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Dadras O. The individual- and community-level women's empowerment and utilization of maternity care services in Afghanistan: a multilevel cross-validation study. Int Health 2024; 16:428-437. [PMID: 38127005 PMCID: PMC11218885 DOI: 10.1093/inthealth/ihad116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/02/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND This study aimed to explore the relationship between women's empowerment and utilization of maternity care for married Afghan women aged 15-49 y in Afghanistan, assessing the convergence validity of the Survey-based Women's Empowerment Index in Afghanistan (SWEI-A). METHODS The study used data from the 2015 Afghanistan Demographic Health Survey to examine the association of different domains of women's empowerment with the utilization of maternity care using multilevel Poisson regression at both individual and community levels. RESULTS The utilization of maternity services was considerably higher among women with high scores compared with those with low scores in almost all domains of the SWEI-A, except for property owning, in which women with high scores appeared to have lower rates of utilization of such services compared with those with low scores. At the community level, those communities with high participation of women in the labor force were less likely to have adequate antenatal care (ANC), institutional delivery and postnatal care (PNC). Individual-level literacy was associated with higher utilization of ANC, institutional delivery and PNC, contrary to community-level literacy. CONCLUSIONS Except for property owning, the high score in almost all other domains was associated with higher utilization of maternity care, which indicates an acceptable level of convergence validity for the developed index (i.e. the SWEI-A) in measuring women's empowerment among married Afghan women aged 15-49 y.
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Affiliation(s)
- Omid Dadras
- Department of Global Public Health and Primary Care, University of Bergen (UiB), 5009 Bergen, Norway
- Department of Addiction Medicine, Haukland University Hospital, 5012 Bergen, Norway
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Winter AK, Due C, Ziersch A. Wellbeing Outcomes and Risk and Protective Factors for Parents with Migrant and Refugee Backgrounds from the Middle East in the First 1000 Days: A Systematic Review. J Immigr Minor Health 2024; 26:395-408. [PMID: 37410193 PMCID: PMC10937786 DOI: 10.1007/s10903-023-01510-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 07/07/2023]
Abstract
The First 1000 Days (the period from conception to a child's second birthday) is an important developmental period. However, little is known about experiences of parents with refugee and migrant backgrounds during this period. A systematic review was conducted according to PRISMA guidelines. Publications were identified through searches of the Embase, PsycINFO, PubMed, and Scopus databases, critically appraised, and synthesised using thematic analysis. A total of 35 papers met inclusion criteria. Depressive symptomatology was consistently higher than global averages, however maternal depression conceptualisations differed across studies. Several papers reported changes in relationship dynamics as a result of having a baby post-migration. Consistent relationships were found between social and health support and wellbeing. Conceptualisations of wellbeing may differ among migrant families. Limited understanding of health services and relationships with health providers may impede help-seeking. Several research gaps were identified, particularly in relation to the wellbeing of fathers, and of parents of children over 12 months old.
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Affiliation(s)
- Amelia Kate Winter
- School of Psychology, The University of Adelaide North Terrace, Adelaide, 5005, Australia.
| | - Clemence Due
- School of Psychology, The University of Adelaide North Terrace, Adelaide, 5005, Australia
| | - Anna Ziersch
- College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, 5001, Australia
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Deresa Dinagde D, Tesema KF, Wolde F, Heyi GW, Feyisa GT, Walle AD. Intimate partner violence is independently associated with poor utilization of antenatal care in Arba Minch town, southern Ethiopia: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002246. [PMID: 38165837 PMCID: PMC10760698 DOI: 10.1371/journal.pgph.0002246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/07/2023] [Indexed: 01/04/2024]
Abstract
To ensure the best possible health conditions for both mother and fetus throughout pregnancy, skilled healthcare professionals provide antenatal care (ANC) to expectant mothers. Even though the introduction of antenatal care has reduced maternal mortality by 34% since 2002, some atypical behaviors, such as intimate partner violence, have had a significant impact on how often women seek out expert medical treatment during pregnancy. Hence, early identification of such risk factors is very important to decrease maternal mortality from preventable causes. To assess the prevalence and factors of intimate partner violence and associated factors among pregnant women at Arba Minch town, southern Ethiopia. An institution-based cross-sectional study was conducted among 403 mothers who were enrolled from December 1, 2022, to January 30, 2023. The total sample size was allocated proportionately to the number of women attending antenatal care at each public health facility. Thus, systematic sampling was applied. Kobo Toolbox was used for data collection and cleaning, which was then analyzed using IBM SPSS Version 26. Statistical significance was determined at a p-value of less than 0.05. In this study area, the prevalence of intimate partner violence among pregnant women was 35% (95% CI: 30.5-39). The associated factors of intimate partner violence were late initiation of antenatal care (AOR = 3.81, 95% CI: 1.7, 6.04), non-autonomous women (AOR = 1.8, 95% CI: 1.18, 3.14), inadequate antenatal utilization (AOR = 3.41, 95% CI: 1.8, 6.2), and a husband with an extra wife (AOR = 6.0, 95% CI: 4.2, 10.57).This study showed that more than one-third of pregnant women in this study area were facing intimate partner violence. Having extra wife, lack of women's autonomy, less antenatal care utilization and late initiation of antenatal care were associated with Intimate Partner Violence (IPV). Therefore, it is essential to greatly empower women and provide them significant prestige in the home.
