Women's health (London, England)最新文献

{"title":"The lived experiences and coping mechanisms of women with obstetric fistula in Ethiopia: A systematic review and meta-synthesis of qualitative evidence.","authors":"Yonas Abebe, Diriba Bekele, Robera Demissie","doi":"10.1177/17455057251411072","DOIUrl":"10.1177/17455057251411072","url":null,"abstract":"<p><strong>Background: </strong>Obstetric fistula, a preventable consequence of prolonged obstructed labor, inflicts profound physical, psychological, and social suffering, leaving many women described as \"living dead.\" In Ethiopia, where the burden remains high, little is known about women lived experiences and coping strategies beyond clinical outcomes. This review was conducted to synthesize qualitative evidence, illuminate these challenges, and inform holistic interventions.</p><p><strong>Objectives: </strong>To synthesize available evidence on the lived experiences and coping mechanisms of women with obstetric fistula in Ethiopia.</p><p><strong>Design: </strong>This study employed a qualitative meta-synthesis approach.</p><p><strong>Data sources and methods: </strong>This review was conducted in accordance with the Joanna Briggs Institute systematic review and meta-synthesis methodological guidance and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. ATLAS.ti software, Version 25, Lumivero was used for analysis. A comprehensive literature search was performed across multiple databases up to May 25, 2025, including both published and unpublished studies examining the lived experiences of women with obstetric fistula. All eligible studies were critically appraised using the Critical Appraisal Skills Program to ensure methodological rigor. Data were systematically extracted and analyzed using thematic synthesis, and the results are presented through tables, narrative summaries, and illustrative diagrams, providing a coherent and evidence-based synthesis of women's experiences and coping mechanisms.</p><p><strong>Results: </strong>Eight studies met the inclusion criteria, encompassing the diverse experiences of women with obstetric fistula in Ethiopia. Four major themes were developed: physical challenges such as pain, foot drop, odor, and urinary incontinence; psychological challenges including hopelessness, grief, and suicidal ideation; socioeconomic challenges like stigma, isolation, divorce, loneliness, social disintegration, and economic difficulties; and coping mechanisms such as self-isolation and wearing multiple layers of clothing.</p><p><strong>Conclusion: </strong>Women with obstetric fistula face intersecting physical, psychological, and socioeconomic burdens that erode dignity and social participation. Coping strategies such as self-isolation and layering clothes, while adaptive, often reinforce stigma and exclusion. These findings highlight the need for comprehensive interventions that go beyond surgical repair to include psychosocial support, stigma reduction, and economic reintegration programs.</p><p><strong>Registration: </strong>Registered with PROSPERO 2025 CRD420251064015.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057251411072"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12759115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890730","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":"Intimate Partner Violence and Early Initiation of Breastfeeding: Evidence from the Peruvian Demographic and Family Health Survey.","authors":"Jennyfher R Toro-Vera, Jerry K Benites-Meza, Christopher J Alarcón-Toro, Andrea A Aldea-García, Liseth Pinedo-Castillo, Carlos J Zumaran-Nuñez, Percy Herrera-Añazco, Vicente A Benites-Zapata","doi":"10.1177/17455057261424821","DOIUrl":"10.1177/17455057261424821","url":null,"abstract":"<p><strong>Background: </strong>Violence against women is a serious human rights violation and a public health problem. In Peru, more than 55% of women have suffered intimate partner violence (IPV), which has a negative impact on their health and breastfeeding.</p><p><strong>Objective: </strong>To evaluate the association of IPV and early initiation of breastfeeding (EIBF) in Peruvian women.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>A secondary analysis was conducted using data from the Demographic and Family Health Survey (ENDES) of the period 2018-2022. The population included women of reproductive age (15-49 years). The outcome variable was the EIBF, and the main predictor variable was IPV. Crude prevalence ratios and adjusted prevalence ratios were estimated as a measure of association.</p><p><strong>Results: </strong>We analyzed a final sample of 30,482 women. The prevalence of IPV was 16.25%, while the prevalence of mothers who did not initiate early breastfeeding was 33.37%. It was found that partner violence was associated with a lower likelihood of complying with EIBF.</p><p><strong>Conclusion: </strong>We identified that women who experienced IPV were less likely to initiate early breastfeeding.