Frontiers in global women's health最新文献

Introduction: Menstrual hygiene management is an important public health component to promote reproductive health, especially in rural areas of low-and middle-income countries (LMICs). Present study assessed the menstrual hygiene practices, the disposal methods and associated health effects among school students, college students, and community women in rural setting of a Health Demographic Environmental Surveillance System (HDESS) in Odisha, India.

Methods: A cross-sectional survey was carried out in March-May 2023 using three cohorts of participants, namely school students, college students, and community women aged between 14 and 49 years and currently experiencing cycles of menstruation. The study used a multi-stage random sampling method with a descriptive analysis comparing patterns of sanitary pad use, its disposal practice and complications linked to the use of pads. Continuous variables such as age and cost incurred on menstrual products were reported using mean and standard deviation. The chi-squared value was used to determine possible associations and affirm the statistical significance, p-value (<0.05).

Results: Among 622 participants, 541 (86.9%) reported using sanitary pads. Cloth users rated their experience as "excellent" (48.7%), while dissatisfaction was highest among government-provided pad users (29.7%). Self-procured pad users reported the highest "manageable" experience (44.9%). The most common method of disposing the sanitary materials was by burying (40.2%). Approximately 68.32% of participants reported menstruation related health issues whilst 23.9% reported sanitary pad-related issues. About 16.8% of the participants reported of menstrual irregularities, school students being the most (44.8%).

Discussion: The use of disposable sanitary pads appear to be the most common menstrual hygiene management practice in rural areas. Awareness, shame, and costs could be barriers to accessing sanitary pads along with poor environmental impact when disposing of these using improper methods. Reform the policy by introducing awareness of overall health implications linked to menstrual hygiene and access to low-cost menstrual management products could promote reproductive health. Also, government partnerships with NGOs to implement village-level menstrual waste management systems, subsidies for eco-friendly pad production, and mandatory disposal education in school health programs could mitigate the problem.

Reproductive politics lie at the intersection of gender, power, and governance, shaping women's autonomy through laws, policies, and cultural norms. Historically, colonialism and population control initiatives marginalized women, particularly in the Global South, fostering distrust in healthcare systems. Feminist movements advocate for reproductive justice, yet economic and nationalistic interests continue to influence access to care. Governments regulate reproduction to control demographics, labor markets, and national power. Pronatalist and antinatalist policies, such as China's One-Child Policy, have led to coercive interventions, disproportionately affecting marginalized communities. Reproductive politics also shape masculinity, fatherhood, and state-controlled family structures. Global reproductive policies reflect ideological struggles, from restrictive abortion laws in Poland and the U.S. to progressive approaches in Nepal and Vietnam. Socioeconomic barriers further limit access to contraception, maternal healthcare, and fertility treatments. Achieving reproductive justice requires inclusive policies, healthcare reform, and recognition of reproductive rights as fundamental to gender equality.

Background and aim: This pilot study aimed to explore the feasibility and effects of auricular acupuncture called NADA, according to the principles of the National Acupuncture Detoxification Association. Previous studies have reported the effects of NADA on stress, anxiety, and sleep. Given the high levels of stress, anxiety, and psychological distress commonly experienced by parents of infants admitted to the Neonatal Intensive Care Unit (NICU), the study sought to determine whether NADA could serve as a stress-relieving intervention.

Method: The pilot study was conducted as an observational cross-sectional study for 6 months from October 2019. The "Nada in NICU" pilot project involved 41 parents (33 women and 8 men) who received between 3 and 16 NADA interventions during their child's NICU hospitalization. Data were collected through a questionnaire assessing sleep, stress/restlessness, and physical well-being. Participants were also given the option to add free-text comments in the questionnaire regarding their experiences with the NADA treatment. Quantitative data were analyzed using mixed regression, while qualitative data were thematically analyzed to identify recurring themes.

Findings: The results indicated a statistically significant reduction in stress, sleep disturbances, and physical discomfort post-NADA intervention, with a mean difference in sleep scores of -1.951. Qualitative feedback generated an overall theme, "An increased feeling of calmness," and two themes, "A psychological booster," reflecting parents' experiences of enhanced mental clarity and emotional regulation and "Bodily calmness," highlighting improved physical relaxation and sleep quality. Parents universally regarded NADA as a relevant and beneficial intervention during their NICU stay.

