Frontiers in global women's health最新文献

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.

Background: Primary dysmenorrhea (PD) is a common gynecological condition affecting many young women, especially university students. It can have significant effects on daily activities and quality of life. This study aims to describe the prevalence and some factors related to PD among female nursing students at Hanoi Medical University and evaluate its impact on students quality of life. The goal is to provide data for developing treatment and prevention strategies for PD in the community, particularly among female university students.

Methods: A cross-sectional descriptive study was conducted on all female nursing students at Hanoi Medical University from January 15th to 31st, 2024. A simple random sampling method was used to select 341 participants. The data were collected using a paper survey and analyzed using SPSS software. The chi-square test was used to compare proportions, and difference rates along with 95% confidence intervals (CIs) were applied to evaluate associations between variables.

Results: The majority of the students were aged 20 years or older, accounting for 72.8%. Most students (73.9%) reported menarche between the ages of 13 and 18. Out of 341 students, the prevalence of PD was 78.6%. Among them, 68.7% reported moderate to severe pain. PD was significantly associated with a family history of menstrual pain (p < 0.001), irregular menstrual cycles (p = 0.02), and frequent caffeine consumption (p = 0.03). Quality of life, assessed using the Q-LES-Q-SF questionnaire, was significantly lower in all domains among students with PD compared with those without menstrual pain (p < 0.05).

Conclusion: PDis highly prevalent among female nursing students and negatively affects their quality of life. Several modifiable and non-modifiable factors are associated were found to be significantly associated with PD. The findings underscore the need for targeted interventions and further analytical studies to improve reproductive health and well-being among female students.

Background: Inspired by feminist theory and Durkheim's social perspective, this study used intersectionality to delve into the determinants of hysterectomy.

Methods: Using data from the Demographic and Health Survey (DHS) of India, we examined the determinants of hysterectomy, focusing on three key themes: society, women's empowerment, and biological factors.

Results: The overall hysterectomy rate in India increased from 31.5 per 1,000 women (age 15-49 years) during 2015-16 to 32.6 per 1,000 women during 2019-21. The results of bivariate and multivariate analyses echo the findings of the interaction analysis, indicating that, among women of the general caste, illiteracy and higher parity correlate with an increased likelihood of undergoing a hysterectomy. Illiterate women from the Other Backward Class also exhibited higher hysterectomy rates, regardless of parity. The second interaction result states that wealth influences hysterectomy, and illiteracy remains a significant risk factor across wealth statuses. The results of the third intersection indicate that higher education is a protective factor against hysterectomy, regardless of residence or parity.

Conclusion: From the intersection of variables, the study observed that illiteracy, residing in rural areas, and high parity increase the likelihood of undergoing hysterectomy among women of reproductive age. There is a need to establish a mechanism for disseminating reproductive health knowledge to women in rural areas.

Background: At least one in four women in the UK has experienced trauma, such as sexual abuse or violence, with profound implications for mental and physical health, particularly during the perinatal period. Despite the potential benefits of addressing trauma in maternity care, many women are reluctant to disclose their experiences due to stigma, fear of judgment, or lack of trust in healthcare systems. This paper presents the development and evaluation of the EMPATHY framework, a novel, evidence-based approach to routine trauma discussions in maternity care, designed to address these challenges and promote emotionally-centred care.

Methods: The EMPATHY framework was developed through a critical participatory action research approach, integrating findings from a systematic review, qualitative interviews, and stakeholder input, including experts by experience, healthcare professionals, and voluntary sector practitioners. The framework was refined through iterative workshops and a public consultation (n = 52), ensuring its relevance and applicability. The development and evaluation of the EMPATHY framework were guided by the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool, ensuring methodological rigor, transparency, and adherence to established standards in guideline development.

Results: The framework is structured around six core principles: system-wide change, promote trauma awareness, trust and relationships, training and support, local tailoring, and continuous improvement. A key innovation is the recommendation that all women, regardless of disclosure, should have access to information and support. Feedback from the public consultation highlighted the framework's value and its potential to transform perinatal experiences. Challenges such as resource constraints and implementation barriers were acknowledged, but respondents emphasised the importance of the framework in improving care for women who have experienced trauma.

Discussion/conclusion: The EMPATHY framework addresses a critical gap in existing guidance by offering a structured yet flexible approach to routine trauma discussions. Its implementation has the potential to empower women, strengthen therapeutic relationships, and reduce re-traumatisation. The framework represents a significant step forward in trauma-informed perinatal care.

Background: Digital technologies like the electronic partograph have revolutionised the documentation of progress of labour and birth. The purpose of the electronic partograph is to improve documentation of the progress of the intrapartum period by addressing challenges in partograph use. The tool provides real-time decision support, enhances data entry, and increases access and coordination of information for informed decision-making. Further research is required to map innovations in partograph technologies embedded in data documentation and labour progress monitoring.

Objective: The aim of this scoping review is to map innovations in partograph technologies based on studies published between 2000 and 2025.

Methods: This scoping review followed the five-step framework established by Arksey and O'Malley as well as the population, concepts, and contexts model. A comprehensive search was conducted across seven databases using refined keywords. Data were extracted, charted, synthesised, and summarised.

Result: A total of 13 original articles-studying 8,655 women in labour-were included in this review. The studies evaluated an electronic or digital paperless partograph, assessing its effectiveness and user-friendliness compared with the WHO/modified WHO partograph. This scoping review highlights that digital partographs, especially mobile applications and digital paperless versions, are practical tools for improving labour monitoring globally.

Conclusion: This scoping review found that digital paperless and novel partograph designs show promise for improving labour monitoring, particularly in resource-limited settings. The adoption of these tools can streamline documentation, enhance communication among healthcare providers, and facilitate timely interventions. This review recommends integrating ultrasound-based digital tools into labour monitoring for improved diagnostic accuracy and patient comfort.

Systematic review registration: https://osf.io/m96tw/.

Introduction: Many Ethiopian mothers and their infants do not have access to maternity and child health care during the first week after birth, increasing their risk of becoming ill or dying. Midwives doing maternity and child health care home visits could improve the overall maternity and child health care experience. There is inadequate empirical evidence to show the desire of midwives to implement home-based maternity and child health care in low-income countries like Ethiopia.

Methods: Between February 27 and October 27, 2023, 423 midwives participated in an institutional-based mixed methods, cross-sectional study. For the quantitative study, data were collected using a standardized self-administered questionnaire, whereas for the qualitative study, we conducted in-depth interviews with 12 midwives'. Bivariate and multivariable logistic regression analyses were performed. The adjusted odds ratio with confidence intervals at P-value 0.05 was used to identify a statistically significant relationship between the independent and outcome variables. Thematic analysis was used to interpret qualitative data.

Result: The percentage of midwives' who would be willing to offer child health care and home-based maternity care was 74.3%, with a 95% confidence interval between 74% and 77.4%. A strong correlation was found between midwives' high level of willingness to Implement home-based maternity and child health care and their history of obstetrics-related family loss (aOR: 2.2 with CI (1.04-4.8), P = 0.036. organizational factor (aOR: 0.087 CI (0.034-0.22), P = 0.000 individual beliefs factor (aOR: 0.19 CI (0.07-0.48), P = 0.000 and attitudes (aOR: .22 CI (0.08-0.61), P = 0.004. Based on the qualitative findings, the main obstacles to home-based maternity and child health care were found to be infrastructures, finances, and implement burden.

Conclusion and recommendation: This study found that many midwives were willing to offer child health care and home-based maternity services. Establishing and implementing a home-based maternity and child healthcare service requires sufficient manpower, facility equipment, and access infrastructure.