PLOS global public health最新文献

{"title":"Perceptions regarding making household air pollution a routine topic for health education during antenatal care: A qualitative study in Eastern Uganda.","authors":"Joshua Epuitai, Katherine E Woolley, Rose Chalo Nabirye, Julius N Wandabwa, Joseph Odula, Ivan Lyagoba, G Neil Thomas","doi":"10.1371/journal.pgph.0003973","DOIUrl":"10.1371/journal.pgph.0003973","url":null,"abstract":"<p><p>In Uganda, pregnant women do not routinely receive health education during antenatal care regarding exposure to household air pollution (HAP). The study was conducted to explore perceptions regarding what would be needed to incorporate HAP as a routine topic for health education during antenatal care. The study was based on the capability, motivation, opportunity-behavior (COM-B) model. Qualitative interviews were conducted among healthcare workers and pregnant women attending antenatal care at Mbale Regional Referral Hospital in Uganda. Thematic analysis was used to identify key themes. Capability to provide health education on HAP emanated from health system factors (e.g., lack of capacity, workload, time constraints) and behavioral factors (e.g., HAP not seen as a major risk factor for adverse pregnancy outcomes). Capability to adopt cleaner fuels following health education was thought to be affected by willingness to adopt short-term interventions ahead of cleaner fuels alternatives, cost/affordability constraints, unwillingness to change, and socio-cultural concerns. Socio-economic constraints, weather and safety concerns were thought to affect women's capability to open doors/windows and cook outdoors following health education. Participants were motivated to provide/receive antenatal health education because of their need to reduce adverse birth outcomes caused by HAP, acceptability of HAP as a topic for education, and the perception of healthcare workers as role models. Training midwives about HAP, using innovative teaching aids, including prompts on HAP in the antenatal card to remind healthcare workers to talk about HAP, giving incentives to healthcare workers and involving them when designing health education about HAP were suggested to enable integration of HAP as routine topic. Our study highlights an opportunity to empower and create demand among pregnant people to adopt behaviors that could reduce exposure to HAP during ANC. Integration of HAP into antenatal care could help transition households from precontemplation and contemplation stage in the uptake of cleaner fuels.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 9","pages":"e0003973"},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071105","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":"Respiratory virus infection dynamics and genomic surveillance to detect seasonal influenza subtypes in wastewater: A longitudinal study in Bengaluru, India.","authors":"Namrta Daroch, Subash K Kannan, Vishwanath Srikantaiah, Rakesh Mishra, Farah Ishtiaq","doi":"10.1371/journal.pgph.0004640","DOIUrl":"10.1371/journal.pgph.0004640","url":null,"abstract":"<p><p>Recent global pandemics have been caused by respiratory viruses in humans and animals with zoonotic spillover potential. Respiratory viruses, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respiratory syncytial virus (RSV), influenza A virus (IAV), and influenza B virus (IBV), share overlapping ecology and similar symptoms. However, respiratory disease surveillance is often passive, relying on clinical specimen testing. Wastewater surveillance has been used for early detection of SARS-CoV-2 variants and can differentiate between respiratory virus infections and SARS-CoV-2 peaks at the community level. In this retrospective longitudinal study covering four SARS-CoV-2 Omicron waves, we conducted monthly sampling for 28 months (812 samples) between August 2021 and December 2023 at 28 sewershed sites in Bengaluru (~11 million inhabitants), India. Using RT-qPCR kits, we quantified SARS-CoV-2 RNA concentrations, IAV, IBV, and RSV to understand community viral infections. We found 86% of samples positive for SARS-CoV-2, while positivity rates for influenza virus and RSV were lower (37% for IAV, 16% for IBV, and 15% for RSV) and this pattern was consistent across sites. We observed a seasonal increase in influenza viruses during the monsoon, peaking in October, with mean IAV viral loads of 755 copies/person/day in 2021, 2000 copies/person/day in 2022, and 1749 copies/person/day in 2023. IAV was present in January and February