{"title":"Corrigendum: Oral pre-exposure prophylaxis implementation in South Africa: a case study of USAID-supported programs.","authors":"Jerome Wendoh Milimu, Lauren Parmley, Mahlodi Matjeng, Mathata Madibane, Mandisi Mabika, Jacques Livingston, Joseph Lawrence, Orapeleng Motlhaoleng, Hasina Subedar, Rethabile Tsekoa, Zandile Mthembu","doi":"10.3389/frph.2025.1560111","DOIUrl":"https://doi.org/10.3389/frph.2025.1560111","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/frph.2024.1473354.].</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1560111"},"PeriodicalIF":2.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383579","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}
Fabio Mathias Correa, Peter Enesi Omaku, Joseph Odunayo Braimah
{"title":"Assessing factors influencing adolescent sexual debut in Nigeria: a multi-cluster survival analysis approach.","authors":"Fabio Mathias Correa, Peter Enesi Omaku, Joseph Odunayo Braimah","doi":"10.3389/frph.2025.1475421","DOIUrl":"10.3389/frph.2025.1475421","url":null,"abstract":"<p><strong>Introduction: </strong>Early sexual debut is an area of concern in Nigeria with implications for reproductive health.</p><p><strong>Methods: </strong>This study addresses this by proposing a more effective survival model-one that incorporates both independent and identically distributed (IID) and Besag intrinsically conditional auto-regressive (ICAR) random effect priors, using a generalised additive model that accounts for both individual and spatial influences on age at first sex. We analyse data from the 2018 Nigerian NDHS survey and compare our model with existing models: a model without the cluster frailty effect, a model that ignores the Besag ICAR and includes the IID, and a model that ignores the IID and includes only the Besag ICAR.</p><p><strong>Results: </strong>Our approach, which combines independent and spatial random effects, outperforms others based on statistical criteria (Deviation Information Criterion and the Widely Applicable Information Criterion).</p><p><strong>Discussion: </strong>As shown in this study, the proposed model effectively captures the complexity of age at first sex. In addition, visualisations reveal significant geographic and social clusters with high rates of early sexual debut in Nigeria. These findings highlight the importance of considering multi-level clustering to better understand and promote healthy sexual behaviour among young Nigerians through targeted interventions.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1475421"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383524","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":"Tryptophan as a biomarker of pregnancy-related immune expression and modulation: an integrative review.","authors":"Stephanie Prescott, Natasa Billeci, Melissa Gotcher, Sapna Patel, Addison Almon, Hailey Morgan, Danielle Abukhalaf, Maureen Groer","doi":"10.3389/frph.2024.1453714","DOIUrl":"10.3389/frph.2024.1453714","url":null,"abstract":"<p><strong>Background: </strong>Degradation pathways of Tryptophan (TRP) are implicated in a spectrum of physiological adaptations and outcomes associated with pregnancy. The immunomodulatory role of TRP and its metabolites through the indoleamine 2,3-dioxygenase (IDO) pathway is particularly relevant to pregnancy due to its potential influence on maternal and fetal immune tolerance and the mother's health.</p><p><strong>Methods: </strong>A targeted literature search was conducted via PubMed, Web of Science, and Embase, focusing on maternal serum TRP levels in pregnancy. We included original human subject research on maternal serum TRP, published in English within the last five years. We included 16 quality studies with direct measurement of TRP in pregnancy including ten prospective cohorts, four case-control studies, and two cross-sectional studies.</p><p><strong>Results: </strong>TRP levels are reduced both pre- and postnatally in women with depressive symptoms, but not during pregnancy, though the TRP/Kynurenine pathway is disturbed during pregnancy in women with depressive symptoms, women with prolonged labor, women with gestational hypertension, and in adverse outcomes of pregnancy including prematurity and growth restriction.</p><p><strong>Conclusion: </strong>TRP and its metabolites hold promise as biomarkers for various pregnancy-related outcomes. Future research should aim to clarify the mechanisms by which TRP metabolism influences maternal and fetal health outcomes.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1453714"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366225","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}
Bao Ngoc Vu, Kimberly Green, Huong Phan, Long Tran, Phuong Phan, Tham Tran, Linh Doan, Yen Vu, Chau Pham, Dao Nguyen, Anh Doan, Trang Ngo, Phuong Tran, Vuong Nguyen, Bieu Nguyen, Thai Phan, Ha Nguyen
