Frontiers in global women's health最新文献

Background: Both mothers and newborns go through a critical time in their lives during the postnatal period, and the majority of deaths of mothers and neonates happen during this period. Postnatal care is the care given to women and their neonates, starting from delivery to 42 postnatal days. Although the significance of postnatal care in maternal and child health is acknowledged, the influence of husbands in either facilitating or impeding access to these services has been largely unexplored. So it's important to find out husbands' involvement in postnatal care service utilization in Bishoftu town.

Objectives: To assess husband involvement in postnatal care services utilization and associated factors in Bishoftu town, Central Ethiopia.

Methods: A community-based cross-sectional study was conducted in Bishoftu town, central Ethiopia, between April 1 and 27, 2022, among 624 fathers. After being selected through simple random sampling, 610 husbands were interviewed face-to-face. The data was then entered into Epi-Data version 3.1 and analyzed using SPSS version 26. Binary logistic regression was employed for analysis and variables with a p-value ≤0.2 in the bivariate analysis were entered into multivariable logistic regression analysis. In multivariable analysis, statistical significance was declared at p-value <0.05.

Results: This study reveals that overall husband involvement in postnatal care utilization was found to be 34.1% with a 95% CI (30.3%-38.0%). Residing in urban areas (AOR = 2.3, 95% CI 1.39-3.82), having good knowledge of neonatal (AOR = 3.1, 95% CI 2.04-4.7) and maternal danger signs and complications during the postnatal period (AOR = 2.44; 95% CI: 1.64, 3.63), having history of child illness (AOR = 2.18; 95% CI: 1.4-3.3), and accompanying wife in antenatal care services (AOR = 2.73, 95% CI 1.82-4.07) were the factors found to determine husband's involvement in postnatal care service utilization.

Conclusion: The level of husband involvement in their spouse's postnatal care service utilization was relatively low in this study. Encouraging husbands to participate in prenatal care services, availing healthcare facilities to rural communities, and increasing community awareness of maternal and neonatal warning signs might boost husbands' involvement in postnatal care services utilization.

Objective: This article aims to examine the influence of individual and community-contextual factors on the well-being of older women in Zambia during the COVID-19 pandemic, drawing on Bronfenbrenner's process-person-context-time model.

Methods: Secondary data from the nationally representative 2021 SEIA were used, and bivariate and logistic regression analyses were performed to determine factors associated with the well-being of older women during the COVID-19 pandemic.

Results: Overall, 29% (613) of older women reported a decline in their well-being due to COVID-19. Older women in rural areas had lower odds of well-being [Adjusted Odds Ratio (AOR) 0.607, 95% 0455,0.809]. At the individual level, the well-being of older women during COVID-19 was associated with age (AOR O.362, 95% CI: 0.190,0.689) and being in paid work (AOR 0.737, 95% CI: 0.552,0.984). Despite education having a strong relationship with well-being, it had a weak effect on the well-being of older women during COVID-19. Community-level factors significantly associated with the well-being of older women amidst COVID-19 included attendance at public gatherings (e.g., church meetings, funerals) (AOR 1.465, 95% CI: 1.139,1.885) and perceived fear or anxiety due to COVID-19 (AOR 0.522, 95% CI: 0.392,0.696). A significant contextual-level factor was access to transport services during the pandemic (AOR 0.589, 95% CI: 0.390,0.890).

Conclusion: COVID-19 has exposed the inadequacy of systems at different levels in meeting the needs of older women and promoting their well-being during emergencies. At the individual level, there is a need to support older women's livelihoods and educational opportunities. Despite limitations on social interactions during COVID-19, access to social gatherings and interactions supported older women's well-being. However, this was hampered by fear of contracting COVID-19 and the limitations in public transport that compromised their mobility to access services and visit people. A more extensive analysis of individual, community, and contextual factors should identify factors that support or compromise the well-being of older women during emergencies or shocks. There is a need for information about what livelihood strategies during and/or post shocks, or critical events such as COVID-19 could sustainably support older women's well-being.

