Frontiers in global women's health最新文献

Severe cyclical mastalgia is a common condition that can substantially impair women's daily activities and quality of life. Pharmacological treatments are often used, but non-pharmacological strategies remain underexplored. We report a case of a 28-year-old woman with long-standing severe cyclical mastalgia and hyperprolactinemia, who achieved symptom resolution through strict avoidance of soy foods and certain nuts, while maintaining her usual lifestyle and diet otherwise. Hormonal measurements indicated decreases in premenstrual prolactin, progesterone and estradiol levels, and even minimal intake of these foods provoked mild breast discomfort. This case suggests a potential link between soy consumption and cyclical mastalgia in susceptible individuals and highlights the possibility of non-pharmacological dietary management. Further research is needed to assess the efficacy, safety, and broader applicability of this approach.

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in women worldwide. Due to the high prevalence, communities need to know that the risk of HPV infection can be prevented by HPV vaccination.

Aim: This study aims to assess the knowledge and attitudes of female nursing students at Umm Al-Qura University regarding HPV infection and HPV vaccination.

Materials and methods: A descriptive cross-sectional quantitative study was conducted among 261 female nursing students using a self-administered online questionnaire. Data were collected through the validated 28-item Knowledge and Attitudes Toward HPV and Its Vaccination for University Students Scale, which was adapted and culturally modified to align with the Saudi context. The instrument comprised three parts: demographic information, general knowledge, and attitudes toward HPV vaccination. A non-probability purposive sampling technique was used. Data were analyzed using descriptive statistics and one-way ANOVA to explore differences across demographic variables.

Results: Of the 261 participants, 49.4% demonstrated poor knowledge, 47.1% moderate knowledge, and 3.4% high knowledge. The mean attitude score was 2.79 ± 0.87, indicating a moderate level of acceptance toward HPV vaccination. Although most participants recognized its preventive importance, barriers remained, primarily related to parental consent and communication. One-way ANOVA results showed no significant differences in knowledge based on academic year or parental education, whereas living arrangement demonstrated a significant effect (F = 2.826, p = 0.025, η ² = 0.042).

Conclusion: Nursing students had low to moderate knowledge of HPV and held a moderate level of acceptance toward the HPV vaccine highlighted the needs for targeted interventions and educational initiatives to enhance HPV vaccination uptake and promote overall well-being in the community.

Background: Nausea and vomiting of pregnancy (NVP) often go undertreated due to several reasons including medication costs, patient hesitancy, underestimation of NVP by healthcare professionals, and their reluctancy to treat pregnant patients.

Case: A 24-year-old primigravida with severe NVP and stress-related concerns received behavioral health consultation integrated into prenatal care via the Primary Care Behavioral Health model.

Intervention: The patient engaged in brief behavioral strategies including supportive contact, diaphragmatic breathing, prayer, music, and mindfulness techniques across four consultations.

Outcome: Symptom improvement was observed during the course of behavioral support.

Conclusion: This case supports Primary Care Behavioral Health integration into prenatal care as a feasible, cost-effective adjunct to routine medical interventions, particularly in underserved communities.

Limitations: Meaningful clinical conclusions cannot be made due to the nature of this being a case report and to the confounding nature of NVP typically resolving by the second trimester. Further investigation is warranted.

Background: Pregnant women with disabilities experience significantly higher rates of adverse pregnancy outcomes compared to those without disabilities. Evidence-based interventions that address disability-related barriers during pregnancy are essential to reducing health disparities.

Objective: We aimed to update a 2014 systematic review to identify interventions designed for pregnant women with disabilities.

Methods: We conducted a systematic review of studies published between 2012 and 2025 to identify interventions addressing disability-related barriers during pregnancy and birth.

Results: We found a striking absence of evidence with no eligible studies identified from 22,719 publications. While we found multiple studies that evaluated the safety and efficacy of medications to manage disability-associated conditions during pregnancy, none of these studies focused on the potential disabling impact of the health conditions for pregnant women with disabilities, our intended focus. However, in our discussion, we describe three recent pilots, including co-produced resources for pregnant patients with disabilities, educational interventions for midwives, and an innovative patient empowerment tool, that suggest the field may be at a turning point.

Conclusions: Our systematic review did not find evidence of disability inclusive maternal health interventions to improve pregnancy and childbirth experiences. However, we point to limited but promising studies for their use of co-production and patient engagement principles underscoring the potential for accelerating progress when research is conducted with, rather than on, disabled communities. While the pilots serve as proof of concept that disability-inclusive reproductive health research is both necessary and achievable, investments in disability inclusive maternal healthcare could yield significant returns for those with disabilities.