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Affiliation(s)
- Dagne Deresa Dinagde
- Department of Midwifery, College of Health Sciences, Mattu University, Mettu, Ethiopia
| | - Kassahun Fikadu Tesema
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Fitsum Wolde
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gudisa Weyessa Heyi
- Department of Midwifery, College of Health Sciences, Dire-Dawa University, Dire-Dawa, Ethiopia
| | - Gizu Tola Feyisa
- Department of Midwifery, College of Health Sciences, Mattu University, Mettu, Ethiopia
| | - Agmasie Damtew Walle
- Departments of Health Informatics, College of Health Sciences, Mattu University, Mettu, Ethiopia
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Mpalatsouka I, Zachariou M, Kyprianidou M, Fakonti G, Giannakou K. Assessing awareness of long-term health risks among women with a history of preeclampsia: a cross-sectional study. Front Med (Lausanne) 2023; 10:1236314. [PMID: 38020133 PMCID: PMC10662303 DOI: 10.3389/fmed.2023.1236314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Pregnancy complications, such as hypertensive disorders, present a substantial global public health challenge, with significant long-term implications for maternal and offspring health. This cross-sectional study aims to determine the level of awareness regarding long-term health risks among women who experienced preeclampsia during pregnancy in Cyprus and Greece. The study participants included adult women with a history of preeclampsia, while women with normal pregnancies were used as the comparison group. Data collection took place between June 2021 and February 2022, utilizing an online, self-administered questionnaire. The study included 355 women, with 139 (39.2%) in the preeclampsia group and 216 (60.8%) in the comparison group. Findings revealed that more than half of the women with prior preeclampsia (55.4%) were not aware of hypertensive disorders that can occur during pregnancy before their diagnosis, and a similar percentage (45.2%) had not received information about the long-term health risks following their diagnosis. Remarkably, only 3 participants (4.7%) with a history of preeclampsia were aware of the risk of developing cardiovascular diseases. There were no statistically significant differences between the preeclampsia and the comparison group regarding their concerns about long-term health risks, frequency of health checks, perceptions of factors influencing cardiovascular disease development, and doctor communication about different health topics, except from hypertension or high blood pressure. The study underscores the low level of awareness of long-term health risks among women with prior preeclampsia in Cyprus and Greece. This emphasizes the importance of implementing public health programs aimed at promoting cardiovascular risk assessment and effective management, both for clinicians and women with have experienced preeclampsia.
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Affiliation(s)
| | | | | | | | - Konstantinos Giannakou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
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Akum LA, Offei EA, Kpordoxah MR, Yeboah D, Issah AN, Boah M. Compliance with the World Health Organization's 2016 prenatal care contact recommendation reduces the incidence rate of adverse birth outcomes among pregnant women in northern Ghana. PLoS One 2023; 18:e0285621. [PMID: 37289811 PMCID: PMC10249792 DOI: 10.1371/journal.pone.0285621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 04/26/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Children born with adverse birth outcomes (ABOs) have a greater risk of mortality, stunting, and poor cognitive development. In 2016, the World Health Organization (WHO) recommended at least eight antenatal care (ANC) contacts before delivery for a healthy mother and baby. We examined the association between compliance with this recommendation and the risk of ABOs, such as low birthweight (LBW) and preterm birth (PTB), in the Tamale Metropolitan Area of the northern region of Ghana. METHODS We conducted a cross-sectional study in the Tamale Metropolis of the northern region of Ghana. We analysed a systematic random sample of 402 postnatal women aged 15-49 drawn from five public health facilities. We gathered information electronically on their birth outcomes, specifically their birthweight and gestation at delivery, using a structured questionnaire. Information on women's background characteristics, including the number of ANC contacts made before delivery, was also collected. The association between the number of ANC contacts and ABOs was investigated using regression models. RESULTS We found that 37.6% (95% CI: 32.9, 42.4) of our sample had at least eight ANC contacts before delivery. We estimated that 18.9% of babies were born prematurely and 9.0% were born LBW. ABOs were found in 22.9% (95% CI: 19.0, 27.3) of babies. A minimum of eight ANC contacts before delivery reduced the risk of ABOs (adjusted IRR = 0.43; 95% CI: 0.25, 0.73), PTB (AOR = 0.28; 95% CI: 0.14, 0.58), and LBW (AOR = 0.36; 95% CI: 0.14, 0.91). CONCLUSION In the current study's setting, about a quarter of newborns have ABOs, jeopardising their survival, health, and development. Compliance with at least eight ANC contacts prior to birth was associated with a reduced incidence rate ratio of ABOs. However, less than four out of every ten pregnant women make at least eight ANC contacts before delivery. Efforts are needed to increase coverage of eight contacts among pregnant women before delivery to reduce the risk of ABOs in the study setting.