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261424821"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367661","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":"Structure, utilization, and screening adherence of a student-run women's health clinic for uninsured Spanish-speaking women: A descriptive analysis.","authors":"Alicia M Faszholz, Vanessa Lozano, Jacqueline Garda","doi":"10.1177/17455057261424823","DOIUrl":"10.1177/17455057261424823","url":null,"abstract":"<p><strong>Background: </strong>Uninsured, low-income Spanish-speaking women face systemic barriers to accessing gynecologic care, especially within Fort Worth, Texas. Because of this health disparity, we elected to evaluate screening outcomes of patients receiving care at La Clínica de las Mujeres (LCDM), a student-run clinic (SRC) providing free, culturally competent care to this population in Fort Worth, Texas.</p><p><strong>Objectives: </strong>To assess the structure and utilization of an SRC on cancer screening adherence among uninsured, Spanish-speaking women in Fort Worth, Texas.</p><p><strong>Design: </strong>Retrospective descriptive pre-post study.</p><p><strong>Methods: </strong>Chart review of patients seen at LCDM from August 2022 to September 2024 was conducted. Data included 147 clinical encounters with 114 individual patients, assessing demographics, screening history, services, and referrals. McNemar's test assessed changes in screening adherence.</p><p><strong>Results: </strong>Patients (mean age: 47.5 years; 95.6% Hispanic) primarily resided in underserved zip codes (77.2% in 76110). Pre-intervention, 46% adhered to Pap smear guidelines and 64% to mammography guidelines. Post-intervention adherence approaches complete compliance among those with available post-intervention data (Pap χ²[1] = 66.0, <i>p</i> < 0.0001; Mammogram χ²[1] = 27.0, <i>p</i> < 0.0001). Services included pelvic ultrasounds (<i>n</i> = 20), specialist referrals (<i>n</i> = 11), and contraceptive access (<i>n</i> = 12).</p><p><strong>Conclusions: </strong>LCDM was associated with significant improvements in gynecologic preventive care adherence for uninsured Spanish-speaking populations in Fort Worth, Texas. Student-run models may help address critical gaps in accessibility to women's health services and mitigate systemic barriers to care for underserved populations.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261424823"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367663","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":"Effect of relaxation practices on labour pain and choice of epidural: An exploratory mixed-method study.","authors":"Mo Tabib, Tracy Humphrey, Katrina Forbes-McKay","doi":"10.1177/17455057261435178","DOIUrl":"10.1177/17455057261435178","url":null,"abstract":"<p><strong>Background: </strong>Theoretical literature suggests utilising relaxation practices during labour can mitigate perceived pain. However, empirical evidence regarding their effectiveness in reducing epidural use remains inconclusive. Investigating women's experiences with relaxation techniques during labour, alongside their use of epidural, may provide further insights into these conflicting results.</p><p><strong>Objective: </strong>To investigate women's experiences regarding the impact of relaxation practices on labour pain and the utilisation of epidurals, following attendance at an antenatal relaxation class (ARC).</p><p><strong>Design: </strong>An exploratory sequential mixed method was used.</p><p><strong>Methods: </strong>Phase 1 explored the experiences of women using qualitative interviews. Phase 2 was a prospective longitudinal cohort study using online surveys completed before and after attending ARC and post-birth.</p><p><strong>Results: </strong>Of the 17 women interviewed in Phase 1, all 15 who experienced labour reported using '<b>relaxation for labour pain</b>' which enhanced their ability to <i>cope with labour pain</i>, resulting in <i>satisfaction and pride.</i> However, the effectiveness of these practices in influencing epidural use depended on the '<b>space for relaxation</b>' shaped by the physical <i>surroundings, clinical context</i>, and <i>birth attendants</i>. Among the 91 women who participated in Phase 2, both the 'intended use of epidural' post-class and the 'actual use of epidural' post-birth were significantly lower than the 'intended use of epidural' pre-class. Women whose labour started spontaneously reported using relaxation techniques at home to manage pain, and most delayed hospitalisation until labour was established.</p><p><strong>Conclusion: </strong>Educating women on relaxation practices can enhance their ability to cope with labour pain and reduce the use of epidural for pain management.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261435178"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635098","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 systematic review of the implications of desexed language in women's healthcare and healthcare literature.","authors":"Abigail Greenfield, Ciara Higley, Naomi Black, Majel McGranahan","doi":"10.1177/17455057261430199","DOIUrl":"10.1177/17455057261430199","url":null,"abstract":"<p><strong>Introduction: </strong>Increasing numbers of people identifying as transgender and gender diverse (TGD) have introduced challenges regarding language used in women's healthcare. TGD individuals are defined as those whose gender identity does not align with their sex. This growing patient group has ignited debates over whether language in women's health should be desexed to accommodate TGD individuals, for example, replacing \"mother\" with \"pregnant people.