Background: Pelvic inflammatory disease (PID) is mainly induced by the sexually transmitted infection (STI). However, the global burden and trends of STI excluding human immunodeficiency virus (HIV)-associated PID (non-HIV PID) has not been specifically assessed.

Methods: The prevalence and years lived with disability (YLDs) were collected from the Global Burden of Disease (GBD) 2021 database. The disease burden was evaluated with the case numbers, age-standardized rates (ASR) and estimated annual percentage changes (EAPC). According to the SocioDemographic Index (SDI), frontier and health inequality analysis were conducted. Autoregressive Integrated Moving Average (ARIMA) model was applied to predict the future trends of Non-HIV PID.

Results: The age-standardized prevalence rates (ASPR) and YLDs of non-HIV PID was 27.02/100,000 and 3.68/100,000 in 2021 globally. Except for the decline of gonococcal-associated PID, the EAPC of chlamydial and other non-HIV PID were stable. The countries with fastest-growing prevalence were Brazil (4.19 [2.92, 5.47]), Spain (3.98 [3.19, 4.77]), Greece (3.05 [2.55, 3.55]), Portugal (2.76 [2.22, 3.29]), which suggested the increased burden of non-HIV PID in these years. Moreover, the non-HIV PID was mainly concentrated in 30-34 years, which was most common in the low and low-middle SDI. Additionally, prevention of non-HIV PID should also be concerned in the high SDI regions, especially for United Kingdom, Canada, Japan, and Singapore, which would also increase in the next 30 years.

Conclusion: The burden and prevention of non-HIV PID were still arduous and required a long-term effort, especially for the 30-34 years, which need more attentions even for the developed countries.

Background: This study was conducted to assess the effectiveness of visual inspection with acetic acid (VIA) followed by colposcopy for cervical cancer screening. Like many low- and middle-income countries (LMICs), Bangladesh struggles with inadequate cervical cancer screening and diagnostic facilities, as well as a shortage of cytopathologists and histopathologists in remote rural areas. Human papillomavirus (HPV) testing has not yet been implemented effectively in Bangladesh, and cytology (Pap smear) is a costly procedure. The current study performed VIA and colposcopy on apparently healthy adult women, primarily to screen for cervical lesions and, secondarily, to identify associated risk factors.

Methods: This cross-sectional study was conducted in a remote rural health center in Bangladesh using a straightforward and affordable approach: VIA followed by colposcopy. This facility-based, cross-sectional study included 384 married women aged between 18 and 65 years recruited after field-level awareness on cervical cancer prevention.

Results: Out of 384 women tested, 247 (64.3%) were adults, 85 (22.1%) were middle-aged, 33 (8.6%) were older, and only 19 (4.9%) were young adults. The study found that more than one-third of the participants (39.1%) engaged in sexual activities without using condoms. A total of 20 participants tested VIA-positive (5.2%), of whom 60% were confirmed by colposcopy. The chi-squared test identified multiple sexual exposures without condom use as a significant risk factor for cervical cancer. All double-positive cases (n = 12) received treatment; 7 (58.3%) underwent thermocoagulation (heat-based ablation), and 5 (41.7%) received a loop electrosurgical excision procedure (LEEP) at referral hospitals.

Conclusion: We propose that, to achieve Sustainable Development Goals 3.7 and 3.8, VIA followed by colposcopy is suitable for screening cervical cancer in rural areas of Bangladesh and other LMICs, where screening techniques such as Pap smear and HPV tests are not yet widely available and accessible.

[This corrects the article DOI: 10.3389/fgwh.2025.1592538.].

Introduction: Anemia remains a critical public health challenge in India, particularly among pregnant women, where its multifactorial etiology is often underappreciated. Despite long-standing supplementation programs, anemia prevalence in Gujarat remains high, necessitating granular, region-specific investigations.

Objectives: To assess the prevalence of anemia among pregnant women across ten districts of Gujarat, and to identify key sociodemographic, nutritional, hematological, and biochemical determinants contributing to anemia and its geographic disparities.

Methodology: This community-based study included 2,805 pregnant women from diverse settings (tribal/rural/urban). Hematological and biochemical assessments included serum ferritin, iron, C-Reactive Protein (CRP), folate, vitamin B12, prealbumin, and hemoglobinopathy screening. A logistic regression analysis was conducted to determine the independent factors associated with anemia, with the findings presented as adjusted odds ratios (aOR) along with their 95% confidence intervals (CI).

