African journal of reproductive health最新文献

The postpartum period entails physical, emotional and social changes, and municipalities are well placed to provide support. We conducted a systematic review of municipal initiatives for postpartum women by searching PubMed and Web of Science (10 January-8 February 2024). Of 147 records, 13 studies met the inclusion criteria. Reported actions clustered around: prevention of postpartum depression (routine screening, counselling, referral-often via home visits); targeted programs for vulnerable groups; measures to improve accessibility (transport vouchers, e-health/teleconsultation); social protection/insurance; multi-actor collaborations; and home-visiting schemes. Across settings, municipal engagement was associated with earlier detection of depressive symptoms, increased use of maternal services, longer exclusive breastfeeding, and gains in maternal empowerment. Evidence favors integrated approaches that combine health and social support and prioritize equity. Local governments should expand home visits, embed screening and referral in essential services, address transport and insurance barriers, and partner with community and NGO actors to tailor support to context.

This study investigated the knowledge, awareness, and use of emergency contraceptives (ECs) among female Senior High School students in the Akuapem South Municipality of Ghana, guided by the Theory of Planned Behaviour (TPB). A cross-sectional quantitative design was employed, surveying 300 students from two schools. Data were collected using a structured, self-administered questionnaire and analyzed with descriptive statistics and regression models. Results showed while awareness of ECs was high (98%), its actual use was moderate (50%). Attitude (p<0.001) and subjective norms (p<0.001) significantly predicted intention, while perceived behavioural control (p<0.005) predicted actual use of emergency contraceptives. Mean construct scores reflected positive attitudes (M=3.9), low subjective norms (M=2.7), moderate perceived control (M=3.5), weak intentions (M=2.8), and low reported behaviour (M=2.6). Cultural, religious, and moral concerns were major deterrents to EC use. The findings highlighted the need for culturally sensitive interventions to: bridge the gap between awareness and effective use of ECs, that would help reduce unintended pregnancies among students (including adolescents) in Ghana.

The statement of Hippocrates on the relevance of seasonality led to various theories culminating in the effect of climate change for seasoning of the human body. Whereas reproductive epidemiology has been useful to assess health trends over years, interesting observations emerged regarding seasonality and other time-related variations in outcome studies of maternal health services. Rainy and dry seasons have their own particular influences on health care. There are also challenges regarding access, whether for transport or quality of care with the weekend effect. By examining time-related variations, other studies, whether institutional or population-based, have the potential to provide valuable insights.

This study was conducted to compare health care students' beliefs about sexual myths and their attitudes towards addressing This study compared health profession students' beliefs in sexual myths and their attitudes toward sexual health in their future profession. Data were collected online from 420 students between January and April 2023. The Sexual Myths Scale and Sexual Health Attitudes Questionnaire were used. Results showed that students generally had moderate belief levels in sexual myths and positive attitudes toward sexual health, with significant differences based on gender and education level. Findings highlight the need for integrating sexual health education into health curricula to promote evidence-based and inclusive professional practice.

This study explored the status of postpartum lactation in caesarean section mothers and identified the factors that influence lactation insufficiency. A total of 265 mothers who delivered via cesarean section between November 2021 and November 2022 were followed for six months. Lactation efficiency was measured by collecting daily milk output using a breast pump from postpartum days 1 to 10; insufficient lactation was defined as a total daily milk volume <500 mL on day 10. Lactation typically began between 25 and 48 hours postpartum (45.1%), with a delayed onset of lactogenesis incidence of 19.6% and an overall lactation insufficiency rate of 48.3%. Multivariate logistic regression analysis identified advanced maternal age (>35 years), excessive weight gain during pregnancy (≥5.6 kg/m²), high postpartum pain scores (≥4), gestational diabetes mellitus, and postpartum depression as significant risk factors for insufficient lactation. In contrast, early skin-to-skin contact and suckling significantly reduced the risk. Furthermore, infants in the exclusive breastfeeding group showed significantly better nutritional outcomes, as measured by the Kaup index, compared to partially or non-breastfed infants. These findings underscore the need for targeted clinical interventions during the perinatal period, including effective pain management, mental health support, and promotion of early breastfeeding, to enhance lactation outcomes among cesarean section mothers.

Maternal mortality remains a major public health challenge, particularly in low- and middle-income countries such as Ghana. There is limited data on timing and seasonality of maternal deaths particularly from the Sub-Saharan African region. This study examined the timing and seasonality of maternal deaths at Korle Bu Teaching Hospital, Accra, Ghana from January 2021 to December 2023. The maternal mortality ratio (MMR) was 801.3 per 100,000 live births over the period. A higher proportion of maternal deaths occurred during weekends, with Saturdays recording the highest percentage (18.5%). Deaths during night shifts accounted for 55.1% of all cases. Significantly higher proportion of maternal deaths occurred during the wet season (p < 0.001). On a month-by-month comparison, December recorded the highest MMR (1,142.1 per 100,000 live births), while November had the lowest (410.1 per 100,000 live births). More maternal deaths occurred during the night shift, weekends, wet and holiday-dense seasons.

