International Journal of Reproductive Medicine最新文献

Background: Pregnancy risk perception affects a pregnant woman's decision about health care services such as prenatal care, place of birth, choices about medical interventions, adherence to medical procedures, and recommendations. Therefore, the study is aimed at assessing pregnancy risk perception and associated factors among pregnant women attending antenatal care at health centers in Jabi Tehnan District.

Methods: An institutional-based cross-sectional study was conducted among 424 mothers attending ANC at health centers in the Jabi Tehnan District from April 1 to 30, 2021. Data was collected through a face-to-face interview using a structured questionnaire which was developed according to the health belief model. The logistic regression model was used using an adjusted odds ratio with 95% CI and pvalue < 0.05 to declare significance and associations.

Result: Four hundred twenty four (424) pregnant women were interviewed of which nearly half of the respondents 48% (43.2%, 52.7%) had good pregnancy risk perception. Women who had a history of obstetric complications (AOR: 95% CI = 3.44 : 1.73, 6.83), those who knew at least one pregnancy danger sign (AOR: 95% CI = 5.22, 2.46, 11.07), pregnant women who had a bad obstetric history (AOR: 95% CI = 2.23 : 1.13, 4.41), and knowing women who died due to pregnancy-related complications (AOR: 95% CI = 2.85 : 1.45, 5.60) were more likely to have good perception towards pregnancy risk compared to their counterparts.

Conclusion: Obstetric complications, awareness of pregnancy danger signs, bad obstetric history, and known women who died due to pregnancy-related complications were found to be significantly associated with pregnancy risk perception.

Background: The primary objective of this research was to investigate how socioeconomic and demographic factors influence the usage of contraceptives by women in 18 developing countries.

Methods: The study used the latest DHS data from 18 developing countries in order to acquire a broad perspective of contraceptive methods. We applied meta-analysis techniques for 18 developing countries to find out the summary results.

Results: The overall summary effect showed that the variable respondent education (OR = 1.39; 95% CI: 1.17 to 1.65), husband education (OR = 1.60; 95% CI: 1.32 to 1.93), type of place of residence (OR = 0.88; 95% CI 0.78 to 0.98), current working status (OR = 1.47; 95% CI 1.30 to 1.66), age of the respondent (OR = 3.41; 95% CI 2.35 to 4.93), breastfeeding status (OR = 1.34; 95% CI 1.11 to 1.62), and desire for more children (OR = 0.53; 95% CI 0.43 to 0.65) were the significant factors for contraceptive utilization in developing countries.

Conclusions: According to the findings of this descriptive study, the respondent's age, level of education, and work status were shown to be the most significant factors that influence the usage of contraceptives in developing countries. It is necessary to take reasonable steps in order to increase the rate of utilizing methods of contraception among women of reproductive age who are uneducated, living in rural areas, and unemployed.

Background: An obstetric fistula is an abnormal opening between the vagina, rectum, and/or bladder. Obstetric fistula has a devastating impact on women's physical, social, and psychological health. Despite the numerous health consequences in developing countries, including Ethiopia, there have been few studies on the determinants of time to recovery from obstetric fistula. Therefore, this study is aimed at addressing the gap.

Methods: A retrospective cohort study was employed to include 328 randomly selected records of women admitted for obstetric fistula treatment at Mekelle Hamlin Fistula Center from January 2015 to 2020. Data collected from the medical records was coded and entered into SPSS software version 20 and exported to STATA 10 and R statistical software for data cleaning and data analysis. The Kaplan-Meier and log-rank tests were computed to explore the data. The log-logistic inverse Gaussian shared frailty model was employed using a 95% CI, and variables with a p value < 0.05 were declared as determinants of recovery time.

Results: Of 328 fistula patients, 293 (89.33%) were physically cured. The Kaplan-Meier result showed that the overall mean and median survival time of time to recovery from obstetric fistula patients at Mekelle Hamlin Fistula Center is 42 and 33 days, respectively. In a log-logistic inverse Gaussian shared frailty model analysis, extensive fistula size (AHR : 1.282; 95% CI = 1.175-1.388), secondary and above education level (AHR : 0.830; 95% CI = 0.693-0.967), rural residence (AHR : 1.357; 95% CI = 1.236-1.479), and physiotherapy use (AHR : 0.801, 95% CI = 0662-0.940, 95% CI = 1.175-1.388) were statistically significant predictors of recovery from obstetrics fistula.

