1
|
Rotimi DE, Iyobhebhe M, Oluwayemi ET, Evbuomwan IO, Asaleye RM, Ojo OA, Adeyemi OS. Mitophagy and spermatogenesis: Role and mechanisms. Biochem Biophys Rep 2024; 38:101698. [PMID: 38577271 PMCID: PMC10990862 DOI: 10.1016/j.bbrep.2024.101698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/06/2024] Open
Abstract
The mitophagy process, a type of macroautophagy, is the targeted removal of mitochondria. It is a type of autophagy exclusive to mitochondria, as the process removes defective mitochondria one by one. Mitophagy serves as an additional level of quality control by using autophagy to remove superfluous mitochondria or mitochondria that are irreparably damaged. During spermatogenesis, mitophagy can influence cell homeostasis and participates in a variety of membrane trafficking activities. Crucially, it has been demonstrated that defective mitophagy can impede spermatogenesis. Despite an increasing amount of evidence suggesting that mitophagy and mitochondrial dynamics preserve the fundamental level of cellular homeostasis, little is known about their role in developmentally controlled metabolic transitions and differentiation. It has been observed that male infertility is a result of mitophagy's impact on sperm motility. Furthermore, certain proteins related to autophagy have been shown to be present in mammalian spermatozoa. The mitochondria are the only organelle in sperm that can produce reactive oxygen species and finally provide energy for sperm movement. Furthermore, studies have shown that inhibited autophagy-infected spermatozoa had reduced motility and increased amounts of phosphorylated PINK1, TOM20, caspase 3/7, and AMPK. Therefore, in terms of reproductive physiology, mitophagy is the removal of mitochondria derived from sperm and the following preservation of mitochondria that are exclusively maternal.
Collapse
Affiliation(s)
- Damilare Emmanuel Rotimi
- Department of Biochemistry, Landmark University, Omu-Aran 251101, Kwara State, Nigeria
- SDG 3, Good Health & Well-being, Landmark University, Nigeria
| | - Matthew Iyobhebhe
- Department of Biochemistry, Landmark University, Omu-Aran 251101, Kwara State, Nigeria
- SDG 3, Good Health & Well-being, Landmark University, Nigeria
| | - Elizabeth Temidayo Oluwayemi
- Department of Biochemistry, Landmark University, Omu-Aran 251101, Kwara State, Nigeria
- SDG 3, Good Health & Well-being, Landmark University, Nigeria
| | | | - Rotdelmwa Maimako Asaleye
- Department of Biochemistry, Landmark University, Omu-Aran 251101, Kwara State, Nigeria
- SDG 3, Good Health & Well-being, Landmark University, Nigeria
| | | | | |
Collapse
|
2
|
Martins C, Mitchell JJ, Hamer M, Blodgett JM. Associations between psychological distress in adolescence and menstrual symptoms across life: Longitudinal evidence from the 1970 British Cohort Study. J Affect Disord 2024; 354:712-718. [PMID: 38494131 DOI: 10.1016/j.jad.2024.03.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/18/2024] [Accepted: 03/09/2024] [Indexed: 03/19/2024]
Abstract
PURPOSE This study aimed to investigate the association between psychological distress (PD) at age 16 and menstrual symptoms experienced across women's life. METHODS Up to 2584 females from the 1970 British Cohort Study, a study of individuals born within one week in 1970, were included. PD at age 16 was measured with the 12-item General Health Questionnaire. Three categories were derived: low PD (<11), moderate PD (11-15), and severe PD (>15). Five menstrual health symptoms were self-reported at each age (16, 30 and 42 years). Binomial logistic regressions examined associations between PD at age 16 and each individual symptom, adjusted for age of menarche, sleep and appetite problems, physical activity levels and socioeconomic position. RESULTS The most prevalent symptoms were "pain" (61 %), "painful period" (10 %) and "heavy period" (33 %) at ages 16, 30 and 42, respectively. At age 16, those with severe PD were more likely to experience depression (OR: 2.92; 95% CI: 2.31, 3.70)), irritability (1.67; 1.33, 2.11), menstrual pain (1.34; 1.01, 1.80), and headaches (1.29; 1.02, 1.63). A weak association was found between severe PD at age 16 and pre-menstrual tension at age 30 (1.72; 1.01, 2.83). At age 42, those with severe PD at age 16 were more likely to experience pre-menstrual tension (1.89; 1.46, 2.44), painful periods (1.64; 1.27, 2.11), and heavy periods (1.28; 1.00, 1.62). DISCUSSION Menstruating females with higher levels of PD in adolescence have an increased risk of menstrual symptoms across adolescence, early and mid-adulthood. Our findings suggest the need to consider early-life psychological interventions to improve women's menstrual experiences across their reproductive years.
