Sexual & Reproductive Healthcare最新文献

{"title":"The importance of clinical supervision and teaching methods for midwifery students’ confidence in intrapartum care. A mixed method study","authors":"Lena Bäck ,&nbsp;Anette Björk ,&nbsp;Bharati Sharma ,&nbsp;Lisbeth Kristiansen ,&nbsp;Ingegerd Hildingsson","doi":"10.1016/j.srhc.2025.101128","DOIUrl":"10.1016/j.srhc.2025.101128","url":null,"abstract":"<div><h3>Objective</h3><div>Midwifery students’ need to be confident, and it is important to identify factors that might affect students’ confidence. Achieving registration as a midwife requires academic, clinical and professional competence. In the 1,5-year post-nursing program in Sweden 50% is allocated to clinical practice, and students must assist a minimum of 50 births. There is a lack of knowledge regarding the significance of supervision and to consider both theoretical and practical aspects of midwifery education. This study intends to identify relationships between midwifery students’ confidence in intrapartum care and associated factors. An additional aim was to provide a member check of the validity of the findings.</div></div><div><h3>Methods</h3><div>All midwifery programs in Sweden participated in this cross-sectional study, where 238 (78%) midwifery students completed a questionnaire based on the competency descriptions by the International Confederation of Midwives. Confirmatory interviews were conducted for checking the results relevance.</div></div><div><h3>Result</h3><div>The organization of midwifery education, satisfaction with supervision and theoretical teaching significantly impacted students’ confidence. Few background variables were associated with confidence.</div></div><div><h3>Conclusion</h3><div>Clinical supervision was important. Students preferred lectures and practical demonstrations instead of self-studies. The structure and quality of both practical and theoretical training are crucial for building confidence. Newly graduated midwives qualitatively confirmed the results of the analysis. They also experienced a stressful environment, only focusing on to assist at the required 50 births.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101128"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between exclusive breastfeeding and quality of care and maternal factors in a tertiary maternity hospital in Finland: A cross-sectional study","authors":"Jaana Lojander ,&nbsp;Anna Axelin ,&nbsp;Aydin Tekay ,&nbsp;Seppo Heinonen ,&nbsp;Satu Polkko ,&nbsp;Laura Lehti ,&nbsp;Terhi Kolari ,&nbsp;Hannakaisa Niela-Vilén","doi":"10.1016/j.srhc.2025.101127","DOIUrl":"10.1016/j.srhc.2025.101127","url":null,"abstract":"<div><h3>Background</h3><div>Mothers’ perceptions of high-quality hospital care may improve breastfeeding outcomes, yet postnatal care in hospitals is often rated poorly by mothers, highlighting the need to focus on the quality and maternal perceptions of care, not just its provision. Fewer women exclusively breastfeed than intend to. The aim was to examine the association between exclusive breastfeeding, quality of care, and maternal factors based on maternal reports.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted at a Finnish maternity hospital in 2022–2023. Data were collected through an online survey of mothers within 12 weeks of childbirth. Quality of care was measured by childbirth satisfaction, early breastfeeding initiation, family-centered care, maternal satisfaction with postnatal care, and breastfeeding support. Binary logistic regression analyzed associations between exclusive breastfeeding, quality of care, and maternal factors.</div></div><div><h3>Findings</h3><div>A total of n = 160 mothers participated. Lack of early breastfeeding initiation (OR 2.20, p = 0.05), inadequate breastfeeding support (OR 2.05, p = 0.05), lower family-centered care quality (OR 2.14, p = 0.04), primiparity (OR 2.94, p &lt; 0.001), antenatal non-exclusive breastfeeding plan (OR 6.44, p &lt; 0.0001), and lower parenting self-efficacy (OR 4.98, p &lt; 0.0001) were associated with non-exclusive breastfeeding. The most significant predictor of non-exclusive breastfeeding was a lack of antenatal breastfeeding plan (OR 6.22) combined with lower parenting self-efficacy (OR 4.81).</div></div><div><h3>Conclusion</h3><div>Early breastfeeding initiation, support, and family-centered care were initially associated with breastfeeding outcomes; however, only the maternal factors—absence of antenatal breastfeeding plans and lower parenting self-efficacy—remained significantly associated with non-exclusive breastfeeding.