Pub Date : 2024-02-21eCollection Date: 2024-01-01DOI: 10.3389/fgwh.2024.1169347
Anagaw Derseh Mebratie
Background: Despite recent promising progress, maternal morbidity and mortality are still unacceptably high in Ethiopia. This is partly attributed to the lack of quality health services. Pregnant women may not receive adequate services that are essential to protect the health of women and their unborn children. This study aimed to examine the extent of receiving prenatal care components and associated factors in Ethiopia. It also assessed prenatal service use inequality between urban and rural residents.
Methods: The analysis was carried out using the 2016 Ethiopian Demographic and Health Survey (EDHS), which is nationally representative survey data. A weighted sample of 4,772 women nested within 595 communities who had live births five years preceding the survey was included in the study. Necessary adjustments were made to account for the design of the survey, and sampling weights were used to adjust for nonproportional allocation of the sample to strata. Bivariate and multivariable multilevel ordered logit models were used to analyze factors associated with receiving comprehensive ANC contents. Statistically significant predictors were identified at p value ≤ 0.05.
Results: Among those women who had at least one ANC visit, only 15% (95% CI: 13, 16) received six core elements of antenatal care. The proportion of mothers who had essential prenatal components in rural areas was less than 13 percentage points. Approximately 43% of women did not receive at least two doses of tetanus toxoid vaccines to protect them and newborn infants against this life-threatening disease. Moreover, the majority of them, particularly those in rural Ethiopia, were not informed about pregnancy danger signs. Mothers who had at least four ANC visits received more types of prenatal components compared to those who had fewer ANC visits. The multilevel regression analysis revealed that receiving adequate ANC content is positively associated with having more frequent ANC visits, attaining a higher education level, being a member of a household in the highest wealth quintile and residing in urban areas.
Conclusion: The evidence implies that the quality of maternal health services needs to be improved. Health programs and interventions should also give priority to rural areas where the majority of Ethiopian women reside.
{"title":"Receipt of core antenatal care components and associated factors in Ethiopia: a multilevel analysis.","authors":"Anagaw Derseh Mebratie","doi":"10.3389/fgwh.2024.1169347","DOIUrl":"10.3389/fgwh.2024.1169347","url":null,"abstract":"<p><strong>Background: </strong>Despite recent promising progress, maternal morbidity and mortality are still unacceptably high in Ethiopia. This is partly attributed to the lack of quality health services. Pregnant women may not receive adequate services that are essential to protect the health of women and their unborn children. This study aimed to examine the extent of receiving prenatal care components and associated factors in Ethiopia. It also assessed prenatal service use inequality between urban and rural residents.</p><p><strong>Methods: </strong>The analysis was carried out using the 2016 Ethiopian Demographic and Health Survey (EDHS), which is nationally representative survey data. A weighted sample of 4,772 women nested within 595 communities who had live births five years preceding the survey was included in the study. Necessary adjustments were made to account for the design of the survey, and sampling weights were used to adjust for nonproportional allocation of the sample to strata. Bivariate and multivariable multilevel ordered logit models were used to analyze factors associated with receiving comprehensive ANC contents. Statistically significant predictors were identified at <i>p</i> value ≤ 0.05.</p><p><strong>Results: </strong>Among those women who had at least one ANC visit, only 15% (95% CI: 13, 16) received six core elements of antenatal care. The proportion of mothers who had essential prenatal components in rural areas was less than 13 percentage points. Approximately 43% of women did not receive at least two doses of tetanus toxoid vaccines to protect them and newborn infants against this life-threatening disease. Moreover, the majority of them, particularly those in rural Ethiopia, were not informed about pregnancy danger signs. Mothers who had at least four ANC visits received more types of prenatal components compared to those who had fewer ANC visits. The multilevel regression analysis revealed that receiving adequate ANC content is positively associated with having more frequent ANC visits, attaining a higher education level, being a member of a household in the highest wealth quintile and residing in urban areas.</p><p><strong>Conclusion: </strong>The evidence implies that the quality of maternal health services needs to be improved. Health programs and interventions should also give priority to rural areas where the majority of Ethiopian women reside.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"5 ","pages":"1169347"},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Delays in seeking care in health facilities during pregnancy and childbirth can potentially lead to adverse outcomes for women with obstetric complications. These complications lead to maternal mortality and morbidity in developing countries such as Ethiopia. The magnitude and underlying causes of maternal first delay in Ethiopia, particularly in rural areas of the country, are not well documented. This study aims to assess the magnitude of delay in the decision to seek care and associated factors among mothers who gave birth in rural health centers in Wolaita Zone, Southern Ethiopia.
Method and materials: A facility-based cross-sectional study was undertaken among mothers who gave birth in rural health centers of Wolaita Zone, Southern Ethiopia, from 30 June 2020 to 30 July 2022. A sample size of 410 study participants was selected from each public health center using the systematic random sampling method. Data were collected from a pretested and structured questionnaire using an Open Data Kit; analysis was carried out using SPSS version 25. The determining factors for the first delay were identified using binary logistic regression. Variables with a p-value of less than 0.25 in binary analysis were selected for a multivariable analysis. Variables with a p-value of less than 0.05 were considered statistically significant.