Conclusion: Rural place of residence, home delivery, and large and extensive size of the fistula prolong the timing of healing from the obstetric fistula. However, having tall height, physiotherapy treatment, secondary and above-educated women, and RVF type of fistula has a short time of healing for obstetric fistula in Mekelle Hamlin Fistula Center. Therefore, we recommend that health professionals promote institutional delivery and physiotherapy, shorten the duration of catheterization, and manage urine incontinence. In addition, we recommend that the regional health bureau promotes female education and pregnancy after 18 years. The survival probability of patients with obstetric fistulas is better predicted by the log-logistic inverse Gaussian shared frailty model. Therefore, it would be good for future researchers to take this model into account.

Background: Adequate antenatal care is essential for the health of the mother and the development of the fetus. The World Health Organization recommends at least four antenatal care (ANC) visits during pregnancy. In Ethiopia, only 32% of women of childbearing age attend four or more ANC visits. This figure is significantly lower than the average for least developed countries. This study is aimed at calculating the magnitude and identifying the factors associated with optimal antenatal care utilization in the South Gondar Zone, Northwest Ethiopia.

Methods: A community-based cross-sectional study was conducted in the South Gondar Zone of Northwest Ethiopia from September 2020 to May 2021. A total of 434 participants were selected using multistage cluster sampling. Data were gathered through face-to-face interviews using a structured questionnaire. A multivariate binary logistic regression model was used to determine the factors associated with the optimal use of antenatal care.

Result: The magnitude of optimal antenatal care utilization was 59% (95% CI; 54.20, 63.65). The study showed that mothers who completed their secondary school (AOR = 8.205; 95% CI: 3.406, 19.767), women who completed their tertiary school (AOR = 6.406; 95% CI: 2.229, 18.416), women whose husbands' level of education is secondary school (AOR = 5.967; 95% CI: 2.753, 12.936), those with a planned pregnancy (AOR = 1.912; 95% CI: 1.117, 3.271), those with a wanted pregnancy (AOR = 2.341; 95% CI: 1.366, 4.009), women whose husbands work in the government or nongovernment sector (AOR = 3.736; 95% CI: 2.093, 6.669), those not being exposed to the media (AOR = 0.520; 95% CI: 0.345, 0.783), and rural women (AOR = 0.267; 95% CI: 0.164, 0.435) were significantly associated with optimal ANC utilization.

Conclusion: The findings suggest that more emphasis should be placed on education-based programs for women and their husbands that highlight the benefits of a planned pregnancy, desired pregnancy, and maternal health care. Meanwhile, the government and other concerned bodies should focus on expanding road accessibility, health institutions, and ambulance distribution to improve optimal ANC utilization in the area.

Purpose: There are very limited evidences showing the status of adolescent-parent communication in rural areas of Ethiopia as most of the studies focus in urban areas and were school-based. Therefore, this study intends to determine the adolescent-parent communication on sexual and reproductive health matters and its determinants among rural adolescents in Jimma Zone, Southwest Ethiopia.

Methods: Community-based cross-sectional study design was employed using the multistage sampling technique. Structured questionnaire was used to collect the data. The data was cleaned and entered into Epi data version 3.1 and exported to SPSS version 23 for descriptive and regression analysis.

Results: From 833 adolescents participated in the study, only 364 (43.7%) of them had ever discussed sexual and reproductive health matters of which males represent 196 (53.8%) followed by females 168 (46.2%). Among these, only 35 (9.6%) had discussed with their mother, and 24 (6.6%) had discussed with their father. The proportion of adolescents who communicated with their parents on sexual and reproductive health issues was 364 (43.7%). Multivariable logistic regression analysis indicated that never getting information on SRH issues (AOR = 0.5, 95% CI, 0.4-0.8) and particularly on sexually transmitted infections (AOR = 0.5, 95% CI, 0.4-0.7) and unknowing the period in which there is a possibility to be pregnant for a girl (AOR = 0.2, 95% CI, 0.04-0.9) were found to be independent factors affecting adolescent-parental communication negatively.

