Frontiers in global women's health最新文献

Background: Maternity waiting homes are cost-effective, World Health Organization-approved components of comprehensive prenatal, delivery, and postpartum care strategies. However, few community-based studies within Ethiopia's pastoralist communities, and none in the study area, have been conducted to determine actual usage or to gain a thorough understanding of the factors influencing utilization.

Methods: A cross-sectional study, supplemented by qualitative methods, was conducted from June 25 to July 25, 2023. A simple random sampling technique was used to select 305 study participants. Data were gathered through an interviewer-administered questionnaire, entered into Epi-data version 3.1, and analyzed using SPSS version 25. Descriptive data were presented in tables, graphs, text, and percentages. Bivariate logistic regression identified candidate predictors at a P-value of <0.25, and predictors of maternity waiting home utilization were identified through multivariate logistic regression at a 95% confidence interval and P-value of <0.05. Qualitative interviews were transcribed, translated, and thematically analyzed.

Results: The prevalence of maternity waiting home use in the study area was 35.2% (95% CI: 30.9%, 39.5%). Factors associated with maternity waiting home utilization included travel time greater than 60 min to nearby health facilities (AOR: 5.47 CI: 1.77, 16.91), good knowledge of danger signs of pregnancy (AOR: 5.41, CI: 1.86, 15.79), lack of a caretaker to household tasks (AOR: 0.1, CI: 0.03, 0.31), and a refusal to accept a waiting time of 2-4 weeks (AOR: 0.24 CI: 0.08, 0.74). The qualitative findings underscored hurdles such as resource constraints, challenges in providing maternity services, and the importance of community awareness and access to network connectivity in ensuring safe childbirth.

Conclusion: This study aims to determine the utilization of maternity waiting homes and the factors associated with their use among women who gave birth within the last year in the Dire district, Borana zone, southern Ethiopia. The prevalence of maternity waiting home use was low compared to national efforts to promote this service. Longer travel time, lack of a caretaker, good knowledge of danger signs of pregnancy, and a refusal to accept a waiting time of 2-4 weeks were associated with maternity waiting home use in this study.

Introduction: Family planning knowledge and access to quality family planning services occupy a central position in the lives of all women of reproductive age. However, women with mental illness and epilepsy who are at a high risk of sexual violence, unwanted pregnancies, poor obstetric outcomes, and drug interaction consequences, need it the most. Understanding their family planning knowledge and utilization remains crucial for meeting their needs. The present study aims to assess knowledge, use of family planning, and associated factors among women living with mental illness and epilepsy who attend the Ndera Neuropsychiatric Hospital and affiliated branches.

Methodology: A cross-sectional study was conducted between October 2022 and February 2023. The study involved a purposive sample of 289 women who attended the Ndera Neuropsychiatric Hospital and its two affiliated branches during the data collection period. Psychiatric nurses administered a structured questionnaire. Data were analyzed using descriptive statistics, and multiple logistic regression analysis was performed to assess the factors associated with the use of family planning methods.

Results: Out of 289 who participated in the study, the majority (96.9%) were aware of family planning methods, most (67.8%) had used one method once in their life course, a half (51.9%) were using a family planning method at the time of data collection, and a slight number (26%) expressed intentions of using a family planning method in the future. The most known and used methods were respectively the injectable (17.5%) and oral contraceptive pill (17.5%). Regarding the natural family planning methods, breastfeeding and withdrawal were less used. Being single (AOR = 66.4, 95% CI: 9.8, 44) or married (AOR = 51.4, 95% CI: 11.9-22), having a primary level of education (AOR = 5.6, 95% CI: 2.0, 15.9), knowing a contraceptive method (AOR = 5.8, 95% CI: 0.6, 49) and suffering from brief psychotic disorders (AOR = 2.7, 95% CI: 1.1, 6.6) predicted a higher utilization of family planning.

Conclusion: Most of the women with mental illness in this study were aware of family planning methods and had used one of the family planning methods in life. The national average is below when it comes to family planning awareness. It is important to improve family planning education and counseling for women who attend psychiatric outpatient clinics.

Introduction: Human Papillomavirus is a sexually transmitted agent, causing cervical cancer. In Saudi Arabia, cervical cancer is ranked as the ninth most common carcinoma in women. HPV vaccine is an effective prevention method against HPV high-risk types such as HPV 18 and 16. Research on HPV vaccine knowledge and awareness is limited due to the lack of extensive data reportage on HPV and cervical cancer cases among Saudi women.

Aim: This study was aimed to determine the knowledge and awareness of human papillomavirus vaccination among Saudi nursing female students.