Background: Recent research suggests that attention-deficit/hyperactivity disorder (ADHD) is a risk factor for suboptimal cognitive and emotional aging. Due to menopause, women may be more vulnerable to these outcomes than men. This study quantifies age-related changes in the association between self-reported ADHD symptoms and cognitive and emotional complaints, comparing men and women.

Methods: Participants were 118 community adults aged 19-79 years (78.0% women). Most had a self-reported ADHD diagnosis (71.2%) or clinically significant ADHD symptoms (78.0%). All completed the self-report Connors Adult ADHD Rating Scale, the Cognitive Failures Questionnaire, the Barkley Deficits in Executive Functioning Scales and the Difficulties in Emotion Regulation Scale. Gender-stratified general linear models predicted cognitive and emotional difficulties from ADHD symptoms, testing age as a moderator.

Results: ADHD symptoms showed moderate to strong correlations with all cognitive (.39 < r < .68) and emotional outcomes (.21 < r < .64). In men, the association between ADHD symptoms and cognitive (B = -0.009, p = .021, η _p ² = .23) and emotional impulsivity (B = -0.017, p = .012, η _p ² = .28) was less pronounced in older than younger participants. Theses patterns were not observed in women. In older women, the association between ADHD symptoms and self-reported cognitive failures was slightly weaker than in younger women (B = -0.017, p = .030, η _p ² = .05). Although this interaction was not statistically significant in men, the effect was of similar medium-sized magnitude (η _p ² = .08). All associations survived adjustments for depression and anxiety symptoms.

Conclusion: Some cognitive and emotional difficulties associated with ADHD symptoms were worse in younger than in older men, but age moderation was not observed in women. The cross-sectional design precludes any conclusions about causality, and it is possible that these results may be explained by greater self-disclosure in women than in men. Results are also interpreted cautiously in the context of relatively small sample size. Altogether, results support the need for a gender-specific lens when considering the lifespan impacts of ADHD symptoms and point to women as a potentially vulnerable segment of the ADHD population regarding cognitive and emotional aging.

Background: Maternal mortality remains a critical concern in low-income countries, where low utilization of institutional delivery services is a contributing factor. This study investigates the influence of individual and community-level factors on institutional delivery among women in Somaliland, a region with a high maternal mortality rate.

Methods: This cross-sectional study used data from the 2020 Somaliland Demographic and Health Survey (SDHS), a nationally representative survey of 3804 women aged 15-49. We employed descriptive statistics and Chi-square tests to examine bivariate associations and multi-level binary logistic regression to assess the impact of individual and community-level factors on the place of delivery.

Results: Only 30.8% of deliveries occurred in health institutions. Bivariate analyses showed significant associations between institutional delivery and maternal age, education (χ² = 328.534, p < 0.001), husband's education (χ² = 362.669, p < 0.001), wealth (χ² = 787.937, p < 0.001), region (χ² = 50.760, p < 0.001), and parity (χ² = 65.227, p < 0.001). Multilevel analysis revealed that 50% of the variance in place of delivery was attributable to community level factors (Model I). Higher maternal education was significantly associated with increased odds of institutional delivery (AOR = 8.87, p < 0.05), while nomadic residence (AOR = 0.28, p < 0.05), residing in Sanaag region (AOR = 0.36, p < 0.05), high parity (five or more children) (AOR = 0.52, p < 0.05), not intending to use contraceptives (AOR = 0.62, p < 0.05), and wanting the pregnancy later (AOR = 0.79, p < 0.05) were significantly associated with decreased odds of institutional delivery. Women in the highest wealth quintile were significantly more likely to deliver in a health facility (AOR = 18.71, p < 0.05).

Conclusion: The study highlights the complex interplay of individual and community-level factors influencing the utilization of institutional delivery in Somaliland. Interventions to promote health facility deliveries must address socioeconomic disparities, improve women's education, ensure accessibility of healthcare for nomadic communities, reduce regional variations, promote family planning and reproductive health services, and take into consideration the impact of parity on health seeking behaviors.

