urban areas consistently demonstrated lower fertility diversity than rural areas. Overall, most states experienced a decline in fertility diversity over time, reflecting increasing concentration of childbearing within specific age groups.</p><p><strong>Discussion: </strong>The findings indicate that fertility beyond age 30 is becoming increasingly concentrated across India, although substantial regional and rural-urban disparities persist. These results highlight the need for region-specific reproductive health and family planning strategies and provide valuable evidence for understanding fertility transitions and informing demographic and women's reproductive health policies.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1882364"},"PeriodicalIF":2.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681309","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":"Associations of health and lifestyle factors with multidimensional quality of life among women with endometriosis: a cross-sectional study.","authors":"Marijana Matek Sarić, Marija Ljubičić, Tamara Sorić, Ana Sarić, Emili Marušić, Salma Abdi Mahmoud, Miran Čoklo","doi":"10.3389/fgwh.2026.1837763","DOIUrl":"10.3389/fgwh.2026.1837763","url":null,"abstract":"<p><strong>Introduction: </strong>Endometriosis is a chronic disease associated with pain, fertility difficulties, and reduced quality of life (QoL). Beyond clinical symptoms, health-related and lifestyle behaviors may influence the long-term impact of the disease. This study aimed to assess multiple QoL dimensions in women with endometriosis and examine their associations with disease-related symptoms, body mass index (BMI), and lifestyle characteristics.</p><p><strong>Methods: </strong>A cross-sectional online survey was completed by 153 women aged ≥ 18 years with self-reported endometriosis. Data included sociodemographic characteristics, body weight, physical activity, diet, smoking, and digestive symptoms, including painful defecation. The Endometriosis Impact Questionnaire evaluated physical, psychological, social, sexual and intimate, fertility, educational, employment and financial, and lifestyle QoL across three recall periods. Non-parametric tests and multivariate linear regression models assessed group differences and factors associated with QoL dimensions and overall impact.</p><p><strong>Results: </strong>The greatest burden was observed in fertility, physical, and psychological dimensions, particularly during the previous 12 months. Body-weight change since symptom onset was associated with poorer outcomes across all QoL domains. BMI showed coding-dependent associations: continuous BMI predicted greater physical and psychological impact, whereas BMI ≥ 25.0 kg/m² was linked to lower impact in physical (β=-0.42; <i>p</i> = 0.005), sexual and intimate (β=-0.31; <i>p</i> = 0.044), and employment and financial QoL (β=-0.31; <i>p</i> = 0.049). Painful defecation was associated with greater psychological and sexual and intimate impact and higher overall impact. Smoking was associated with greater lifestyle impact (β=0.38; <i>p</i> < 0.001) and higher overall impact (β=0.17; <i>p</i> = 0.042). Dietary supplement use was associated with lower fertility impact (β=-0.18; <i>p</i> = 0.049), whereas following a dietary regimen was associated with higher fertility impact (β=0.22; <i>p</i> = 0.014).</p><p><strong>Conclusion: </strong>Endometriosis substantially affects multiple life domains, particularly fertility and physical and psychological well-being. Weight change, painful defecation, and smoking were linked to poorer QoL, while BMI demonstrated complex domain-specific associations. Integrated medical and lifestyle approaches may improve long-term disease impact.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1837763"},"PeriodicalIF":2.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681306","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":"Evaluating a neonatal public health education and empowerment programme to reduce infant mortality risks: insights from parents and facilitators in the midlands, UK.","authors":"Olufisayo Olakotan, Samuel Oluwatobi Atiku, Gregory Maniatopoulos, Nicola O'Brien, Thillagavathie Pillay","doi":"10.3389/fgwh.2026.1843810","DOIUrl":"10.3389/fgwh.2026.1843810","url":null,"abstract":"<p><strong>Introduction: </strong>Infant mortality rates in the Midlands are among the highest in the UK, with regional and ethnic disparities highlighting persistent inequalities, and risks greatest for infants born preterm. This calls for inclusive educational programmes that support diverse families in improving infant safety. The STORK (Supportive Training Offering Reassurance and Knowledge) parent education and empowerment programme, which includes a digital application to support learning and reinforce key messages, was developed to equip parents, families and carers with practical knowledge and skills to reduce key risks associated with infant mortality. This study evaluates the perceived usefulness of the STORK programme among parents of preterm infants in reducing risks associated with infant mortality and explores the future implementation of the programme in terms of programme facilitators' barriers and facilitators to programme delivery.