but absent the rest of 2022. However, IAV viral load was detected throughout 2023 (except in June). IBV showed a similar trend, peaking in October, with mean viral loads of 616.56 copies/person/day in 2021, 323.37 copies/person/day in November 2022, and 373.37 copies/person/day in September 2023. RSV displayed a shorter transmission window, peaking at around 2000 copies/person/day in October. Using genomic data, we provide evidence of changes in the relative abundance of influenza subtypes and SARS-CoV-2 variants, identifying all eight segments of influenza virus genomes and emerging SARS-CoV-2 variants in wastewater samples. Wastewater surveillance provides data on the diversity and relative abundance of respiratory viruses in urban Bengaluru that would not be reported otherwise. Under the One Health framework, wastewater surveillance can offer early warning signs and enhance traceability of infectious diseases in wildlife and humans.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 9","pages":"e0004640"},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056482","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 and determinants of the triple burden of malnutrition in Ghana; Analyses of two decades of demographic and health survey datasets.","authors":"Hammond Yaw Addae, Rafatu Tahiru, Afizu Alhassan, Abdul-Ganiyu Fuseini, Mohammed Iddrisu, Wilhelmina Mensah, Fusta Azupogo, Martin Nyaaba Adokiya","doi":"10.1371/journal.pgph.0005078","DOIUrl":"10.1371/journal.pgph.0005078","url":null,"abstract":"<p><p>Anaemia, undernutrition and obesity remain complex public health challenges. Their coexistence among households, commonly known as the triple burden of malnutrition (TBM) is a new concept that lacks scholarship within the maternal and child nutrition discourse in Ghana. This study therefore aimed to evaluate the trends and factors associated with TBM among mothers and their children aged 0-59 months in Ghana. This study combined and analysed datasets from the Ghana Demographic and Health Survey from 2003 to 2022. Prevalence and multivariable logistic regression were used to evaluate the trends and determinants of TBM among 11,925 mother-child pairs using complex sample procedures. The pooled prevalence of TBM was 6.7% (5.7 - 6.7). This reduced from 7.6% (6.6 - 8.7) in 2003 to 5.0% (4.1-6.2) in 2022. Male children [AOR 2.23, 95% CI:1.33 - 3.74, p = 0.002] were more likely to suffer TBM than female children. Large birth size [AOR 0.30, 95% CI: 0.17 - 0.54, p < 0.001] and breastfed children [AOR 0.13, 95% CI:0.05 - 0.34, p < 0.001] were less likely to suffer TBM. Women with no education [AOR 5.14, 95% CI:1.16 - 22.75, p < 0.031] and those with inadequate dietary diversity [AOR 2.53, 95% CI:1.50 - 4.26, p < 0.001] were more likely to suffer TBM. Also, high-wealth [AOR 0.13, 95% CI:0.05 - 0.33, p < 0.001] and rural households [AOR 0.34, 95% CI: 0.05 - 0.33, p < 0.001] were less likely to suffer TBM. Although the prevalence of TBM reduced over the past two decades, the pooled estimate remains high in Ghana. The associated factors include breastfeeding, childbirth size, maternal education, dietary diversity, wealth and urbanicity. Strategies that promote breastfeeding, improve dietary diversity and ensure equitable distribution of resources are urgently needed to mitigate the TBM.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 9","pages":"e0005078"},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056573","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":"Survival analysis of under-five mortality and associated risk factors using survival analysis approaches.","authors":"Abdul-Karim Iddrisu, Emmanuel Boanyo","doi":"10.1371/journal.pgph.0005179","DOIUrl":"10.1371/journal.pgph.0005179","url":null,"abstract":"<p><p>The risk of under-five mortality is a vital measure of healthcare system performance and directly reflects progress toward Sustainable Development Goal (SDG) 3.2, which targets the elimination of preventable deaths among newborns and children under-five, aiming to reduce mortality rates to at least 25 per 1,000 live births by 2030. While Ghana has made notable progress in lowering child mortality in recent decades, the current rates remain above this benchmark. Identifying the predictors of under-five mortality is therefore critical for shaping evidence-based policies and targeted interventions that can accelerate progress toward SDG 3 and improve child health outcomes. To explore these predictors, we employed advanced survival modeling techniques. The