Results: The magnitude of delay in the decision to seek care in health facilities was 42.1% among mothers who gave birth in rural health centers in the Wolaita Zone, Southern Ethiopia. Unemployed mothers (Adjusted Odd Ratio, 2,529; 95% CI, 1.546, 4.136), husbands with no formal education (Adjusted Odd Ratio, 1.290; 95% CI, 1.029, 1.616), mothers who had negative attitudes towards seeking care in health facilities, and (Adjusted Odd Ratio; 1.695; 95% CI, 1.061, 2.709) were significantly associated with a delay in the decision to seek care at a health facility.
Conclusion: The magnitude of the first maternal decision to seek care at health facilities among mothers was high in the study area. Efforts should be made to strengthen the literacy level of the husbands of mothers and increase household income through various income-generating approaches. In addition, the dissemination of health information could effectively raise community awareness of the importance of institutional delivery.
{"title":"Delays in the decision to seek care and associated factors among mothers who delivered in rural health centers in Wolaita Zone, Southern Ethiopia.","authors":"Kelemu Abebe Gelaw, Yibeltal Assefa Atalay, Firehiwot Zerefu, Natnael Atnafu Gebeyehu","doi":"10.3389/fgwh.2023.1236242","DOIUrl":"10.3389/fgwh.2023.1236242","url":null,"abstract":"<p><strong>Background: </strong>Delays in seeking care in health facilities during pregnancy and childbirth can potentially lead to adverse outcomes for women with obstetric complications. These complications lead to maternal mortality and morbidity in developing countries such as Ethiopia. The magnitude and underlying causes of maternal first delay in Ethiopia, particularly in rural areas of the country, are not well documented. This study aims to assess the magnitude of delay in the decision to seek care and associated factors among mothers who gave birth in rural health centers in Wolaita Zone, Southern Ethiopia.</p><p><strong>Method and materials: </strong>A facility-based cross-sectional study was undertaken among mothers who gave birth in rural health centers of Wolaita Zone, Southern Ethiopia, from 30 June 2020 to 30 July 2022. A sample size of 410 study participants was selected from each public health center using the systematic random sampling method. Data were collected from a pretested and structured questionnaire using an Open Data Kit; analysis was carried out using SPSS version 25. The determining factors for the first delay were identified using binary logistic regression. Variables with a <i>p</i>-value of less than 0.25 in binary analysis were selected for a multivariable analysis. Variables with a <i>p</i>-value of less than 0.05 were considered statistically significant.</p><p><strong>Results: </strong>The magnitude of delay in the decision to seek care in health facilities was 42.1% among mothers who gave birth in rural health centers in the Wolaita Zone, Southern Ethiopia. Unemployed mothers (Adjusted Odd Ratio, 2,529; 95% CI, 1.546, 4.136), husbands with no formal education (Adjusted Odd Ratio, 1.290; 95% CI, 1.029, 1.616), mothers who had negative attitudes towards seeking care in health facilities, and (Adjusted Odd Ratio; 1.695; 95% CI, 1.061, 2.709) were significantly associated with a delay in the decision to seek care at a health facility.</p><p><strong>Conclusion: </strong>The magnitude of the first maternal decision to seek care at health facilities among mothers was high in the study area. Efforts should be made to strengthen the literacy level of the husbands of mothers and increase household income through various income-generating approaches. In addition, the dissemination of health information could effectively raise community awareness of the importance of institutional delivery.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"4 ","pages":"1236242"},"PeriodicalIF":2.3,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10808602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-11eCollection Date: 2023-01-01DOI: 10.3389/fgwh.2023.1221913
Giselle Newton, Kerryn Drysdale, Christy E Newman
Sociological scholarship has begun to explore imaginaries of family and reproduction, yet less work has focused on the emerging social form of the donor family. In this article, we consider the embodied sociotechnical imaginaries of donor-conceived people, exploring their reflections, judgements, hopes, and predictions regarding donor conception. Combining reflexive thematic analysis of free-text survey responses from sperm donor-conceived (n = 90) and egg donor-conceived (n = 1) and data from semi-structured interviews with sperm donor-conceived people (n = 28), conceived in both clinical and non-clinical contexts in Australia, we analyse donor-conceived people's imaginings of family, identity, and the practice of donor conception in the digital age. Our analysis centres the donor-conceived body that imagines, and in doing so, highlights the entanglements of reproductive and digital technologies, and the humans and institutions that drive their uptake. We argue that leveraging the imaginative and political capacities of donor-conceived people is a productive approach that illuminates possible (re)directions of the assisted reproduction industry as well as illustrating potential policy futures.