Postpartum hemorrhage (PPH) remains the leading cause of maternal mortality and a common obstetric complication. Rapid onset and severity can lead to hemorrhagic shock and fatal outcomes if not promptly managed. Major causes include uterine atony, placental abnormalities, birth canal trauma, and coagulation disorders. This study proposes a risk prediction model for PPH based on a Deep Belief Network (DBN), using relevant risk factors as input features. To address limitations from random initialization in the DBN, an improved Particle Swarm Optimization (IPSO) algorithm-featuring adaptive inertia weight and learning factors-was introduced to optimize network parameters. The optimized model, referred to as IDBN, was applied to predict PPH risk levels more accurately and efficiently. The results demonstrate the superior performance of the IDBN method, which achieved the highest accuracy and F1 score among all models evaluated. This approach offers a novel, data-driven method for early PPH risk identification and clinical intervention.

L'hémorragie du post-partum (HPP) demeure la principale cause de mortalité maternelle ainsi qu'une complication obstétricale fréquente. Son apparition rapide et sa gravité peuvent entraîner un choc hémorragique et des issues fatales si elle n’est pas prise en charge rapidement. Les causes majeures incluent l’atonie utérine, les anomalies placentaires, les traumatismes du canal génital et les troubles de la coagulation. Cette étude propose un modèle de prédiction du risque de HPP basé sur un Réseau de Croyance Profond (Deep Belief Network, DBN), utilisant des facteurs de risque pertinents comme variables d'entrée. Afin de pallier les limitations dues à l'initialisation aléatoire dans le DBN, un algorithme amélioré d’optimisation par essaim particulaire (IPSO) – intégrant un poids d'inertie adaptatif et des facteurs d’apprentissage modulables – a été introduit pour optimiser les paramètres du réseau. Le modèle optimisé, nommé IDBN, a été appliqué pour prédire les niveaux de risque de HPP de manière plus précise et efficace. Les résultats démontrent les performances supérieures de la méthode IDBN, qui a obtenu les meilleurs scores en termes de précision et de F1 parmi tous les modèles évalués. Cette approche offre une méthode innovante et fondée sur les données pour l'identification précoce du risque de HPP et pour guider les interventions cliniques.

Infertility affects 15% of couples worldwide, with male factors contributing to over half of the cases. Varicocele, present in 35% of men with primary infertility, impairs sperm quality. This study evaluates the effect of electroacupuncture (EA) on improving sperm motility and morphology in varicocele patients. A single-blind, randomized controlled trial was conducted with 14 participants divided into an EA group (n=7) and a control group (n=7). The intervention group received EA in combination with a herbal regimen and Tribulus Terrestris, while the control group received only the herbal regimen and Tribulus Terrestris without EA. Men aged 20-35 with ultrasound-confirmed varicocele and abnormal spermiograms were included. Statistical analysis used the paired t-test, Wilcoxon, and Mann-Whitney tests. The EA group showed significant improvements in sperm morphology (P=0.029) and motility (P=0.026) compared to the control group. These findings suggest that EA significantly enhances sperm quality in varicocele patients and may serve as an effective complementary treatment for male infertility.

This study aimed to explore how comprehensive psychological intervention combined with traditional Chinese medicine (TCM) external therapy affects treatment adherence and quality of life in breast cancer patients undergoing chemotherapy. The research included 124 patients from January 2023 to December 2023, randomly assigned to either a control group (n=60) receiving standard chemotherapy and routine care and an intervention group (n=64) receiving additional psychological support (mindfulness training, cognitive restructuring, group therapy) and TCM therapies (moxibustion, acupoint application, herbal fumigation). Results showed that the intervention group had significantly better chemotherapy completion (92.2% vs 85.0%) and dose intensity (89.1% vs 80.0%), with fewer delays (10.9% vs 20.0%) and regimen changes (15.6% vs 26.7%). Quality of life improved notably, particularly in emotional (Δ=16.7) and social functions (Δ=14.2). Psychological metrics also improved, with anxiety and depression rates dropping significantly. Additionally, the intervention group experienced fewer severe side effects such as myelosuppression, nausea, fatigue, and neuropathy. These findings suggest that combining psychological support with TCM therapies enhances treatment adherence, quality of life, and psychological well-being while reducing chemotherapy-related adverse effects, offering a promising approach for supportive care in breast cancer patients.

This analytical cross-sectional study assessed the evolution of maternal health indicators in the Marrakech province by comparing data from 2014-2015 and 2020-2022. A total of 1,070 pregnant women were surveyed in three health facilities using a self-administered questionnaire and non-probability accidental sampling. Statistical analyses (Chi-square, Student's t-tests, and logistic regression with Wald tests) were performed using SPSS 21.0. The results showed a significant improvement in prenatal care utilization over time. The percentage of women completing four recommended antenatal visits (ANC) increased from 36.9% to 49.5%, and early initiation of care in the first trimester rose from 55.3% to 82.8%. Completion rates of ANC1, ANC3, and ANC4, as well as the medicalization of consultations, also improved significantly. Logistic regression revealed strong associations between the 2020-2022 period, rural residence, and enhanced maternal health indicators. These findings underscore the positive impact of public health strategies and the resilience of Morocco's health system during the COVID-19 pandemic.