\" Some argue such language is inclusive, while others are concerned it is inaccurate and disrespectful.</p><p><strong>Objective: </strong>To examine the implications of desexed language in women's healthcare and healthcare literature.</p><p><strong>Design: </strong>Qualitative systematic review synthesising primary research on desexed language in women's healthcare.</p><p><strong>Data sources and methods: </strong>Qualitative studies examining desexed language in women's healthcare, published 2010-2024, were included. A systematic search was conducted across MEDLINE, PsycINFO, and CINAHL. Risk of bias was assessed using the Critical Appraisal Skills Programme checklist and data analysed thematically.</p><p><strong>Results: </strong>Six studies were included, with 80 participants, 13 of whom were women who were not TGD. Themes identified: (1) Language and communication - reflecting differing views on desexed language and the importance of consistent definitions of sex and gender identity; (2) Education - gaps in healthcare professionals' confidence highlight the need for improved clinical education on TGD language use; (3) Structural challenges - issues with clinical documentation and environments; and (4) Barriers to care - poor healthcare experiences meaning TGD patients may avoid seeking care.</p><p><strong>Conclusion: </strong>This review highlights the need for resources tailored to TGD individuals, clinician education on personalised language use and improvements to clinical documentation to ensure sex is always recorded, with gender identity included if relevant. Insufficient evidence exists to support universal implementation of desexed language in women's healthcare. Findings suggest it is not well understood or accepted by women who are not TGD and research is needed to understand its impact on wider groups.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261430199"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147535247","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 longitudinal, qualitative exploration of women's sexual recovery following surgical repair of pelvic organ prolapse.","authors":"Kaylee Ramage, Erin A Brennand, Lauren M Walker","doi":"10.1177/17455057261437391","DOIUrl":"10.1177/17455057261437391","url":null,"abstract":"<p><strong>Background: </strong>Pelvic organ prolapse (POP) occurs when one or more female pelvic structures descend from their anatomic position into or through the vagina. Previous quantitative research has shown that POP may adversely affect sexual activity, with mixed results regarding the impact of surgical repair of POP on women's sexual activity.</p><p><strong>Objectives: </strong>Our study addresses the need for longitudinal, qualitative research centering women's lived experiences of POP, examining women's sexual activity before and after POP surgery.</p><p><strong>Design: </strong>Qualitative.</p><p><strong>Methods: </strong>We conducted remote, longitudinal, qualitative interviews with women experiencing POP across three time points: prior to surgery, 3 months post-surgery, and 6 months post-surgery.</p><p><strong>Results: </strong>Three major themes emerged elucidating women's return to sexual activity after surgical repair of POP, experiences with sexual activity prior to and post-surgery, and sexual outcomes and rewards experienced prior to and post-surgery. Women's expectations for sexual activity post-surgery were not always achieved, and recovery time was often slower than anticipated; however, most women reported improved sexual activity by 6 months post-surgery.</p><p><strong>Conclusion: </strong>Our study highlights the complexity of women's sexual experiences before and after POP surgery. Clinical counseling around the impact of surgical repair of POP on sexual activity should include expectation management, including the timeline for recovery and which aspects of sexuality may improve.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261437391"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724906","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":"Predicting health facility deliveries using explainable machine learning in Sidama Region, Ethiopia: A prospective cohort study.","authors":"Mehretu Belayneh, Yohannes Seifu Berego, Francisco Guillen-Grima, Amanuel Yoseph","doi":"10.1177/17455057261442711","DOIUrl":"10.1177/17455057261442711","url":null,"abstract":"<p><strong>Background: </strong>Health facility delivery (HFD) is a key intervention for reducing maternal and neonatal morbidity and mortality. However, a substantial proportion of women in Ethiopia continue to give birth at home. Early identification of women at risk of home delivery is essential to support targeted maternal health interventions.</p><p><strong>Objective: </strong>This study aimed to predict HFD utilization using machine learning (ML) models and to identify key determinants of delivery service uptake in the Sidama Region of Ethiopia.</p><p><strong>Design: </strong>A prospective cohort study was conducted among 3855 pregnant women who initiated antenatal care (ANC) in public health facilities across 4 districts of the Sidama Region between January 2021 and January 2025.