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101127"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women’s experiences of the transition phase of physiological labour during freebirth: A qualitative study","authors":"Eleanor Young ,&nbsp;Karen-Ann Clarke ,&nbsp;Rachel Reed ,&nbsp;Carolyn Hastie","doi":"10.1016/j.srhc.2025.101115","DOIUrl":"10.1016/j.srhc.2025.101115","url":null,"abstract":"<div><h3>Purpose</h3><div>There is a poverty of knowledge relating to the transition phase of labour and undisturbed childbirth physiology. This study explored women’s experiences of the transition phase of physiological labour during freebirth.</div></div><div><h3>Background</h3><div>Transition within physiological labour is described as a phase occurring as a woman ends the first stage of labour. The woman may display a range of signs and symptoms, including shaking, thirst, nausea, difficulty in communication, irritation, loss of control and inability to cope.</div></div><div><h3>Aim</h3><div>The study aimed to explore women’s experiences of the transition phase of physiological labour during an intended, unassisted labour and birth, known as freebirth.</div></div><div><h3>Methods</h3><div>A qualitative study design, using narrative inquiry was undertaken. Individual in-depth interviews were conducted with women who had experienced physiological births in Australia without the presence of registered health practitioners, doulas or childbirth attendants (n = 10). Reflexive thematic analysis was undertaken to identify themes and patterns.</div></div><div><h3>Findings</h3><div>Women experienced a physiological ‘peak intensity’ of labour that was individualised and nuanced. Three over-arching themes, <em>inner world</em>, <em>outer world</em> and <em>other world,</em> were conceptualised from data analysis. The <em>inner world</em> focussed on the somatic experience of labour. The <em>outer world</em> centred on the women’s perceptions of others and feelings of safety. The <em>other world</em> explored experiences of liminal space and oneness.</div></div><div><h3>Conclusions</h3><div>Findings support earlier studies regarding how women experience physiological processes and affirm that women experience the peak intensity of labour in individualised ways which are not reflected or supported in the common midwifery discourse. This study provides evidence about women’s experiences of physiological labour and insight into their dynamic <em>inner, outer</em> and <em>other</em> worlds. Further research is recommended into the freebirth experience in Australia from the perspective of childbirth physiology, and how the context of the birth setting, and midwifery practice may influence physiology and experience. It is also recommended that emergent knowledge on the altered states of consciousness and the sexual nature of birth be explored.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101115"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and predictors of depression in Jordanian women post-hysterectomy: A multi-centre cross-sectional study","authors":"Nadeen Abu Ghali ,&nbsp;Rasmieh Al-Amer ,&nbsp;Yacoub Abuzied ,&nbsp;Ahmad Aqel ,&nbsp;Ruba W. Al-Rwashdih ,&nbsp;Mohammad Y.N. Saleh ,&nbsp;Mohammed Albashtawy ,&nbsp;Eman Zmaily Dahmash","doi":"10.1016/j.srhc.2025.101113","DOIUrl":"10.1016/j.srhc.2025.101113","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to assess the prevalence of depression among Jordanian women who underwent hysterectomy and determine the associations with their demographic characteristics and their social support levels.</div></div><div><h3>Methods</h3><div>The study included women over 18 years who underwent hysterectomy and received care at government hospitals in Amman, the capital of Jordan. The study instruments were a demographic questionnaire, a Depression, and Stress Scale (DASS), and a social support scale. The DASS categorises depression levels as ’No depression’, ‘Mild’, ’Moderate’, ’Severe’, to ’Extremely severe’.</div></div><div><h3>Results</h3><div>The study included 220 participating women; 68.2 % of them (n = 150) were married, with a mean age of 48.17 (SD = 11.78) years. Approximately half of the women reported experiencing some form of depressive symptoms. The study found significant negative relationships between depression and age, (r = −0.403; p &lt; 0.001), number of children (r = −0.342; p &lt; 0.001), and sexuality pattern change. Additionally, there were significant positive correlations between depression and duration of marriage, body mass index, employment status, marital status, fertility wishes, education level, and family income. The whole regression model concerning depression was significant, with an R² of 0.256. Depression among Jordanian women who underwent hysterectomy was significantly predicted by their age (β = −0.315, p &lt; 0.001); sexuality change (β = −0.207, p = 0.001); and number of children (β = −0.202, p = 0.002).