Frontiers in global women's health最新文献

[This corrects the article DOI: 10.3389/fgwh.2023.1230109.].

Objectives: To investigate the unique challenges faced by older women during the COVID-19 pandemic regarding social connection, feelings of loneliness, and their subsequent impact on mental health and well-being.

Method: A qualitative research methodology is used to examine how older women experienced loneliness, social relationships, and mental health consequences during the COVID-19 pandemic.

Results: The results are discussed in terms of two main themes each with their sub-themes; 1. Social Connection amidst Physical Distancing Measures, 2. Impact on Mental Health and Well-being.

Conclusion: The study highlights the significant impact of loneliness and social isolation on the mental health of older women during the COVID-19 pandemic, emphasizing the need for targeted interventions and support systems.

Background: Electronic fetal heart rate monitoring (EFM) has been widely used in obstetric practice for over 40 years to improve perinatal outcomes. Its popularity is growing in Ethiopia and other sub-Saharan African countries to reduce high perinatal morbidity and mortality rates. However, its impact on delivery mode and perinatal outcomes in low-risk pregnancies remains controversial. This study aimed to assess the effect of continuous EFM on delivery mode and neonatal outcomes among low-risk laboring mothers at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.

Methods: A prospective follow-up study was conducted from November 20, 2023, to January 10, 2024. All low-risk laboring mothers meeting the inclusion criteria were included. Data were collected via pretested structured questionnaires and observation, then analyzed using Epi-data 4.6 and SPSS. The incidences of cesarean delivery and continuous EFM were compared using the chi-squared test and Fisher's exact test.

Results: The study found higher rates of instrumental-assisted vaginal delivery (7% vs. 2.4%) and cesarean sections (16% vs. 2%) due to unsettling fetal heart rate patterns in the continuous EFM group compared to the intermittent auscultation group. However, there were no differences in immediate neonatal outcomes between the groups.

Conclusion: When compared to intermittent auscultation with a Pinard fetoscope, the routine use of continuous EFM among low-risk laboring mothers was associated with an increased risk of cesarean sections and instrumental vaginal deliveries, without significantly improving immediate newborn outcomes. However, it is important to note that our study faced significant logistical constraints due to the limited availability of EFM devices, which influenced our ability to use EFM comprehensively. Given these limitations, we recommend avoiding the routine use of continuous EFM for low-risk laboring mothers to help reduce the rising number of operative deliveries, particularly cesarean sections. Our findings should be interpreted with caution, and further research with adequate resources is needed to draw definitive conclusions.

Background: Husbands are the primary decision-makers about the place of childbirth. Lack of husbands' support for maternal health care is associated with low maternal waiting home utilization and less is known about the husbands' intention to support their wife's use of maternal waiting homes (MWHs) and underlying beliefs in Ethiopia. This community-based cross-sectional survey aimed to study husbands' intention to support during pregnancy through the use of maternity waiting homes in Jimma Zone, Southwest Ethiopia.

Method: A cross-sectional study was conducted among 396 randomly selected husbands whose wives were pregnant. Interviewer-administered, a structured questionnaire developed based on the Theory of Planned Behavior (TPB) was used to collect the data. Multivariable logistic regression analyses were used to examine the association between behavioral intention and constructs of the theory of planned behavior.

Results: Of the 396 husbands who took part in the study, 42.7% intend to support their partner's use of a maternity waiting home. Intention to support a wife to use a maternity waiting home was associated with subjective norm [AOR = 1.303, 95% CI (1.054, 1.611)] and perceived behavioral control [AOR = 1.446, 95% CI (1.234, 1.695)]. Among the control beliefs, "having childcare"; "having a person who stays with a wife at a maternity waiting home"; and "availability of quality service provided to a wife in the maternity waiting home" significantly separated intenders and non-intenders.

Conclusion: The findings suggest that husbands who perceived more social pressure and felt in control of barriers were more likely to intend to support their partner in using a maternity waiting home. Intervention should focus on underlying normative and control beliefs to improve the husband's intention.