</p><p><strong>Methods: </strong>Data were analyzed using the R software version 4.3.1 (R Core Team, R Foundation for Statistical Computing, Vienna, Austria). Predictive models - including logistic regression, random forest, gradient boosting, and extreme gradient boosting (XGBoost) were developed to predict HFD utilization. Model performance was assessed using accuracy, sensitivity, specificity, F1-score, and the area under the receiver operating characteristic curve (AUC-ROC). SHapley Additive exPlanations (SHAP) were used to identify the most influential predictors.</p><p><strong>Results: </strong>Overall, 59.2% of women delivered in health facilities, while 40.8% delivered at home. Among the evaluated models, XGBoost demonstrated the highest predictive performance, achieving an accuracy of 86.9% (95% confidence interval (CI): 85.6-88.1) and an AUC-ROC of 0.91 (95% CI: 0.90-0.93). SHAP analysis identified place of residence, maternal education, timing of ANC initiation, parity, and distance to the nearest health facility as the most influential predictors. Rural residence, lower educational attainment, late ANC initiation, higher parity, and greater distance to health facilities were associated with a lower likelihood of HFD utilization.</p><p><strong>Conclusion: </strong>Despite improvements in HFD utilization, a substantial proportion of women in the Sidama Region continue to deliver at home. ML models offer a robust approach for identifying women at high risk of home delivery and supporting targeted, data-driven interventions. Strategies that promote early ANC engagement, maternal education, improved geographic access to health facilities, and integration of predictive analytics into health systems may enhance HFD utilization.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261442711"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725047","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":"What are women's experiences of gestational breast cancer, and how do they describe their interactions with the healthcare system? An exploratory study.","authors":"Sara Hurren, Marie McAuliffe, Karen Yates, Tracey Ahern, Cate Nagle","doi":"10.1177/17455057261435753","DOIUrl":"10.1177/17455057261435753","url":null,"abstract":"<p><strong>Background: </strong>Gestational breast cancer (GBC) is defined as a breast cancer diagnosis during pregnancy or within 12 months post-partum. The incidence of GBC varies between 1:1000 and 1:3000 pregnancies. Breast cancer is the most frequent malignant tumour in women and the leading cause of cancer-related female mortality worldwide.</p><p><strong>Objectives: </strong>The main objective of this study was to better understand the experiences of women diagnosed with GBC and their interactions with the healthcare system. By exploring their perspectives, the study aimed to contribute to further research and knowledge to improve care and outcomes for these women.</p><p><strong>Design: </strong>A qualitative exploratory study.</p><p><strong>Methods: </strong>The study involved one-on-one semi-structured interviews conducted in Australia between November 2021 and June 2022. Participants were women diagnosed with GBC. Interviews were recorded digitally, transcribed verbatim, and analysed thematically following Braun and Clarke's (2006) six steps.</p><p><strong>Results: </strong>Six women diagnosed with GBC participated in the study. Analysis determined three central themes. First: <i>My happiness was stolen</i>. Upon receiving a GBC diagnosis, women described feeling terrified, overwhelmed, concerned for their baby, distressed, yet feeling fortunate at the same time. Second: <i>It really knocked me around</i>. Women expressed their unique circumstances and difficulties in comprehending having a cancer diagnosis while being pregnant, the different treatment modalities, limited information on surgical and fertility preservation options, and being unprepared for the side effects. Third: <i>I wanted control</i>; the importance of being able to take charge of their circumstances and decision-making was important to these women, especially as options were frequently restricted due to the urgency to commence treatment.</p><p><strong>Conclusion: </strong>The findings provide an understanding of the unique challenges of women diagnosed with GBC. Empowering women through personalised knowledge about their disease, understanding their needs, discussing surgical options, addressing fertility preservation, and providing psychological support is essential.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261435753"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576868","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":"We care about Brooklyn: A remote precision support intervention designed to improve maternal health and well-being.","authors":"Aimee Afable, Sandra Bruening, Breanna Watson, Faven Araya, Christina Pardo","doi":"10.1177/17455057261435755","DOIUrl":"10.1177/17455057261435755","url":null,"abstract":"<p><strong>Background: </strong>Black maternal mortality is an urgent public health crisis in the United States. Community-based interventions show promise in addressing this crisis but remain underutilized.