</div></div><div><h3>Conclusions</h3><div>Depression was highly prevalent among Jordanian women who underwent hysterectomy and was significantly predicted by age, sexuality change, and number of children.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101113"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updating the European Union’s Midwifery Directive advance women’s sexual and reproductive health in the future and reinforce professional standard within the midwifery profession","authors":"L. Brigante ,&nbsp;D. Drandic ,&nbsp;R.D. Maimburg","doi":"10.1016/j.srhc.2025.101138","DOIUrl":"10.1016/j.srhc.2025.101138","url":null,"abstract":"<div><div>The ongoing revision of the European Directive on Professional Qualifications for midwives presents a once in a generational opportunity to bring its outdated standards into alignment with contemporary evidence and international frameworks.</div><div>This short communication outlines key limitations in the current directive and its revision process, and proposes pragmatic, forward-looking updates informed by existing consensus and aligned with the International Confederation of Midwives (ICM) Essential Competencies for Midwifery Practice. The revision holds the potential to strengthen professional mobility, support high-quality care across European Union (EU) and European Economic Area (EEA) countries as well as globally. Moreover, to ensure that midwifery education continues to meet the sexual and reproductive health care needs of women and their families in the future.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101138"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum post-traumatic stress symptoms and mother-infant bonding: A population-based cross-sectional study","authors":"Valgerður Lísa Sigurðardóttir ,&nbsp;Guðrún Anna Hákonardóttir ,&nbsp;Stefanía Birna Arnardóttir ,&nbsp;Linda Bára Lýðsdóttir ,&nbsp;Emma Marie Swift","doi":"10.1016/j.srhc.2025.101140","DOIUrl":"10.1016/j.srhc.2025.101140","url":null,"abstract":"<div><h3>Objective</h3><div>Postpartum post-traumatic stress symptoms are associated with negative outcomes for women’s mental health and may disrupt the development of the mother–infant bond. However, previous research has reported inconsistent findings. The aim was to examine the predictive role of postpartum post-traumatic stress symptoms on mother–infant bonding 6 to 12 weeks after birth in a population-based sample.</div></div><div><h3>Method</h3><div>This population-based cross-sectional study was conducted in 2022 and included 598 women 6 to 12 weeks postpartum. Postpartum post-traumatic stress symptoms were measured using the City Birth Trauma Scale, and mother–infant bonding was assessed with the Postpartum Bonding Questionnaire. Linear regression analysis was used to examine the association between post-traumatic stress symptoms and mother–infant bonding, adjusting for maternal age, parity, mode of birth, educational level, and depressive symptoms.</div></div><div><h3>Results</h3><div>The mean score on the City Birth Trauma Scale was 8.4, and 5.5 on the Postpartum Bonding Questionnaire. A total of 1.5 % of participants scored above the cut-off for significant bonding difficulties. Higher levels of postpartum post-traumatic stress symptoms were significantly associated with greater bonding difficulties (B = 0.380, p &lt; 0.005). This association remained significant after adjustment for background variables and depressive symptoms (B = 0.113, p = 0.007). Primiparity, higher educational attainment, and depressive symptoms were also significantly associated with bonding difficulties (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The findings suggest that postpartum post-traumatic stress symptoms negatively affect the development of the mother–infant bond. A targeted screening of post-traumatic stress symptoms and bonding difficulties is recommended, followed by appropriate support in postpartum care.