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Affiliation(s)
- Leticia Achangebe Akum
- Department of Population and Reproductive Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Eunice Amina Offei
- Department of Midwifery and Women’s Health, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Mary Rachael Kpordoxah
- Department of Global and International Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Daudi Yeboah
- Department of Epidemiology, Biostatistics, and Disease Control, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Abdul-Nasir Issah
- Department of Health Services, Policy, Planning, Management and Economics, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Michael Boah
- Department of Epidemiology, Biostatistics, and Disease Control, School of Public Health, University for Development Studies, Tamale, Ghana
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Mirzania M, Shakibazadeh E, Bohren MA, Hantoushzadeh S, Babaey F, Khajavi A, Foroushani AR. Mistreatment of women during childbirth and its influencing factors in public maternity hospitals in Tehran, Iran: a multi-stakeholder qualitative study. Reprod Health 2023; 20:79. [PMID: 37226263 DOI: 10.1186/s12978-023-01620-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 05/14/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Mistreatment during labour and childbirth is a common experience for many women around the world. This study aimed to explore the manifestations of mistreatment and its influencing factors in public maternity hospitals in Tehran. METHODS A formative qualitative study was conducted using a phenomenological approach in five public hospitals between October 2021 and May 2022. Sixty in-depth face-to-face interviews were conducted with a purposive sample of women, maternity healthcare providers, and managers. Data were analyzed with content analysis using MAXQDA 18. RESULTS Mistreatment of women during labour and childbirth was manifested in four form: (1) physical abuse (fundal pressure); (2) verbal abuse (judgmental comments, harsh and rude language, and threats of poor outcomes); (3) failure to meet professional standards of care (painful vaginal exams, neglect and abandonment, and refusal to provide pain relief); and (4) poor rapport between women and providers (lack of supportive care and denial of mobility). Four themes were also identified as influencing factors: (1) individual-level factors (e.g., providers' perception about women's limited knowledge on childbirth process), (2) healthcare provider-level factors (e.g., provider stress and stressful working conditions); (3) hospital-level factors (e.g., staff shortages); and (4) national health system-level factors (e.g., lack of access to pain management during labour and childbirth). CONCLUSIONS Our study showed that women experienced various forms of mistreatment during labour and childbirth. There were also multiple level drivers for mistreatment at individual, healthcare provider, hospital and health system levels. Addressing these factors requires urgent multifaceted interventions.