Methods: This study was cross-sectional and included (n = 114) participants. The study used an online survey, which included demographical variables and the HPV knowledge scale. The data were collected from October 10, 2023, until January 3, 2024. Descriptive data, Mann-Whitney Z-tests and nonparametric tests were used to analyze the study's findings.

Results: The study participants' mean age was 20.8 years (SD 1.6). Most students (72%) did not receive the HPV vaccine. The overall mean HPV knowledge was 10.0 (SD 7.08). The HPV knowledge subscales showed poor levels of knowledge of HPV infection, screening, and vaccines: 5.15 (SD 3.87), 1.39 (SD 1.34), and 2.06 (SD 1.87), respectively.

Discussion: In conclusion, Saudi Arabia having a predominantly youthful population, it is crucial to implement educational programs that improve the understanding and awareness of HPV infection among nursing students and other health professionals. There is a necessity to establish impactful awareness campaigns and integrate interventional research to inform health professionals and the public about the disease and dispel misunderstandings and cultural beliefs about HPV and HPV vaccines to prevent cervical cancers among young females.

Background: Venezuela continues to face a humanitarian crisis, where healthcare is difficult to access and abortion is legally restricted. In response to a growing need for life-saving abortion and sexual and reproductive health (SRH) services, a digital application called Aya Contigo was co-developed with local partners to support self-managed medication abortion. We sought to evaluate this digital health tool among pregnant people seeking abortion in Venezuela.

Methods: This is a mixed-methods pilot evaluation of Aya Contigo, a digital tool for pregnant people seeking abortion in Venezuela. From April to June of 2021, people in the first trimester of pregnancy were recruited via passive sampling. Once enrolled, participants accessed information and resources on the application and were supported by study team members over an encrypted chat. Following medication abortion, participants completed an online survey and a semi-structured interview. Descriptive statistics were used to evaluate the survey responses. Interviews were coded thematically and analyzed qualitatively with NVivo.

Results: Forty participants seeking medication abortion in Venezuela were recruited to the study and given access to Aya Contigo. Seventeen completed the online survey (42.5%), with all participants identifying as women and a mean age of 28 (range 19-38; SD 5.55). Participants expressed confidence in Aya Contigo; 53% (9/17) felt "very supported" and the remaining 47% (8/17) felt "somewhat supported" by the app throughout the self-managed abortion process. The app was rated as highly usable, with an overall System Usability Scale score of 83.4/100. Thirteen respondents participated in a semi-structured phone interview, and qualitative analysis identified key themes relating to the experience of seeking abortion in Venezuela, the user experience with Aya Contigo, and the app's role in the existing ecosystem of abortion and contraceptive care in Venezuela.

Discussion: This mixed-methods pilot study demonstrates that the Aya Contigo mobile application may support pregnant people seeking medication abortion and post-abortion contraceptive services in Venezuela. Participants valued the provision of evidence-based information, virtual accompaniment services, and locally-available sexual and reproductive health resources via the digital tool. Further research and interventions are needed to ensure that all pregnant people in Venezuela can access safe abortion and contraceptive resources.

Background: Teenage women's fertility health faces significant challenges from unintended pregnancies and unsafe abortions. Using an emergency contraception within a defined time period could prevent unintended pregnancy and its damaging consequences, like unintended childbirth and unsafe abortion. Despite it being an appropriate contraception, the knowledge of teenage women about emergency contraception is lower among women in developing countries. Therefore, this study aimed to examine the magnitude of emergency contraception knowledge and its associated factors among teenage women in Ethiopia.

Methods: Data for this study was obtained from the recent Demographic and Health Surveys. A total weighted sample of 3,381 teenage reproductive women were included. The significant associated factors with emergency contraception knowledge among teenage reproductive women were determined by fitting a multilevel mixed-effect binary logistic regression model. Finally, Adjusted Odds Ratio (AOR) with a 95% confidence interval and a P value of less than 0.05 was used to declare statistical significance.

Results: In Ethiopia, the magnitude of teenage women who knew about emergency contraception was 19.47% (95%CI: 18.17, 20.84). Age 17 years (AOR = 1.76, 95%CI, 1.24, 2.48) and age 19 years (AOR = 2.18, 95%CI, 1.47, 3.22), primary education level (AOR = 2.76, 95%CI, 1.60, 4.76), secondary and above educational level (AOR = 4.70, 95%CI, 2.62, 8.44), being protestant followers (AOR = 0.63, 95%CI, 0.45, 0.87), being muslim followers (AOR = 0.68, 95%CI, 0.49, 0.93), media exposure (AOR = 3.36, 95%CI, 2.59, 4.34), rural residence (AOR = 0.45; 95%CI: 0.22, 0.86), and high community level education (AOR = 140, 95%CI: 1.32, 2.00) were factors significantly associated with knowledge of emergency contraception among teenage women.