{"title":"Engaging the private sector as part of HIV pre-exposure prophylaxis service delivery in Vietnam: a comparative analysis of uptake, persistence and HIV seroconversion from 2018 to 2023.","authors":"Bao Ngoc Vu, Kimberly Green, Huong Phan, Long Tran, Phuong Phan, Tham Tran, Linh Doan, Yen Vu, Chau Pham, Dao Nguyen, Anh Doan, Trang Ngo, Phuong Tran, Vuong Nguyen, Bieu Nguyen, Thai Phan, Ha Nguyen","doi":"10.3389/frph.2024.1439461","DOIUrl":"10.3389/frph.2024.1439461","url":null,"abstract":"<p><strong>Background: </strong>In Vietnam, PrEP was introduced in 2017 and scaled up from 2019. Private sector engagement (PSE) in PrEP service delivery was deployed as a strategy from the start to increase PrEP access. We assessed the effectiveness of this approach to inform ongoing efforts to accelerate epidemic control by 2030.</p><p><strong>Methods: </strong>We implemented a process evaluation with longitudinal design using retrospective programmatic data collected and uploaded onto a secure online system (HMED) from 23 public and 17 private PrEP clinics in Hanoi, Ho Chi Minh City (HCMC), and Dong Nai. We measured the effectiveness of PrEP service delivery by PrEP initiation/reinitiation, uptake, persistence, discontinuation, and HIV seroconversion. We used the Kaplan-Meier time-to-event approach to estimate PrEP persistence and mixed-effects logistic regression analysis to assess factors associated with the PrEP persistence.</p><p><strong>Results: </strong>From October 2017 to September 2023, 29,944 individuals initiated PrEP, and among these, 79.3% started PrEP at a private sector clinic while 20.7% initiated in a public sector clinic. The median duration of PrEP use persistence at private clinics was significantly longer than that at public clinics (268 days vs. 148 days, respectively). Mixed-effects logistic regression analysis results indicated a significant statistical association between PrEP persistence for at least three months and initiating PrEP at a private clinic [adjusted odds ratio [aOR] = 4.28; 95% confidence interval [CI]: 2.96-6.19], opting for TelePrEP (aOR = 3.42; 95% CI: 2.12-5.53), or being 20 years of age or older (aOR = 1.86; 95% CI: 1.62-2.13). HIV seroconversion was significantly lower among PrEP users at private clinics compared to public clinics (0.03 vs. 0.13 per 100 person-years, respectively; <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>Offering choice in PrEP service delivery options is essential to increase access and uptake. Private-sector PrEP providers play a pivotal role in increasing PrEP uptake and coverage in Vietnam, and will be critical to delivery of new long-acting options.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1439461"},"PeriodicalIF":2.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191458","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}
Akanksha A Marphatia, Jonathan C K Wells, Alice M Reid, Marios Poullas, Aboli Bhalerao, Pallavi Yajnik, Chittaranjan S Yajnik
{"title":"Generational trends in education and marriage norms in rural India: evidence from the Pune Maternal Nutrition Study.","authors":"Akanksha A Marphatia, Jonathan C K Wells, Alice M Reid, Marios Poullas, Aboli Bhalerao, Pallavi Yajnik, Chittaranjan S Yajnik","doi":"10.3389/frph.2024.1329806","DOIUrl":"10.3389/frph.2024.1329806","url":null,"abstract":"<p><strong>Introduction: </strong>Globally in 2024, 1 in 5 women aged 20-24 years worldwide had been married before the age of 18 years. One reason for this persistent prevalence of underage marriage may be the slow change in social norms relating to education levels and women's marriage age. However, we know little about how norms change, and whether they vary by socio-demographic characteristics. We aimed to investigate changes in social norms across generations in rural Maharashtra, India.</p><p><strong>Methods: </strong>To understand the status quo, we identified education levels and marriage ages typical of contemporary young adults in rural Maharashtra using the National Family Health Survey. To see if norms have shifted across generations, we analysed data on education and marriage age in 659 parent-adolescent dyads from the Pune Maternal Nutrition Study (PMNS) in rural Maharashtra. To ascertain if norms might shift in the future, we investigated adolescents' aspirations for their future hypothetical children's education and marriage, and classified adolescents as wanting (a) their children to decide themselves, (b) more education and later marriage age, or (c) the status quo. We assessed whether these aspirations differed by socio-demographic characteristics.</p><p><strong>Results: </strong>Compared to the status quo and PMNS adults, PMNS adolescents had substantially more education, and girls were marrying slightly later. About 70% of the adolescents wanted their children to themselves decide their schooling. The remainder of both sexes wanted their children to have the same education as them (15 years). Only 10% of adolescent girls and 14% of boys wanted their child to decide their own marriage age. Most adolescents wanted a later marriage age for their children than their own experience. Lower educated and early married girls aspired for greater education for their children. More educated boys aspired for later marriage for their children.</p><p><strong>Discussion: </strong>Education norms have changed by a larger magnitude than marriage age norms. Adolescents are already attaining their education aspirations, but aspire for later marriage of their children, more so for their hypothetical sons than daughters. Since senior household members remain influential in marriage decisions, it may take time before adolescents' aspirations for their children become a new norm.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1329806"},"PeriodicalIF":2.