Frontiers in reproductive health最新文献

{"title":"Academic stress and irregular menstruation influence the dysmenorrhea, school absenteeism and healthcare seeking among adolescent girls in junior high school in Shanghai: a cross-sectional study.","authors":"Tiantian Liu, Deyun Qi, Li Zhang, Jun Hou, Jing Zhao, Yuan Zhou, Bingbing Sun, Fei Wang, Hui Tan, Ruiping Wang","doi":"10.3389/frph.2025.1574195","DOIUrl":"10.3389/frph.2025.1574195","url":null,"abstract":"<p><strong>Background: </strong>Dysmenorrhea is a cramping pain during menstrual period and the leading cause for recurrent short-term school absenteeism among adolescent girls. However, evidence on the factors associated with the occurrence of dysmenorrhea, school absenteeism and health care seeking behavior among adolescent girls is still limited, especially in China. This study aim to understand the prevalence of dysmenorrhea and to explore factors associated with the school absenteeism and healthcare seeking habit among adolescent girls with dysmenorrhea.</p><p><strong>Methods: </strong>This cross-sectional,questionnaire-based study included 1,243 participants recruited from five junior high schools using cluster sampling method. Data were collected through a structured questionnaire interviews and SPSS 22.0 was used for data analysis.</p><p><strong>Results: </strong>The prevalence of dysmenorrhea was 67.2%. Logistic regression analysis indicated that adolescent girls in grade 8 (OR = 1.98, 95% CI: 1.32-2.97) and grade 9 (OR = 2.32, 95% CI: 1.54-3.48), whose mothers had a college and above education (OR = 1.85; 95% CI: 1.12-3.07), those with controllable learning burden (OR = 1.69, 95% CI: 1.10-2.60) and uncontrollable learning burden (OR = 2.04, 95% CI: 1.10-3.80) had higher prevalence of dysmenorrhea. Logistic regression indicated that adolescent girls with normal weight (OR = 0.60, 95% CI: 0.43-0.83) had lower proportion of school absenteeism, and adolescent girls with uncontrollable learning burden (OR = 2.73, 95% CI: 1.29-5.75) and with irregular menstruation (OR = 1.74, 95% CI: 1.26-2.39) had higher proportion of school absenteeism. Moreover, underweight adolescent girls, adolescent girls whose mother had senior high education and those with irregular menstruation had a higher proportion of healthcare seeking experience.</p><p><strong>Conclusions: </strong>Dysmenorrhea was common among adolescent girls in junior high schools in Shanghai, and academic stress as well as irregular menstruation was positively associated with dysmenorrhea and school absenteeism. More attention and intervention measures focusing on menstrual health problems should be implemented directly among adolescent girls in junior high school, especially among those with low body weight, irregular menstruation, and academic stress. Most importantly, this study provides scientific evidence on adolescent dysmenorrhea issues, offering targeted recommendations for policymakers to advance the refinement and implementation of public health policies.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1574195"},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777072","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":"First live birth after <i>in vitro</i> fertilization in a woman with Alström syndrome: a case report.","authors":"Andrea Roberto Carosso, Marco Carosso, Alberto Revelli, Stefano Canosa, Luca Marozio, Gianluca Gennarelli, Pietro Maffei, Serena Ditaranto, Chiara Benedetto","doi":"10.3389/frph.2025.1585308","DOIUrl":"10.3389/frph.2025.1585308","url":null,"abstract":"<p><strong>Purpose: </strong>Alström syndrome (AS) is an extremely rare, autosomal recessive genetic disorder. Fertility implications are particularly relevant for women affected by AS, and no cases of patients achieving pregnancy and live birth with <i>in vitro</i> fertilization (IVF) have been previously described. This case report describes the first worldwide live birth after IVF in a woman affected by AS.</p><p><strong>Methods: </strong>This case report describes the IVF procedure and pregnancy management of an infertile woman suffering from AS.</p><p><strong>Results: </strong>After two intracytoplasmic sperm injections (ICSI), combined with preimplantation genetic testing for aneuploidies (PGT-A), a euploid blastocyst was transferred, resulting in a clinical pregnancy. Gestation was complicated by gestational diabetes mellitus and chronic hypertension, which were well controlled by specific treatments. At 38 weeks of gestation, a healthy child of 3,110 g was born.</p><p><strong>Conclusion: </strong>The successful outcome of this rare case suggests that IVF is feasible in the case of women with AS, but a multidisciplinary, continuous follow-up aimed at controlling comorbidity-linked complications is needed.