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101140"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating cannabis use during pregnancy: life trajectories, relationships, and contextual influences","authors":"Kristelle Alunni-Menichini ,&nbsp;Rose Chabot ,&nbsp;Genève Guilbert-Gauthier ,&nbsp;Karen A. Dominguez-Cancino ,&nbsp;Lysiane Robidoux ,&nbsp;Nadia L’Espérance ,&nbsp;Christophe Huynh ,&nbsp;Karine Bertrand ,&nbsp;Helen-Maria Vasilidis ,&nbsp;Julie Loslier ,&nbsp;Yolaine Frossard de Saugy ,&nbsp;Pablo Martínez ,&nbsp;Victoria Massamba ,&nbsp;José Ignacio Nazif-Munoz","doi":"10.1016/j.srhc.2025.101129","DOIUrl":"10.1016/j.srhc.2025.101129","url":null,"abstract":"<div><h3>Background</h3><div>In Canada, between 3 and 7 % of women have reported using cannabis during pregnancy despite public health recommendations. While fetal risks are well researched, the socio-economic, psychological, and environmental factors shaping cannabis use before and during pregnancy remain underexplored.</div></div><div><h3>Method</h3><div>Drawing on semi-structured interviews with eighteen women who consumed cannabis while being pregnant in Québec (Canada), this interpretive study explores the meanings pregnant women attach to cannabis consumption throughout their lives and pregnancy, the factors conditioning their decisions, and the impact of their choices on their wellbeing.</div></div><div><h3>Results</h3><div>Women’s decisions to reduce, cease, or continue cannabis use during pregnancy are shaped by their life trajectories, gendered experiences, and broader socio-environmental influences. Pregnancy can serve as a motivation to stop or reduce consumption, but for some, especially those with a deep connection to cannabis, pressure for abstinence can generate stress and anxiety. Moreover, decision-making regarding cannabis use is tied to gender norms and inequalities that shape the meanings pregnant persons attribute to their own use during pregnancy.</div></div><div><h3>Conclusion</h3><div>This research highlights how the interplay of long-term social, relational, and environmental factors shapes cannabis use during pregnancy. It underscores the need for tailored, non-stigmatizing public health interventions that acknowledges this complexity, while also addressing stress, anxiety, and informational gaps. Providing harm reduction strategies and context-sensitive support systems can help ensuring that pregnant women receive compassionate, evidence-based care to navigate cannabis use during pregnancy.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101129"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144685833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"pre-SUCCECS: Lessons learned from implementing resuscitation and stabilisation with an intact cord during caesarean sections – Focus group discussions with implementation teams","authors":"Katarina Ekelöf ,&nbsp;Elisabeth Sæther ,&nbsp;Ola Andersson ,&nbsp;Jenny Svedenkrans ,&nbsp;Karolina Linden","doi":"10.1016/j.srhc.2025.101114","DOIUrl":"10.1016/j.srhc.2025.101114","url":null,"abstract":"<div><h3>Objective</h3><div>The primary aim of this study was to explore the lessons learned from implementing a procedure of resuscitation and stabilization with an intact umbilical cord for preterm and term infants requiring resuscitation or stabilization during emergency caesarean sections.</div></div><div><h3>Methods</h3><div>Data were collected by two focus group discussions and one individual interview. Participants were members of implementation teams responsible for implementing of resuscitation and stabilization with an intact cord during caesarean sections. The implementation teams were from two hospitals from different metropolitan areas in Sweden. We used a deductive approach with data collection and analysis guided by the Consolidated Framework for Implementation Research 2.0 and an inductive approach to derive lessons learned.</div></div><div><h3>Results</h3><div>All implementation domains except the outer setting were represented in the results. Suggested solutions to common concerns such as maintaining sterility, temperature control of the neonate and availability of the equipment were described by the implementation teams. Additionally, the participants highlighted the importance of a multidisciplinary implementation team with all professions represented as well the need for decision-making authority in the team, for successful implementation.</div></div><div><h3>Conclusions</h3><div>The lessons learned from implementing neonatal resuscitation and stabilisation with an intact umbilical cord during caesarean section can inform efficient strategies for implementing this complex intervention into clinical routines across difverse birth settings.</div></div><div><h3>Synopsis</h3><div>Lessons learned from implementing resuscitation and stabilization with an intact cord during emergency caesarean sections are included. Possible solutions to concerns about sterility, neonatal temperature control, and equipment availability are presented.