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124094","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":"Histopathologic effects of mobile phone radiation exposure on the testes and sperm parameters: a systematic literature review of animal studies.","authors":"Ebrahim Msaye Assefa, Seid Mohammed Abdu","doi":"10.3389/frph.2024.1515166","DOIUrl":"10.3389/frph.2024.1515166","url":null,"abstract":"<p><strong>Introduction: </strong>Male infertility, often attributed to insufficient production of healthy and active sperm, can be exacerbated by electromagnetic radiation emitted from mobile phones, which disrupts normal spermatogenesis and leads to a notable decline in sperm quality. The main targets of mobile phone-induced damage in the testes are Leydig cells, seminiferous tubules, and sperm cells. The aim of this systematic literature review is to identify histopathological changes in the testes due to mobile phone radiation exposure and to examine its effects on sperm parameters in experimental animals.</p><p><strong>Methods: </strong>In this systematic review, an extensive literature search was conducted across databases such as PubMed, ScienceDirect, Hinari, and Google scholar.</p><p><strong>Results: </strong>A total of 752 studies were identified for screening, and 18 studies were deemed eligible for data extraction. Studies have identified histopathological alterations in testicular tissue caused by mobile phone radiation, such as reduced seminiferous tubule diameter, tunica albuginea and germinal epithelial thickness, Leydig cell hypoplasia, and increased intertubular space. Consistent exposure to mobile phone radiation has been shown to significantly reduce sperm count, motility, and viability, while also increasing abnormal sperm morphology in male rats, mice, and rabbits.</p><p><strong>Conclusion: </strong>Animal studies indicate that electromagnetic radiation from mobile phones can negatively impact testicular tissue and sperm parameters, including sperm count, motility, viability, and morphology. As a precaution, preventive measures are recommended to minimize potential risks from mobile phone exposure, and further research is needed to fully understand its effects on human reproductive health.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1515166"},"PeriodicalIF":2.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082547","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":"Editorial: The impact of metabolic disorders on female reproductive health.","authors":"Lokesh Kumar, Vineet K Maurya, Manasi Kamat","doi":"10.3389/frph.2024.1436451","DOIUrl":"https://doi.org/10.3389/frph.2024.1436451","url":null,"abstract":"","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1436451"},"PeriodicalIF":2.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069646","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":"Primary dysmenorrhea and its associated factors among female high school students in Nekemte town, East Wallaga Zone, Western Oromia, Ethiopia: a cross-sectional study.","authors":"Bekan Gudata Gindaba, Tesfaye Abera Gudeta, Lemane Dereje Sebu, Ebisa Zerihun Gindaba, Misgana Tesgara Abdisa","doi":"10.3389/frph.2024.1451551","DOIUrl":"10.3389/frph.2024.1451551","url":null,"abstract":"<p><strong>Background: </strong>Primary dysmenorrhea is a common gynecological problem characterized by recurrent, periodical, and <i>cramping pain in the lower abdomen</i> that occurs before or during menstruation, usually without pelvic disease. Its magnitude has not been well studied; some of the associated factors are inconclusive. Therefore, the goal of this study was to fill gaps on the magnitude, and associated factors of primary dysmenorrhea among female high school students in Nekemte town.</p><p><strong>Objectives: </strong>To assess the magnitude of primary dysmenorrhea, its associated factors among high school students in Nekemte town, East Wallaga, Western Oromia, Ethiopia, 2023.</p><p><strong>Methods: </strong>An institutional-based cross-sectional study was conducted among high school students in Nekemte town from June 05 to 19, 2023. The calculated total sample size was 534, and data were collected from four governmental high schools and one private high school that were selected by multistage stratified sampling. The collected data were entered into Epi Info version 3.1 and analyzed using SPSS version 25. Binary and multivariable logistic regressions were used to find associations between dependent and independent variables.</p><p><strong>Results: </strong>The magnitude of primary dysmenorrhea was 68.4% (95% CI = 64.3%, 72.0%). Anxiety (AOR = 2.41, 95% CI = 1.31, 4.43), family history of primary dysmenorrhea (AOR = 4.64, 95% CI = 2.74, 7.86), sexual intercourse (AOR = 0.34, 95% CI = 0.21, 0.55), drinking tea <4 cups per day (AOR = 0.38, 95% CI = 0.22, 0.60), and physical activity (AOR = 0.06, 95% CI = 0.03, 0.11) were factors associated with primary dysmenorrhea.</p><p><strong>Conclusion: </strong>The magnitude of primary dysmenorrhea was high among high school students in the study area. Sexual intercourse, physical activity, drinking tea, anxiety, and family history of primary dysmenorrhea were significantly associated with primary dysmenorrhea.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1451551"},"PeriodicalIF":2.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11747760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017579","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}
Amal Benbella, Gitau Mburu, Asmaa Zaidouni, Sanae Elomrani, Abdelhakim Yahyane, Karima Gholbzouri, James Kiarie, Rachid Bezad