Collapse
Affiliation(s)
- C Martins
- Institute of Sport, Exercise & Health, Division of Surgery and Interventional Science, UCL, London, UK; Faculty of Mathematical and Physical Sciences, UCL, London, UK.
| | - J J Mitchell
- Institute of Sport, Exercise & Health, Division of Surgery and Interventional Science, UCL, London, UK.
| | - M Hamer
- Institute of Sport, Exercise & Health, Division of Surgery and Interventional Science, UCL, London, UK; Faculty of Mathematical and Physical Sciences, UCL, London, UK.
| | - J M Blodgett
- Institute of Sport, Exercise & Health, Division of Surgery and Interventional Science, UCL, London, UK; University College London Hospitals NIHR Biomedical Research Centre, London, UK.
| |
Collapse
|
3
|
Wagman JA, Gresbach V, Cheney S, Kayser M, Kimball P. Protocol for designing and evaluating an undergraduate public health course on sexual and reproductive health at a public university in California. Heliyon 2024; 10:e28503. [PMID: 38644866 PMCID: PMC11033060 DOI: 10.1016/j.heliyon.2024.e28503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 02/09/2024] [Accepted: 03/20/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction Comprehensive sexuality education (CSE) is associated with positive sexual and reproductive health (SRH) outcomes, including increased contraceptive use, lower rates of unintended pregnancy and prevention of sexual violence. However, implementation of and requirements for CSE vary across the United States which can negatively impact students, both during and beyond high school, including among college students. Methods and Analysis: This paper describes the research protocol for a multi-staged approach for designing, implementing and evaluating an SRH course for up to 60 undergraduate students at a public university in California. Before the class is offered, we will conduct 20 in-depth interviews with current students, educators and course design experts to learn from their experiences and seek their guidance on course design. To evaluate the course, enrolled students will complete a pre-course and a post-course survey before and after class is taught, to assess students' attitudes and values relevant to educational concepts and the format and delivery of the course and its modules and activities. Approximately 20 students will take part in an in-depth exit interview, after completing the course, to gather perceptions about how the course impacted their knowledge and behavior. The goal is to refine materials for future in-person course offerings and develop a prototype for a fully online version of the course. Discussion This study introduces a novel university-level course to provide young adult students comprehensive, evidence-based education on sexual and reproductive health from a public health perspective. The program leverages existing CSE efforts, enhancing them with academic rigor, inclusive content and digital inclusion. This approach, inclusive of diverse sexual orientations, content on pleasure and sexual violence prevention, aims to fill existing gaps in university curricula and also set a new standard in CSE. The project's innovative and multidisciplinary design offers a model for broader impact within a large public university system and beyond.
Collapse
Affiliation(s)
- Jennifer A. Wagman
- Jonathan and Karin Fielding School of Public Health, Department of Community Health Science, University of California Los Angeles (UCLA), Los Angeles, CA, United States
| | - Victoria Gresbach
- Jonathan and Karin Fielding School of Public Health, Department of Community Health Science, University of California Los Angeles (UCLA), Los Angeles, CA, United States
| | - Samantha Cheney
- Jonathan and Karin Fielding School of Public Health, Department of Community Health Science, University of California Los Angeles (UCLA), Los Angeles, CA, United States
| | - Mark Kayser
- UCLA Online Teaching and Learning Initiative, University of California Los Angeles, Los Angeles, CA, United States
| | - Paul Kimball
- UCLA Online Teaching and Learning Initiative, University of California Los Angeles, Los Angeles, CA, United States
| |
Collapse
|
4
|
Liang Y, Li M, Lyu Q, Li P, Lyu Y, Yu Y, Peng W. The relationship between maternal exposure to ambient air pollutants and premature rupture of membranes: A systematic review and meta-analysis. Environ Pollut 2024; 347:123611. [PMID: 38417606 DOI: 10.1016/j.envpol.2024.123611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 02/05/2024] [Accepted: 02/18/2024] [Indexed: 03/01/2024]
Abstract
Air pollution is an environmental stimulus that may predispose pregnant women to preterm rapture of membrane (PROM). However, the relationship of maternal exposure to air pollutants and PROM is still unclear. To investigate the relationship between the long-term and short-term maternal exposure to air pollution and PROM. We searched all studies published in PubMed, Embase and Web of Science up to February 2024. The studies provided quantitative effect estimates with 95% confidence intervals, for the impact of short-term (<30 days) or long-term (≥30 days) maternal exposure to air pollutants on PROM, preterm PROM (PPROM) or term PROM (TPROM). The odds ratio (OR), risk ratio (RR), or hazard ratio (HR), with 95% confidence intervals was extracted, and RR or HR were deemed as OR because of the low prevalence of PROM. Fixed- or random-effects meta-analyses performed. In total, 17 relevant studies were included. Maternal exposure to PM2.5 in the second trimester increases the risk of PROM (pooled OR = 1.15, 95%CI: 1.05-1.26). Maternal exposure to PM10, NO2, NO, CO and SO2 during pregnancy and short-term maternal exposure to PM2.5, NO2, SO2 and O3 also associate with PROM occurrence. The results of the study show that both long-term maternal exposure in the second or third trimester and short-term maternal exposure to ambient air pollution can increase the risk of PROM.