{"title":"Embodied sociotechnical imaginaries: how donor-conceived people imagine identity, family and reprodigital futures beyond regulation.","authors":"Giselle Newton, Kerryn Drysdale, Christy E Newman","doi":"10.3389/fgwh.2023.1221913","DOIUrl":"10.3389/fgwh.2023.1221913","url":null,"abstract":"<p><p>Sociological scholarship has begun to explore imaginaries of family and reproduction, yet less work has focused on the emerging social form of the donor family. In this article, we consider the embodied sociotechnical imaginaries of donor-conceived people, exploring their reflections, judgements, hopes, and predictions regarding donor conception. Combining reflexive thematic analysis of free-text survey responses from sperm donor-conceived (<i>n</i> = 90) and egg donor-conceived (<i>n</i> = 1) and data from semi-structured interviews with sperm donor-conceived people (<i>n</i> = 28), conceived in both clinical and non-clinical contexts in Australia, we analyse donor-conceived people's imaginings of family, identity, and the practice of donor conception in the digital age. Our analysis centres the donor-conceived body that imagines, and in doing so, highlights the entanglements of reproductive and digital technologies, and the humans and institutions that drive their uptake. We argue that leveraging the imaginative and political capacities of donor-conceived people is a productive approach that illuminates possible (re)directions of the assisted reproduction industry as well as illustrating potential policy futures.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"4 ","pages":"1221913"},"PeriodicalIF":2.3,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10811956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: This research aims to provide concrete insight into cancer incidence, mortality, and survivorship dynamics among African women between 2016 and 2020.
Methods: The study computes the Mortality-to-Incidence Ratio (MIR) for 53 countries in Africa with available mortality and incidence data. It uses relevant Life Tables to obtain the 5-year Relative Survival rate for women in different age cohorts based on General Survival Rate and 5-year Cancer Prevalence data from the World Health Organization (WHO). The study performs an analysis of variance tests.
Results: The results of the initial data analysis show that women in the top economies in Africa have the highest cancer incidence and mortality. The study also finds that women in Northern and Southern African countries have higher relative survival rates and lower MIR than other African regions. ANOVA results confirm statistically significant differences in 5-year relative survival across the African regions. The relative survival at 5 years was an average of 45% across all age groups within the continent although relative survival is highest among females aged 5-19 and 80-84. The lowest relative survival rates are seen for infants (0-4), adolescents and young adults (25-29), and the very elderly (85+).
Conclusion: The study concludes that while cancer incidence in Africa is linked to affluence, survival is very challenging, especially for the least developed economies in Western, Eastern, and Central Africa. The results indicate the need for crucial intervention in the continent concerning awareness, research, and data collection methodology.
{"title":"Cancer incidence, mortality, and survivorship in African women: a comparative analysis (2016-2020).","authors":"Chibuikem Chrysogonus Nwagwu, Uchenna Petronilla Ogoke","doi":"10.3389/fgwh.2023.1173244","DOIUrl":"10.3389/fgwh.2023.1173244","url":null,"abstract":"<p><strong>Objectives: </strong>This research aims to provide concrete insight into cancer incidence, mortality, and survivorship dynamics among African women between 2016 and 2020.</p><p><strong>Methods: </strong>The study computes the Mortality-to-Incidence Ratio (MIR) for 53 countries in Africa with available mortality and incidence data. It uses relevant Life Tables to obtain the 5-year Relative Survival rate for women in different age cohorts based on General Survival Rate and 5-year Cancer Prevalence data from the World Health Organization (WHO). The study performs an analysis of variance tests.</p><p><strong>Results: </strong>The results of the initial data analysis show that women in the top economies in Africa have the highest cancer incidence and mortality. The study also finds that women in Northern and Southern African countries have higher relative survival rates and lower MIR than other African regions. ANOVA results confirm statistically significant differences in 5-year relative survival across the African regions. The relative survival at 5 years was an average of 45% across all age groups within the continent although relative survival is highest among females aged 5-19 and 80-84. The lowest relative survival rates are seen for infants (0-4), adolescents and young adults (25-29), and the very elderly (85+).</p><p><strong>Conclusion: </strong>The study concludes that while cancer incidence in Africa is linked to affluence, survival is very challenging, especially for the least developed economies in Western, Eastern, and Central Africa. The results indicate the need for crucial intervention in the continent concerning awareness, research, and data collection methodology.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"4 ","pages":"1173244"},"PeriodicalIF":2.3,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10808777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-09DOI: 10.3389/fgwh.2023.1315711
Temesgen Gebeyehu Wondmeneh
Pre-lacteal feeding prevents the early initiation of breastfeeding and exclusive breastfeeding. It is understudied in Afar, a pastoral region in northeast Ethiopia. The study assessed the prevalence of pre-lacteal feeding practice and its associated factors among mothers with children under the age of two years in Dubti, North East Ethiopia.A community-based mixed-study design was employed. A systematic sampling technique was used to recruit 370 study participants for the quantitative study, while purposive sampling was used to select 17 study participants for the qualitative study. Logistic regression analysis was used to determine the association between independent variables and dependent variable. The results of logistic regression analysis were presented as an odd ratio with a 95% CI. A P-value <0.05 was used as a cutoff point to determine statistical significance. The qualitative data were analyzed using a thematic approach.Pre-lacteal feeding was practiced by 36% of mothers. Afar ethnicity (AOR = 2.5, 95% CI: 1.2–5.1), an extended family size (≥5) (AOR = 1.73, 95% CI: 1.02–2.9), a birth interval of less than 2 years (AOR = 2.77, 95% CI: 1.59–4.82), the first birth order of an indexed child (AOR = 3.87, 95% CI: 2.14–7.0), male-indexed children (AOR = 2.95, 95% CI: 1.67–5.2), and no antenatal care visits (AOR = 2.67, 95% CI: 1.67), or once or twice antenatal visits were significantly associated with pre-lacteal feeding practice. Breastfeeding counseling (AOR = 0.38, 95% CI: 0.2–0.7) and delivery at a health institution (AOR = 0.3, 95% CI: 0.17–0.55) were protective factors of pre-lacteal feeding practice. The most common pre-lacteal foods were dairy products, water, and certain plant species. Cultural beliefs are the main reason for practicing these pre-lacteal feedings.A significant number of study participants practiced prelacteal feeding. A public health campaign emphasizing the importance of antenatal care follow-ups should be initiated. Breastfeeding counseling and delivery in a health facility should also be strengthened. Community health education about the disadvantages of pre-lacteal feeding practices should be provided to reduce traditional beliefs.