Results: Overall anemia prevalence was 64.2%, with mild anemia comprising 82.1% of cases. Tribal women had 2.21-fold higher odds of anemia than urban counterparts (aOR = 2.21, 95% CI: 1.88-2.61, p < 0.001). Anemia was also associated with illiteracy (aOR = 2.16, p < 0.001), underweight status (aOR = 1.58, p < 0.001), and low dietary diversity (aOR = 2.26, p < 0.001). Biochemical assessments revealed absolute iron deficiency in 17.2%, folate deficiency in 15.5%, and vitamin B12 deficiency in 60.3% of anemic women. Elevated CRP levels indicated inflammation in 34.7%. Multivariable binary logistic regression revealed five significant and independent predictors of anemia: reduced red blood cell count (aOR = 0.26; 95% CI: 0.22-0.31), elevated red cell distribution width (RDW-CV) (aOR = 1.39; 95% CI: 1.33-1.46), diminished serum prealbumin (aOR = 0.92; p < 0.001), lower folate levels (aOR = 0.97; p < 0.001), and decreased ferritin concentrations (aOR = 0.99; p < 0.001), each independently contributing to anemia risk.

Conclusion: Anemia in Gujarat's pregnant women is highly prevalent and multifactorial, shaped by overlapping nutritional, inflammatory, and social determinants. Region-specific, integrated strategies targeting biochemical deficits and structural inequities are essential for effective anemia mitigation.

Background: Physical activity (PA) is a key determinant of women's physical, mental, and social well-being, yet participation in structured sports remains limited due to sociocultural norms, caregiving roles, and accessibility barriers. The Mamanet Cachibol League (Mamanet), a community-based sports initiative in Israel, addresses these barriers by fostering participation among mothers from diverse backgrounds. This study evaluates Mamanet's health and economic impacts among Arab women through a cost-benefit analysis (CBA) and quality-adjusted life year (QALY) framework.

Methods: A quantitative pre-post evaluation was conducted with 174 Arab women participating in Mamanet teams across diverse geographic and socioeconomic contexts in Israel. The non-randomized design examined within-participant changes over a 10-month period, providing real-world evidence of programme effectiveness. Participants completed validated Hebrew and Arabic questionnaires before and after the intervention. Health-related variables included self-rated health, psychosomatic symptoms, physical activity, mental well-being, and social capital indicators. The economic evaluation incorporated reductions in healthcare utilization and medication costs, productivity gains, and QALY improvements, accounting for direct and opportunity costs.

Results: Mamanet participation was associated with improvements in physical health outcomes, including a significant reduction in psychosomatic symptoms (p < 0.001, effect size = 0.75). Gains in mental well-being were observed but did not reach statistical significance (p = 0.09). Modest increases were found in social capital and community engagement. Economically, participation in the programme was associated with reduced healthcare use, lower absenteeism, and decreased medication expenditures, as well as enhanced productivity. The benefit-cost ratio (BCR) was 1.13, indicating that overall benefits exceeded programme costs.

Conclusion: The Mamanet programme yields measurable health, social, and economic benefits for Arab women in Israel, demonstrating how culturally adapted, community-based interventions can reduce barriers to physical activity and promote health equity. Its low-cost, inclusive model offers a scalable framework for integrating women's sports into public health strategies and strengthening community resilience. Beyond Israel, the programme's principles affordability, inclusion, and engagement can inform policies supporting the Sustainable Development Goals (SDG), particularly those addressing gender equality, well-being, and reduced inequalities.

This community case study examines the efficacy of the Women's Housing Support Program (WHSP)_, which provides case management to older women experiencing homelessness in Melbourne, Australia. In recent years there has been an increase in the number of older women experiencing homelessness in Australia. Some have experienced long-term, chronic homelessness, but there has also been an escalation in homelessness for women who have previously led conventional lives before a significant event such as relationship breakdown, loss of employment, or health crisis results in poverty that contributes to homelessness. The circumstances of older age, gender, and homelessness mean that some older women require specialised responses to access suitable long-term housing and to receive appropriate support that will stabilise their housing. This case study explores the distinctive social, health, and housing needs of women accessing the WHSP and considers how the sustaining tenancies model of support responds to these needs. Based on a mixed-methods study that included interviews with service users, case managers, senior managers, and an external service provider, as well as program data analysis, the case study indicates that older women benefit from specialised support that focuses on housing for life, health care, emotional support, and digital literacy. Additionally, in order to facilitate successful outcomes, this support needs to be flexible, client-centred, and trauma-informed.