Women in rural Bangladesh encounter significant barriers to seeking mental healthcare, primarily due to stigmatization rooted in a lack of knowledge about mental health. To address this issue, community-based participatory research (CBPR) has been identified as a promising approach. CBPR involves the active collaboration of community members and stakeholders in the research process to tackle pressing community issues. This study examines the application of CBPR to enhance mental health awareness and education among women. The program described in this study leverages local technology centers and community health workers to boost participation in improving access to equitable mental healthcare and increasing health literacy. Implemented across three rural districts in Bangladesh, the program began with a needs assessment survey to evaluate participants' knowledge, experiences, and stigmatization of psychological conditions such as depression, anxiety, psychosis, suicide, and postpartum depression. This survey assessed baseline knowledge, personal experiences, and the perceived impact of mental wellness as a community issue. Additionally, five focus group discussions were conducted at local tech hubs with trained community health workers to explore participants' perceptions and attitudes toward mental health. These discussions highlighted the role of medical misinformation, the shortage of professionals, and other factors contributing to mental health stigmatization. The study's second phase would focus on developing digital medical content for screening at tech hubs, followed by live Q&A sessions with Bangladeshi health experts. This initiative aims to familiarize women with user-friendly telehealth services, fostering healthcare literacy and improving well-being in rural Bangladesh.

Introduction: Human Papillomavirus (HPV) is a widespread sexually transmitted infection and a leading cause of cervical cancer. Although there is a significant HPV prevalence in Ethiopia, yet the uptake of the HPV vaccine remains low. This study aimed to assess the level of caregivers' willingness to vaccinate their daughters against the human papilloma virus and associated factors in Jimma town.

Methods: A community-based cross-sectional study was conducted from June 1-30, 2023. A total of 471 study participants were selected using multi-stage sampling techniques. Data was collected using an interviewer-administered questionnaire. Binary and multiple logistic regression analyses were done to identify associated factors, and the adjusted odds ratio and 95% confidence interval were computed. A value p of <0.05 was used to determine statistical significance.

Results: About 82.4% (95% CI: 79.0-86.0) of caregivers indicated a willingness to have their daughters vaccinated. Having college education or above (AOR:3.31, 95%CI:1.02-10.8), good knowledge of the HPV vaccine (AOR:2.25, 95%CI:1.05-4.85), good knowledge of sexually transmitted infections (STIs) (AOR:2.04, 95%CI: 1.09-3.82), good knowledge of cervical cancer (AOR:2.50, 95%CI:1.31-4.77) and a positive attitude towards the vaccine (AOR:4.03, 95%CI: 2.26-7.22), were associated with willingness.

Discussion: The majority of caregivers were willing to vaccinate their daughters against HPV. Caregivers who had higher education, good knowledge about the HPV vaccine, cervical cancer, and STIs, as well as positive attitudes towards the vaccine, were more likely to be willing to vaccinate. Efforts should be made to educate caregivers about the vaccine, cervical cancer, and STIs while promoting positive attitudes.

Introduction: Unintended pregnancy is a global public health challenge. Many contraceptive methods are available to end users, but non-use and discontinuation due to health concerns or side effects, particularly related to unpredictable or undesirable menstrual bleeding, are common. Oral contraceptive pills (OCPs) often have regular bleeding patterns compared to other hormonal contraceptives but require daily adherence. To address the issues of bleeding-related side effects and daily adherence, researchers are developing a monthly oral contraceptive (MOC) containing the same hormones as common OCPs. We studied women's and healthcare providers' (HCPs') perceptions of the MOC technology with the primary goal of providing feedback on product attributes to inform early design decisions.

Methods: Our study consisted of a qualitative phase with in-person in-depth interviews (IDIs) with a total of 60 women of reproductive age in three regions in three countries (Bangladesh, Senegal, and Zimbabwe) and quantitative surveys, which took place after the qualitative phase, via face-to-face computer-assisted interviews of a total of 1,825 women in 17 regions in these three countries. We conducted 96 IDIs and 632 quantitative interviews with HCPs in one urban area per country.