{"title":"Pre-lacteal feeding practice and its associated factors among mothers with children under the age of two years in Dubti town, Afar region, North East Ethiopia: a community based mixed study design","authors":"Temesgen Gebeyehu Wondmeneh","doi":"10.3389/fgwh.2023.1315711","DOIUrl":"https://doi.org/10.3389/fgwh.2023.1315711","url":null,"abstract":"Pre-lacteal feeding prevents the early initiation of breastfeeding and exclusive breastfeeding. It is understudied in Afar, a pastoral region in northeast Ethiopia. The study assessed the prevalence of pre-lacteal feeding practice and its associated factors among mothers with children under the age of two years in Dubti, North East Ethiopia.A community-based mixed-study design was employed. A systematic sampling technique was used to recruit 370 study participants for the quantitative study, while purposive sampling was used to select 17 study participants for the qualitative study. Logistic regression analysis was used to determine the association between independent variables and dependent variable. The results of logistic regression analysis were presented as an odd ratio with a 95% CI. A P-value <0.05 was used as a cutoff point to determine statistical significance. The qualitative data were analyzed using a thematic approach.Pre-lacteal feeding was practiced by 36% of mothers. Afar ethnicity (AOR = 2.5, 95% CI: 1.2–5.1), an extended family size (≥5) (AOR = 1.73, 95% CI: 1.02–2.9), a birth interval of less than 2 years (AOR = 2.77, 95% CI: 1.59–4.82), the first birth order of an indexed child (AOR = 3.87, 95% CI: 2.14–7.0), male-indexed children (AOR = 2.95, 95% CI: 1.67–5.2), and no antenatal care visits (AOR = 2.67, 95% CI: 1.67), or once or twice antenatal visits were significantly associated with pre-lacteal feeding practice. Breastfeeding counseling (AOR = 0.38, 95% CI: 0.2–0.7) and delivery at a health institution (AOR = 0.3, 95% CI: 0.17–0.55) were protective factors of pre-lacteal feeding practice. The most common pre-lacteal foods were dairy products, water, and certain plant species. Cultural beliefs are the main reason for practicing these pre-lacteal feedings.A significant number of study participants practiced prelacteal feeding. A public health campaign emphasizing the importance of antenatal care follow-ups should be initiated. Breastfeeding counseling and delivery in a health facility should also be strengthened. Community health education about the disadvantages of pre-lacteal feeding practices should be provided to reduce traditional beliefs.","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"31 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139442986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-08DOI: 10.3389/fgwh.2023.1278777
Bekry Aleye, Ahmedin Aliyi Usso, B. Mengistie, Yadeta Dessie, Hassen Abdi Adem, A. Alemu, M. Yuya, Aminu Mohammed
The short birth interval is a common public health issue that affects women's and children's health in sub-Saharan Africa. Despite a higher burden of short birth intervals reported in Ethiopia, there is limited evidence to indicate the primary risk factors, particularly in rural eastern Ethiopia. Therefore, this study assessed the determinants of the short birth interval among married multiparous women in Chinaksen district, Eastern Ethiopia.A community-based case-control study was conducted among randomly selected 210 cases and 210 controls from April 01 to June 30, 2019. The total sample size (219 cases and 219 controls) were calculated using Epi-Info software version 7.2. Data were entered using EpiData version 3.1 and analyzed using SPSS version 27, and multivariable logistic regression analyses conducted to identify the determinants of short birth intervals. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report the strength of association and statistical significance declared at p-value < 0.05.The women in the young age group (AOR = 2.33, 95% CI: 1.03, 5.26), missed their antenatal care visits (AOR = 2.23, 95% CI: 1.18, 4.21), failed to utilize postpartum contraceptives (AOR = 5.98, 95% CI: 3.62, 9.89), did not attend postnatal care visit (AOR = 1.86, 95% CI: 1.13, 3.05), nonexclusive breastfed (AOR = 4.05, 95% CI: 2.18, 7.52), short and medium period of breastfeeding (AOR = 4.00, 95% CI: 1.34, 12.10) and (AOR = 3.56, 95% CI: 1.62, 7.82), respectively and female sex of preceding child (AOR = 1.92, 95% CI: 1.18, 3.12) were the important risk factors of short birth interval.Women's age, antenatal care visits, postnatal care attendance, utilization of postpartum contraceptives, exclusive breastfeeding practice, duration of breastfeeding, and sex of the preceding child were the primary predictors of short birth intervals. Improving the utilization of maternal healthcare services in health facilities would be imperative to prevent and reduce short birth intervals, and its negative consequences.