</p><p><strong>Objective: </strong>Using New York City (NYC) as a case study, we describe a formative study of a comprehensive community health worker (CHW)-led intervention, We Care About Brooklyn (WeCAB), designed to address structural drivers of NYC's maternal health crisis: fragmented care and unmet health-related social needs (HRSNs), such as food insecurity and unstable housing.</p><p><strong>Design: </strong>Guided by the transcreation framework, we conducted a community-engaged, mixed methods formative study to design an intervention prototype.</p><p><strong>Methods: </strong>We conducted a document review (<i>N</i> = 7 HRSN screening tools), documentary film analysis, and primary qualitative data collection. We interviewed 10 key informants representing diverse community expertise. Interpretative phenomenology guided qualitative data analysis.</p><p><strong>Results: </strong>Analysis elaborated on five central themes-trust and rapport building, frequency of patient engagement and critical time periods, system fragmentation and care coordination challenges, technology for care coordination, and provider and client expectations. These findings, along with the document review, results of the film analysis, and evidence-based intervention inputs, informed the design of a remote precision support intervention with two core activities: (1) a digital closed-loop care navigation platform (Unite Us^©) using a 41-item maternal HRSN screener, and (2) CHW check-in schedules based on gestational age and social risk, including care reminders, escalation protocols for patient concerns, urgent warning signs education, and linkage to urgent care.</p><p><strong>Conclusion: </strong>WeCAB was designed to enable CHWs to function as a human safety net and provide continuity of care in the context of a fragmented healthcare landscape. We propose that this approach fosters trust and patient empowerment, promoting physical and emotional well-being and engagement in care.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261435755"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791329","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":"Learning from the experiences of midwifery students and recent graduates in humanitarian and conflict-affected settings: A prospective cohort study protocol.","authors":"Hannah Tappis, Emilia Iwu, Hawa Abdullahi, Charity Maina, Asia Mohammed, Shatha Elnakib","doi":"10.1177/17455057261438787","DOIUrl":"10.1177/17455057261438787","url":null,"abstract":"<p><strong>Background: </strong>Health workforce shortages are a serious impediment to the delivery of effective and person-centered care, particularly in conflict settings. Midwives are a critical cadre who can help avert maternal and child death, but face persistent barriers to education, employment, regulation, and professional development-challenges that are especially pronounced in conflict-affected areas. Few studies have systematically explored midwives' experiences in these settings.</p><p><strong>Objectives: </strong>The EQUAL midwifery cohort study was established to systematically examine midwives' educational and professional trajectories in Northeast Nigeria and in Central and Southeast Somalia, with the goal of identifying context-specific factors influencing retention, deployment and professional growth.</p><p><strong>Design: </strong>Multiple cohorts of students and recent graduates will be enrolled, complete an intake survey, and be followed with additional surveys approximately 6 months after enrollment and then annually. Focus group discussions and in-depth interviews with a sub-set of participants will follow each round of surveys to expand on survey findings.</p><p><strong>Methods and analysis: </strong>Qualitative data analysis will focus on the lived experiences of participants, and how these experiences shape their professional identities and career trajectories. Survey analysis will assess levels of attrition, including withdrawal from training and exit from the profession post-graduation. Cox regression models will estimate hazard ratios and 95% confidence intervals for these outcomes, and median survival time in the profession will be calculated to determine when attrition is most likely. Risk factors for attrition during both training and professional practice will be examined.</p><p><strong>Ethics: </strong>Ethical approval was obtained from John Hopkins Bloomberg School of Public Health, the Somali Research and Development Institute, and Yobe State Health Ministry of Health Ethics Committee.</p><p><strong>Discussion: </strong>This research will offer insights into a critical yet under-explored segment of the global health workforce: early career midwives in conflict-affected settings. It serves as a proof-of-concept for the feasibility of longitudinal health workforce research in conflict-affected areas of Nigeria and Somalia, offering unprecedented evidence on the lived experiences and expressed needs of midwives to inform the improvement of midwifery education, working conditions, and support networks in these settings.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261438787"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791874","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}