Results: Women's and HCPs' perceptions of MOC product attributes were assessed and included a focus on potential menstrual changes and possible reasons for discontinuation. Overall, the most appealing attribute of an MOC was its 1-month duration. Women and HCPs alike preferred regular, monthly menstruation. Any unpredictable or irregular bleeding, including heavy bleeding or amenorrhea, would be a reason to discontinue an MOC if it were to have those attributes.

Discussion: Overall, an MOC has a high and broad level of appeal amongst all the groups of women and HCPs who participated in the study and has a strong value proposition for important contraceptive needs including convenient duration, ease of use, discretion, and acceptable side effects. This appeal assumes that the experience of using an MOC would be very similar to that of daily OCPs except for dose timing. Future research on a hormonal MOC should include an exploration of women's tolerance and acceptability of potential side effects, particularly regarding bleeding, to validate its value proposition.

Introduction: Globally, maternal mortality is a major public health problem mainly due to a lack of access to skilled care during childbirth. Maternity waiting homes (MWHs) play a critical role in accessing emergency obstetric care for pregnant women during childbirth. However, available studies show inconsistent findings about women's utilization of maternity waiting homes. Therefore, the aim of this review was to identify the pooled prevalence of women's utilization of maternity waiting homes and its associated factors in Ethiopia.

Method: We used the PRISMA guidelines to report the review. We searched for potentially eligible studies in Google Scholar, PubMed, Cochrane Library, and Google using Medical Subject Heading terms and keywords. The retrieved articles were screened and assessed for quality. The heterogeneity across studies was checked using Cochran's Q test and I ² statistics. The pooled levels of women's utilization and associated factors were analyzed using meta-analysis. The publication bias was measured using the funnel plot and Egger's test. The subgroup analysis and sensitivity analysis were carried out to identify the studies with high effects.

Results: A total of 11 eligible studies with 11,784 study participants were included. The utilization of MWHs was in the range of 7%-42.5%. The pooled estimate of women's utilization of maternity waiting homes was 22.49%. Factors associated with utilization included women's decision-making power, access to transport, walking distance to the nearest facility, and having a companion.

Conclusion and recommendation: The overall prevalence of maternity waiting home utilization in Ethiopia is low, with significant variation across regions. Health sector program administrators should focus on both the consumer and healthcare system.

Systematic review registration: The review protocol was registered in PROSPERO (number CRD42021243526).

[This corrects the article DOI: 10.3389/fgwh.2024.1487820.].

Background: Contraception use remains low in Ethiopia, particularly within the first year after childbirth. While some women might have medical conditions that limit their contraceptive options, the primary obstacle to wider family planning adoption is not a specific health problem. Instead, it is the lack of equitable access to high-quality family planning services. This barrier significantly hinders women's ability to make informed decisions about their reproductive health. This study examines postpartum family planning utilization and its associated factors among postpartum mothers in the Bule Hora District.

Methods: We conducted a community-based cross-sectional study. A multistage sampling technique was employed to recruit a total of 630 women who had given birth. To collect the data, structured, standardized, and pretested questionnaires were used, and the collected data were coded and entered into Epi-data version 4.6. The data were analyzed using SPSS version 25. Both bivariable and multivariable logistic regressions were used to identify factors associated with postpartum family planning utilization.

Results: The study found that 71.3% of women utilized postpartum family planning. Significant associations were found between postpartum family planning utilization and various factors, including counseling on family planning during pregnancy [adjusted odds ratio (AOR) = 1.79, 95% confidence interval (CI) 1.61-2.82], delivery (AOR = 2.62, 95% CI 1.56-4.38), and the postpartum period (AOR = 2.71, 95% CI 1.75-4.21). Women who resumed sexual activity after birth (AOR = 1.92, 95% CI 1.25-2.96), and who had at least four antenatal care visits (AOR = 3.09, 95% CI 1.61-5.92) were also more likely to use postpartum family planning. Women with grand multiparity were 69% less likely to use family planning methods than primiparous women (AOR = 0.31, 95% CI 0.13-0.73).