Background: Sub-Saharan Africa has the highest rate of maternal death due to pregnancy-related complications. The delayed onset of Antenatal care (ANC) is a major underlying factor for maternal mortality. The overall well-being and health of pregnant women and their fetuses greatly depend on the timely initiation of ANC care. This study aims to identify the top predictors of delayed antenatal care initiation in East Africa, including Ethiopia, to provide input for policymakers.

Methodology: We employed secondary data from the Demographic Health Surveys conducted across ten East African countries between 2016 and 2023. After preprocessing the data, which included cleaning and feature selection through Recursive Feature Elimination, we addressed class imbalance using Synthetic Minority Over-sampling Technique (SMOTE). We then applied seven supervised learning algorithms to develop a robust machine learning model. The LGBM Classifier emerged as the top performer for predicting delayed antenatal care initiation, achieving accuracy of 75%, an AUC score of 81%, an F1 score of 78%, a recall of 79%, and a precision of 77%. Additionally, we employed association rule mining to further analyze.

Result: Home delivery, low household income, a large number of household members, unemployment, being a younger woman, not using family planning methods, low educational level, and rural residence are predictors of delayed antenatal care initiation.

Conclusion: The prevalence of late antenatal care (ANC) initiation is high (65%). Promote family planning utilization, targeted health literacy campaigns, youth-friendly programs, expand mobile clinics, and promote skilled birth attendance to increase timely ANC initiation are recommended.

Introduction: Recently, there has been growing evidence on self-stigma and personal recovery in people with psychotic spectrum disorders. However, despite the influence of sex on mental health and the social component of self-stigma and recovery, the evidence regarding self-stigma, personal recovery, and sex is limited and inconsistent. This research aims to study the role of sex in the effect that self-stigma has on the personal recovery of people with psychotic spectrum disorders.

Methods: A sample of 118 patients with a psychosis diagnose participated in the study (55.9% men). They were recruited from 9 clinical centers in Spain. Data were collected through the Internalized Stigma of Mental Illness and the Recovery Assessment Scale.

Results: The effect of self-stigma on personal recovery differed according to the sex of the person. Specifically, in women, personal recovery decreased as self-stigma and alienation increased. Also, a higher self-stigma was associated with a lower personal confidence, hope and symptom control. In contrast, in men, a higher alienation was associated with higher personal confidence, hope and success orientation. These results were adjusted for educational level, comorbidity, number of psychotic episodes, and the time between symptom onset and treatment initiation.

Discussion: These findings highlight the urgent need to explore further the role of sex on recovery and to have a sex-sensitive approach in policies and interventions in this population. This would benefit their recovery and, in consequence, their quality of life. Future studies should expand the sample and explore other factors that could be influencing the process of recovery and self-stigma.

Background: This study aimed to evaluate the prevalence and associated factors of depressive and anxiety symptoms among Chinese pregnant women during the middle period of COVID-19.

Methods: From May to August 2021, a cross-sectional online survey was conducted among pregnant women in Shijiazhuang, Hebei Province. The data collected included demographic characteristics (age, occupation, region, parity, number of fetuses, pregnancy-related disorders, education level, awareness of common symptoms, attention to the epidemic, and frequency of temperature measurement). We recruited participants using a convenience sampling approach. Depression and anxiety were assessed using self-depression rating scale (SDS) and a self-rating anxiety scale (SAS). A univariate and multivariable binomial logistic regression model was applied to identify risk factors for depression and anxiety.