Collapse
Affiliation(s)
- Yaxin Liang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Min Li
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China; Department of Gynecology and Obstetrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China; Department of Obstetrics, The First People's Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming 650500, China.
| | - Qiubo Lyu
- Department of Gynecology and Obstetrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Pingping Li
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Hospital, Beijing 100730, China
| | - Yuhan Lyu
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Hospital, Beijing 100730, China
| | - Yue Yu
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Hospital, Beijing 100730, China
| | - Wuqiang Peng
- Maternal and Child Health Care Hospital of Mentougou District, Beijing, China
| |
Collapse
|
5
|
Tian M, Li H, Wu S, Xi H, Wang YX, Lu YY, Wei L, Huang Q. Exposure to haloacetic acid disinfection by-products and male steroid hormones: An epidemiological and in vitro study. J Hazard Mater 2024; 468:133796. [PMID: 38377905 DOI: 10.1016/j.jhazmat.2024.133796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/03/2024] [Accepted: 02/13/2024] [Indexed: 02/22/2024]
Abstract
Haloacetic acids (HAAs) are ubiquitous in drinking water and have been associated with impaired male reproductive health. However, epidemiological evidence exploring the associations between HAA exposure and reproductive hormones among males is scarce. In the current study, the urinary concentrations of dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA), the internal exposure markers of HAAs, as well as sex hormones (testosterone [T], progesterone [P], and estradiol [E2]) were measured among 449 Chinese men. Moreover, in vitro experiments, designed to simulate the real-world scenarios of human exposure, were conducted to assess testosterone synthesis in the Leydig cell line MLTC-1 and testosterone metabolism in the hepatic cell line HepG2 in response to low-dose HAA exposure. The DCAA and TCAA urinary concentrations were found to be positively associated with urinary T, P, and E2 levels (all p < 0.001), but negatively associated with the ratio of urinary T to E2 (p < 0.05). Combined with in vitro experiments, the results suggest that environmentally-relevant doses of HAA stimulate sex hormone synthesis and steroidogenesis pathway gene expression in MLTC-1 cells. In addition, the inhibition of the key gene CYP3A4 involved in the testosterone phase Ⅰ catabolism, and induction of the gene UGT2B15 involved in testosterone phase Ⅱ glucuronide conjugation metabolism along with the ATP-binding cassette (ABC) transport genes (ABCC4 and ABCG2) in HepG2 cells could play a role in elevation of urinary hormone excretion upon low-dose exposure to HAAs. Our novel findings highlight that exposure to HAAs at environmentally-relevant concentrations is associated with increased synthesis and excretion of sex hormones in males, which potentially provides an alternative approach involving urinary hormones for the noninvasive evaluation of male reproductive health following exposure to DBPs.
Collapse
Affiliation(s)
- Meiping Tian
- Key Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China.
| | - Huiru Li
- College of Life Sciences, Hebei University, Baoding 071002, China
| | - Shuangshan Wu
- Key Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China
| | - Hanyan Xi
- College of Life Sciences, Hebei University, Baoding 071002, China
| | - Yi-Xin Wang
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Yan-Yang Lu
- Key Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China
| | - Liya Wei
- College of Life Sciences, Hebei University, Baoding 071002, China
| | - Qingyu Huang
- Key Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China.
| |
Collapse
|
6
|
Logie CH, MacKenzie F, Malama K, Lorimer N, Lad A, Zhao M, Narasimhan M, Fahme S, Turan B, Kagunda J, Konda K, Hasham A, Perez-Brumer A. Sexual and reproductive health among forcibly displaced persons in urban environments in low and middle-income countries: scoping review findings. Reprod Health 2024; 21:51. [PMID: 38609975 PMCID: PMC11010352 DOI: 10.1186/s12978-024-01780-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Most forcibly displaced persons are hosted in low- and middle-income countries (LMIC). There is a growing urbanization of forcibly displaced persons, whereby most refugees and nearly half of internally displaced persons live in urban areas. This scoping review assesses the sexual and reproductive health (SRH) needs, outcomes, and priorities among forcibly displaced persons living in urban LMIC. METHODS Following The Joanna Briggs Institute scoping review methodology we searched eight databases for literature published between 1998 and 2023 on SRH needs among urban refugees in LMIC. SHR was operationalized as any dimension of sexual health (comprehensive sexuality education [CSE]; sexual and gender based violence [GBV]; HIV and STI prevention and control; sexual function and psychosexual counseling) and/or reproductive health (antental, intrapartum, and postnatal care; contraception; fertility care; safe abortion care). Searches included peer-reviewed and grey literature studies across quantitative, qualitative, or mixed-methods designs. FINDINGS The review included 92 studies spanning 100 countries: 55 peer-reviewed publications and 37 grey literature reports. Most peer-reviewed articles (n = 38) discussed sexual health domains including: GBV (n = 23); HIV/STI (n = 19); and CSE (n = 12). Over one-third (n = 20) discussed reproductive health, including: antenatal, intrapartum and postnatal care (n = 13); contraception (n = 13); fertility (n = 1); and safe abortion (n = 1). Eight included both reproductive and sexual health. Most grey literature (n = 29) examined GBV vulnerabilities. Themes across studies revealed social-ecological barriers to realizing optimal SRH and accessing SRH services, including factors spanning structural (e.g., livelihood loss), health