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101114"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Vietnamese version of the childbirth fear prior to pregnancy scale: A validation study","authors":"Thi Thuy Hang Ho ,&nbsp;Thi Hoan Nguyen ,&nbsp;Tiet-Hanh Dao-Tran","doi":"10.1016/j.srhc.2025.101120","DOIUrl":"10.1016/j.srhc.2025.101120","url":null,"abstract":"<div><h3>Background</h3><div>Fear of childbirth affects women’s attitudes toward childbirth, birth choices, health outcomes, and relationships with their baby, partner, and family. Although more Vietnamese women postpone or avoid pregnancy, understanding this fear is limited due to a lack of a valid and reliable measurement scale.</div></div><div><h3>Aim</h3><div>This study translated, adapted, and validated the Childbirth Fear Prior to Pregnancy Scale (CFPP) for Vietnamese users.</div></div><div><h3>Methods</h3><div>Multistep methodological research was conducted between August and October 2021. The research had two phases: (1) translation and cultural adaptation, and (2) validation. Validation was conducted on 510 Vietnamese women who participated in a cross-sectional design study and were selected by convenience sampling methods. Face validity, structural validity, convergent validity and internal consistency reliability were tested.</div></div><div><h3>Results</h3><div>The V-CFPP was comprehensible and culturally appropriate to Vietnamese women prior to pregnancy. The V-CFPP is unidimensional. Childbirth Fear Prior to Pregnancy, measured using the V-CFPP, was significantly associated with depression (r = 0.28, p &lt; 0.05), anxiety (r = 0.30, p &lt; 0.05), and stress (r = 0.29, p &lt; 0.05). The V-CFPP has a Cronbach’s α coefficient of 0.94.</div></div><div><h3>Conclusion</h3><div>The V-CFPP has satisfactory face, structural, and convergent validity. Its internal consistency reliability is excellent. The V-CFPP is a valid and reliable measurement scale for assessing the fear of childbirth prior to pregnancy among Vietnamese women, both nationally and internationally.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101120"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting provision of high-quality maternal and newborn healthcare in Zanzibar – A qualitative study","authors":"Hibaq Warsame ,&nbsp;Malin Bogren ,&nbsp;Margaret Sylvester Tayari ,&nbsp;Sanura Salim ,&nbsp;Helen Elden ,&nbsp;Herborg Holter","doi":"10.1016/j.srhc.2025.101122","DOIUrl":"10.1016/j.srhc.2025.101122","url":null,"abstract":"<div><h3>Objectives</h3><div>In Tanzania and Zanzibar, the maternal mortality ratio remains high, hence, this study explored factors affecting the provision of high-quality maternal and newborn healthcare in Zanzibar.</div></div><div><h3>Methods</h3><div>A qualitative research design was used, with data collected through five focus group discussions (FGDs) with healthcare providers. The discussions, held in Swahili, included midwives, nurses, and medical doctors (n = 27) working at five childbirth clinics in Zanzibar. A semi-structured FGD guide was used. All discussions were audio-recorded, transcribed, and translated into English. Content analysis was performed.</div></div><div><h3>Results</h3><div>Three generic categories describe the factors affecting the provision of high-quality maternal and newborn healthcare: i) a shortage of essential resources, including medical equipment, medication, and an emergency transport system; ii) an inadequate working environment, characterized by understaffing, low salaries, limited involvement of and protection for healthcare providers, and a lack of clinical guidelines; and iii) healthcare perception and cultural dynamics encompassing mistrust of healthcare providers, as well as cultural beliefs and practices.</div></div><div><h3>Conclusions</h3><div>The study highlights critical barriers to the provision of high-quality maternal and newborn care in Zanzibar, including resource shortages, inadequate working environments, and cultural perceptions of healthcare. These findings suggest that addressing systemic challenges, such as improving resource allocation and enhancing healthcare infrastructure, is essential for advancing maternal and newborn health outcomes. Additionally, efforts to align healthcare practices with local cultural dynamics are crucial to improving service utilization. These findings underscore the need for targeted interventions to strengthen healthcare delivery and reduce maternal and newborn mortality in Zanzibar and similar settings.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101122"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}