{"title":"Determinants of short birth interval among married multiparous women in Chinaksen district, eastern Ethiopia: a case-control study","authors":"Bekry Aleye, Ahmedin Aliyi Usso, B. Mengistie, Yadeta Dessie, Hassen Abdi Adem, A. Alemu, M. Yuya, Aminu Mohammed","doi":"10.3389/fgwh.2023.1278777","DOIUrl":"https://doi.org/10.3389/fgwh.2023.1278777","url":null,"abstract":"The short birth interval is a common public health issue that affects women's and children's health in sub-Saharan Africa. Despite a higher burden of short birth intervals reported in Ethiopia, there is limited evidence to indicate the primary risk factors, particularly in rural eastern Ethiopia. Therefore, this study assessed the determinants of the short birth interval among married multiparous women in Chinaksen district, Eastern Ethiopia.A community-based case-control study was conducted among randomly selected 210 cases and 210 controls from April 01 to June 30, 2019. The total sample size (219 cases and 219 controls) were calculated using Epi-Info software version 7.2. Data were entered using EpiData version 3.1 and analyzed using SPSS version 27, and multivariable logistic regression analyses conducted to identify the determinants of short birth intervals. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report the strength of association and statistical significance declared at p-value < 0.05.The women in the young age group (AOR = 2.33, 95% CI: 1.03, 5.26), missed their antenatal care visits (AOR = 2.23, 95% CI: 1.18, 4.21), failed to utilize postpartum contraceptives (AOR = 5.98, 95% CI: 3.62, 9.89), did not attend postnatal care visit (AOR = 1.86, 95% CI: 1.13, 3.05), nonexclusive breastfed (AOR = 4.05, 95% CI: 2.18, 7.52), short and medium period of breastfeeding (AOR = 4.00, 95% CI: 1.34, 12.10) and (AOR = 3.56, 95% CI: 1.62, 7.82), respectively and female sex of preceding child (AOR = 1.92, 95% CI: 1.18, 3.12) were the important risk factors of short birth interval.Women's age, antenatal care visits, postnatal care attendance, utilization of postpartum contraceptives, exclusive breastfeeding practice, duration of breastfeeding, and sex of the preceding child were the primary predictors of short birth intervals. Improving the utilization of maternal healthcare services in health facilities would be imperative to prevent and reduce short birth intervals, and its negative consequences.","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139446093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-08DOI: 10.3389/fgwh.2023.1300788
R. Luckett, D. Ramogola-Masire, Devon A. Harris, Annika Gompers, Kelebogile Gaborone, Lorato Mochoba, Lapelo Ntshese, A. Mathoma, Maduke Kula, Roger Shapiro, Elysia Larson
The WHO strategy for cervical cancer elimination strives to achieve 70% coverage with high-performance cervical screening. While few low- and middle-income countries have achieved this, high-risk human papillomavirus (hrHPV) self-testing creates the possibility to rapidly upscale access to high-performance cervical screening across resource settings. However, effective hrHPV screening requires linkage to follow-up, which has been variable in prior studies. This study developed and tested an implementation strategy aimed at improving screening and linkage to follow-up care in South East District in Botswana.This study performed primary hrHPV self-testing; those with positive results were referred for a triage visit. Withdrawals for any reason, loss-to follow-up between hrHPV test and triage visit, and number of call attempts to give hrHPV results were also documented. Acceptability of the program to patients was measured as the proportion of patients who completed a triage visit when indicated, meeting the a priori threshold of 80%. Feasibility was defined as the proportion of participants receiving the results and attending follow-up. To assess the associations between participant characteristics and loss-to-follow-up we used log-binomial regressions to estimate risk ratios and 95% confidence intervals (CI).Enrollment of 3,000 women occurred from February 2021 to August 2022. In total, 10 participants withdrew and an additional 33 were determined ineligible after consent, leaving a final cohort of 2,957 participants who underwent self-swab hrHPV testing. Half (50%) of participants tested positive for hrHPV and nearly all (98%) of participants received their hrHPV results, primarily via telephone. Few calls to participants were required to communicate results: 2,397 (82%) required one call, 386 (13%) required 2 calls, and only 151 (5%) required 3–5 calls. The median time from specimen collection to participant receiving results was 44 days (IQR, 27–65). Of all hrHPV positive participants, 1,328 (90%) attended a triage visit.In a large cohort we had low loss-to-follow-up of 10%, indicating that the strategy is acceptable. Telephonic results reporting was associated with high screening completion, required few calls to participants, and supports the feasibility of hrHPV self-testing in primary care followed by interval triage.