Conclusions: This finding concluded that less than one in five teenage women knew about emergency contraception in Ethiopia. The knowledge of emergency contraception among teenage women in Ethiopia was substantially associated with women's age, education level, religion, media exposure, residency and community-level education. Hence, there is a need to implement comprehensive awareness programs and promotion of emergency contraception as a way of curbing cases of unintended pregnancies among teenage women. Government and non-governmental organizations should design targeted educational initiatives and media campaigns to improve emergency contraception knowledge among young teenagers, women with lower educational backgrounds, and rural teenagers.

Background: Hepatitis B Virus (HBV) infection during pregnancy poses serious risks by raising the likelihood of chronic infection in newborns by 90% and the risk of cirrhosis and liver cancer by 25% in chronic infections. This study aimed to identify determinants of HBV infection among pregnant women in the Bench Sheko zone, Southwest Ethiopia.

Methods: An unmatched case-control study was conducted from May 15 to July 15, 2022, in selected health facilities of the Bench Sheko zone, Southwest Ethiopia. Medical charts were reviewed to collect the HBsAg status of participants, as all pregnant women attending antenatal care underwent routine screening. It involved 228 pregnant women (76 HBV-positive cases and 152 HBV-negative controls). Data were collected using structured questionnaires, and analyzed using SPSS 21. A multivariable logistic regression was performed to identify significant determinants of HBV infection, and statistical significance was declared at p-value <0.05.

Results: After controlling potential confounders, having no formal education (AOR = 4.94, 95% CI: 2.01, 8.29; P = 0.007), urban residency (AOR = 2.56, 95% CI: 1.43, 6.86; P = 0.010), history of unsafe abortion (AOR = 3.87, 95% CI: 2.17, 6.98; P < 0.001), sharing sharp materials (AOR = 8.43, 95% CI: 5.54, 10.9; P < 0.001), contact with HBV-infected persons in the family (AOR = 2.18, 95% CI: 1.72, 4.87; P < 0.001), tribal scarification (AOR = 3.23, 95% CI: 1.24, 8.91; P = 0.017), and history of unsafe tooth extraction (AOR = 4.52, 95% CI: 2.18, 9.76; P = 0.039) were identified as significant predictors of HBV infection.

Conclusion: The study identifies multiple factors contributing to HBV infection in pregnant women. Therefore, it is crucial to promote safe abortion practices and the responsible use of sharp materials, avoid high-risk contact with infected individuals within the family, raise awareness about the risks associated with tribal scarification while advocating for safer practices, and offer education on safe tooth extraction methods to reduce the risk of HBV.

Background: Point of care hemoglobin meters play key roles in increasing access to anemia screening in antenatal care especially in settings with limited access to laboratories. We aimed to determine the diagnostic accuracy of a non-invasive spot-check hemoglobin (SpHb) meter, Masimo Rad-67® Pulse CO-Oximeter®, in the diagnosis of anemia in pregnant women attending antenatal care clinics in Kilifi, Kenya.

Methods: This was a diagnostic accuracy study that retrospectively evaluated SpHb against a validated reference standard of laboratory assessed hemoglobin (Lab Hb) by a SYSMEX XN-330 automated hematology analyzer. The study was nested within a prospective pregnancy cohort study that recruited unselected pregnant women from antenatal care clinics in two public hospitals in Kilifi County, coastal Kenya. Records with both SpHb and Lab Hb were selected from pregnancy visits between May 2021 and December 2022. Linear regression and Bland-Altman analysis were performed to compare the two tests and diagnostic accuracy parameters obtained for the diagnosis of anemia.

Results: A total of 2,975 records (from 2,203 unique participants), with paired SpHb and Lab Hb were analyzed. Linear regression showed a significant but weak positive correlation, a proportional bias of 0.44 (95% CI 0.41-0.47) and a constant of 7.59 (95% CI 7.30-7.87, p < 0.001). The median bias was 1.70 g/dl, with limits of agreement of -0.80 to 4.20. SpHb tended to be higher than Lab Hb on the low hemoglobin range but lower than Lab Hb on the high hemoglobin range. The sensitivity of SpHb in detecting anemia was 18.66%. Prevalence, specificity, positive predictive value, and negative predictive values were 46.37%, 96.77%, 83.33%, and 57.92% respectively.