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Affiliation(s)
- Marjan Mirzania
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Meghan A Bohren
- Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Sedigheh Hantoushzadeh
- Department of Obstetrics and Gynecology, School of Medicine, Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farah Babaey
- Head of Department of Midwifery, Ministry of Health and Medical Education, Tehran, Iran
| | - Abdoljavad Khajavi
- Department of Social Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Abbas Rahimi Foroushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Dadras O, Hazratzai M, Dadras F. The association of child marriage with morbidities and mortality among children under 5 years in Afghanistan: findings from a national survey. BMC Public Health 2023; 23:32. [PMID: 36604673 PMCID: PMC9817260 DOI: 10.1186/s12889-023-14977-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 01/02/2023] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND There is still a gap in knowledge of the impact that child marriage could have on the mortality and morbidity of children in Afghanistan. This study used the data from the latest Afghanistan demographic health survey conducted in 2015 (ADHS) to address this gap and advance the current knowledge. METHODS A secondary analysis of the 2015 ADHS, including the births in the past 5 years to ever-married women aged 15-24 years old, was carried out. Logistic regression analyses were employed to examine the association of child marriage (< 18y) with morbidities (diarrhea, acute respiratory infection, and fever in the last 2 weeks), mortality (neonatal, infant, child), and size at birth among the children under 5 born to women aged 15-24 years, before and after adjusting for the effect of sociodemographic and structural inequalities. RESULTS Approximately two-thirds of births in the past 5 years belong to 15-24 years old mothers who married at ages < 18. The majority of them were born to mothers residing in rural areas (75.67%) with no education (51.68%) from poor households (39.39%). As compared to the births to women married at ages ≥ 18, there was a significantly higher likelihood of neonatal mortality among births to women married at ages < 18 (crude OR = 2.30, 95% CI: 1.52-3.49 & adjusted OR = 1.94, 95% CI: 1.25-3.01) and higher infant mortality among the births to the women married at ages ≤ 14y (crude OR = 1.94, 95% CI: 1.06-3.53). However, it disappeared for neonatal mortality after adjustment for adequacy of antenatal care (ANC) and infant mortality after adjustment for sociodemographic inequalities. CONCLUSION Although the births to women married as a child (< 18) were more likely to die at an early age, this association disappeared after adjustment for the adequacy of ANC. Given the unavoidable practice of child marriage in Afghanistan, this finding emphasizes the importance of providing adequate ANC for young brides to prevent child mortality. In addition, strong global advocacy is required to empower and support young Afghan women in negotiating their reproductive and maternity rights with their partners by reducing social and gender-based inequalities.
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Affiliation(s)
- Omid Dadras
- grid.7914.b0000 0004 1936 7443Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway ,grid.477239.c0000 0004 1754 9964Section Global Health and Rehabilitation, Høgskulen På Vestlandet (HVL), Bergen, Norway
| | - Mohammadsediq Hazratzai
- grid.27860.3b0000 0004 1936 9684Department of Public Health Sciences, School of Medicine, University of California, Davis (UC Davis), Davis, USA
| | - Fateme Dadras
- grid.411705.60000 0001 0166 0922Department of Gynecology and Obstetrics, Graduate School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Dadras O, Nakayama T, Kihara M. Internal migration and utilization of reproductive and maternity care among women in Pakistan: evidence from a recent National Survey. Front Public Health 2023; 11:1138898. [PMID: 37151583 PMCID: PMC10160609 DOI: 10.3389/fpubh.2023.1138898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/05/2023] [Indexed: 05/09/2023] Open
Abstract
Background During the last decades, migratory behavior has had a key role in population growth and redistribution in Pakistan. Migration has far-reaching socioeconomic implications for individuals and society at large that could influence the health integrity of Pakistani women. This study aimed to describe the migration patterns and drivers as well as their association with adequate access to reproductive and maternal care among married Pakistani women aged 15-49. Methods The data from the 2017-18 Pakistan Demographic Health Survey (PDHS) was used to extract the information on the explanatory (sociodemographic and migration backgrounds) and outcome variables (unmet needs for family planning, adequate antenatal care, and delivery at health facilities). Bivariate and multivariate logistic regression analyses were employed to examine the relationship between these explanatory and outcome variables before and after adjustment for sociodemographic inequalities. Results In unadjusted models, the odds of having adequate ANC and delivery at health facilities were approximately 2 to 4 times higher in those living (urban non-migrant), moving to (urban to urban, rural to urban), or leaving the urban areas (rural to urban) as compared to rural non-migrants; likewise, the odds of the unmet needs for family planning was about 20-50% lower in the same migration streams compared to rural non-migrant. However, after adjustment for sociodemographic inequalities, most of these associations attenuated and only the association of urban to urban migration with unmet needs for family planning and the association of urban non-migrant with delivery at health facilities remained significant. Conclusion Although the findings suggest that Internal migration flows, particularly those to urban areas (urban to urban and rural to urban), could be associated with better access to reproductive and maternity care among married Pakistani women aged 15-49 years; adjustment for sociodemographic inequalities, particularly education and wealth, nullified this association to a great extent. This has important implications for current policies and interventions in Pakistan and calls for policy reform and women's rights advocacy to enhance the literacy level of young Pakistani girls through well-tailored interventions, maintaining them at school.