{"title":"Feasibility and acceptability of an HPV self-testing strategy: lessons from a research context to assess for ability to implement into primary care at a national level in Botswana","authors":"R. Luckett, D. Ramogola-Masire, Devon A. Harris, Annika Gompers, Kelebogile Gaborone, Lorato Mochoba, Lapelo Ntshese, A. Mathoma, Maduke Kula, Roger Shapiro, Elysia Larson","doi":"10.3389/fgwh.2023.1300788","DOIUrl":"https://doi.org/10.3389/fgwh.2023.1300788","url":null,"abstract":"The WHO strategy for cervical cancer elimination strives to achieve 70% coverage with high-performance cervical screening. While few low- and middle-income countries have achieved this, high-risk human papillomavirus (hrHPV) self-testing creates the possibility to rapidly upscale access to high-performance cervical screening across resource settings. However, effective hrHPV screening requires linkage to follow-up, which has been variable in prior studies. This study developed and tested an implementation strategy aimed at improving screening and linkage to follow-up care in South East District in Botswana.This study performed primary hrHPV self-testing; those with positive results were referred for a triage visit. Withdrawals for any reason, loss-to follow-up between hrHPV test and triage visit, and number of call attempts to give hrHPV results were also documented. Acceptability of the program to patients was measured as the proportion of patients who completed a triage visit when indicated, meeting the a priori threshold of 80%. Feasibility was defined as the proportion of participants receiving the results and attending follow-up. To assess the associations between participant characteristics and loss-to-follow-up we used log-binomial regressions to estimate risk ratios and 95% confidence intervals (CI).Enrollment of 3,000 women occurred from February 2021 to August 2022. In total, 10 participants withdrew and an additional 33 were determined ineligible after consent, leaving a final cohort of 2,957 participants who underwent self-swab hrHPV testing. Half (50%) of participants tested positive for hrHPV and nearly all (98%) of participants received their hrHPV results, primarily via telephone. Few calls to participants were required to communicate results: 2,397 (82%) required one call, 386 (13%) required 2 calls, and only 151 (5%) required 3–5 calls. The median time from specimen collection to participant receiving results was 44 days (IQR, 27–65). Of all hrHPV positive participants, 1,328 (90%) attended a triage visit.In a large cohort we had low loss-to-follow-up of 10%, indicating that the strategy is acceptable. Telephonic results reporting was associated with high screening completion, required few calls to participants, and supports the feasibility of hrHPV self-testing in primary care followed by interval triage.","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"54 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139446018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-05DOI: 10.3389/fgwh.2023.1324522
Mary A. O’Neal
This review will elucidate reasons to explain why women may be at greater risk for Alzheimer's disease.Potential mechanisms to explain sex and gender differences in Alzheimer dementia include: differences in risk associated with the apolipoprotein E 4 allele; telomere shortening- which is linked with neurodegeneration, higher incidence of depression and insomnia in women as psychiatric co-morbidities which are linked with an increased Alzheimer disease risk, disorders of pregnancy including gestational hypertension and preeclampsia and psychosocial factors such as educational level which may contribute to differences in cognitive reserve.The sex and gender differences in Alzheimer's disease can be explained by biological and psychosocial factors.