Conclusion: Overall, SpHb by Masimo Rad-67® Pulse CO-Oximeter® did not accurately identify pregnant women with anemia and many cases would be missed. We would not recommend its use in antenatal care settings.

Introduction: During the peripartum, women undergo significant hormonal changes that are crucial for fetal development and a healthy pregnancy and postpartum period for mother and infant. Although several studies have determined healthy norm ranges of estradiol and progesterone, there are discrepancies among the reports, rendering it unclear which hormone levels are linked to adverse health outcomes. To account for the impact of sex steroid patterns on health outcomes in mothers and children, a longitudinal assessment of different parameters is needed.

Materials and methods: We longitudinally assessed a cohort of 130 women over five months during pregnancy and postpartum. The women provided saliva samples and completed psychosocial questionnaires. Hormone analyses were conducted using enzyme-linked immunosorbent assay (ELISA). Different parameters of estradiol and progesterone were analyzed and evaluated in relation to psychometric variables. To examine the presence of heterogenous hormonal trajectories in the peripartum, we applied group-based trajectory modelling as a special case of latent-class group analysis.

Results: Estradiol and progesterone levels rose towards the end of pregnancy and dropped sharply after birth, with considerable individual variation, particularly during pregnancy. However, their ratio remained stable. We identified three estradiol trajectory subgroups and two progesterone subgroups. Age influenced progesterone levels, with older pregnant women having higher levels than younger women. Anxiety and depressive symptoms had a predictive value for trajectories of specific subgroups of women. The study also revealed two distinct subgroups regarding the course of estradiol and progesterone fluctuations as well as their ratio.

Conclusion: This study provides insights into the course and fluctuation of salivary estradiol and progesterone levels among healthy women during the peripartum period, highlighting significant variations in hormone levels but stability in their ratio during this time. The finding of distinct sex steroid courses in the peripartum is new and suggests the need for further research to explore their impact on health outcomes. Our preliminary results suggest that hormonal fluctuations at the end of pregnancy appear to be a normal occurrence and might even be a protective factor for associated psychological symptoms and sleep disturbances in women.

Introduction: Most new HIV infections occur in sub-Saharan Africa due to premarital, likely experiences of abuse, exploitation, intimate partner violence, murder, and suicide. Transient nature of the relationship, cohabiting young females are frequently at risk for poor mental health following disagreements. This study's aim was to predictors of premarital cohabitation timing among young women in Ethiopia.

Method: Secondary data from the 2016 Ethiopian Health and Demographic Survey was analyzed. The study comprised a weighted sample of 6,142 young women. A weighted descriptive analysis of graphs, frequency tables, medians, and percentiles was performed to describe the study participants. The Akaike information criteria were used to choose the best-shared frailty model for the data. Final measures of effect size included the adjusted hazard ratio, both of which had a p-value of less than 0.05.

Result: Premarital cohabitation was reported to have a median age of 16 years (IQR, 15-18 years). Woman's age (AHR = 0.795; 95% CI: 0.761-0.868) was one of the independent predictors of time to premarital cohabitation. For primary, secondary, and higher education, respectively, 0.733 (95% CI: 0.607, 0.959) and 0.610 (95% CI: 0.589, 0.632) were seen among women who can read and write (AHR = 0.896; 95% CI: 0.872, 0.920). Women with access to the media (AHR = 0.722, 95% CI: 0.510, 0.963).

Conclusion: The most important idea is that educational level, access to media, age, and literacy are the most significant factors for the time-to-premarital cohabitation rate.

Introduction: The impact of COVID-19 on mental health has become a relevant object of research. Studies have demonstrated that women have experienced greater mental health challenges, highlighting the importance of public health systems to address women's specific needs.

Methods: This literature review explores the effects of the coronavirus pandemic on psychological distress among women, aiming to provide a comprehensive understanding of the subject and to explore how these research findings can guide public mental health care responses in crisis settings. A total of 131 studies were analyzed and four dimensions were discussed: study characteristics, factors impacting women's mental health in the pandemic setting, particularities of pregnancy and the postpartum period, and proposed interventions. Most studies exclusively addressed populations of adult women, predominantly during pregnancy and the postpartum period.

Results: Anxiety, depression, and stress were the most common outcomes. Lower education and income, preexisting mental health problems, and living alone or with children were risk factors for higher levels of anxiety and depression.

Discussion: A comprehensive care approach supported by public health policies and focused on intersectional factors, including race, socioeconomic status, and access to resources, is necessary to improve women's mental health care response in future crises.