</p><p><strong>Methodology: </strong>A descriptive qualitative study employing semi-structured interviews was conducted at University Hospitals of Leicester (UHL), UK. Participants were recruited between June and December 2024 and met inclusion criteria based on recent or prior engagement with the STORK programme. Interviews were recorded, transcribed verbatim, and analysed thematically using Braun and Clarke's six-step approach.</p><p><strong>Results: </strong>Sixteen parents who had received the programme and three STORK facilitators participated in the study. Parents reported that the STORK programme enhanced their confidence and preparedness in infant care, particularly in areas such as emergency response, safe sleep practices, and infection prevention. They expressed a preference for hands-on, early, and flexible delivery of the programme. The app was valued as a reference tool, though it was infrequently accessed following programme delivery. Facilitators highlighted the programme's positive impact but identified resource shortages and the need to further culturally tailor the STORK programme to better meet the needs of diverse populations as key challenges to effective delivery.</p><p><strong>Conclusion: </strong>This evaluation underscores the importance of culturally, parent-focused education in addressing persistent disparities in infant mortality. Insights from families and facilitators provide valuable guidance for refining and scaling education and empowerment programmes, helping to optimise reach, engagement, and impact across diverse healthcare settings.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1843810"},"PeriodicalIF":2.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681372","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":"Awareness, factual knowledge, attitudes, and acceptability of human papillomavirus vaccination among adult women in Palestine: a cross-sectional study.","authors":"Alhareth M Amro, Leen M Safadi, Shahd R Fahoum, Salahaldeen Deeb, Anas K Assi, Lamar Aabed, Sadeel Suwan, Rayan Abdalhadi Abdullah, Jomana Sbehat, Raghda Amro, Hazem Agha","doi":"10.3389/fgwh.2026.1841337","DOIUrl":"10.3389/fgwh.2026.1841337","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) is a major preventable cause of cervical cancer, yet awareness and uptake of HPV vaccination remain suboptimal in many settings. Evidence regarding women's HPV-related awareness, factual knowledge, and vaccine acceptability in Palestine remains limited. This study assessed awareness, factual knowledge, attitudes, self-reported uptake, willingness, and perceived barriers related to HPV infection and HPV vaccination among adult women in Palestine.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted between October 2025 and February 2026 among women aged ≥18 years residing in Palestine. The questionnaire assessed sociodemographic characteristics, HPV and HPV vaccine awareness, factual knowledge, attitudes, vaccine uptake, willingness to receive or recommend vaccination, and perceived barriers. A 12-item factual knowledge score was calculated, and higher factual knowledge was defined as ≥7 correct responses. Descriptive statistics, subgroup analyses, and multivariable logistic regression were performed.</p><p><strong>Results: </strong>Among 424 adult women included in the final analysis, 220 (51.9%) had heard of HPV and 146 (34.4%) had heard of the HPV vaccine. The mean factual knowledge score was 4.03 ± 2.72 out of 12, and 90 participants (21.2%) had higher factual knowledge. Self-reported HPV vaccine uptake was low (13.0%), whereas willingness to receive the vaccine was higher (55.2%). Lack of awareness (55.8%) and concern about vaccine safety (22.8%) were the most frequently reported barriers among unvaccinated women. In expanded adjusted analyses, prior HPV awareness, prior HPV vaccine awareness, and more supportive HPV-vaccination attitudes were independently associated with higher factual knowledge. Higher factual knowledge and supportive attitudes were associated with self-reported vaccine uptake, while willingness among unvaccinated women was most strongly associated with supportive vaccination attitudes.</p><p><strong>Conclusion: </strong>Adult women in Palestine demonstrated limited HPV-related awareness and low factual knowledge, together with low self-reported HPV vaccine uptake. The gap between willingness and uptake, combined with the predominance of awareness and safety concerns as reported barriers, suggests a need for culturally appropriate education, provider-led counseling, and improved access to reliable HPV vaccine information. Findings should be interpreted cautiously given the cross-sectional design and online convenience sampling.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1841337"},"PeriodicalIF":2.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674734","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":"Trends in maternal mortality in China and Hainan Province: an analysis based on GBD 2023 and Hainan surveillance data.","authors":"Ruili Chen, Xuejiao Li, Guihua Wu, Humin Gong","doi":"10.3389/fgwh.2026.1864385","DOIUrl":"10.3389/fgwh.2026.1864385","url":null,"abstract":"<p><strong>Objective: </strong>To examine long-term trends in maternal mortality ratio (MMR) in China (1990-2023) and Hainan Province (2003-2023), characterize age-specific and cause-specific patterns, and assess the impact of major policy events on MMR trends.