Background: Work-life integration has been extensively researched in various contexts. Women dominate the nursing profession, but work-life integration is essential for men and women since both are expected to focus equally on their families and careers. The nursing faculty perceives nurse educators' work environment as undervalued, lacking support, and limited time to grow and carry the heavy workload.

Method: A qualitative meta-synthesis of studies between 2013 and 2023 was conducted using ScienceDirect, EBSCO Host, Sage and Sabinet databases. Seven articles related to the research phenomenon were retrieved.

Conclusion: The resulting themes revolved around two central aspects: nurse educators' work and life integration. Nurse educators face various challenges with work-life integration and often view their failure as a personal rather than a societal issue. However, as much as achieving work-life integration is personal, there is a call for employers in academic environments to improve workplace policies, like better-paid maternity leave, affordable quality childcare, and social support. Furthermore, nurse educators' line managers should display warmth and encouragement about personal challenges affecting nurse educators.

Background: Premature deliveries are a major public health issue, with high health, economic, and productivity costs associated with lengthy hospitalizations in neonatal critical care units. The goal of this study was to determine the number of premature births in Ethiopia's Debre Berhan Comprehensive Specialized Hospital and the factors that influence them.

Methods: The Debre Berhan Comprehensive Specialized Hospital conducted an institution-based cross-sectional study between February and April 2020. A total of 325 study participants were selected using systematic random sampling. Face-to-face interviews using a pre-tested semi-structured questionnaire were used to collect data. For data entry and analysis, Epi data version 3.1 and SPSS version 20 were used. At a P-value of 0.2, bivariate logistic regression analysis was used to categorize candidate variables to the next level, and variables in multivariate logistic regression models with a p-value of 0.05 were considered statistically significant.

Result: Preterm births accounted for 16.1% of all births at Debre Berhan Comprehensive Specialized Hospital. Cesarean section [AOR = 2.412; 95% CI (1.154, 5.0370)], twin pregnancy [AOR = 3.524; 95% CI (1.114, 11.150)], and maternal anemia during pregnancy [AOR = 3.124; 95% CI (1.417, 6.887)] were statistically significant associations with the outcome variable in the final logistic regression model.

Conclusion and recommendation: Preterm birth was found to be greater in the study area than in the Global Action Report for Sub-Saharan Africa and a few other countries. Efforts should be made to prevent maternal health issues that lead to caesarean section, and all pregnant mothers should be supplemented with iron and folic acid as soon as feasible. This study suggests that there is still a gap in the field in terms of health service intervention.

Introduction: "Women-friendly care" is one of the categories of respectful maternal care and is a method of providing care that improves women's access to safe parenting and to reproductive health services by creating a friendly environment at all levels. Improving service use is crucial, particularly in situations where it is low. There is limited data on women-friendly care during childbirth in Ethiopia.

Objective: This study aimed to assess the provision of women-friendly care and its associated factors among mothers who gave birth at health institutions in the South Gondar zone, Northwest Ethiopia.

Methods: A multicenter institutional-based cross-sectional study design was conducted among mothers who gave birth at South Gondar Zone public health institutions, from February 01 to March 30/2021. Three hundred forty-eight study participants were selected by using systematic random sampling. A validated questionnaire was used for data collection. For analysis, the data were imported into Epi-Data version 4.6 and exported to SPSS version 25. A multivariable logistic regression analysis was performed to identify factors associated with the outcome variable. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance.

Results: The study had 344 participants in total, with a response rate of 98.85%. The study revealed that a full 73% [95%; CI: 68.6, 77.3%] its participants received women-friendly care. Having antenatal care follow-up [AOR: 3.02, 95% CI: 2.16-11.68], being a primipara [AOR = 2.30 95% CI: 1.23-5.49], not experiencing complications during childbirth [AOR: 2.13, 95% CI: 1.17-12.4], stays at health care facilities, specifically between 13 and 24 h [AOR: 0.25, 95% CI: 0.09-0.67], place for delivery [AOR: 2.01, 95% CI: 1.29-6.09] and delivering during daytime hours [AOR = 2.17, 95% CI: 1.08-5.65] were significantly associated with the provision of women-friendly care.

