Reproductive Health最新文献

Background: Although natural rubber latex remains dominant as the primary manufacturing material for male condoms synthetic materials first introduced in the early 1990s address many of the limitations of latex including the risk of allergies. Polyurethane elastomers allow condoms to be made significantly thinner to provide greater sensitivity and encourage greater use of condoms for contraception and STI prophylaxis. The primary objective of this Study was to evaluate the breakage, slippage and acceptability of two ultra-thin polyurethane condoms against a thin control latex male condom, designated latex C, in a randomized, cross over, masked, non-inferiority study. The condom designated Polyurethane A was designed for markets where 52/53 mm wide latex condoms are preferred whereas the condom designated Polyurethane B was designed for markets where the smaller 49 mm wide latex condom is preferred.

Methods: The Study was designed to meet the requirements specified in ISO 29943-1: 2017 and FDA guidelines for clinical studies on synthetic condoms. It was conducted by two Essential Access Health centres, one in Northern California and the other in Southern California. Sexually active heterosexual couples (300) aged between 18 and 45 years were recruited to use three sets of five condoms in a block randomized order, recording breakage, slippage and acceptability after each use. A total of 252 couples contributed 2405 evaluable condom uses per protocol for the Condom A versus Latex C comparison (1193 Polyurethane A plus 1212 Latex C), and 247 couples provided 2335 evaluable condom uses per protocol for the Condom B versus Latex C comparison (1142 Polyurethane B plus 1193 Latex C). Only condoms used for vaginal intercourse were included in the analysis.

Findings: Although the total failure rates (breakage and slippage) for the polyurethane condoms were higher than for the control Latex C condom, all condoms performed extremely well with low failure rates compared to similar condom studies. Condom Polyurethane A met the noninferiority requirements specified in ISO 23409:2011 relative to Latex C, the control NR latex condom, in the full Study population. While condom Polyurethane B did not meet the noninferiority requirement for the full Study population, it did meet the noninferiority requirement when analysis was restricted to the intended population (men with penis lengths ≤ 170 mm). Trial registration The Study is registered with ClinicalTrials.gov, NCT04622306, Protocol Reference SAGCS 2, initial release date 11/02/2020.

Background: Previous studies indicated that excessive engagement in digital devices could lead to negative psychological impacts in general population. We aimed to determine the association of electronic screen exposure with depression among women in early pregnancy.

Methods: A cross-sectional study was conducted from June 2021 to June 2022. A total of 665 women in early pregnancy were recruited and the information included socio-demographic characteristics, screen exposure and Patient Health Questionnaire - 9 depression scale.

Results: Among the women in early pregnancy, the total daily smartphone viewing time was the longest (median [P25-P75], 5 [3-6] hours/day) in the three types of electronic screen exposure. The total daily smartphone viewing time (P = 0.015, OR[95%CI] = 1.09[1.11-1.18]), smartphone (P = 0.016, OR[95%CI] = 1.24[1.04-1.47]) and television viewing time (P = 0.006, OR[95%CI] = 1.35[1.09-1.67]) before nocturnal sleep were significantly associated with depression among women in early pregnancy. The thresholds calculated by receiver operator characteristic curves were 7.5 h/day, 1.5 h/day and 1.5 h/day, respectively. In addition, women with higher scores of smartphone addiction were more susceptible to depression (P<0.001, OR[95%CI] = 1.11[1.07-1.16]). The top three smartphone usages in women with depression were watching videos (22.0%), listening to music (20.9%) and playing games (16.7%).

Conclusions: In conclusion, electronic screen exposure, including screen viewing time, smartphone addiction and problematic smartphone use was associated with depression among women in early pregnancy. Further studies are warranted to verify the conclusions.

Background: Improving maternal healthcare services is crucial to achieving the Sustainable Development Goal (SDG-3), which aims to reduce maternal mortality and morbidity. There is a consensus among different researchers that proper utilization of maternal healthcare services can improve the reproductive health of women, and this can be achieved by providing Antenatal Care (ANC) during pregnancy, Health Facility Delivery (HFD), and Postnatal Care (PNC) to all pregnant women. The main aim of this study was to investigate the utilization and factors associated with maternal and child healthcare services among women of reproductive age in the pastoralist communities in Kenya.

Methods: A cross-sectional survey was conducted among 180 pastoralist women who gave birth in the past two years across ten mobile villages in Marsabit County between 2nd January and 29th February 2019. Three key outcomes were analyzed, whether they attended ANC 4+ visits, delivered at HF, and received PNC. Pearson χ² test and multivariate logistic regression analysis were conducted by IBM SPSS27.0 following Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The significance level was set at p < 0.05.