institution (e.g., lack of health insurance), community (e.g., reduced social support), interpersonal (e.g., gender inequitable relationships), and intrapersonal (e.g., low literacy) levels. CONCLUSIONS This review identified displacement processes, resource insecurities, and multiple forms of stigma as factors contributing to poor SRH outcomes, as well as producing SRH access barriers for forcibly displaced individuals in urban LMIC. Findings have implications for mobilizing innovative approaches such as self-care strategies for SRH (e.g., HIV self-testing) to address these gaps. Regions such as Africa, Latin America, and the Caribbean are underrepresented in research in this review. Our findings can guide SRH providers, policymakers, and researchers to develop programming to address the diverse SRH needs of urban forcibly displaced persons in LMIC. Most forcibly displaced individuals live in low- and middle-income countries (LMICs), with a significant number residing in urban areas. This scoping review examines the sexual and reproductive health (SRH) outcomes of forcibly displaced individuals in urban LMICs. We searched eight databases for relevant literature published between 1998 and 2023. Inclusion criteria encompassed peer-reviewed articles and grey literature. SRH was defined to include various dimensions of sexual health (comprehensive sexuality education; sexual and gender-based violence; HIV/ STI prevention; sexual function, and psychosexual counseling) and reproductive health (antenatal, intrapartum, and postnatal care; contraception; fertility care; and safe abortion care). We included 90 documents (53 peer-reviewed articles, 37 grey literature reports) spanning 100 countries. Most peer-reviewed articles addressed sexual health and approximately one-third centered reproductive health. The grey literature primarily explored sexual and gender-based violence vulnerabilities. Identified SRH barriers encompassed challenges across structural (livelihood loss), health institution (lack of insurance), community (reduced social support), interpersonal (gender inequities), and individual (low literacy) levels. Findings underscore gaps in addressing SRH needs among urban refugees in LMICs specifically regarding sexual function, fertility care, and safe abortion, as well as regional knowledge gaps regarding urban refugees in Africa, Latin America, and the Caribbean. Self-care strategies for SRH (e.g., HIV self-testing, long-acting self-injectable contraception, abortion self-management) hold significant promise to address SRH barriers experienced by urban refugees and warrant further exploration with this population. Urgent research efforts are necessary to bridge these knowledge gaps and develop tailored interventions aimed at supporting urban refugees in LMICs.
Collapse
Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, M5S 1V4, Canada.
- Centre for Gender and Sexual Health Equity, Vancouver, Canada.
- Women's College Research Institute, Women's College Hospital, Toronto, Canada.
- United Nations University Institute for Water, Environment, and Health, Hamilton, Canada.
| | - Frannie MacKenzie
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, M5S 1V4, Canada
| | - Kalonde Malama
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, M5S 1V4, Canada
| | - Nicole Lorimer
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, M5S 1V4, Canada
| | - Anoushka Lad
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, M5S 1V4, Canada
| | - Michelle Zhao
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, M5S 1V4, Canada
| | - Manjulaa Narasimhan
- Department of Sexual and Reproductive Health and Research, including the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Sasha Fahme
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Bülent Turan
- Department of Psychology, Koc University, Istanbul, Turkey
| | - Julia Kagunda
- Elim Trust, Nairobi, Kenya
- Daystar University, Nairobi, Kenya
| | - Kelika Konda
- Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, USA
| | - Aryssa Hasham
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, M5S 1V4, Canada
| | - Amaya Perez-Brumer
- Universidad Peruana Cayetano Heredia, Lima, Peru
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| |
Collapse
|
7
|
Zhang Q, Yang Y, Liu J, Wu Y, Liu Y, Zhang J. Testicular dysfunction and "its recovery effect" after cadmium exposure. Food Chem Toxicol 2024; 188:114656. [PMID: 38615797 DOI: 10.1016/j.fct.2024.114656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/31/2024] [Accepted: 04/08/2024] [Indexed: 04/16/2024]
Abstract
In recent years, with the acceleration of industrialization, the decline of male fertility caused by heavy metal pollution has attracted much attention. However, whether the inhibition of testicular function after cadmium exposure is reversible remains to be studied. In this study, we constructed rat models of cadmium exposure and dis-exposure, and collected relative samples to observe the changes of related indicators. The results showed that cadmium exposure could reduce the fertility, inhibit the hypothalamic-pituitary-testis axis and activate hypothalamic-pituitary-adrenal axis function, the testicular GR/PI3K-AKT/AMPK signal was abnormal, cell proliferation was inhibited and apoptosis was enhanced. Four weeks after the exposure was stopped, the fertility was still decreased, testicular testosterone synthesis and spermatogenesis were inhibited, cell proliferation was inhibited and apoptosis was enhanced, but all of them were reversed. After eight weeks of cadmium exposure, the above indicators were observed to return to normal. At the same time, by giving different concentrations of corticosterone to spermatogonium, we confirmed that corticosterone may regulate the proliferation and apoptosis of spermatogonium through GR/PI3K-AKT/AMPK signal. In this study, the reproductive toxicity of cadmium, a metal environmental pollutant, was analyzed in depth to provide a new theoretical and experimental basis for ensuring male reproductive health.
