Reproductive health in the recent disasters of Iran: a management perspective

Reproductive health challenges during a flood: A qualitative study

AIM

The study aimed to investigate women's reproductive health challenges during floods.

DESIGN

This study is qualitative, specifically employing content analysis with an inductive approach.

METHODS

Data were collected through in-depth, semi-structured individual interviews between July and December 2021. The study involved 13 women affected by floods in Golestan province, Aq Qala Township, and also included seven healthcare providers and officials. Before the interviews, informed and written consent was obtained from all participants. The sampling process continued until data saturation was achieved.

RESULTS

The analysis of the participants' experiences in this study revealed four main categories of requirements, which were as follows: Maternal and Child Health with four subcategories, Essentials of Women's Health Care with two subcategories, Problems of Relationships with two subcategories, and Aggression and Physical Violence with two subcategories. In conclusion, during floods, women encounter numerous challenges in preserving their reproductive health. Recognizing and understanding these challenges can be instrumental in effectively planning measures to prevent or address them during disasters like floods.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE IMPACT

Every disaster has unique conditions and challenges. The health requirements of individuals impacted by floods differ from those affected by other natural disasters. By identifying the specific reproductive health needs of women affected by floods, midwives and other healthcare providers can enhance their planning efforts, enabling them to better address and fulfil these needs during such critical situations.

PATIENT OR PUBLIC CONTRIBUTION

Thirteen women were affected by floods, and seven healthcare providers and officials were interviewed.

Design and psychometric evaluation of health system intervention assessment tools for children in floods

BACKGROUND

Flood is one of the most frequent disasters in Iran, which has highly affected the population and consequences on the health system. Children as the most vulnerable group too need to receive health services during floods. The aim of the present study was to develop a national tool for evaluating the provision of health services to children in floods.

MATERIAL AND METHODS

This study is a sequential-exploratory mixed method study that consists of two qualitative and quantitative stages. The qualitative part includes the analysis of documents and panel of experts while the quantitative part includes the design and validation of the tools.

RESULTS

In this study, organizations providing health services to children were first identified, and according to their mission the relevant items were extracted and the initial checklist was designed. Then validity and reliability of the tools were done. The content validity ratio and content validity index for the tool were 59 and 98%, respectively. Cronbach's alpha and intraclass correlation coefficient were determined as 0.7 and 0.964, respectively. The final tool was presented with 64 items.

CONCLUSIONS

The response program, the scope of interventions, service coverage, and the effectiveness of the response after the flood can help reduce the risk of disasters in children. Using the assessment tool of evaluating the health services to children can assist the stakeholder organizations to meet the standards and best quality of services. Assessing the needs of the children affected by floods, identifying the strengths and weaknesses of health services, and proposing corrective strategies according to the information extracted from this tool are other achievements of this study.

Challenges and Barriers of Humanitarian Hygiene Items Management in Recent Disasters in Iran

OBJECTIVE

The provision and continuation of the basic needs of affected communities, including water, food, and shelter remain the most important priorities in responding to disasters. In this regard, this study sought to investigate the management challenges of humanitarian hygiene items in recent disasters in Iran.

METHODS

This qualitative study was conducted through a semi-structured interview. Nineteen participants with different experiences, roles, and responsibilities in the recent disaster of Iran and experiences of various events in the national and international arenas were included in the study. A thematic analysis was used, and an initial conceptual framework was defined based on the study aim. The relationship between the components was compared and interpreted in this framework and the main and subthemes were extracted accordingly.

RESULTS

Six main themes and 21 subthemes were extracted based on the results. The main challenges in recent disasters were the lack of protocols and standard guidelines, inappropriate selection of items in each hygiene kit, the lack of standard distribution of hygiene kits, and the lack of attention to the affected population's culture.

CONCLUSIONS

Overall, it is necessary to define a system for preparation, supply, storage, and timely distribution of hygiene. Finally, it is suggested that an organization should be appointed for this purpose.

Essential Professional Competencies for Basic Midwifery Practice in Disasters: A Qualitative Study

OBJECTIVE

Educated midwives have a range of abilities to use their skills in normal situations. Given that working under normal situations is different from critical conditions, the recognition of skills and competencies required for midwifery practice is important. The purpose of this study was to explore specific professional competencies that midwives need to have for the provision of reproductive health services during disasters.