Conclusions: Only two-thirds of the study participants received Women's-friendly care during childbirth. It was found to be low in our study area in contrast with the majority of the previous findings. Our own findings also suggest the importance of minimizing elective induction of labor during night, of providing comprehensive counseling on antenatal care follow-up, of ensuring mothers remain at health care facilities until the recommended duration, and of implementing early prevention and management of childbirth complications to ensure that mothers receive women-friendly care.

Background: According to the World Health Organization (WHO), intrapartum care is considered a platform for providing respectful, personalized, and women-centered services to women. This study aims to investigate the intrapartum care model proposed by WHO.

Methods: This convergent parallel mixed-methods study will be carried out in qualitative and quantitative phases. In the quantitative phase (a quasi-experimental study), 108 pregnant women admitted to the maternity ward will be randomized to intervention (receiving intrapartum care based on the WHO model) and control group (receiving routine hospital care) before the beginning of the active stage of labor (cervix dilatation equal to 5 cm) and Wijma's delivery fear scale (DFS) will be completed for them and again at 7-8 cm dilatation. The participants of both groups will be followed up for 6 weeks after labor and then they will be invited to a relatively quiet place to complete the Childbirth Experience Questionnaire (CEQ 2.0), the Edinburgh Postpartum Depression Scale (EPDS), the Post-Traumatic Stress Disorder (PTSD) Symptom Scale (PSS-I), the Pregnancy and Childbirth Questionnaire (PCQ), exclusive breastfeeding and a checklist on willingness to give birth to another child. The qualitative phase will employ content analysis to explain mothers' views about the effects of this model especially subjective components of this model on their labor process after 4-6 weeks. The two phase's results will be discussed in combination.

Discussion: The implementation of such care models is expected to prevent mental disorders caused by negative experiences of childbirth, and also, prevent uncontrolled increases in cesarean sections.

Clinical trial registration: https://fa.irct.ir/user/trial/68313/view, identifier (IRCT20120718010324N69).

According to the Demographic and Health Surveys (DHSs), Zambia has shown an increasing trend in the percentage of married women using contraceptives in the last three decades. As of 2018, this percentage increased from 34.2% in 2001 to 40.8% in 2007 and from 45% in 2013 to 48% in 2018. Despite the increasing trend in contraceptive use, the unmet needs remain relatively high. The low percentage of contraception use translates into 20% of women of reproductive age who are either married/partnered and want to stop or delay childbearing but are not using contraception. This study analyzed factors other than availability that influence women's ability to make or influence the decision to use contraception using logistic regression using data from the Zambia 2013/2014 and 2018 DHSs. Furthermore, adjusted odds ratios and predicted probabilities were estimated using the fitted logistic regression. Data on 8,335 women were analyzed, and 13.7% (n = 1,145) had their husband as the sole decision maker for contraception use, while 86.3% (n = 7,189) made the decisions or participated in making the decision. Contrary to most literature, those with primary or secondary school education were less likely to decide than those without education. The data also associate women who contribute to daily household decisions to having a say in deciding to use contraception. Lastly, women using reversible contraception methods, other methods, hormonal methods, and fertility awareness were associated with less likelihood to decide on using contraceptives than those using barrier methods. Women with lower household decision-making powers are less likely to make or influence decisions to use contraception. Consequently, there is a need to prioritize such women in interventions aimed at increasing contraception use decision-making. Furthermore, more studies are required to investigate why uneducated women in Zambia are more likely to choose contraception. Also, the vast odds ratio difference between all other methods compared to barrier methods (condoms) indicates underlying factors that play a role, which warrants further studies.