</p><p><strong>Methods: </strong>Data were obtained from the Global Burden of Disease Study 2023 and Hainan provincial maternal mortality surveillance records. Joinpoint regression was used to identify segmented trends and estimate annual percent change (APC). Log-linear regression was used to estimate the overall estimated annual percent change (EAPC). National data were used for age- and cause-specific analyses. Interrupted time series analysis assessed temporal associations of the 2009 healthcare reform, the 2016 universal two-child policy, and the 2020 COVID-19 pandemic with national MMR trends.</p><p><strong>Results: </strong>From 1990 to 2023, China's MMR decreased from 121.9 to 10.7 per 100,000 live births, a 91.3% decline, with an EAPC of -9.06% (95% CI: -9.79 to -8.32). In Hainan Province, MMR decreased from 47.5 to 8.9 per 100,000 live births during 2003-2023, an 81.4% decline, with an EAPC of -7.39% (95% CI: -9.06 to -5.72). Three national joinpoints were identified in 2004, 2013, and 2018, indicating a slow decline, rapid decline, slower decline, and stabilization during 2018-2023. No significant joinpoint was detected in Hainan Province. MMR decreased significantly across all age groups but remained relatively high among women aged 40-49 years. Mortality due to postpartum hemorrhage and hypertensive disorders of pregnancy declined markedly. Indirect maternal mortality also decreased but remained relatively high in the later period. After the 2016 policy, both the level and trend terms of MMR increased significantly. After the COVID-19 pandemic, the level term was not significant, whereas the trend term increased significantly.</p><p><strong>Conclusion: </strong>MMR declined substantially in China from 1990 to 2023 and showed a sustained decline in Hainan Province, with a markedly narrowed provincial-national gap. Older pregnant women remain a key high-risk group, and postpartum hemorrhage and hypertensive disorders of pregnancy remain major prevention priorities. After the universal two-child policy, both the level and trend terms of MMR increased significantly. After the COVID-19 pandemic, the MMR trend term also increased significantly.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1864385"},"PeriodicalIF":2.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671521","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":"Factors associated with early implant discontinuation among women receiving implant services from community healthcare providers (CPs/PPMVs) in Nigeria: an analysis of routine service delivery data.","authors":"Sikiru Baruwa, Kolawole Oni, Toyin O Akomolafe, Emeka Emmanuel Okafor, Osimhen Ubuane, Rodio Diallo, Michael Alagbile, Jennifer Ladokun","doi":"10.3389/fgwh.2026.1827336","DOIUrl":"10.3389/fgwh.2026.1827336","url":null,"abstract":"<p><strong>Background: </strong>Contraceptive implants are highly effective long-acting reversible contraceptives (LARCs), yet early discontinuation remains a major challenge globally and in Nigeria, undermining family planning (FP) goals. Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) have been trained through the IntegratE Project, to expand access to implant, but evidence on discontinuation patterns among their clients is limited.</p><p><strong>Methods: </strong>This retrospective descriptive study analyzed 874 routine service delivery records of women aged 15-49 years who sought implant removal services from trained CPs and Tier 2/3 PPMVs between July 2023 and June 2025 across four Nigerian states (Enugu, Kaduna, Kano, and Lagos). Early discontinuation was defined as removal within two years of insertion. Descriptive statistics summarized socio-demographic and service-related characteristics, while bivariate and multivariate logistic regression identified predictors of early removal.</p><p><strong>Results: </strong>Overall, 28.4% (<i>n</i> = 248) of implant users who discontinued discontinued early, with similar proportions for Implanon (29.5%) and Jadelle (25.7%%). More than half (57.6%) of early discontinuers removed their implants within 12 months of insertion. Side effects (38.9%) and desire for pregnancy (37.2%) were the most reported reasons for discontinuation whether early or not, while partner disapproval accounted for 15.4%. Adjusted analysis showed women aged 35-39 years were less likely to discontinue early compared with those aged 25-29 years [Adjusted odds ratio (AOR) = 0.50; 95% confidence interval (CI): 0.31-0.80; <i>p</i> = 0.004]. Geographic variation was noted, with lower odds in Enugu (AOR = 0.53; 95% CI: 0.30-0.91; <i>p</i> = 0.02). Side effects (AOR = 3.01; 95% CI: 1.89-4.78; <i>p</i> < 0.001) and partner disapproval (AOR = 2.31; 95% CI: 1.25-4.26; <i>p</i> = 0.007) were significant predictors.</p><p><strong>Conclusion: </strong>Almost one-third of discontinuers served by CPs and PPMVs did so early that is at less than 24 months, primarily driven by side effects and partner opposition. Strengthening counselling, managing side-effects, and engaging male partners are critical to improving continuation and advancing Nigeria's FP goals.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1827336"},"PeriodicalIF":2.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671428","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":"Disparities in exclusive breastfeeding by current maternal employment status in Peru, 2005-2023: a cross-sectional analysis of ENDES data.","authors":"Lily Mabel Portal-Valqui, Kevin Cusma-Regalado, Jhofree Einstein Briceño-Chavez, Juan Carlos Bustamante-Rodríguez, Jhosmer Ballena-Caicedo, Fiorella E Zuzunaga-Montoya, Víctor Juan Vera-Ponce","doi":"10.3389/fgwh.2026.1865825","DOIUrl":"10.3389/fgwh.2026.1865825","url":null,"abstract":"<p><strong>Introduction: </strong>Exclusive breastfeeding (EBF) improves child survival and maternal health, but structural and employment-related conditions may affect its continuity. Evidence from Peru on EBF disparities by current maternal employment status remains limited.