Collapse
Affiliation(s)
- Qi Zhang
- Department of Clinical Pharmacy, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, 445000, China
| | - YanLing Yang
- Department of Clinical Pharmacy, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, 445000, China
| | - Juan Liu
- Department of Clinical Pharmacy, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, 445000, China
| | - YuJiao Wu
- Department of Clinical Pharmacy, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, 445000, China
| | - Yi Liu
- WuHan University, WuHan, Hubei, 430070, China.
| | - Jing Zhang
- Department of Clinical Pharmacy, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, 445000, China.
| |
Collapse
|
8
|
Ghandour LA, Anouti S, Lotfi T, Meho L, Kashash R, Al-Akkawi A, Majed A, Akl E, Afifi RA. Parenting a High and Growing Population of Youth in the Arab Region: A Scoping Review for an Evidence-Informed Research Agenda. J Adolesc Health 2024:S1054-139X(24)00125-3. [PMID: 38597843 DOI: 10.1016/j.jadohealth.2024.02.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 04/11/2024]
Abstract
The Arab region is experiencing the largest youth cohort in its history. Parental influence is a clear factor in the well-being of this demographic. This scoping review serves as the first consolidated synthesis of existing research on parenting in the Arab world, aimed at identifying research gaps and informing future research agendas. Searches of 18 databases resulted in 4,758 records (1995-2018) in all languages. Using Arksey and O'Malley's methodological framework, eligible studies (n = 152) underwent duplicate data abstraction. An evidence gap map was developed using 3i.e.'s platform. Studies were mostly published in English (88%), and lead authors' affiliations were mostly from Arab institutions. Included studies were mostly cross-sectional (89%), quantitative (96%), conducted in a school/university (83%), and surveyed children and adolescents (70%). Most studies (79%) examined parenting influences on youth outcomes. Fewer examined parenting measurement (30%) or evaluated interventions (1%). Mental health and school performance were the most commonly investigated outcomes. The evidence gap map allows researchers who study youth in the Arab world to efficiently and visually delineate the gaps and strategically prioritize research needs. Future studies should employ robust mixed methods study designs, focus on evaluation and psychometric research, engage youth in the research process and explore a more diverse set of outcomes.
Collapse
Affiliation(s)
- Lilian A Ghandour
- Department of Epidemiology and Population Health, Faculty of Health Sciences, Beirut, Lebanon
| | - Sirine Anouti
- Department of Epidemiology and Population Health, Faculty of Health Sciences, Beirut, Lebanon
| | - Tamara Lotfi
- Global Evidence Synthesis Initiative (GESI) Secretariat, American University of Beirut, Beirut, Lebanon
| | - Lokman Meho
- University Libraries, American University of Beirut, Beirut, Lebanon
| | - Rima Kashash
- Global Evidence Synthesis Initiative (GESI) Secretariat, American University of Beirut, Beirut, Lebanon; Public Health Monitoring Evaluation Accountability and Learning Coordinator, Mercy Corps, Beirut, Lebanon
| | - Alaa Al-Akkawi
- Department of Epidemiology and Population Health, Faculty of Health Sciences, Beirut, Lebanon
| | - AlZahraa Majed
- Department of Epidemiology and Population Health, Faculty of Health Sciences, Beirut, Lebanon
| | - Elie Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon; Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Rima A Afifi
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa.
| |
Collapse
|
9
|
Bose B, Raub A, Sprague A, Martin A, Bhuwania P, Kidman R, Heymann J. Do tuition-free lower secondary education policies matter for antenatal care among women in sub-saharan African countries? BMC Pregnancy Childbirth 2024; 24:250. [PMID: 38589785 PMCID: PMC11000362 DOI: 10.1186/s12884-024-06406-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 03/11/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Antenatal care (ANC) is critical to reducing maternal and infant mortality. However, sub-Saharan Africa (SSA) continues to have among the lowest levels of ANC receipt globally, with half of mothers not meeting the WHO minimum recommendation of at least four visits. Increasing ANC coverage will require not only directly reducing geographic and financial barriers to care but also addressing the social determinants of health that shape access. Among those with the greatest potential for impact is maternal education: past research has documented a relationship between higher educational attainment and antenatal healthcare access, as well as related outcomes like health literacy and autonomy in health decision-making. Yet little causal evidence exists about whether changing educational policies can improve ANC coverage. This study fills this research gap by investigating the impact of national-level policies that eliminate tuition fees for lower secondary education in SSA on the number of ANC visits. METHODS To estimate the effect of women's exposure to tuition-free education policies at the primary and lower secondary levels on their ANC visits, a difference-in-difference methodology was employed. This analysis leverages the variation in the timing of education policies across nine SSA countries. RESULTS Exposure to tuition-free primary and lower secondary education is associated with improvements in the number of ANC visits, increasing the share of women meeting the WHO recommendation of at least four ANC visits by 6-14%. Moreover, the impact of both education policies combined is greater than that of tuition-free primary education alone. However, the effects vary across individual treatment countries, suggesting the need for further investigation into country-specific dynamics. CONCLUSIONS The findings of this study have significant implications for policymakers and stakeholders seeking to improve ANC coverage. Removing the tuition barrier at the secondary level has shown to be a powerful strategy for advancing health outcomes and educational attainment. As governments across Africa consider eliminating tuition fees at the secondary level, this study provides valuable evidence about the impacts on reproductive health outcomes. While investing in free education requires initial investment, the long-term benefits for both human development and economic growth far outweigh the costs.