Conclusion: This study's result implies that the majority of the adolescents in the rural area were not communicating with their parents about sexual and reproductive health issues. However, most of them knew about different sexual and reproductive health services and where they could be found. Therefore, the provision of detailed information on the importance of communication with their parents on such a sensitive issue is suggested. Further research is needed to identify the barrier from the parents' side.

Introduction: Adolescents with disability are often presumed erroneously to be sexually inactive. Though they have the same need for sexual and reproductive health (SRH) services as nondisabled people, they are often overlooked by sexual and reproductive health programs, interventions, and studies.

Objective: To assess determinant factors of sexual and reproductive health service utilization among in-school adolescents with disability in Jimma zone, southwest Ethiopia.

Method: Institution-based cross-sectional study design was employed among in-school adolescents with disability in Jimma zone, Ethiopia, from September 21 to November 30, 2021. A total of 454 participants were included in the study by using the multistage sampling technique. Data were collected by using a structured questionnaire through face-to-face interviews. Data were entered into Epi-data version 4.2 and analyzed by using SPSS version 23. Bivariate and multivariable logistic regression analyses at a 95% confidence interval were performed, and a P value < 0.05 was considered statistically significant.

Result: 454 study participants were included in this study with a respondent rate of 97.4%. Only 38 (8.4%, 95% CI: 5.7-10.8%) of in-school adolescents utilized SRH information and education service. The majority (265, 49%) of adolescents with disability knew family planning as sexual and reproductive health services which were followed by voluntary counselling and testing for HIV/AIDS (116, 21.4%). Seventy-eight (17.2%, 95% CI: 13.7-20.5%) of in-school adolescents with disability visited nearby health facilities for VCT services. Male sex (AOR = 2.32, 95% CI: 1.18-4.57), favourable attitude (AOR = 3.11, 95% CI: 1.59-6.07), and history of sexual intercourse (AOR = 5.34, 95% CI: 2.05-13.92) were significantly associated with SRH service utilization.

Conclusion: The overall sexual and reproductive health service utilization of in-school adolescents with disability was low when compared with other studies. Physical impairment, male sex, ever had sexual intercourse, good knowledge, and favourable attitudes were determinant factors of SRH service utilization among in-school adolescents with disabilities. So, it is recommended that the Jimma zone administration, government, and NGOs should give attention to SRH services.

Introduction: Intimate partner violence (IPV) has a negative impact on women's physical, mental, sexual, and reproductive health. Identifying the determinant factors of IPV among pregnant women is of paramount importance to overcome its negative consequences thereby increasing the performance of women in all activities. Thus, this study applied a generalized structural equation model (GSEM) to determine the prevalence of intimate partner violence among pregnant women and its predictors in Eastern Ethiopia.

Methods: A community based cross-sectional study was conducted in Kersa Health and Demographic Surveillance System (KHDSS), Eastern Ethiopia. Data were collected form a sample of 1051 pregnant women using structured questionnaires. Descript findings were presented in percentage with 95% confidence interval. The generalized structural equation model was used to determine factors associated with each domain of IPV (physical, emotional, and social violence). Adjusted odds ratio (AOR) with a 95% CI were used to declare significant factors associated with intimate partner violence.

Results: The overall prevalence of IPV in the Eastern Ethiopia was 48.57% (95% CI: 45.45, 51.69). The highest intimate partner violence was observed in the sexual domain of IPV (31.6%, 95% CI: (28.8, 34.58)). In GSEM, being a farmer (AOR = 0.42, 95% CI: 0.19, 0.91) was significantly associated with psychological domain of IPV. Age (AOR = 0.97, 95% CI: 0.95, 0.99) and educational status (neither read nor write) (AOR = 2.50, 95% CI: 1.61, 3.89) were significantly associated with physical domain of IPV. Being in medium (AOR = 0.64, 95% CI: 0.46, 0.90) and rich (AOR = 0.53, 95% CI: 0.36, 0.78), wealth quintiles were significantly associated with sexual domain of IPV, whereas husband controlling behavior was significantly associated with all domains of IPV.