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Affiliation(s)
- Omid Dadras
- Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Section Global Health and Rehabilitation, Western Norway University of Applied Sciences, Bergen, Norway
- *Correspondence: Omid Dadras,
| | - Takeo Nakayama
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Masahiro Kihara
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
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Alao MA, Ibrahim OR, Iloh KK, Ayuk AC, Diala UM, Briggs DC, Imam ZO, Yekini SA, Sotimehin SA, Musa AZ, Famutimi EO, Idris AA, Odimegwu CL, Imam ZK, Medupin PF, Adeyemi AT, Nnamani KO, Tongo OO. Factors associated with common mental disorders among breastfeeding mothers in tertiary hospital nurseries in Nigeria. PLoS One 2023; 18:e0281704. [PMID: 36893141 PMCID: PMC9997879 DOI: 10.1371/journal.pone.0281704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/30/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Several studies have shown that the impact of maternal mental health disorders on newborns' well-being in low and middle-income countries (LMIC) are underreported, multi-dimensional and varies over time and differs from what is reported in high-income countries. We present the prevalence and risk factors associated with common mental disorders (CMDs) among breastfeeding mothers whose infants were admitted to Nigerian tertiary care facilities. METHODS This was a national cross-sectional study involving mothers of hospitalised babies from eleven Nigerian tertiary hospitals. We used the WHO self-reporting Questionnaire 20 and an adapted WHO/UNICEF ten-step breastfeeding support package to assess mothers' mental health and breastfeeding support. RESULTS Only 895 of the 1,120 mothers recruited from eleven tertiary healthcare nurseries in six geopolitical zones of Nigeria had complete datasets for analysis. The participants' mean age was 29.9 ± 6.2 years. One in four had CMDs; 24.0% (95% CI: 21.235, 26.937%). The ages of mothers, parity, gestational age at delivery, and length of hospital stay were comparable between mothers with and those without CMDs. Antenatal care at primary healthcare facilities (adjusted odds ratio [aOR:13], primary education [aOR:3.255] living in the south-southern region of the country [aOR 2.207], poor breastfeeding support [aOR:1.467], polygamous family settings [aOR:2.182], and a previous history of mental health disorders [aOR:4.684] were significantly associated with CMDs. In contrast, those from the middle and lower socioeconomic classes were less likely to develop CMDs, with [aOR:0.532] and [aOR:0.493], respectively. CONCLUSION In Nigeria, the prevalence of CMDs is relatively high among breastfeeding mothers with infants admitted to a tertiary care facility. Prior history of mental illness, polygamous households, mothers living in the southern region and low or no educational attainment have a greater risk of developing CMDs. This study provides evidence for assessing and tailoring interventions to CMDs among breastfeeding mothers in neonatal nurseries in LMIC.
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Affiliation(s)
- Michael Abel Alao
- Department of Pediatrics, College of Medicine University of Ibadan & University College Hospital, Ibadan, Oyo State, Nigeria
- * E-mail:
| | - Olayinka Rasheed Ibrahim
- Department of Paediatrics, Federal Medical Centre, Kastina, Kastina State, Nigeria
- Department of Pediatrics, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Kenechukwu Kosisochukwu Iloh
- Department of Paediatrics, University of Nigeria &University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
| | - Adaeze C. Ayuk
- Department of Paediatrics, University of Nigeria &University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
| | - Udochukwu Michael Diala
- Department of Pediatrics, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
| | - Datonye Christopher Briggs
- Rivers State University, Faculty of Clinical Sciences, College of Medical Sciences / Department of Paediatrics, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | | | | | - Sikirat Adetoun Sotimehin
- Paediatrics Department, Asokoro District Hospital / Faculty of Clinical Sciences, College of Health Sciences, Nile University of Nigeria, Abuja, Federal Capital Territory, Abuja, Nigeria
| | - Aishatu Zaidu Musa
- Department of Paediatrics Abubakar Tafewa Balewa University, Bauchi, Bauchi State, Nigeria
| | | | - Adedeji Abiodun Idris
- Department of Paediatrics Abubakar Tafewa Balewa University, Bauchi, Bauchi State, Nigeria
| | - Chioma Laura Odimegwu
- Department of Paediatrics, University of Nigeria &University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
| | | | | | - Ayomide Toluwanimi Adeyemi
- Department of Paediatrics, College of Medicine/University College Hospital Ibadan Centre for African Newborn Health and Nutrition, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Kenechi Ogbodo Nnamani
- Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Olukemi Oluwatoyin Tongo
- Department of Pediatrics, College of Medicine University of Ibadan & University College Hospital, Ibadan, Oyo State, Nigeria
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Women empowerment and access to maternity and reproductive healthcare in Pakistan: cross-validation of a Survey-based Index in Afghanistan (SWEI-A). BMC Womens Health 2022; 22:453. [PMID: 36384773 PMCID: PMC9670496 DOI: 10.1186/s12905-022-02031-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022] Open
Abstract
Background Despite the obvious violation of women’s rights in Pakistan and the vital necessity for women empowerment, a unified country-specific index measuring women empowerment is not yet available. This study cross-validated a survey-based women empowerment index from Afghanistan to be used in Pakistan. Methods The data for married Pakistani women aged 15–49 in the 2017–18 Pakistan demographic health survey was used to construct the final model using the explanatory and confirmatory factor analyses. The Cronbach’s alpha test examined the internal consistency of the developed index. To assess the convergence validity of the index, the association of each emerged domain with indicators of access to reproductive and maternity care was assessed by Poisson regression analysis adjusting for wealth index. Results The final index had six domains; namely, labor force participation, attitude toward violence, decision-making, access to healthcare, literacy, age at critical life events predicting women empowerment of married Pakistani women with decent reliability (Cronbach’s α = 0.70), and validity (SRSEA&SRMR < 0.05, CFI&TLI > 0.92). The emerged domains were significantly associated with at least one of four indicators for access to reproductive and maternity care; indicative of a favorable convergence validity. Conclusion Pakistan and Afghanistan are associated as brother countries with shared religious and ethnocultural identities in which women are perceived inferior to men and in critical need of empowering efforts. The results of this study reflect upon this resemblance in sociocultural structure by yielding similar domains for women's empowerment in Pakistan building upon an index previously developed for Afghan women. The developed index could inform the design of future policies, interventions, and research recognizing the important indicators of women empowerment in Pakistan and could enhance the comparability of the results across future studies. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-02031-2.