Conclusion: Postpartum family planning use in this study was higher than the national average. Factors such as parity; counseling during the pregnancy, delivery, and postpartum periods; and early resumption of sexual activity were linked to increased contraceptive use. These findings suggest that enhanced counseling during antenatal, delivery, and postnatal care could significantly increase contraceptive use.

Introduction: Maternal mortality is a global issue, with developing countries accounting for over 99% of maternal deaths, with 30% of Ethiopian mothers dying from pregnancy-related causes. This study aimed to assess the magnitude, associated factors, and reasons for home delivery among women who gave birth after antenatal care follow-up in the last 6 months in Jabitehnan District, Northwest Ethiopia.

Methods: A mixed community-based study was conducted on women who gave birth after antenatal care follow-up in the last 6 months. Data was collected through face-to-face interviews and structured questionnaires. Bivariate and multivariable logistic regressions were performed to identify factors associated with home delivery. Qualitative data were collected through focus group discussions and in-depth interviews and analyzed using a thematic content analysis method.

Result: In this study, the magnitude of home delivery after ANC follow-up among mothers who gave birth in the last 6 months was 37%, with a 95% CI of 32.5 and 41.5. Pregnancy plan [AOR: 4.56 (2.65, 7.86)], experience of abortion AOR: 3.01 [1.631, (5.55)], ANC follow-up at public hospitals [AOR: 1.89 (1.119, 3.18)], and pregnant mothers visited at home by healthcare providers during their ANC follow-up absent [AOR: 1.61 (1.02, 2.53)] were predictors of home delivery. Poor counseling during ANC, and lack of pregnancy plans, traditions, and beliefs were reasons for home delivery.

Conclusion: The study reveals a high magnitude of home delivery as compared to a study done in Bahir Dar (21.2%). Factors include pregnancy plans, health institution type, abortion experience, and absence from antenatal care. Poor counseling during ANC, and lack of pregnancy plans, traditions, and beliefs were reasons for home delivery. Health professionals should receive training in communication and counseling techniques, and they should encourage mothers to plan their pregnancies and visit facility delivery services during ANC follow-up.

Introduction: Stillbirth remains a major public health problem in developing countries due to low health coverage and services. Approximately two million stillbirths occur every year; in particular, stillbirths are highly prevalent in low- and middle-income countries such as Ethiopia. However, there is scarce information available in Ethiopia regarding the determinants of stillbirth.

Methods: A facility-based, unmatched case-control study was conducted at Bishoftu General Hospital from April 1 to April 30, 2023. A systematic random sampling technique was used to select samples of the study subjects. The collected data were entered into Epi-info version 7.2. A Bayesian logistic regression model was used in this study, with a 95% Credible interval to determine the association between independent variables and stillbirth. All analyses were performed using STATA version 17 software.

Results: A total of 403 (81 cases and 322 controls) participants were included in the study. The average age of participants was 26 years (SD: ±5.03). According to the adjusted model, mothers who attained a middle school [adjusted odds ratio [AOR] = 0.23; 95% credible interval [CrI]: 0.11, 0.43], diploma and above (AOR = 0.25; 95% CrI: 0.12, 0.46), rural residence (AOR = 2.55; 95% CrI: 1.11, 4.99), married women (AOR = 0.46; 95% CrI: 0.20, 0.93), ANC visits more than 4 (AOR = 0.35; 95% CrI: 0.17, 0.63), history of prior stillbirth (AOR = 8.71; 95% CI: 3.22, 17.69), previous history of abortion (AOR = 3.29; 95% CI: 1.13, 7.666), duration of labor more than 24 h (AOR = 3.71; 95% CI: 1.28, 7.83); normal birth weight (AOR = 0.39; 95% CI: 0.15, 0.57) were significantly associated with stillbirth.

Conclusions: This study revealed that maternal education, rural residence, marital status, history of prior stillbirth, ANC visit, previous history of abortion, duration of labor, and birth weight were identified as determinants of stillbirth. Pregnant mothers should be identified early and given appropriate care, including comprehensive prenatal care and other maternal services.