{"title":"Experiences of infertility among couples in Morocco.","authors":"Amal Benbella, Gitau Mburu, Asmaa Zaidouni, Sanae Elomrani, Abdelhakim Yahyane, Karima Gholbzouri, James Kiarie, Rachid Bezad","doi":"10.3389/frph.2024.1513243","DOIUrl":"10.3389/frph.2024.1513243","url":null,"abstract":"<p><strong>Introduction: </strong>Infertility has significant implications on health. It affects physical, emotional, and social wellbeing. In Morocco, about 12% of couples or live with infertility. In 2013 the first public Assisted Reproductive Technology (ART) Center was established at the Maternity and Reproductive Health Hospital les Orangers in Rabat, Morocco. This qualitative study explores the experiences of infertility among couples who have benefited from diagnosis and treatment at ART center. The study represents a part of the overall evaluation of this first public ART centre in Morrocco.</p><p><strong>Methods: </strong>Data were collected through in-depth patient interviews. A semi-structured interview guide was used to elicit the perspectives and experiences couples with infertility. Data collection occurred between January and March 2023. Inductive thematic analysis was conducted to explore the experiences of infertility among the couples.</p><p><strong>Results: </strong>The study showed that couples with infertility were exposed to negative experiences such as (i) biomedical experiences (diagnostic delays, fragmented care, multiplicity of treatments), (ii) social experiences (gendered social pressures, stigma, discrimination, marital challenges, isolation and disrupted social routines), (iii) mental experiences (anger, anxiety, depression, and mood changes) as well as (iv) financial limitations (out of pocket payments and financial indebtedness). Solutions addressing these challenging experiences were suggested by interviewed couples including continued quality and respectful care to enhance biomedical experiences; public education campaigns to educate the public and destigmatize infertility to improve social experience, inclusion of psychosocial services as part of fertility integrated care to enhance psychological experiences, and enhanced financial protection, and service decentralisation to mitigate negative financial pressures.</p><p><strong>Conclusion: </strong>Couples with infertility are exposed to various challenges in the biomedical, social, psychological, and financial domains. A health system strengthening approach is essential to address those challenges, and multiple strategies are needed to improve the experiences of couples with infertility in Morocco. Given interconnectedness between biomedical, social, psychological, and financial divers of experiences, a holistic approach is required to comprehensively improve the experiences of infertile couples and address all the issues faced by couples during their treatment journey.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1513243"},"PeriodicalIF":2.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025373","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}
Mariam F Yusuf, Washington Onyango-Ouma, Jacinta Victoria S Muinde, Cynthia Khamala Wangamati
{"title":"Challenges faced by community health volunteers in offering sexual and reproductive health care services to young women during the COVID-19 pandemic in Khwisero and Nairobi in Kenya.","authors":"Mariam F Yusuf, Washington Onyango-Ouma, Jacinta Victoria S Muinde, Cynthia Khamala Wangamati","doi":"10.3389/frph.2024.1491093","DOIUrl":"10.3389/frph.2024.1491093","url":null,"abstract":"<p><strong>Introduction: </strong>Community health volunteers (CHVs) are fundamental in many health systems across the globe. In Kenya, CHVs were essential in providing sexual and reproductive health (SRH) services during the COVID-19 pandemic. The study highlights challenges experienced by community health volunteers in Kenya while providing SRH services during the COVID-19 pandemic.</p><p><strong>Method: </strong>The study utilized a qualitative research design to explore challenges experienced by CHVs in offering SRH services in Dagoretti North and South sub-counties in Nairobi and Khwisero sub-county in western Kenya during the COVID-19 pandemic period. We conducted 17 in-depth interviews, 7 focus group discussions, and 1 group discussion with CHVs. The data was collected in different periods: in Khwisero, November 2022-August 2023, and in Nairobi, February-April 2023.</p><p><strong>Results: </strong>The study's findings show that CHVs experienced several challenges while providing SRH services. The challenges included distrust by the community as a result of the interaction between anti-COVID-19 measures and other past and present health interventions such as vaccines for other diseases, insufficient personal protective gear and equipment (PPEs), limited human and financial resources to address community needs, limited and poor training on response to misinformation that led to vaccine hesitancy, and mental strain from stigma and burnout.</p><p><strong>Conclusion: </strong>During pandemics, governments should provide adequate personal protective gear and financial and human resources for CHVs' work as they deliver SRH services to the community under risky conditions. In addition, CHVs must be trained to address misinformation about relevant medical interventions during epidemics and pandemics and provided with psychosocial support to mitigate the impact of psychological distress.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1491093"},"PeriodicalIF":2.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11747763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017575","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}