本综述将阐明女性罹患阿尔茨海默病风险更大的原因。解释阿尔茨海默氏痴呆症的性别差异的潜在机制包括:与载脂蛋白 E 4 等位基因相关的风险差异;端粒缩短--这与神经变性有关;女性抑郁症和失眠症的发病率较高,这是精神疾病的并发症,与阿尔茨海默氏病的风险增加有关;妊娠期疾病,包括妊娠高血压和先兆子痫;以及社会心理因素,如教育水平,这可能会导致认知储备的差异。阿尔茨海默氏症的性别差异可以用生物和社会心理因素来解释。
{"title":"Women and the risk of Alzheimer's disease","authors":"Mary A. O’Neal","doi":"10.3389/fgwh.2023.1324522","DOIUrl":"https://doi.org/10.3389/fgwh.2023.1324522","url":null,"abstract":"This review will elucidate reasons to explain why women may be at greater risk for Alzheimer's disease.Potential mechanisms to explain sex and gender differences in Alzheimer dementia include: differences in risk associated with the apolipoprotein E 4 allele; telomere shortening- which is linked with neurodegeneration, higher incidence of depression and insomnia in women as psychiatric co-morbidities which are linked with an increased Alzheimer disease risk, disorders of pregnancy including gestational hypertension and preeclampsia and psychosocial factors such as educational level which may contribute to differences in cognitive reserve.The sex and gender differences in Alzheimer's disease can be explained by biological and psychosocial factors.","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"78 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139383603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-03DOI: 10.3389/fgwh.2023.1264837
Mathieu Nacher, Julie Blanc, Sébastien Rabier, A. Lucarelli, A. Adenis, C. Basurko, Alphonse Louis, Dominique Dotou, Malika Leneuve, Lindsay Osei, N. Elenga, N. Hcini
In a context of high HIV prevalence, poor pregnancy follow-up, frequent poverty, preeclampsia, and preterm delivery, we aimed to describe the characteristics and outcomes of pregnancies among women living with HIV in French Guiana.A retrospective cohort study was conducted on HIV-infected pregnancies enrolled between January 1st 1992 to 31st July 2022. Overall, there were 1,774 pregnancies in 881 women living with HIV.For 75.1% of pregnancies, the HIV diagnosis was already known before pregnancy and in 67.6% of women, HIV follow-up predated pregnancy. Nearly half of women, 49.6%, only had one pregnancy since having been diagnosed with HIV. Although most women received antiretroviral therapy during pregnancy, for those with the available information we found only 48.5% had an undetectable viral load at delivery. Overall, 15.3% of pregnancies ended with an abortion. There were a total of 110 newborns infected with HIV representing an overall transmission rate of 6.2% (110/1,771). Between 1993 and 2002, the transmission rate was 34%, between 2003 and 2012 it was 1.3%, and between 2013 and 2022 it was 0.7%. Overall, in Cayenne, since 2008, 106 of 581 HIV–infected pregnancies (18.2%) with available information were premature before 37 weeks of pregnancy; of these, 33 (5.7%) were very preterm deliveries and 73 (13.3%) were late preterm deliveries. Over time, in Cayenne, preterm delivery declined significantly.The present study emphasizes that, despite spectacular progress in reducing mother to child transmission, pregnancy outcomes among women living with HIV are still preoccupying with high incidence of preterm delivery and low birth weight. Teasing out what fraction is linked to HIV and what fraction is linked to social precariousness and poor follow-up was not possible in this study. Despite the high incidence of very preterm delivery recent progress suggests that coordination efforts to improve follow-up may also have improved obstetrical outcomes.
{"title":"Thirty years of HIV pregnancies in French Guiana: prevention successes and remaining obstetrical challenges","authors":"Mathieu Nacher, Julie Blanc, Sébastien Rabier, A. Lucarelli, A. Adenis, C. Basurko, Alphonse Louis, Dominique Dotou, Malika Leneuve, Lindsay Osei, N. Elenga, N. Hcini","doi":"10.3389/fgwh.2023.1264837","DOIUrl":"https://doi.org/10.3389/fgwh.2023.1264837","url":null,"abstract":"In a context of high HIV prevalence, poor pregnancy follow-up, frequent poverty, preeclampsia, and preterm delivery, we aimed to describe the characteristics and outcomes of pregnancies among women living with HIV in French Guiana.A retrospective cohort study was conducted on HIV-infected pregnancies enrolled between January 1st 1992 to 31st July 2022. Overall, there were 1,774 pregnancies in 881 women living with HIV.For 75.1% of pregnancies, the HIV diagnosis was already known before pregnancy and in 67.6% of women, HIV follow-up predated pregnancy. Nearly half of women, 49.6%, only had one pregnancy since having been diagnosed with HIV. Although most women received antiretroviral therapy during pregnancy, for those with the available information we found only 48.5% had an undetectable viral load at delivery. Overall, 15.3% of pregnancies ended with an abortion. There were a total of 110 newborns infected with HIV representing an overall transmission rate of 6.2% (110/1,771). Between 1993 and 2002, the transmission rate was 34%, between 2003 and 2012 it was 1.3%, and between 2013 and 2022 it was 0.7%. Overall, in Cayenne, since 2008, 106 of 581 HIV–infected pregnancies (18.2%) with available information were premature before 37 weeks of pregnancy; of these, 33 (5.7%) were very preterm deliveries and 73 (13.3%) were late preterm deliveries. Over time, in Cayenne, preterm delivery declined significantly.The present study emphasizes that, despite spectacular progress in reducing mother to child transmission, pregnancy outcomes among women living with HIV are still preoccupying with high incidence of preterm delivery and low birth weight. Teasing out what fraction is linked to HIV and what fraction is linked to social precariousness and poor follow-up was not possible in this study. Despite the high incidence of very preterm delivery recent progress suggests that coordination efforts to improve follow-up may also have improved obstetrical outcomes.","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"15 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139389608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-21DOI: 10.3389/fgwh.2023.1320640
