Frontiers in global women's health最新文献

Introduction: Pregnant women with neglected tropical diseases like snakebites are considered doubly neglected due to the intersection of multiple vulnerabilities, including compounded challenges stemming from socio-economic marginalization, inadequate healthcare access and most importantly, the lack of targeted public health interventions. Despite these concerns, there is a substantial gap in the literature regarding the presentation, management and outcomes of snakebites among pregnant women, especially in low-resource settings like northeastern Nigeria.

Methods: Consequently, a retrospective observational study was conducted at the Snakebite Treatment and Research Hospital (SBTRH) in Kaltungo, Northeastern Nigeria. Six years of patient folders were searched to identify patients of all ages that were pregnant at the time of presentation.

Results: Between 2019 and 2024, 77 pregnant women presented to SBTRH with snakebites. The median age among pregnant women presenting with snakebite was 26 [interquartile range (IQR) 20-30], and most had not completed any level of education (n = 70, 91%). On average, patients were not experiencing their first pregnancy (median gravidity 3, IQR 1-5), and the median gestational age at admission was 22 weeks (IQR 16-28 weeks). Most patients (n = 73, 95%) visited a traditional healer prior to arriving at SBTRH. All patients recovered from snakebite. Of the two women that gave birth prior to discharge, one underwent spontaneous vaginal delivery followed by neonatal death, and one underwent caesarean section, where both mother and child survived.

Discussion: These findings underscore the urgent need to recognize and respond to the unique vulnerabilities of pregnant women affected by snakebite in northeastern Nigeria. There is a need to integrate snakebite education during antenatal care period, engaging traditional healers in referral networks, developing pregnancy-specific clinical protocols and strengthening surveillance systems to capture maternal and foetal outcomes comprehensively.

The perceptions, beliefs, and experiences of Muslim women regarding sexual and reproductive health are influenced by numerous factors. This study explores the sexual and reproductive health needs and challenges faced by women in Saudi Arabia, drawing on insights from key professional stakeholders. It examines the challenges faced by Saudi women and the obstacles they encounter in accessing healthcare services from the perspectives of stakeholders.

Methods: The study employed a qualitative design using semi-structured one-on-one interviews with healthcare professionals, policymakers, and religious scholars in Riyadh, Saudi Arabia. The data were analysed using reflexive thematic analysis. Participants were recruited using purposive sampling.

Results: The professional stakeholder sample included 16 participants: seven healthcare providers, six policymakers, and three religious scholars. The data revealed widespread gaps in women's sexual and reproductive health knowledge, including misconceptions about menstruation, reproduction, contraception, and sexual function. Participants described how cultural taboos and restrictive social norms foster negative attitudes toward sex and sexuality, which contribute to misinformation, fear, and sexual dysfunction. Women's ability to seek information or express sexual needs was often limited by expectations of modesty, with sexual awareness perceived as inappropriate or shameful. Stakeholders highlighted childhood sexual abuse as a prevalent yet silenced issue, with lasting effects on sexual health and well-being. Stakeholders emphasised the importance of improving sexual health education, promoting public awareness, and encouraging open, culturally sensitive dialogue to support sexual and reproductive health.

Conclusion: This study highlights the impact of societal taboos and cultural beliefs on women's sexual and reproductive experiences. The study emphasises the need for improved education, greater public awareness, and open communication to address misconceptions and support women's well-being. Promoting women's sexual well-being includes creating a more informed, inclusive, and supportive environment for women's sexual and reproductive health and advocating for policies that protect and promote their sexual and reproductive health.

Introduction: Little research has explored the constructs of grief and shame-proneness for pregnant and early parenting women seeking recovery from substance use disorders (SUD) and the impact on parents' and children's well-being.

Purpose: This study aimed to explore the contexts of reported guilt and shame and the associations with grief and loss among pregnant and early parenting women in SUD recovery.

Methods: Using a community based participatory research (CBPR) approach, we conducted in-depth interviews with 30 pregnant and early parenting women with SUD who were recruited from a residential drug recovery facility in the Southeastern United States. A qualitative descriptive six-step thematic analysis established by Braun and Clarke (2006) was used to identify core themes surrounding loss events and feelings of grief, guilt, and shame.

Results: There were 21 (70%) participants that reported at least one significant loss with a total of 56 loss events. Most participants who reported grief associated with a loss also experienced guilt and shame. Events surrounding grief and shame included: losing custody of children, adoption or child death, loss of romantic or familial relationships, guilt from using drugs while pregnant, loss of family support, and perceived loss of maternal attachment. Feelings of guilt and shame were mostly in the context of one's personal feelings of judgement or judgement from their family.