Results: Of the 180 eligible pastoralist women (mean age 27.44 ± 5.13 years), 92.2% were illiterate, 93.9% were married, 33.3% were in polygamy, and 14.4% had mobile phones. The median commuting distance was 15.00 (10-74) km, 41.7% attended ANC 4+, 33.3% HFD, and 42.8% PNC. Those women residing close (≤ 15 km) to a health facility had a threefold higher ANC 4+ (OR 3.10, 95% CI 1.47-6.53), 2.8-fold higher HFD (OR 2.80, 95% CI 1.34-5.84), and 2.5-fold higher PNC (OR 2.49, 95% CI 1.19-5.22) probability. The likelihood was 30-fold higher for ANC 4+ (OR 29.88, 95% CI 6.68-133.62), 2.5-fold higher for HFD (OR 2.56, 95% CI 0.99-6.63), and 60-fold higher for PNC (OR 60.46, 95% CI 10.43-350.55) in women with mobile phones. A monogamous marriage meant a fivefold higher ANC 4+ (OR 5.17, 95% CI 1.88-14.23), 1.6-fold higher HFD (OR 1.67, 95% CI 0.77-3.62), and a sevenfold higher PNC (OR 7.05, 95% CI 2.35-21.19) likelihood. Hosmer Lemeshow test indicated a good-fitting model for ANC 4+, HFD, and PNC (p = 0.790, p = 0.441, p = 0.937, respectively).

Conclusion: In conclusion, the utilization of three essential maternal health services is low. Geographic proximity, monogamous marriage, and possession of mobile phones were significant predictors. Therefore, it is recommended that stakeholders take the initiative to bring this service closer to the pastoralist community by providing mobile health outreach and health education.

With a keen awareness of the size and health needs of the global adolescent population, governments, nongovernment organizations and the technical and funding agencies that support them continue to seek innovative answers to persistent programming challenges to increasing contraceptive use among sexually active adolescents. Adolescents 360 (A360) is a project implemented by Population Services International (PSI) and partners with funding from the Bill and Melinda Gates Foundation (BMGF) and the Children's Investment Fund Foundation (CIFF). The first phase of the project was implemented from 2016 - 2020 in Ethiopia, Nigeria, and Tanzania. A360 hypothesized that human centered design (HCD) could catalyze new insights into identifying and solving problems that limit adolescents' use of contraception. Despite initial promising results, A360 demonstrated very limited impact on modern contraceptive uptake among adolescents. The authors of this commentary were members of a technical advisory group to A360 and are uniquely positioned to provide insights on this project to complement those of A360's staff and evaluators, which are already in the public arena. Our analysis suggests that all stakeholders should take steps to rebalance their programs and investments to not only seek new solutions (i.e. game changers), but to also invest in the institutionalization of the solutions that have been generated over the past 40 years, prioritizing those that have shown evidence of effectiveness (i.e. adolescent responsive health service delivery) and those that demonstrate significant promise (i.e. social norm change).

Background: Family planning (FP) is crucial for reducing maternal and infant mortality and morbidity, particularly through the prevention of unsafe abortions resulting from unwanted pregnancies. Despite Cameroon's commitment to increasing the adoption of modern FP strategies, rural and poor populations still exhibit low demand due to limited access to healthcare services. This study documents the approach in developing family planning messages for the BornFyne prenatal management system as a platform to improve family planning awareness and enhance uptake.

Method: This is a mixed-methods study that employed the Health Belief Model (HBM). The study included a cross-sectional survey and focus group discussions in four districts of Cameroon. The survey explored household perspectives of FP and the use of mobile phone. Focus group discussions involved women, men, and community health workers to gain in-depth insights. Thematic analysis using themes from the HBM guided the analysis, focusing on perceived benefits, barriers, and cues to action.

Results: The survey included 3,288 responses. Thematic analysis of focus group discussions highlighted knowledge gaps and areas requiring additional information. Identified gaps informed the development of targeted FP messages aligned with BornFyne objectives and the Health Belief Model. Results revealed that most respondents recognized the benefits of FP but faced knowledge barriers related to side effects, cultural influences, and communication challenges between partners. Focus group discussions further highlighted the need for education targeting both men and women, dispelling misconceptions, and addressing adolescent and youths' ignorance. The study emphasized the importance of tailored messaging for specific demographic groups and culture.

Conclusion: Developing effective FP intervention messages requires a nuanced understanding of community perspectives. The BornFyne-PNMS family planning feature, informed by the Health Belief Model, addresses knowledge gaps by delivering educational messages in local dialects via mobile phones. The study's findings underscore the importance of community-based approaches to contextualizing and developing FP content targeting specific populations to generate tailored messages to promote awareness, acceptance, and informed decision-making. The contextualized and validated messages are uploaded into the BornFyne-family planning feature.