Collapse
Affiliation(s)
- Bijetri Bose
- WORLD Policy Analysis Center, Fielding School of Public Health, University of California, Los Angeles, USA.
| | - Amy Raub
- WORLD Policy Analysis Center, Fielding School of Public Health, University of California, Los Angeles, USA
| | - Aleta Sprague
- WORLD Policy Analysis Center, Fielding School of Public Health, University of California, Los Angeles, USA
| | - Alfredo Martin
- WORLD Policy Analysis Center, Fielding School of Public Health, University of California, Los Angeles, USA
| | - Pragya Bhuwania
- WORLD Policy Analysis Center, Fielding School of Public Health, University of California, Los Angeles, USA
| | - Rachel Kidman
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Jody Heymann
- WORLD Policy Analysis Center, Fielding School of Public Health, University of California, Los Angeles, USA
| |
Collapse
|
10
|
Baleige A. Action framework for reproductive health promotion: Analysis of contemporary French public policies using a critical lexicometric approach and a transgender perspective. Sante Publique 2024; 36:73-80. [PMID: 38580469 DOI: 10.3917/spub.241.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
INTRODUCTION In France, since 2017 the law has allowed people to change the gender marker on their civil status documents without having undergone medical treatment and sterilization surgery. However, no legislative framework has been provided to ensure their right to family, leaving those who wish to become parents in a space of social, political, and legal uncertainty that is inconsistent with international and human rights. In parallel, France has developed an arsenal of health strategies that constrain actors working in the field. PURPOSE OF THE RESEARCH This study examines the possibilities available to public health actors for promoting reproductive health in the absence of legislation and in the context of political and legislative adversity. To this end, it relies on a participatory, critical, and lexicometric analysis of national strategies for sexual and reproductive health and parenthood support. RESULTS Governance strategies make no mention of parentality among transgender people. Sexual and reproductive health policies focus on tackling sexually transmitted infections, on health pathways, and on violence and discrimination. The analysis also highlights a lack of awareness on this topic. CONCLUSIONS Shortcomings in the legislative framework and public health strategies raise ethical questions about the promotion of reproductive health and the potentially non-inclusive approach of actors in the field. These issues force communities to carry out actions outside the scope of ordinary regulations, and they highlight the political positioning of the public-health field in France.
Collapse
Affiliation(s)
- Anna Baleige
- Université François-Rabelais, faculté de médecine, EA 75-05 Éducation Éthique Santé, Tours, France
| |
Collapse
|
11
|
Forbes SM, Tarasoff LA, Evans M, Brown HK. Preconception health disparities among reproductive-aged women with and without disabilities in Canada. Can J Public Health 2024:10.17269/s41997-024-00873-x. [PMID: 38573493 DOI: 10.17269/s41997-024-00873-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 02/27/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Preconception health (PCH), which describes the health status of reproductive-aged individuals, can influence reproductive, maternal, and fetal/neonatal outcomes. PCH disparities have been observed in certain populations, prompting the development of tailored resources. Our objective was to compare the PCH characteristics of women with and without disabilities. METHODS We undertook a secondary analysis of the 2003-2014 cycles of the Canadian Community Health Survey (CCHS), which included n = 115,295 women aged 15-49 years. Among these, we also examined a sub-sample of n = 12,495 women with a subsequent obstetrical delivery identified in a linkage of the CCHS with the Discharge Abstract Database (DAD, 2003-2017). The outcomes were 8 PCH indicators. We used modified Poisson regression to estimate adjusted prevalence ratios (aPRs) for each PCH indicator, comparing women with and without disabilities, and multinomial logistic regression to calculate adjusted odds ratios for 1, 2, and ≥ 3 PCH indicators (vs. 0). Analyses were adjusted for baseline demographics. RESULTS Reproductive-aged women with disabilities had significantly increased aPRs of smoking (1.42 [95% CI:1.37-1.48]), obesity (1.57 [1.48-1.65]), and self-reported fair/poor physical (5.56 [5.09-6.07]) and mental health (4.07 [3.71-4.47]), compared to those without disabilities. They were also more likely to have ≥ 3, 2, and 1 PCH indicators (vs. 0). Findings were similar in the sub-sample with a subsequent obstetrical delivery. CONCLUSION Canadian reproductive-aged women with disabilities experience important PCH disparities. Further research is needed to inform tailored education and resources to support PCH in individuals with disabilities, in combination with policies to address structural barriers to PCH.
Collapse
Affiliation(s)
- Samantha M Forbes
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lesley A Tarasoff
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Meredith Evans
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Hilary K Brown
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON, Canada.