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1585308"},"PeriodicalIF":2.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746367","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":"Efficacy of estradiol-dydrogesterone and auto-crosslinked hyaluronan gel in preventing intrauterine adhesions following missed miscarriage curettage: a retrospective observational study.","authors":"Huilin Sheng, Mengyun Sui, Lin Zhang, Jingfang Shi, Long Xue","doi":"10.3389/frph.2025.1602451","DOIUrl":"10.3389/frph.2025.1602451","url":null,"abstract":"<p><strong>Objective: </strong>Curettage is a common treatment for missed abortion (MA). However, intrauterine adhesions (IUA) are a major postoperative problem that can lead to infertility and menstrual abnormalities. This study aimed to evaluate the effectiveness of estradiol-dydrogesterone (ED), auto-crosslinked hyaluronan (AH) gel, and their combination in preventing IUA following MA curettage.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted between June 2022 and December 2023. A total of 284 women following MA curettage were included, with 265 completing follow-up assessments. Participants were divided into four groups: (1) ED group (oral estradiol-dydrogesterone therapy), (2) AH group (intrauterine AH gel application), (3) ED + AH group (combination therapy), and (4) control group (no intervention). IUA diagnosis was confirmed via hysteroscopy.</p><p><strong>Results: </strong>The incidence of IUA was significantly lower in the intervention groups compared to the control group (<i>p</i> = 0.001). The IUA rates were 7.94% in the ED group, 6.15% in the AH group, 5.71% in the ED + AH group, and 23.88% in the control group. Logistic regression analysis identified a significant reduction in IUA risk for patients receiving ED (OR = 0.17, <i>p</i> = 0.005), AH (OR = 0.13, <i>p</i> = 0.002), and ED + AH (OR = 0.15, <i>p</i> = 0.005) compared to the control group. Additionally, a history of three or more miscarriages was associated with a higher risk of IUA (OR = 4.34, <i>p</i> = 0.027).</p><p><strong>Conclusion: </strong>This study demonstrates that prophylactic treatment with ED and/or AH significantly reduces the incidence of IUA following curettage for MA. These findings underscore the importance of individualized endometrial repair and adhesion prevention strategies in preserving female reproductive health.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1602451"},"PeriodicalIF":2.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735877","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":"Mapping the journey: enhancing abortion care in Uganda's health systems.","authors":"Steve Biko Sigu, Isaac Milton Odongo, Wilbert Nango, Silvester Ochieno Okechi, Annah Kukundakwe, John Musoba Kitui","doi":"10.3389/frph.2025.1609662","DOIUrl":"10.3389/frph.2025.1609662","url":null,"abstract":"<p><strong>Introduction: </strong>This study explores women's experiences with abortion care in Uganda's public health system, assessing satisfaction levels and their influence on the uptake of abortion and post-abortion contraception services. Conducted across nine districts, it highlights challenges within a legally restricted abortion landscape that continues to contribute to high rates of unintended pregnancies and unsafe abortions.</p><p><strong>Methods: </strong>The study employed a mixed-methods approach involving client exit interviews and in-depth interviews across nine Ugandan districts from January to June 2024 in 13 Ipas Alliance-supported health facilities. Data from 440 women aged 15-49 captured demographics, treatment outcomes, abortion service uptake, post-abortion contraception use, and satisfaction levels. Additionally, 63 in-depth interviews provided qualitative insights into women's care experiences. Quantitative data were analyzed using logistic regression to assess associations between sociodemographic factors, provider interaction, and satisfaction with abortion services, offering a comprehensive understanding of the client journey and care quality.</p><p><strong>Results: </strong>Logistic regression analysis of client exit interview data revealed no statistically significant differences in satisfaction levels across sociodemographic groups, including age, marital status, facility location, education level, or type of abortion service. However, positive provider engagement was strongly associated with higher satisfaction. Clients who experienced respectful and supportive interactions were significantly more likely to report satisfaction (OR: 0.47, 95% CI: 1.14-14.47, <i>p</i> = 0.01), and indicated greater willingness to recommend the facility and return for future services, underscoring the importance of quality provider-client engagement. Qualitative insights offered an in-depth understanding of women's experiences with abortion care services across different levels of the health system.