Discussion: Our findings highlight multiple challenges and stigma surrounding maternal SUD, particularly during pregnancy and postpartum. We also attend to the critical need for relevant maternal support to adequately address complicated grief and shame-proneness in SUD treatment to facilitate positive parenting, recovery outcomes, and positive child health.

Introduction: Climate change significantly impacts sexual and reproductive health (SRH) attitudes and practices, yet large-scale quantitative analyses exploring these effects are limited. This study investigates the historical associations between climate change, specifically temperature and precipitation anomalies, and key SRH attitudes and practices including contraception use, fertility preferences, and contraceptive autonomy.

Methods: Using data from 74 IMPUMS-harmonized Demographic and Health Surveys merged with high-resolution climate data, we analyzed a sample of 820,746 non-pregnant, reproductive-aged women across 33 low- and middle-income countries from 2000 to 2016. Fixed-effect logistic regression models were employed to assess the association between climate anomalies and SRH attitudes and practices.

Results: Pooled sample results indicate modest but significant associations globally: higher exposure to extreme heat in the year prior to survey administration was associated with lower odds of modern contraception use, lower odds of desire for children, and higher odds of contraceptive autonomy, while higher exposure to extreme precipitation was associated with lower odds of desire for children and higher odds of contraceptive autonomy. These associations were more pronounced when both temperature and precipitation anomalies occurred concurrently. Substantial demographic and geographic variability were observed, with mixed directionality and strength of association observed across countries and stronger associations observed among nulliparous women and younger respondents.

Discussion: Our findings underscore the potential impact of climate change on SRH attitudes and practices, as well as SRH service delivery needs in the context of extreme heat and extreme precipitation, highlighting the importance of targeted, gender-responsive health interventions tailored to climate change-affected populations.

Background: Educational level is an important aspect of one's life and is associated with biopsychosocial and economic factors. The present study aimed to investigate the association of educational level with intelligence, affective temperament, and parental bonding.

Methods: This is a cross-sectional study. The dataset included 130 individuals consisting of 20 with high school education level, 51 with college education level, and 59 with university or higher education level. First, demographic data, including intelligence, affective temperament, and parental bonding were compared among the three groups using analysis of variance (ANOVA). Second, multiple regression analysis using stepwise method was performed, with educational levels as dependent variable and significant variables in the ANOVA as independent variables.

Results: Intelligence, maternal care, and male sex were significantly and positively associated with educational level, whereas age was significantly and negatively associated with educational level.

Conclusion: The present findings suggest that maternal care as well as intelligence may be associated with higher educational level. Further prospective studies are required to determine any causal relationship and investigate other factors related to educational level.

Introduction/aim: This review explores the Community-Based Health Planning and Services (CHPS) model and its impact on maternal healthcare delivery in Ghana's primary healthcare system. It highlights both the achievements and challenges of the initiative, focusing on community involvement, trained human resources, and effective referral linkages.

Aim: To critically examine how CHPS model contributes to strengthening maternal healthcare delivery in Ghana, by assessing its successes, challenges, and potential for promoting equitable and sustainable health outcome.

Methods: The study systematically reviewed literature from databases including PubMed, Google Scholar, and JSTOR, using keywords related to CHPS, maternal and child healthcare, reproductive health, and community health initiatives. Peer-reviewed articles, reports, and grey literature published within the past 10 years were prioritized, with additional insights drawn from references in the selected studies. The thematic areas were organized into maternal and child health services, reproductive health challenges, community health programs, and CHPS's role in addressing healthcare inequalities.

Results: Findings reveal that, CHPS as a strategy has significant potential to improve maternal health outcomes, reduce mortality rates, and ensure equitable access to care for women in rural and underserved areas. Key challenges such as inadequate funding, staff shortages, political interference, and cultural barriers persist, limiting the model's overall impact.

Conclusion: The study provides policy recommendations to enhance the effectiveness of the CHPS model and calls for a collective effort from health sector stakeholders to build a sustainable maternal healthcare system in Ghana.

Background: Maternal mortality has remained a major public health issue globally. Although there has been substantial reduction in maternal mortality, Ethiopia is still one of the highest burden countries in sub-Saharan Africa. Person-centered maternity care plays a key role in ending preventable maternal mortality. Nevertheless, little is known about the status of person-centered maternity care during facility-based childbirth in eastern Ethiopia. Therefore, the aim of this study was to assess the status of person-centered maternity care and its associated factors during childbirth at selected public hospitals in eastern Ethiopia.

Methods: We had conducted a facility-based cross-sectional study at selected public hospitals in eastern Ethiopia from May 16 to June 17, 2022. A total of 420 postpartum women, selected by a systematic random sampling technique, were included in the study. We had collected our data by face-to-face interview using a pretested structured questionnaire. Then, the data were entered into EpiData 4.6 and exported to SPSS version 26 for cleaning and analysis. We applied linear regression analyses to determine the associations between dependent and independent variables. The association was reported using a β coefficient with a 95% confidence interval (CI) and a p-value ≤0.05.