| |
Collapse
|
12
|
Okyere J, Ayebeng C, Dickson KS. Early age at menarche and history of sexually transmitted infections significantly predict cervical cancer screening uptake among women aged 25-49 years: evidence from the 2021 Côte d'Ivoire demographic and health survey. BMC Health Serv Res 2024; 24:423. [PMID: 38570834 PMCID: PMC10993584 DOI: 10.1186/s12913-024-10881-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 03/19/2024] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION Cervical cancer is the second dominant type of cancer among Ivorian women with an estimated age-standardised incidence and mortality rate of 31.2 cases and 22.8 deaths per 100,000 women in 2020, respectively. The Ivorian government through its Ministry of Health implemented the National Cancer Control Programme (NCCP) in 2003 with the aim of improving the prevention, early detection and treatment of cancers in Côte d'Ivoire. Yet, there is a low uptake of CCS (1.2%). Thus, making CCS uptake an important public health concern in the country. Understanding of the extent to which reproductive factors predict CCS uptake is limited in literature. This study aimed to investigate reproductive factors as a predictor of women's uptake of CCS in Côte d'Ivoire. METHODS Data from the 2021 Côte d'Ivoire Demographic and Health Survey. A sample of 9,078 women aged 25-49 years were analyzed. The outcome variable was CCS uptake while other variables considered included age at menarche, history of STI, sexual debut, parity, age, educational level, wealth index, health insurance, place of residence, and media exposure. A multivariable logistic regression model was fitted to examine the association between the outcome of interest and predictors at 95% confidence interval. RESULTS Approximately, 7.52% of women aged 25-49 years had ever undergone testing for cervical cancer by a healthcare provider. Early menarche was associated with lower odds of CCS uptake [AOR = 0.78; CI = 0.65-0.95]. Compared to those who had no STI, women with a history of STI were more likely to screen for cervical cancer [AOR = 2.63; CI = 2.02-3.42]. Increasing age, higher educational attainment, having health insurance, and being exposed to media were significantly associated with CCS uptake. CONCLUSION In Cote d'Ivoire, age at menarche and STI history constitute reproductive factors that were significantly associated with women's uptake of CCS. It is imperative for public policy to focus on increasing CCS in these higher-risk women (i.e., women who experienced early menarche, women with early sexual debut and higher parity) through increased sensitization on cervical cancer risk factors.
Collapse
Affiliation(s)
- Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
- School of Nursing & Midwifery, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Castro Ayebeng
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | | |
Collapse
|
13
|
Dorney E, I Black K, Haas M, Street D, Church J. The preferences of people in Australia to respond and engage with advertisements to promote reproductive health: Results of a discrete choice experiment. Prev Med Rep 2024; 40:102657. [PMID: 38444564 PMCID: PMC10912617 DOI: 10.1016/j.pmedr.2024.102657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/07/2024] Open
Abstract
Objectives The health of people prior to pregnancy impacts pregnancy outcomes and childhood health, making the preconception period an important time to optimise health behaviours. Low awareness of the importance of this issue is a recognised barrier to achieving good preconception health. Public health messaging can help to address this barrier. Methods A discrete choice experiment to assess the preferences of people of reproductive age for a health promotion advertisement for preconception health was conducted. Attributes of the advertisement image, title, additional text content and positioning, and the location of advertisement were assessed by fitting a mixed logit model to the choices made. Results Three hundred and thirty-four responses were obtained, from people of reproductive age, both planning and not planning a pregnancy, in Australia. Participants placed most importance on the image, and the location in which they saw the advertisement. An image of adult and baby hands was preferred to adult hands only, and healthcare settings were preferred to more general media locations such as advertising online or on public transport. Preference was also given to the advertisement title of "Healthy you, Healthy baby", closely followed by "Are you ready for pregnancy?". The location and content of additional text did not significantly impact engagement with the advertisement. Conclusion The image and title on the advertisement, and the locations in which they are placed were the most significant features to impact engagement with a health promotion advertisement for preconception health. This can inform health promotion efforts for preconception health.
Collapse
Affiliation(s)
- Edwina Dorney
- Faculty of Medicine and Health, Central Clinical School, The Tavern, The University of Sydney, Medical Foundation Building K25, Sydney, New South Wales 2006, Australia
| | - Kirsten I Black
- Faculty of Medicine and Health, Central Clinical School, The Tavern, The University of Sydney, Medical Foundation Building K25, Sydney, New South Wales 2006, Australia
| | - Marion Haas
- Centre for Health Economics Research and Evaluation, Faculty of Health, University of Technology Sydney, New South Wales 2007, Australia
| | - Deborah Street
- Centre for Health Economics Research and Evaluation, Faculty of Health, University of Technology Sydney, New South Wales 2007, Australia
| | - Jody Church
- Centre for Health Economics Research and Evaluation, Faculty of Health, University of Technology Sydney, New South Wales 2007, Australia
| |
Collapse
|
14
|
Barnard ME, DuPré NC, Heine JJ, Fowler EE, Murthy DJ, Nelleke RL, Chan A, Warner ET, Tamimi RM. Reproductive risk factors for breast cancer and association with novel breast density measurements among Hispanic, Black, and White women. Breast Cancer Res Treat 2024; 204:309-325. [PMID: 38095811 PMCID: PMC10948301 DOI: 10.1007/s10549-023-07174-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/02/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE There are differences in the distributions of breast cancer incidence and risk factors by race and ethnicity. Given the strong association between breast density and breast cancer, it is of interest describe racial and ethnic variation in the determinants of breast density. METHODS We characterized racial and ethnic variation in reproductive history and several measures of breast density for Hispanic (n = 286), non-Hispanic Black (n = 255), and non-Hispanic White (n = 1694) women imaged at a single hospital. We quantified associations between reproductive factors and percent volumetric density (PVD), dense volume (DV), non-dense volume (NDV), and a novel measure of pixel intensity variation (V) using multivariable-adjusted linear regression, and tested for statistical heterogeneity by race and ethnicity. RESULTS Reproductive factors most strongly associated with breast density were age at menarche, parity, and oral contraceptive use. Variation by race and ethnicity was most evident for the associations between reproductive factors and NDV (minimum p-heterogeneity:0.008) and V (minimum p-heterogeneity:0.004) and least evident for PVD (minimum p-heterogeneity:0.042) and DV (minimum p-heterogeneity:0.041). CONCLUSION Reproductive choices, particularly those related to childbearing and oral contraceptive use, may contribute to racial and ethnic variation in breast density.