</p><p><strong>Objective: </strong>To estimate descriptive disparities in EBF prevalence by current maternal employment status and describe their temporal and territorial patterns in Peru from 2005 to 2023.</p><p><strong>Methods: </strong>We conducted an analytical cross-sectional study using pooled data from the Peruvian Demographic and Family Health Survey [Encuesta Demográfica y de Salud Familiar (ENDES)] from 2005 to 2023. The revised descriptive sample included 15,780 mother-child dyads with infants younger than six months and mothers currently married or cohabiting. EBF was defined by 24 h recall. Maternal employment status was classified as no current survey-defined employment, current active formal-sector employment, or current active informal-sector employment, based on current work and employer type. Survey-weighted prevalences and crude and adjusted prevalence ratios (PRs) were estimated; adjusted models included maternal age, educational level, wealth quintile, parity, child age, child sex, residence area, natural region, and survey year. Temporal trends, absolute gaps, and departmental ecological correlations were assessed.</p><p><strong>Results: </strong>The revised weighted prevalence of EBF was 72.6%. In the complete-case model sample (<i>n</i> = 15,101), EBF prevalence was 76.2% among mothers with no current survey-defined employment, 46.5% among mothers with current active formal-sector employment, and 74.2% among mothers with current active informal-sector employment. Compared with no current survey-defined employment, current active formal-sector employment was associated with lower EBF prevalence in both crude (PR = 0.61; 95% CI: 0.55-0.67) and adjusted models (adjusted PR = 0.72; 95% CI: 0.65-0.79). Current active informal-sector employment showed little difference after adjustment (adjusted PR = 0.97; 95% CI: 0.94-1.00). At the departmental level, current active formal-sector employment was negatively correlated with EBF prevalence (<i>r</i> = -0.72; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>In this descriptive cross-sectional analysis, current active formal-sector employment was associated with lower EBF prevalence. These findings identify mothers actively participating in formal-sector work as a group requiring further evaluation of employment-compatible breastfeeding support, without implying causal effects of labor formality or direct evidence about specific workplace or health policies.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1865825"},"PeriodicalIF":2.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671476","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":"Characteristics of the transgender community in Lebanon and barriers to proper healthcare.","authors":"Diala Harkous, Mariana Boulos, Marie-Hélène Gannagé-Yared, Nada El Ghorayeb","doi":"10.3389/fgwh.2026.1828265","DOIUrl":"10.3389/fgwh.2026.1828265","url":null,"abstract":"<p><strong>Background: </strong>Individuals with gender dysphoria represent a growing portion of the global population. Yet data about this community is lacking in Lebanon.</p><p><strong>Objectives: </strong>This study aimed to characterize the health status of the transgender and gender-diverse (TGD) Lebanese adults by addressing challenges and disparities in access to basic needs.</p><p><strong>Methods: </strong>An anonymous online survey was conducted between January and May 2021 across the Non Governmental Organization (NGO) supporting TGD individuals in Lebanon. The study consisted of self-reported health assessments collecting data on medical and mental disorders, social stigma and discrimination, gender-affirming therapies, and barriers to proper healthcare.</p><p><strong>Results: </strong>Among forty-eight participants, 75% were assigned as male sex at birth (AMAB), and 25% as female (AFAB). Median age was 30 years. Approximately half (58.3%) of the cohort was unemployed despite 81.2% having completed high school or a university degree. Non-medical gender affirmation was observed in 79.2%. Gender-affirming hormone therapy was used in 52.8% of AMAB and in 58.3% of AFAB gender-affirming surgical procedures were done in 30.5% of AMAB and in 50% of AFAB. TGD individuals tested positive for HIV in 14.6% of the cases. The use of illicit drugs was reported in 35.4%. Mental health problems were found in 83.3% of AMAB and 91.7% of AFAB. They claimed being victims of assault in 83.3%, and faced discrimination in 87.5%. Barriers to access to medical care were observed in 75%, mainly due to financial limitations (47.2%) and lack of medical expertise in 10.4%.</p><p><strong>Conclusion: </strong>In Lebanon, TGD individuals still struggle for basic services due to rigid sociocultural norms and the ongoing economic crisis. There is an urgent need to adopt health policies and train healthcare providers in order to provide a safe and appropriate gender affirmation to these individuals.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1828265"},"PeriodicalIF":2.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655099","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}