Louise S. Schindler, Sivaniya Subramaniapillai, Ananthan Ambikairajah, Claudia Barth, Arielle Crestol, I. Voldsbekk, D. Beck, T. Gurholt, A. Topiwala, S. Suri, Klaus P. Ebmeier, O. Andreassen, Bogdan Draganski, L. Westlye, A. D. de Lange
The menopause transition is associated with several cardiometabolic risk factors. Poor cardiometabolic health is further linked to microvascular brain lesions, which can be detected as white matter hyperintensities (WMHs) using T2-FLAIR magnetic resonance imaging (MRI) scans. Females show higher risk for WMHs post-menopause, but it remains unclear whether changes in cardiometabolic risk factors underlie menopause-related increase in brain pathology.In this study, we assessed whether cross-sectional measures of cardiometabolic health, including body mass index (BMI) and waist-to-hip ratio (WHR), blood lipids, blood pressure, and long-term blood glucose (HbA1c), as well as longitudinal changes in BMI and WHR, differed according to menopausal status at baseline in 9,882 UK Biobank females (age range 40–70 years, n premenopausal = 3,529, n postmenopausal = 6,353). Furthermore, we examined whether these cardiometabolic factors were associated with WMH outcomes at the follow-up assessment, on average 8.78 years after baseline.Postmenopausal females showed higher levels of baseline blood lipids (HDL β=0.14, p<0.001, LDL β=0.20, p<0.001, triglycerides β=0.12, p<0.001) and HbA1c (β=0.24, p<0.001) compared to premenopausal women, beyond the effects of age. Over time, BMI increased more in the premenopausal compared to the postmenopausal group (β=−0.08, p<0.001), while WHR increased to a similar extent in both groups (β=−0.03, p=0.102). The change in WHR was however driven by increased waist circumference only in the premenopausal group. While the group level changes in BMI and WHR were in general small, these findings point to distinct anthropometric changes in pre- and postmenopausal females over time. Higher baseline measures of BMI, WHR, triglycerides, blood pressure, and HbA1c, as well as longitudinal increases in BMI and WHR, were associated with larger WMH volumes (β range = 0.03–0.13, p≤0.002). HDL showed a significant inverse relationship with WMH volume (β=−0.27, p<0.001).Our findings emphasise the importance of monitoring cardiometabolic risk factors in females from midlife through the menopause transition and into the postmenopausal phase, to ensure improved cerebrovascular outcomes in later years.
{"title":"Cardiometabolic health across menopausal years is linked to white matter hyperintensities up to a decade later","authors":"Louise S. Schindler, Sivaniya Subramaniapillai, Ananthan Ambikairajah, Claudia Barth, Arielle Crestol, I. Voldsbekk, D. Beck, T. Gurholt, A. Topiwala, S. Suri, Klaus P. Ebmeier, O. Andreassen, Bogdan Draganski, L. Westlye, A. D. de Lange","doi":"10.3389/fgwh.2023.1320640","DOIUrl":"https://doi.org/10.3389/fgwh.2023.1320640","url":null,"abstract":"The menopause transition is associated with several cardiometabolic risk factors. Poor cardiometabolic health is further linked to microvascular brain lesions, which can be detected as white matter hyperintensities (WMHs) using T2-FLAIR magnetic resonance imaging (MRI) scans. Females show higher risk for WMHs post-menopause, but it remains unclear whether changes in cardiometabolic risk factors underlie menopause-related increase in brain pathology.In this study, we assessed whether cross-sectional measures of cardiometabolic health, including body mass index (BMI) and waist-to-hip ratio (WHR), blood lipids, blood pressure, and long-term blood glucose (HbA1c), as well as longitudinal changes in BMI and WHR, differed according to menopausal status at baseline in 9,882 UK Biobank females (age range 40–70 years, n premenopausal = 3,529, n postmenopausal = 6,353). Furthermore, we examined whether these cardiometabolic factors were associated with WMH outcomes at the follow-up assessment, on average 8.78 years after baseline.Postmenopausal females showed higher levels of baseline blood lipids (HDL β=0.14, p<0.001, LDL β=0.20, p<0.001, triglycerides β=0.12, p<0.001) and HbA1c (β=0.24, p<0.001) compared to premenopausal women, beyond the effects of age. Over time, BMI increased more in the premenopausal compared to the postmenopausal group (β=−0.08, p<0.001), while WHR increased to a similar extent in both groups (β=−0.03, p=0.102). The change in WHR was however driven by increased waist circumference only in the premenopausal group. While the group level changes in BMI and WHR were in general small, these findings point to distinct anthropometric changes in pre- and postmenopausal females over time. Higher baseline measures of BMI, WHR, triglycerides, blood pressure, and HbA1c, as well as longitudinal increases in BMI and WHR, were associated with larger WMH volumes (β range = 0.03–0.13, p≤0.002). HDL showed a significant inverse relationship with WMH volume (β=−0.27, p<0.001).Our findings emphasise the importance of monitoring cardiometabolic risk factors in females from midlife through the menopause transition and into the postmenopausal phase, to ensure improved cerebrovascular outcomes in later years.","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"63 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138950649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}