Conclusions: The magnitude of IPV among pregnant women was relatively high in Eastern Ethiopia. This finding pin a light to pay special consideration to pregnant women at each point of service delivery to alleviate consequence of IPV. Being a farmer, older ages and being in higher wealth quintiles were protective factor, whereas being uneducated increase the risk of IPV. Improving socioeconomic status and promoting legal rights of women is needed to alleviate the problem, and younger women require special attention.

Introduction: Worldwide, specifically in developing countries, women believe that a woman cannot become pregnant unless she sees her first postpartum menstruation. Due to this knowledge gap, most women did not use any contraceptives till their 1^st postpartum menstruation. Hence, about 44% of women were susceptible to unintended pregnancy in the postpartum period. Assessing women knowledge on possibility of pregnancy after giving birth but before returning of menses and its associated factors will help to increase women's recognition on the issue and for early commencement of appropriate postpartum family planning methods to reduce burden of unintended pregnancy.

Objective: To assess the level of knowledge on possibility of pregnancy after giving birth but before returning of menses and its associated factors among reproductive women in Ethiopia.

Methods: A secondary data analysis using the 2016 Ethiopian Demographic Health Survey was employed. Samples were selected using two-stage stratified sampling technique. Descriptive statistics and logistic regressions were used. Adjusted odds ratio (AOR) with 95% confidence interval was used to interpret associations, and a significant association was declared at a p value of <0.05.

Result: A total of 15,683 reproductive women aged from 15 to 49 years were included. Of them, about 53% did not know that a woman can get pregnant after giving birth but before resumption of her menstruation. Age being 35 years and above (AOR = 1.50; 95%CI = 1.34, 1.67), educational status of secondary and above (AOR = 1.18; 95%CI = 1.06, 1.32), being ever married (AOR = 1.67; 95%CI = 1.47, 1.89), knowledge of any family planning method (AOR = 1.81; 95%CI = 1.52, 2.16), getting counseling on family planning methods (AOR = 1.41; 95%CI = 1.28, 1.55), and being knowledgeable on their ovulatory cycle (AOR = 1.68; 95%CI = 1.55, 1.82) were found to be significantly associated with being knowledgeable on the issue.

Conclusion: Reproductive women's level of knowledge on the possibility of pregnancy after giving birth but before returning of menses was low. Factors associated with being knowledgeable on the issue were identified. Therefore, strategies should be developed to increase their level of knowledge for reducing unintended pregnancy and its complications by integrating family planning counseling with infant immunization services.

Background: Traditional birth attendants have since ancient time provided care to pregnant women. As such, the collaboration between midwives and traditional birth attendant (TBAs) can be an essential effort towards the reduction of the maternal and neonatal mortality and morbidity rate especially in low- and middle-income countries (LMICs). This paper argues that the collaboration between traditional and formal health systems expands the reach and improves outcomes of community health care. The study is aimed at exploring the traditional birth attendant's views on collaboration with midwives for maternal health care services at selected rural communities in South Africa (SA).

Methods: The study was conducted in two rural communities in Tshwane and Johannesburg metropolitan districts from 15 June to 31 October 2021. The study followed the qualitative explorative and descriptive research design. The sampling technique was nonprobability purposive, and snowballing technique was also used to sample the key informants who are the traditional birth attendants also known as traditional healers and who provide maternal health care services in the respective communities. The access to these participants was through the gatekeepers, the Traditional Health Organisation Council (THO) council. Data collection was through semistructured in-depth interviews. Data were analysed thematically through the eight steps of Tesch.

Results: Five main themes were identified which included the recognition of traditional birth attendants as enablers of collaboration, the envisaged value of the collaboration, processes required to foster collaboration, repositioning for new roles, and barriers to collaboration.

Conclusion: The TBAs are ready to collaborate with the formal health care system, and all they require is for their services to maternal health care to be recognised and acknowledged.