conventional Cox-proportional hazards (Cox-PH) model assumes constant covariate effects over time, but violations of this assumption can lead to biased results. To address this, we used the extended Cox-PH model, which accommodates time-varying effects. Data were drawn from the 2022 Ghana Demographic and Health Survey (GDHS), based on a stratified two-stage cluster sampling design. Since under-five deaths are relatively rare (<10%), traditional models may yield unstable hazard ratios. We therefore applied Bayesian survival analysis to obtain more stable estimates and incorporated multilevel survival modeling to account for unobserved heterogeneity within the DHS sampling structure. Results showed that male children (HR = 1.20, 95% CI: 1.11-1.30) and twins (HR = 2.90, 95% CI: 2.51-3.34) faced higher mortality risk. Caesarean delivery (HR = 1.60, 95% CI: 1.08-2.37) and larger birth size also increased hazards. In contrast, term birth (HR = 0.16, 95% CI: 0.14-0.19), maternal education, and higher household wealth were protective. Children requiring special attention after delivery had improved survival (HR = 0.57, 95% CI: 0.38-0.89). Strengthening maternal and newborn care, coupled with addressing socioeconomic inequalities, is essential to reducing child mortality and achieving Ghana's SDG 3.2 targets.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 9","pages":"e0005179"},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056523","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":"Invisible inequities in type I diabetes care in India: A multi-stakeholder qualitative study from Karnataka.","authors":"Veruschka Pandey, Satyanarayana Ramanaik, Lalitha Krishnappa, Patel Swathe, Suresh Shastri, Santhosh Olety Sathyanarayana, Giridhara Rathnaiah Babu","doi":"10.1371/journal.pgph.0005129","DOIUrl":"10.1371/journal.pgph.0005129","url":null,"abstract":"<p><p>Type 1 Diabetes mellitus (T1DM) affects a substantial population in India, with significant challenges related to healthcare access and financial burden. This study aims to explore the multi-level barriers and enablers of T1DM care in Karnataka state, providing evidence-based recommendations for policymakers to improve healthcare services. This qualitative study employed in-depth interviews (IDIs) and focus group discussion (FGDs) with multiple stakeholders, including ten People with Type-1 Diabetes Mellitus (PwT1DM) aged 5-23 years and their caregivers, 13 Healthcare providers (HCPs) -Endocrinologists, paediatricians, diabetes educators, and primary care physicians; and ten senior health officials and six Policymakers. Participants were selected using purposive sampling from both urban and rural settings across Karnataka. Data was collected over six months, and qualitative research software was used to analyse the transcribed data thematically. The study was approved by the Institutional Ethical Committee of M.S. Ramaiah Medical College. Significant obstacles include inadequate integration of policies within India's national framework, erratic insulin availability, substantial out-of-pocket costs, and insufficient training for healthcare providers. Rural demographics face compounded disadvantages due to poor healthcare infrastructure, while caregivers, especially mothers, struggle with financial and emotional burdens; People with TIDM endure social stigma and mental health issues, particularly affecting females. The study highlights the critical need for formulating dedicated T1DM policies within the framework of the existing Non-Communicable Disease program. Implementation of subsidized insulin schemes and expansion of primary care services, along with a multi-sectoral strategy, encompassing enhanced training for HCPs, integration of digital health solutions, and development of community-based support systems, is essential for effective and sustainable T1DM management. Addressing financial and gender-based disparities is crucial to ensure equitable care in both urban and rural areas.