Infertility refers to the inability to conceive after 12 months of regular, unprotected sexual intercourse. Psychosocial aspects of infertility research are predominant in developed countries. A scoping review of psychosocial aspects of infertility research conducted in Africa between 2000 and 2022 was conducted. Twelve databases and grey literature were searched for articles. Studies were included if they were published in English and included findings from patients diagnosed with primary or secondary infertility. A total of 2 372 articles were initially found and screening resulted in 116 articles being included in the scoping review. Most of the studies (81%) were conducted in Nigeria, Ghana and South Africa. Psychosocial aspects explored included quality of life, barriers to treatment, attitudes and stigma, and sociocultural and religious aspects of infertility, among others. The review maps published psychosocial research in the context of infertility in Africa and identifies gaps for future research.

Introduction: Suburban population is increasingly growing in Iran. People in the suburbs usually have limited sexual information and there are limited studies into their sexual issues. This study aims the effect of sexual education (SE) based on the Sexual Health Model (SHM) on sexual functioning among women living in the suburbs.

Methods: This is a randomized controlled trial with two parallel groups. Seventy-six women will be selected through simple random sampling from healthcare centers in suburban areas and will be allocated to a control group (n = 38) and an intervention group (n = 38) with a randomization ratio of 1:1. Participants in the intervention group will receive SHM-based SE in three120 min weekly sessions which will be held using the lecture, question-and-answer, group discussion, and educational booklet methods. Data will be collected through a demographic and midwifery characteristics questionnaire, the Female Sexual Function Index, the Depression Anxiety Stress Scale, and the Sexual Quality of Life-Female, and will be analyzed through the analysis of covariance as well as the independent-sample t, the paired-sample t, and the Chi-square tests.

Discussion: We hope this study provides a clear framework for decision-makers and healthcare providers to provide appropriate policies and interventions for SE and thereby improve the sexual health of women in the suburbs.

Trial registration: This study was registered in the Iranian Registry of Clinical Trials on 2024.03.05 (code: IRCT20231121060133N1).

Background: Physical, affective and behavioural symptoms associated with the menstrual cycle are commonplace. Adolescents with problematic symptoms have reported a negative impact on school attendance, behaviour and participation in physical activity. In the United Kingdom, evidence suggests that menstrual health education delivered by teachers focusses on menstrual cycle biology as opposed to management of menstruation and menstrual cycle related symptoms. Through obtaining the pupil voice, this study aimed to understand young people's perceptions and experiences of menstrual education in schools and their experiences of menstruating whilst at school, including within Physical Education.

Methods: To address the aims, a qualitative descriptive study was conducted. Nine focus groups with female pupils (n = 48; ages 10-15 years) were completed across six school locations in England and Wales, including primary and secondary schools. A range of elements relating to the menstrual cycle, education at school and PE were discussed by pupils.

Results: Four main themes were developed (a) Education preferences, (b) Period positive environments, (c) Personal experiences and (d) Impact on school. Similarities were reflected across focus groups in terms of current (lacking) education, lesson style and preferences, comfort of conversations, lack of school support and impact on school and PE.

Conclusion: The findings highlight the lack of menstrual education received and subsequent impact of menstruation and menstrual-related symptoms in school and PE. The abundance of information requested by pupils highlights the deficit in understanding about how to manage periods in school and remain engaged in physical activity. Schools can utilise information from the current study to; create period positive environments; consider lesson content and format; and explore how to support girls to stay physically active in PE.

Background: Social problems related to infertility are associated with a significant psychological burden for the involved couple. Previous studies have shown the positive effects of couple interactions on the psychological health of these couples; however, the specific conditions of participating in assisted reproductive treatments (ART) might influence the effect of couple collaboration. Therefore, the present study aimed to evaluate the relationship between couple collaboration, well-being during infertility, and the psychological indicators of infertile couples undergoing fertility treatment.

Methods: This cross-sectional study was conducted on 200 ART volunteer couples. Couple collaboration and well-being during infertility were evaluated using a validated researcher-made questionnaire, and the level of depression, anxiety, and stress was evaluated using the DASS-21 questionnaire in both couples. Statistical analysis was performed using the plug-in application PROCESS macro for SPSS and AMOS software.

Results: The results showed that couple collaboration was correlated with the level of depression, anxiety, and stress. Moreover, depression, anxiety, and stress levels were correlated with well-being during infertility. The direct and indirect effect of couple collaboration on the depression level was significant; however, the direct effect of couple collaboration on the level of anxiety and stress was not significant, and the effect of couple collaboration on these indicators was mediated by well-being during infertility. The fit index of the equation modelling showed a good fit of the relationship path between the variables of couple collaboration, well-being during infertility, and psychological indicators (CMIN = 4.196, p = 0.260).

Conclusion: The results of this study show that the specific conditions of participating in ART may affect the direct effects of couple interaction on an infertile couple's levels of anxiety and stress. These results suggest that in order to develop mental health programs for infertile couples, strategies based on couple collaboration that are associated with higher well-being during infertility should be developed and presented.