Results: The percentage mean score of person-centered maternity care was 68.1 (CI: 59.94, 62.66), SD (±14.1). From the subscales of person-centered maternity care, the percentage mean score of dignity and respect was 80.6%, communication and autonomy 61.1%, and 67.3% for supportive care. Women who'd had antenatal care (ANC) follow-up (β = 5.66, 95% CI: 2.79, 8.53) and women who gave birth to a live newborn (β = 7.59, 95% CI: 3.97, 11.20) had a positive association with person-centered maternity care. However, women who had experienced childbirth complications (β = -7.01, 95% CI: -9.88, -4.13) and those who had a hospital stay of more than two days (β = -4.08, 95% CI: -6.79, -1.38) were negatively associated with person-centered maternity care.

Conclusion: Our study revealed that the mean person-centered maternity care score of the participants was significantly higher than in previous studies. Women who had antenatal care follow-up, experienced complications during childbirth, gave birth to a live newborn, and had a hospital stay of more than two days were significantly associated with person-centered maternity care. Therefore, we strongly concluded that strengthening antenatal care utilization and early detection and appropriate management of childbirth and pregnancy complications would greatly improve person-centered maternity care.

Introduction: Gestational diabetes (GD) significantly impacts maternal well-being, influencing both physical and psychological health. Non-pharmacological interventions, such as mindfulness, have emerged as potential nursing strategies to promote positive experiences during pregnancy. This study investigates the perceptions of mindfulness in pregnant women diagnosed with GD, with the aim of analyzing the perceptions of pregnant women about mindfulness. The research question was defined as "What are the perceptions of mindfulness to diabetic pregnant women?".

Methods: An exploratory qualitative approach was employed to deeply explore the perceptions of pregnant women regarding mindfulness. Seven pregnant women with GD, who met specific inclusion criteria, were intentionally selected and invited to participate in the study. Data were collected through semi-structured interviews and analyzed using Bardin's content analysis method.

Results: Participants perceived mindfulness as beneficial in several areas. Improvements in general well-being, physical and psychological health, better interpersonal relationships, increased relaxation, greater preparation for childbirth, and strengthened confidence during the transition to motherhood.

Discussion: The results indicate that mindfulness is perceived by pregnant women with GD as a valuable tool for improve their well-being and facilitating a smoother transition to motherhood. The study highlights the importance of incorporating mindfulness into nurse care, especially in the context of high-risk pregnancies. The results suggest that mindfulness can be integrated into nursing practices to more effectively support pregnant women. Further research is recommended to explore the broader implications of mindfulness in high-risk pregnancy care.

Introduction: Migrant women who speak languages other than English in the UK face elevated risks of adverse birth outcomes and experience significant maternal health disparities, conditions exacerbated by persistent inadequacies in interpreting service availability, quality, and costs. While video-mediated interpreting has been proposed as a solution, little is known about the systemic barriers that might limit its effectiveness in real-world settings.

Methods: This study employed a transformative mixed-methods approach to investigate systemic barriers in maternity interpreting services, focusing on interpreter retention, service availability, and video-mediated interpreting implementation, specifically LanguageLine Solutions' interpreter-on-wheels (IOW). Data were collected in the UK between 2019 and 2022 from seven key stakeholder groups: Migrant women (n = 24), support workers (n = 10), maternity care professionals (n = 46), interpreters (n = 159), bilingual health advocates (n = 7), language service providers (n = 6) and a commissioner. Semi-structured interviews, surveys, focus groups, ethnographic observations and service provider data were analysed using reflexive thematic analysis and descriptive statistics.

Results: The analysis revealed three interconnected systemic barriers forming a vicious circle in interpreting service provision: (1) Constrained user agency, where migrant women prioritised basic access to any interpreting support over preferences for service quality due to systematic service failures; (2) interpreter workforce sustainability crisis, with nearly 60.4% of interpreters having decreased or stopped healthcare interpreting assignments due to poor remuneration and better opportunities elsewhere; (3) infrastructure implementation failures, with interpreter-on-wheels implementation hampered by unreliable infrastructure, achieving only 11% utilisation despite its potential benefits.

Discussion: These findings demonstrate how interpreting service challenges form an interconnected system where workforce issues, technical infrastructure, and institutional practices mutually reinforce one another, creating a vicious circle that perpetuates service inadequacies. This study advances understanding of the systemic nature of interpreting service challenges in maternity care for migrant women and highlights the need for coordinated interventions that address multiple interconnected barriers simultaneously, rather than isolated technological solutions.