</p><p><strong>Conclusion: </strong>Client satisfaction with abortion services was strongly linked to positive provider engagement rather than sociodemographic factors. Respectful, supportive interactions significantly increased the likelihood of satisfaction with care, future service use of services, and facility recommendation. These findings underscore the critical role of provider-client relationships in improving service experience. To enhance the quality of abortion care, health systems should prioritize respectful counseling, strengthen referral pathways, and address structural constraints to service delivery.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1609662"},"PeriodicalIF":2.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735878","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":"Role of personal care products as endocrine disruptors affecting reproductive age women.","authors":"Nitin Kalsi Rajashekara, Madhumitha Natarajan, Asha Srinivasan, Jovitha Babu, SubbaRao V Madhunapantula, Bindu Jayshankar, Raghu Nataraj","doi":"10.3389/frph.2025.1514060","DOIUrl":"10.3389/frph.2025.1514060","url":null,"abstract":"<p><p>The impact of endocrine-disrupting chemicals (EDCs) on public health is growing due to their wide-ranging consequence and likelihood of morbidity on human health. Humans are confronted with EDCs through their skin and drinks, as well as by inhaling. EDCs are extensively dispersed in the environment. EDCs have been shown to primarily influence puberty, the reproductive system, embryonic growth, the hypothalamus-pituitary-gonadal axis (HPG) neuroendocrine axis, and gender differentiation in the foetus, despite their capacity to influence a variety of hormone systems. Treatment for afflicted persons will benefit greatly from an understanding of the several ways that modifiable lifestyle circumstances connected to PCPS impede female infertility. The purpose of this review is to raise awareness of the hidden danger that environmental dyes (EDCs) pose to human health, particularly in terms of their detrimental effects on female reproductive health.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1514060"},"PeriodicalIF":2.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735879","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 induced abortions in Pakistan: a comprehensive analysis of Pakistan maternal mortality survey 2019.","authors":"Samina Naeem Khalid, Farid Midhet, Qudsia Uzma, Ellen Mpangananji Thom, Shehla Baqai, Muhammad Talha Khan, Areeba Memon","doi":"10.3389/frph.2025.1536582","DOIUrl":"10.3389/frph.2025.1536582","url":null,"abstract":"<p><strong>Background: </strong>Induced abortions (IA) remain a serious public health issue in Pakistan despite social constraints and legal prohibitions. The number is alarmingly high, and the study done by the Population Council (2012) indirectly estimated 2.2 million abortions per year and an abortion rate of 50 per 1,000 women.</p><p><strong>Methodology: </strong>This study reports the results of a secondary data analysis of the Pakistan Maternal Mortality Survey 2019 to compare the women who reported having an IA in the last three years with those having a live birth in the same period. A nested case-control comparison of women reporting IA as cases and those having a live birth as controls. Logistic regression was used to estimate odds ratios (OR) for major risk factors of maternal mortality after adjusting for women's age, parity, education, and wealth quintile.</p><p><strong>Results: </strong>Results show that recent use of family planning, having a prior history of pregnancy loss, and higher gravidity are all linked to IA (<i>P</i> < 0.05). On the other hand, neither the average household education nor the women's education affects the rates. The other associated factors include parity, past use of family planning, socioeconomic status, place of residence, and the educational level of women. These correlations are based only on uncorrected odds ratios and do not account for confounding variables.</p><p><strong>Conclusion: </strong>Women having past miscarriages, having several children, or improperly using family planning methods are more likely to have induced abortions. These findings can help medical professionals develop evidence-based policies and regulations.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1536582"},"PeriodicalIF":2.