Results: Cronbach's α coefficients for SDS and SAS were 0.837 and 0.826, respectively. Among 1,036 participants, the prevalence of depressive and anxiety symptoms was 59.8% (620 cases) and 6.7% (69 cases), respectively. Factors associated with depression included the number of fetuses (OR = 2.98, 95% CI 1.22-7.31), education level (OR = 0.58, 95% CI 0.45-0.75), attention to the epidemic (OR = 0.65, 95% CI 0.42-0.91), and frequency of temperature measurement (OR = 0.62, 95% CI 0.41-0.93). Factors associated with anxiety included parity (OR = 0.51, 95% CI 0.31-0.83), attention to the epidemic (OR = 2.14, 95% CI 1.18-3.89), and frequency of temperature measurement (OR = 2.86, 95% CI 1.08-7.52). Multivariate binomial logistic regression analysis indicated that a higher education level was an associated factor for depression (adjusted OR = 0.52, 95% CI 0.38-0.70). However, the parity (adjusted OR = 0.46, 95% CI 0.26-0.82) and pregnancy-related disorders (adjusted OR = 2.55, 95% CI 1.46-4.45) were independent associated factors for anxiety.

Conclusion: Pregnant women with lower education levels, primipara status, and pregnancy-related disorders were association with higher levels of depression and anxiety during the middle period of COVID-19. These findings suggest the need for targeted interventions to support the mental health of pregnant women during pandemics.

Introduction: Ethiopian women in prison face unique and exacerbated issues that are not adequately addressed by the criminal justice system, especially when it comes to gender responsive social work services. This study uses a qualitative phenomenological design to investigate the lived experiences of women who are incarcerated in the Amhara region at Kobo Prison. The study focuses on the ways in which social work interventions affect the psychosocial well-being and empowerment of these women.

Methods: Seven participants were specifically chosen from among the roughly 70 female inmates housed at Kobo Prison to offer a range of viewpoints on the experiences of incarceration. Owing to COVID-19 limitations, open-ended written questionnaire that participants filled out in private were used to collect data, guaranteeing confidentiality. An inductive thematic approach was used to manually analyze the responses.

Results: Findings indicate that incarcerated women face significant barriers including inadequate mental health support, lack of childcare provisions, and insufficient protection from gender based violence, and limited access to vocational and educational opportunities. The informal, underfunded, and frequently gender-insensitive social work services provided in prisons increase women's vulnerabilities and impede their rehabilitation. Notwithstanding these obstacles, counseling services and skill building exercises turned out to be crucial facilitators of empowerment and resilience.

Discussion: The study emphasizes how important it is to establish gender responsive social work programs that are specifically designed to meet the needs of Ethiopian women who are incarcerated. By putting women's voices front and center, the study adds important knowledge to the little studied field of correctional social work in low-income settings and offers data to support program development and policy changes. In the end, the results support comprehensive, gender-sensitive strategies to enhance the wellbeing and social reintegration of women who are incarcerated.

Background: Climate change significantly affects Uganda's economy and human well-being, with disproportionate impacts on the sexual and reproductive health (SRH) services of women and girls. However, SRH remains largely absent from climate change policy frameworks. This study examines the extent to which SRH is integrated into Uganda's climate policy frameworks and explores stakeholder perceptions of the impacts of climate change on SRH to provide insights for more inclusive and integrated policies.

Methods: The study used a mixed-methods approach, combining policy document analysis with primary qualitative data. Key documents reviewed included climate change and health policies, strategies, plans, and national medium- and long-term development frameworks. Forty purposively selected key informants and 24 focus group discussions with 321 participants in Buikwe District were conducted. Qualitative data were analyzed using content analysis to identify key themes and gaps.

Results: Uganda's climate policy frameworks acknowledge the gender-differentiated impacts of climate change and highlight the importance of SRH services but fall short of outlining concrete actions to address SRH within climate adaptation and mitigation strategies. Key informants highlighted limited stakeholder awareness and weak institutional coordination as major barriers to integrating SRH into climate action. Community respondents noted that climate extremes degrade critical infrastructure, disrupt access to SRH services and increase vulnerabilities, including a heightened risk of gender-based violence.

Conclusions: The impact of the climate crisis on SRH is increasingly evident, particularly for women and girls, yet Uganda's key climate policies still exhibit lack of concrete actions to address SRH vulnerabilities. Prioritizing SRH within climate adaptation efforts, especially through resilient health systems and livelihood support such as climate resilient agricultural training and vocational programs for women and girls is key to advancing both gender and health equity, and climate resilience in Uganda. This should be supported by robust gender disaggregated data, stronger institutional coordination, and inclusive, community-led planning.