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 9","pages":"e0005129"},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056505","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":"Advancing the safe motherhood initiative: A qualitative and sentiment analysis of local physician's perspectives on antibiotic self-medication during pregnancy in a low- and middle-income country.","authors":"K Umeh, S Adaji, M Sacks, G U Eleje, E O Umeh, S Ushie, C G Okafor, C B Oguejiofor, U Bawa, S Bature, N H Madugu, R Singh, H Karuppuchamy","doi":"10.1371/journal.pgph.0004794","DOIUrl":"10.1371/journal.pgph.0004794","url":null,"abstract":"<p><p>Although the Safe Motherhood Initiative is currently a global priority, the implications of maternal self-medication for meeting Safe Motherhood and Sustainable Development Goal 3 objectives in low- and middle-income countries has yet to be addressed. Although local medical doctors are an influential stakeholder group, able to determine health policy, how they view and feel about the problem of antimicrobial self-medication during pregnancy is not well understood. Thus, this study explores physicians' views and sentiments regarding antibiotic self-medication in pregnant women from a West African country. We used mixed qualitative and quantitative analytic approaches. Semi-structured interviews were conducted with 25 medical doctors working in three tertiary hospitals. Thematic analysis was employed to identify key perspectives, while sentiment analysis was used to determine the emotional tone, based on an open-source pre-trained machine learning model for natural language processing. Several checks for methodological rigour were performed, including reviewing records of over 800 email conversations, and conducting respondent validation. Seven distinct themes emerged depicting views on antimicrobial treatment (e.g., easy availability of antibiotics), patient behaviour (e.g., use of medicinal herbs) and policy guidelines on antibiotics stewardship (lack of clear protocols). The prevailing sentiment portrayed a predominantly neutral demeanour towards antibiotic self-medication during pregnancy (χ2 (1, N = 1484) = 1314.858, p < 0.001), with an unusually high number of neutral labels, compared with positive (z = -36.058, p < 0.001) and negative (z = -36.410, p < 0.001) categories. The results of this investigation can provide useful information for managing antibiotic self-medication in pregnant women from resource-deprived regions where medical doctors are influential stakeholders. Our findings can be used to tailor local Safe motherhood policy initiatives on antimicrobial stewardship during pregnancy such that they address physician's concerns and sentiments, including insufficient clinical practice guidelines and an ostensible lack of urgency.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 9","pages":"e0004794"},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056491","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":"Status and prospects of seasonal malaria chemoprevention among children in Sahelian countries: A systematic review and meta-analysis.","authors":"Medard Djedanem, Noura Mamane Salé, Elhadji Yacoudima Yacoubou Mahaman Aminou, Jean Testa, Ronan Jambou","doi":"10.1371/journal.pgph.0005124","DOIUrl":"10.1371/journal.pgph.0005124","url":null,"abstract":"<p><p>In areas with seasonal malaria transmission, seasonal malaria chemoprevention (SMC) involves giving children a three-day course of sulfadoxine-pyrimethamine and amodiaquine once a month during the transmission season. This strategy has been used for ten years for children under five years of age. The logistical cost is affordable in malaria-endemic countries and varies slightly depending on accessibility. This systematic review and meta-analysis aims to better assess the effectiveness of seasonal malaria chemoprevention in reducing malaria incidence and prevalence in Sahelian countries, ten years after its introduction. This review followed the Preferred Reporting Items for Systematic Reviews (PRISMA) 2020 guidelines, and was based on Google scholar, MEDLINE (PubMed), the Cochrane library, African Journal Online, and Index Medicus African to compile its data. The combination of keywords such as \"malaria\", \"Plasmodium\", \"malaria chemoprevention\", \"Sahel\", \"Efficacy\", \"Resistance\", as well as Boolean operators (AND, OR) were used to inventory studies published between 2013 and 2023. Eligible studies included randomized clinical trials (RCTs), non-randomized trials, prospective cohort studies, intervention studies and observational studies. For randomized trials (RCTs), Cochrane's Risk of Bias 2 (RoB 2) tool was used to specifically assess the risk of bias in randomized controlled trials. And for non-randomized trials and observational studies, we applied the ROBINS-I (Risk of Bias in Non-randomized Studies of Interventions) tool, which included a meta-analysis of the studies. The study protocol was registered under the number (PROSPERO registry CRD42023413920), and R