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Dadras O, Khampaya T, Nakayama T. Child Marriage, Reproductive Outcomes, and Service Utilization among Young Afghan Women: Findings from a Nationally Representative Survey in Afghanistan. Stud Fam Plann 2022; 53:417-431. [PMID: 35736515 DOI: 10.1111/sifp.12207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study explored the prevalence of child marriage and its association with reproductive outcomes and service utilization among young women in Afghanistan. We conducted a secondary analysis of data from the 2015 Afghanistan Demographic and Health Survey (DHS), focusing on women aged 20-24 years old based on the United Nations' recommendation on child marriage study. Multivariate logistic models examined the association between child marriage, reproductive outcomes, and service utilization. An estimated 52% of the Afghan women aged 20-24 married at ages less than 18 years. Poverty and illiteracy were associated with the higher likelihood of early marriage. There was a significant negative relationship between child marriage and history of rapid repeat childbirth, delivery by skilled personnel, and institutional delivery. In both adjusted and unadjusted models, women married at age ≤14 were more likely to experience terminated or unintended pregnancy, inadequate ANC, unmet need for family planning, and fistula; while, for those married at age 15-17 years, only terminated or unintended pregnancy remained significant. Strict international law enforcement and advocacy are needed in the current situation of Afghanistan to increase young women's education, promote their civil rights, and improve their autonomy and role in decision-making concerning their fertility preferences and reproductive health.
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Affiliation(s)
- Omid Dadras
- Excellent Center for Dengue and Community Public Health (EC for DACH), Walailak University, Nakhon Si Thammarat, Thailand.,Iranian Research Center for HIV/AIDS (IRCHA), Tehran University of Medical Sciences, Iran
| | - Tanaporn Khampaya
- School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Takeo Nakayama
- Department of Health Informatics, School of Public Health, Kyoto University, Japan
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Behboudi-Gandevani S, Bidhendi-Yarandi R, Panahi MH, Mardani A, Prinds C, Vaismoradi M. Perinatal and Neonatal Outcomes in Immigrants From Conflict-Zone Countries: A Systematic Review and Meta-Analysis of Observational Studies. Front Public Health 2022; 10:766943. [PMID: 35359776 PMCID: PMC8962623 DOI: 10.3389/fpubh.2022.766943] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/03/2022] [Indexed: 12/16/2022] Open
Abstract
Objectives There are controversies regarding the risk of adverse pregnancy outcomes among immigrants from conflict-zone countries. This systematic review and meta-analysis aimed to investigate the risk of perinatal and neonatal outcomes among immigrants from conflict-zone countries compared to native-origin women in host countries. Methods A systematic search on the databases of PubMed/MEDLINE, Scopus, and Web of Science was carried out to retrieve studies on perinatal and neonatal outcomes among immigrants from Somalia, Iraq, Afghanistan, Yemen, Syria, Nigeria, Sudan, Ethiopia, Eritrea, Kosovo, Ukraine, and Pakistan. Only peer-reviewed articles published in the English language were included in the data analysis and research synthesis. The odds ratio and forest plots were constructed for assessing the outcomes of interests using the DerSimonian and Laird, and the inverse variance methods. The random-effects model and the Harbord test were used to account for heterogeneity between studies and assess publication bias, respectively. Further sensitivity analysis helped with the verification of the reliability and stability of our review results. Results The search process led to the identification of 40 eligible studies involving 215,718 pregnant women, with an immigration background from the conflict zone, and 12,806,469 women of native origin. The adverse neonatal outcomes of the risk of small for gestational age (Pooled OR = 1.8, 95% CI = 1.6, 2.1), a 5-min Apgar score <7 (Pooled OR = 1.4, 95% CI = 1.0, 2.1), stillbirth (Pooled OR = 1.9, 95% CI = 1.2, 3.0), and perinatal mortality (Pooled OR = 2, 95% CI = 1.6, 2.5) were significantly higher in the immigrant women compared to the women of native-origin. The risk of maternal outcomes, including the cesarean section (C-S) and emergency C-S, instrumental delivery, preeclampsia, and gestational diabetes was similar in both groups. Conclusion Although the risk of some adverse maternal outcomes was comparable in the groups, the immigrant women from conflict-zone countries had a higher risk of neonatal mortality and morbidity, including SGA, a 5-min Apgar score <7, stillbirth, and perinatal mortality compared to the native-origin population. Our review results show the need for the optimization of health care and further investigation of long-term adverse pregnancy outcomes among immigrant women.