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710041","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 qualitative exploration of STI partner notification services delivery models among key stakeholders in rural southwestern Uganda.","authors":"Pooja Chitneni, Moran Owembabazi, Eunice Kanini, Rosemary Kansiime, Winnie R Muyindike, Christina Psaros, Jessica E Haberer, Lynn T Matthews","doi":"10.3389/frph.2025.1564836","DOIUrl":"10.3389/frph.2025.1564836","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive STI care requires not only patient treatment but STI partner notification (PN) and evaluation to prevent ongoing STI transmission and reinfection. In rural, southwestern Uganda, we explored healthcare practitioners' views on three STI PN models that focused on task-shifting to non-physician practitioners to inform the development of a novel STI PN services delivery system.</p><p><strong>Methods: </strong>From September to November 2023, we conducted individual in-depth interviews with 32 participants from 4 categories (8 participants from each category): patients with a self-reported history of having an STI in Uganda, healthcare workers (physicians, nurses, and community health workers), pharmacists, and healthcare administrators (Ministry of Health officials and regional referral hospital administrators). Interviews explored participants' views on a nursing-based, pharmacy-based, and community-based STI PN models as well as healthcare system tools and needs to facilitate PN. We used inductive and deductive approaches to generate a codebook guided by the Consolidated Framework for Implementation Research in a thematic analysis.</p><p><strong>Results: </strong>Ten female and twenty-two male participants participated in individual in-depth interviews. The median age of the patient and healthcare practitioner participants was 32 and 34 years, respectively. We found that (1) the nursing model was overall supported as nurses (though with one participant noting dissatisfaction with nurses), (2) pharmacies are well-positioned to engage in STI PN as they are early points of contact for patients, incentivized monetarily by PN and patient-delivered partner medication, and have the potential to physically restructure to create private spaces and increase counseling training, (3) the community-based model should center on village health teams and focus on advocacy and education.</p><p><strong>Conclusion: </strong>Given the high STI incidence globally and in sub-Saharan Africa, exploring innovative STI care models that resonate with patients and healthcare practitioners will be important. Future work includes a Delphi method to refine these models for testing.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1564836"},"PeriodicalIF":2.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683642","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":"Risk factors and countermeasures for abnormal uterine bleeding during dienogest therapy for adenomyosis: a review.","authors":"Shiyu Zhang, Hua Duan","doi":"10.3389/frph.2025.1550814","DOIUrl":"10.3389/frph.2025.1550814","url":null,"abstract":"<p><p>Adenomyosis, an estrogen-dependent disorder, requires long-term therapy as current treatments (GnRH agonists, danazol, etc.) show symptom recurrence post-discontinuation. Dienogest (DNG), a selective progesterone receptor agonist, effectively reduces adenomyosis-related pain but causes abnormal uterine bleeding (AUB) in some patients, likely due to pseudodecidual breakthrough bleeding, significantly impacting treatment compliance. This review examines risk factors for DNG-associated AUB and advances in management strategies to improve patient adherence during prolonged therapy.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1550814"},"PeriodicalIF":2.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638784","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":"Equipping community health workers in Rwanda to deliver a gender transformative parenting program to prevent violence against women and children at scale.","authors":"Kate Doyle, Isha Bhatnagar, Emmanuel Karamage, Jean Paul Tuyisingize, Chantal Muhimpundu, Ange Marie Yvette Nyiransabimana, François Regis Cyiza, Fidèle Rutayisire, Silas Ngayaboshya, Webster Mavhu","doi":"10.3389/frph.2025.1602136","DOIUrl":"10.3389/frph.2025.1602136","url":null,"abstract":"<p><strong>Introduction: </strong>In Rwanda, the Bandebereho program has demonstrated long-term reductions in intimate partner violence (IPV) and violence against children. Since 2019, the program has partnered with government to train community health workers (CHWs) to deliver at scale. Evidence on how to equip CHWs to deliver Bandebereho, or similar programs, with quality and fidelity is needed to support scaling. This study sought to assess the impact of training on CHWs and their capacity to deliver Bandebereho during scale up.