software was used for the meta-analysis. The meta-analysis shows that SMC is effective in reducing the incidence of uncomplicated malaria, severe malaria and mortality in children under five. Compared with control groups a reduction in the burden of malaria was observed in children receiving SMC. SMC appears to effectively reduce the incidence of malaria in children under five. However, it should be noted that SMC is always used alongside other prevention strategies, such as indoor residual spraying and long-lasting insecticide-treated nets. However, the epidemiological context of the Sahelian region is changing, and the strategy must be adapted to address the persistence of transmission during the dry season and the increase in malaria cases among older children.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 9","pages":"e0005124"},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056502","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 role of Rwanda Field Epidemiology and Laboratory Training Program graduates and residents in response to the first Marburg Virus Disease outbreak in Rwanda.","authors":"Edouard Ruseesa, Aphrodis Hagabimana, Fredrick Ntirenganya, Peace Kinani, Ruton Hinda, Emmanuel Nshimiyimana, Claude Niyoyita, Angela Umutoni, Caroline Stamatakis, Hugues Valois Mucunguzi, Edson Rwagasore","doi":"10.1371/journal.pgph.0004452","DOIUrl":"10.1371/journal.pgph.0004452","url":null,"abstract":"<p><p>Rwanda Field epidemiology and laboratory training programs (RFELTP) build capacity to improve disease surveillance, respond to public health emergencies, and inform evidence-based decision-making to mitigate the impact of epidemics and other public health events. On September 27, 2024, Rwanda declared its first Marburg virus disease (MVD) outbreak. MVD disease is a severe haemorrhagic fever with a fatality rate ranging from 24% to 90%. We describe the role played by the RFELTP in the outbreak response, and identify key strengths and challenges of the program related to the response. In November 2024, we provided a self-administered questionnaire delivered online to all residents and graduates of RFELTP. The questionnaire included sections on sociodemographic, experience in outbreak response, and MVD outbreak response experiences. Descriptive statistical analysis was performed, and the data were analysed using Stata version 16. Among the 523 total participants, 209 responded (40.0%). About a third of the participants (34.8%) supported MVD response activities. Residents and graduates supported the response in all 30 districts of Rwanda, mainly at the national and district levels. Most supported epidemiology and surveillance 41.2%, data management 19.2%, infection prevention control 14.3%, and leadership and coordination pillars 10.4%. Nearly all 96.7% felt adequately prepared by their RFELTP to handle outbreak responses. The RFELTP graduates and residents proved to be a critical resource in the MVD outbreak response, enhancing the country's capacity to respond to public health emergencies. Continued investment in this training program is essential for enhancing global health security and strengthening capabilities to respond to public health emergencies.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 9","pages":"e0004452"},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056535","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":"How maternal morbidities impact women's quality of life during pregnancy and postpartum in sub-Saharan Africa and South Asia: A qualitative study.","authors":"Martha Ali Abdulai, Priyanka Adhikary, Sasha G Baumann, Muslima Ejaz, Jenifer Oviya Priya, M Bridget Spelke, Victor Akelo, Kwaku Poku Asante, Bitanya M Berhane, Shruti Bisht, Ellen Boamah-Kaali, Gabriela Diaz-Guzman, Anne George Cherian, Zahra Hoodbhoy, Margaret P Kasaro, Amna Khan, Janae Kuttamperoor, Dorothy Lall, Gifta Priya Manohari, Sarmila Mazumder, Karen McDonnell, Mahya Mehrihajmir, Wilbroad Mutale, Winnie K Mwebia, Imran Nisar, Kennedy Ochola, Peter Otieno, Gregory Ouma, Piya Patel, Winifreda Phiri, Neeraj Sharma, Emily R Smith, Charlotte Tawiah, Natalie J Vallone, Allison C Sylvetsky","doi":"10.1371/journal.pgph.0004229","DOIUrl":"10.1371/journal.pgph.0004229","url":null,"abstract":"<p><p>Maternal morbidities present a major burden to the health and well-being of childbearing women. However, their impacts on women's functional health are not well understood. This work aims to describe how maternal morbidities affect women's quality of life (QoL) in