METHODS

This was a qualitative study using a content analysis method. Subjects were 19 midwives with the work experience of practice in disaster situations. Data were collected using semi-structured interviews and analysis was based on the approach suggested by Graneheim and Lundman.

RESULTS

Six major categories developed in this study were "safe pregnancy," "safe childbirth," "women's health care," "contraception," "violence and sexually transmitted infections," and "infant care."

CONCLUSIONS

Midwives can play a very important role in the provision of reproductive health services. Therefore, they must have special capabilities and capacities. Policies and curriculum development are recommended in accordance with the needs of reproductive health in disaster-affected communities.

Effects of the COVID-19 Pandemic on the Intimate Partner Violence and Sexual Function: A Systematic Review

INTRODUCTION

The pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), or coronavirus disease 2019 (COVID-19), has affected many people in the world and has impacted the physical, social, and mental health of the world population. One of these psychological consequences is intimate partner violence affecting sexual health.

METHODS

This study was performed as a systematic review on the effect of the SARS-CoV-2 pandemic on sexual function and domestic violence in the world. Accordingly, all English-language studies conducted from the beginning of the SARS-CoV-2 pandemic to the end of 2020 were extracted by searching in the Scopus, Web of Science, PubMed (including Medline), Cochrane Library, and Science Direct databases and then reviewed. The quality of the articles was assessed using the STROBE checklist.

RESULTS

A total of 11 studies were included in the systematic review. Accordingly, domestic violence during the exposure to COVID-19 had increased. Moreover, the mean scores of sexual function and its components had reduced at the time of exposure to the pandemic compared to before.

CONCLUSION

Given the potential long-term effects of the coronavirus crisis and the large population being affected by this disease, strategies to promote sexual health and fertility of families to prevent or further reduce violence and sexual functions should be chosen.

Challenges in Maternal and Child Health Services Delivery and Access during Pandemics or Public Health Disasters in Low-and Middle-Income Countries: A Systematic Review

Maternal and child health (MCH) has been a global priority for many decades and is an essential public health service. Ensuring seamless delivery is vital for desirable MCH outcomes. This systematic review outlined the challenges in accessing and continuing MCH services during public health emergencies-pandemics and disasters. A comprehensive search approach was built based on keywords and MeSH terms relevant to 'MCH services' and 'pandemics/disasters'. The online repositories Medline, CINAHL, Psyc INFO, and Epistemonikos were searched for studies. We included twenty studies-seven were on the Ebola outbreak, two on the Zika virus, five related to COVID-19, five on disasters, and one related to conflict situations. The findings indicate the potential impact of emergencies on MCH services. Low utilization and access to services have been described as common challenges. The unavailability of personal safety equipment and fear of infection were primary factors that affected service delivery. The available evidence, though limited, indicates the significant effect of disasters and pandemics on MCH. However, more primary in-depth studies are needed to understand better the overall impact of emergencies, especially the COVID-19 pandemic, on MCH. Our synthesis offers valuable insights to policymakers on ensuring the uninterrupted provision of MCH services during an emergency.

Meeting Maternal and Reproductive Health Needs in a Post-Disaster Setting: A Qualitative Case Study From Indonesia

Meeting and planning for maternal and reproductive health (MRH) needs during post-disaster scenarios is paramount, however, not without considerable challenges. This study was aimed at understanding the provision of MRH services in Siosar, a relocation site for a population displaced by the volcanic eruption in 2013 of Mount Sinabung, Indonesia. A qualitative case study approach was used, and data were collected through focus group discussions and individual interviews with women of reproductive age, community leaders, health personnel, and policymakers. The findings show that while considerable efforts were made to provide MRH services, these were described as "unfinished," due to challenges such as changes to funding, inadequate provision of supplies and health personnel, and geographical location. Recommendations are that health and other sectors design a relocation site that counts physical, psychological, and social needs of a community and policymakers integrate humanitarian and development plans that include MRH services into World Health Organization's Building Blocks of Health System.