</p><p><strong>Methods: </strong>A pre/post, follow-up study was conducted with 573 CHWs in Burera district. Data were collected at three time points over 20 months using self-administered questionnaires (pre/post) and a follow-up phone survey. Questionnaires gathered data on CHW attitudes about gender roles and violence, self-reported skills, knowledge and confidence to implement Bandebereho, and training impacts on partner relations and community work. Informed consent was obtained from all study participants.</p><p><strong>Results: </strong>The pre-survey was completed by 562 CHWs and 564 CHWs completed the post-survey after six to nine months. The phone survey was administered to 506 CHWs at follow-up (at 17-19 months). Analysis of changes between pre- and post-surveys found CHWs had more equitable gender attitudes after the training. Linear regression analysis found that CHWs with some secondary education (coefficient: -2.15, <i>p</i> < 0.01) and more than three years' experience (coefficient: -2.27, <i>p</i> < 0.001) were less likely to hold inequitable attitudes. At post-survey, CHWs reported a high level of preparedness to implement, regardless of gender. A majority reported improved partner relations, including greater partner support for their community work. At follow-up, a majority of CHWs reported a high degree of comfort and confidence implementing Bandebereho, and benefits to their work and personal relationships.</p><p><strong>Conclusions: </strong>The findings highlight the importance of investing in high-quality facilitator training, which allows sufficient time for facilitators' own transformation, to maintain quality and fidelity at scale. The findings underscore the importance of a slow and steady approach, with sufficient time to adapt, test, and refine IPV programs for scale, which can also support a progressive handover to government. The findings may support program originators who seek to scale proven IPV prevention programs with government in other settings.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1602136"},"PeriodicalIF":2.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585748","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":"Using quality improvement to close HIV prevention gaps and strengthen district health systems: Blantyre, Malawi's approach and early implementation.","authors":"Sara M Allinder, Edward Moses, Moses Enock, Gift Kawalazira, Rose Nyirenda, Andrew Gonani, Yohane Kamgwira, Bruce Agins, Richard Birchard, Joseph Murungu, Deborah Hoege, Charles B Holmes, Martias Joshua","doi":"10.3389/frph.2025.1558630","DOIUrl":"10.3389/frph.2025.1558630","url":null,"abstract":"<p><p>Application of quality improvement (QI) methodology to HIV prevention is relatively nascent but has the potential to transform national and local programs. In Blantyre, Malawi, a unique government-led partnership known as the Blantyre Prevention Strategy (BPS) is applying QI as a core element of a cohesive sub-national HIV prevention system. BPS launched a QI collaborative (QIC) in early 2021-the first of its kind dedicated to HIV prevention within a health system context-focused on scale-up of pre-exposure prophylaxis (PrEP) to prevent HIV. Known as PrEPUp!, the QIC included 23 participating facilities-representing the public and private sectors, drop-in centers for key populations, and a tertiary education clinic-and has become the major platform for facility teams to exchange knowledge and share progress. Based on the implementation of QI activities, interventions identified for testing resulted in health center system modifications that promotes increased uptake of PrEP. In addition, knowledge generated through the QIC informs other stakeholders, including implementing partners funded by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), and improves coordination and mentoring executed by the Blantyre District Health Office (DHO). In a departure from traditional QI, BPS has engaged community labs that generate insights from clients and other influential stakeholders about demand and service access barriers and has connected those labs with facilities through learning sessions. This approach has been widely lauded locally in Malawi and is being adapted in Lilongwe District to underpin implementation science for injectable PrEP.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1558630"},"PeriodicalIF":2.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562170","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}