pregnancy and the postpartum period . This qualitative study involved 118 pregnant and 135 postpartum women at six study sites in Kenya, Ghana, Zambia, Pakistan, and India. Data were collected between December 2023 and June 2024. Participants were selected via purposive sampling, with consideration of age, trimester, and time since delivery. A total of 23 focus group discussions with pregnant and late postpartum (≥6 months) participants and 48 in-depth interviews with early postpartum (≤6 weeks) participants were conducted using semi-structured guides. Data were analyzed using a collaborative, inductive, thematic approach. Four overarching themes were identified and were cross-cutting irrespective of continent or country : (1) physical and emotional challenges pose a barrier to daily activities; (2) lack of social support detracts from women's QoL; (3) receipt of social support mitigates adverse impacts of maternal morbidities on QoL; and (4) economic challenges exacerbate declines in women's QoL during pregnancy and postpartum. Physical and emotional morbidities related to childbearing severely limited women's ability to complete daily tasks and adversely impacted their perceived QoL. Social and financial support from the baby's father, family and/or in-laws, community members, and healthcare providers are important to mitigate the impacts of pregnancy and postpartum challenges on women's health and well-being.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 9","pages":"e0004229"},"PeriodicalIF":2.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042437","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":"Prevalence and risk factors for severe food insecurity and poor food consumption during a drought emergency in Ethiopia.","authors":"Noah Baker, Yunhee Kang, Gregory Makabila, Seifu Tadesse, Shannon Doocy","doi":"10.1371/journal.pgph.0004636","DOIUrl":"10.1371/journal.pgph.0004636","url":null,"abstract":"<p><p>Frequent drought has heightened nutritional concerns in Ethiopia. This study retrospectively assesses the prevalence and risk factors of severe food insecurity and poor food consumption in Productive Safety Net Programme households in drought-prone Ethiopia. Data was from the USAID-funded Resilience Food Security Activity baseline survey in East Hararghe, Ethiopia. Severe food insecurity (n = 4628; multivariate n = 4335) was defined as Food Insecurity Experience Scale (≥7) and poor food consumption (n = 4554; multivariate n = 4268) was defined as Food Consumption Score (≤21). Logistic regression identified adjusted odds ratio and 95% confidence interval of risk and protective factors. Severe food insecurity prevalence was 77.79% and poor food consumption was 69.74%. Risk factors for severe food insecurity included women/girls aged 15-19 (1.79; 1.36-2.34), current pregnancy (1.51; 1.17-1.96), history of pregnancy (3.46; 2.76-4.33), cash-earning work (1.35; 1.12-1.61), daily-per-capita food consumption <1.61USD (2.98; 1.91-4.66), crop-planting (1.67; 1.31-2.13), and handwashing facilities (3.83; 1.92-7.63); protective factors included two or more children-under-5 (0.72; 0.60-0.88), raising livestock/crops to sell (0.50; 0.42-0.60), and raising oxen (0.34; 0.26-0.45). Risk factors for poor food consumption included woman/girl (1.44; 1.15-1.81) and household-head no education (1.46; 1.18-1.79), daily-per-capita food consumption <1.61USD (4.01; 2.58-6.21), and financial services (2.10; 1.69-2.59); protective factors included women/girls aged 15-19 (0.59; 0.46-0.76) and 30-49 (0.76; 0.63-0.91), two or more children-under-5 (0.77; 0.64-0.91), current pregnancy (0.57; 0.47-0.70), history of pregnancy (0.70; 0.55-0.89), crop-planting (0.57; 0.44-0.75), raising livestock/crops to sell (0.40; 0.34-0.48) and raising oxen (0.68; 0.52-0.90). Vulnerable households included those with pregnant/lactating women, mothers, adolescent girls/women, no education, low assets, and no livestock. Our findings highlight a conceptual distinction, women/girls pregnancy and/or age status may influence household perception and/or definitions of food security despite reporting adequate consumption. The dual burden of food insecurity and poor consumption threatens current and future generations, and data-driven action can help progress towards the goal of zero hunger in Ethiopia.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 9","pages":"e0004636"},"PeriodicalIF":2.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042587","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}