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Affiliation(s)
- Samira Behboudi-Gandevani
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- *Correspondence: Samira Behboudi-Gandevani
| | - Razieh Bidhendi-Yarandi
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Hossein Panahi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Nursing Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Christina Prinds
- Department of Clinical Research, University South Denmark, Odense, Denmark
- Department of Midwifery Education, University College South Denmark, Esbjerg, Denmark
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Dadras O, Nakayama T, Kihara M, Ono-Kihara M, Dadras F. Intimate partner violence and unmet need for family planning in Afghan women: the implication for policy and practice. Reprod Health 2022; 19:52. [PMID: 35216612 PMCID: PMC8881829 DOI: 10.1186/s12978-022-01362-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/17/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Intimate Partner Violence (IPV) is a serious public health issue and has been linked to a range of adverse health outcomes. This study explored the prevalence of IPV and its relationship with the unmet need for family planning among a sample of married Afghan women aged 18-49 years. METHODS This study used the data from Afghanistan Demographic and Health Survey (DHS) conducted in 2015. The data relating to IPV, unmet need for family planning, and sociodemographic characteristics of Afghan women aged 18-49 (n = 20,593) were extracted and analyzed accounting for the sampling weights and survey design in bivariate and multivariate analyses using the STATA software version 14. RESULTS An estimated 55.89% experienced some type of IPV during the last 12 months. Unmet need for family planning was documented in less than a third of the population. Illiterate employed women from poorer families who were living in the rural areas were more likely to suffer from any type of IPV. Moreover, those from Pashtun, Tajik, and Pashai ethnic groups had a higher odds of any type of violence compared to the reference group (Turkmen). Illiterate women (OR = 1.37, 95% CI 1.02-1.83) with more than 5 pregnancy experiences (OR = 1.44, 95% CI 1.19-1.74) had more unmet needs for family planning compared to the reference group. The unmet needs were almost 40% and 30% less likely to be observed among women from Pashtun and Tajik ethnic backgrounds compared to the reference group (Turkmen), respectively. The likelihood of having unmet needs was 30% less in those women who suffered from any type of violence. CONCLUSION IPV is an important predictor of several adverse health outcomes. The findings portray the disastrous situation of Afghan women's rights violation and violence against them and communicate an important message to the international communities and human rights advocate to take immediate actions in order to mitigate the current situation and prevent the violence against Afghan women to improve the integrity of their reproductive health.
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Affiliation(s)
- Omid Dadras
- Department of Community Public Health, School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand.
- Excellent Center for Dengue and Community Public Health (EC for DACH), Walailak University, Nakhon Si Thammarat, Thailand.
| | - Takeo Nakayama
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Masahiro Kihara
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Masako Ono-Kihara
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Fateme Dadras
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Tamiru D, Misgana T, Tariku M, Tesfaye D, Alemu D, Weldesenbet AB, Gebremichael B, Dheresa M. Prevalence and Associated Factors of Common Mental Disorders Among Pregnant Mothers in Rural Eastern Ethiopia. Front Psychiatry 2022; 13:843984. [PMID: 35418883 PMCID: PMC8995426 DOI: 10.3389/fpsyt.2022.843984] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/01/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Antenatal common mental disorder is a significant public health issue, especially in low- and middle-income countries with an extensive treatment gap. Common mental disorders have multifaceted implications on maternal and fetal health outcomes during pregnancy with long-running economic and social sequels. This study aimed to determine the prevalence of common mental disorder and associated factors among pregnant mothers in eastern Ethiopia, Kersa and Haramaya Health, and Demographic surveillance sites. METHODS A community-based cross-sectional study was conducted in Kersa and Haramaya health and demographic surveillance sites from January 30 to April 30, 2021. World Health Organization Self-Reporting Questionnaire (SRQ-20) was used to measure common mental disorder among 1,015 randomly selected pregnant women. Data were collected face-to-face using open data kit software. Logistic regression was fitted to identify factors associated with common mental disorders. RESULTS The overall prevalence of common mental disorders (SRQ > 6) among pregnant women was 37.5% (95% CI: 34.5, 40.5). Current substance use (AOR = 1.99, 95% CI 1.37, 2.88), intimate partner violence (AOR = 2.67, 95% CI 2.02, 3.53), null parity (AOR = 3.10, 95% CI 1.65, 5.84), gestational age [first trimester (AOR = 2.22, 95% CI 1.01, 4.93) and third trimester (AOR = 1.74, 95% CI 1.31, 2.31)], history of abortion (AOR = 2.03, 95% CI 1.27, 3.24), and absence of antenatal care follow-up (AOR = 1.43, 95% CI 1.08, 1.89) were significantly associated with common mental disorder during pregnancy. CONCLUSION Common mental disorders are prevalent among pregnant women in the study area with significant correlates. Administration of regular screening programs for maternal mental health conditions in rural, low-income communities, integrating into primary health care settings is imperative to reduce the risk.
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Affiliation(s)
- Dawit Tamiru
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tadesse Misgana
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mandaras Tariku
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dejene Tesfaye
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Daniel Alemu
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adisu Birhanu Weldesenbet
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Berhe Gebremichael
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Hossain MA, Dawson A. A Systematic review of sexual and reproductive health needs, experiences, access to services, and interventions among the rohingya and the afghan refugee women of reproductive age in Asia. WHO South East Asia J Public Health 2022; 11:42-53. [PMID: 36308272 DOI: 10.4103/who-seajph.who-seajph_144_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Approximately 9.2 million refugees live in Asia, with most originating from Afghanistan and Myanmar, and half of them are women, girls, and children. Humanitarian crises disrupt the existing health-care system, limiting access to sexual and reproductive health (SRH) services. This review explores the SRH status of Afghan and Rohingya refugee women of reproductive age in Asia and their needs and experiences in accessing these services and commodities. MATERIALS AND METHODS We used the PRISMA checklist and searched for qualitative and quantitative peer-reviewed studies from five online bibliographic databases, SCOPUS, EMBASE (Ovid), MEDLINE (Ovid), CINAHL, and PROQUEST, from January 2000 to April 2021. Content analysis was undertaken following the minimum initial service package objectives. RESULTS Fifteen studies were included in this review from four countries: Bangladesh (5), Pakistan (5), Iran (4), and Malaysia (1). Approximately 50.91% of Rohingya and 54% of Afghan refugee women used contraceptives. About 56.6% of Afghan refugee mothers experienced pregnancy-related complications, one-third received antenatal care, and low birth weight was 2.6 times higher among infants born to Afghan refugee mothers than to Pakistani-born mothers. One out of five Rohingya women received delivery-related care. Approximately 72% of Rohingya and 79.8% of Afghan refugee women had experienced gender-based violence, and 56.5% of Rohingya women engaged in unwanted sexual intercourse with their husbands. CONCLUSION Social norms, stigma, cultural values, distrust of providers, inadequate staff, and prohibition by family members limit their access to SRH services and influence their needs, knowledge, and perceptions regarding SRH.
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Affiliation(s)
- Muhammad Anwar Hossain
- Department of Sociology, Begum Rokeya University, Rangpur, Bangladesh; Western Sydney Sexual Health, Sydney Medical School, University of Sydney, Australia
| | - Angela Dawson
- Professor, School of Public Health, Faculty of Health, University of Technology, Sydney, Australia
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Dehghan M, Farokhzadian J, Ferdosi H, Abazari F, Jangipour Afshar P, Sheikhbardsiri H. Maternal–Fetal Attachment and Domestic Violence Against Iranian and Afghan Pregnant Women: A Cross-Cultural Study. VIOLENCE AND GENDER 2021. [DOI: 10.1089/vio.2020.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mahlagha Dehghan
- Critical Care Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Hakimeh Ferdosi
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Faroukh Abazari
- Department of Community Health Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Parya Jangipour Afshar
- Department of Biostatistics and Epidemiology, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hojjat Sheikhbardsiri
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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