Collapse
Affiliation(s)
- Mollie E Barnard
- Slone Epidemiology Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, 02118, USA.
- University of Utah Intermountain Healthcare Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
| | - Natalie C DuPré
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | - John J Heine
- Division of Population Sciences, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Erin E Fowler
- Division of Population Sciences, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Divya J Murthy
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Rebecca L Nelleke
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ariane Chan
- Volpara Health Technologies Ltd., Wellington, New Zealand
| | - Erica T Warner
- Clinical Translational Epidemiology Unit, Department of Medicine, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Rulla M Tamimi
- Department of Population Health Sciences, Weill Cornell Medical, New York, NY, USA
| |
Collapse
|
15
|
Bellizzi S, Murgia P, Panu Napodano CM, Nivoli A. Displacement and Sexual Exploitation of Girls: The Recurrent Case of the Democratic Republic of the Congo. J Pediatr Adolesc Gynecol 2024; 37:220-221. [PMID: 38320687 DOI: 10.1016/j.jpag.2024.01.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 02/27/2024]
Affiliation(s)
- Saverio Bellizzi
- Medical Epidemiologist, Independent Consultant, Geneva, Switzerland.
| | - Paola Murgia
- Intensive Unit Care, "SS Annunziata" Hospital, 07100 Sassari, Italy
| | | | - Alessandra Nivoli
- Psychiatric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| |
Collapse
|
16
|
Zablock K, Fei YF. Young Men's Attitudes and Understanding of Menstruation. J Adolesc Health 2024; 74:782-786. [PMID: 38069935 DOI: 10.1016/j.jadohealth.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 03/24/2024]
Abstract
PURPOSE To identify sources of information, perceptions, and potential misinformation about menstruation among college-aged men in the United States. METHODS This is a mixed-methods cross-sectional survey study of students in the United States. Inclusion criteria included participants aged 17-29 years, male gender identity, enrolled as an undergraduate or graduate student, and no personal history of menstruation. RESULTS This study included 70 participants. Almost half of all participants (42.9%) first learned about menstruation from family members. More than two-thirds of respondents felt that menstrual education was essential or very important for all genders. The most common symptoms noted to be associated with periods included cramping (93.6%), mood changes (80.9%), and vague "hormonal" changes (36.2%). When asked how a menstrual period might affect someone's ability to perform daily activities, one-third reported debilitating or very burdensome symptoms, whereas one-fifth felt periods do not have much impact. DISCUSSION Comprehensive education and accurate reproductive health knowledge are critical in combating gender bias and stigma. Most males surveyed agree that education on menstruation is important, yet the majority do not have or do not remember formal education on this topic, instead relying on family members and friends as learning tools and resources. Most participants identified negative symptoms associated with menstrual periods, especially mental health concerns including mood changes and irritability. This association with mood changes, as well as vague "hormonal fluctuations," contributes to the societal bias against people who menstruate by marking them as prone to emotional instability, thereby exacerbating gender prejudices. It is therefore critical that accurate menstrual education be widely available for everyone, regardless of gender.
Collapse
Affiliation(s)
- Kaitlyn Zablock
- Department of Women's and Gender Studies, University of Michigan, Ann Arbor, Michigan
| | - Y Frances Fei
- Section of Pediatric and Adolescent Gynecology, Nationwide Children's Hospital, Columbus, Ohio.
| |
Collapse
|
17
|
Olorunsaiye CZ, Brunner Huber LR, Degge HM, Yada FN, Yusuf KK. Assessing the Contraceptive Attitudes of US-Born and Foreign-Born Black Women Living in the USA: a Descriptive Cross-Sectional Study. J Racial Ethn Health Disparities 2024; 11:874-884. [PMID: 36952122 DOI: 10.1007/s40615-023-01569-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 03/07/2023] [Accepted: 03/13/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Racially and ethnically marginalized US women experience unintended pregnancy at twice the rate of White women. Understanding contraceptive attitudes can help identify women at increased risk of contraceptive non-use and unintended pregnancy. We assessed the contraceptive attitudes of US-born and foreign-born Black women and examined differences by nativity. METHODS We used an electronic survey, implemented by Lucid LLC, a consumer research firm, to collect cross-sectional data from 657 reproductive-aged women. Analysis was limited to 414 Black women aged 18-44 years. The exposure variable was nativity (US-born or foreign-born), and the outcome variable was cumulative score on the 32-item Contraceptive Attitude Scale (CAS). Analysis included multivariable linear regression, adjusted for confounders. We also estimated separate models, stratified by nativity to identify predictors of contraceptive attitude among US-born Black women and foreign-born Black women, respectively. RESULTS Three in four participants were US-born (76.6%). The average cumulative CAS score was 118.4 ±20.4 out of 160 indicating favorable contraceptive attitudes. In pooled analysis, foreign-born Black women had significantly lower contraceptive attitude scores compared to US-born women (adjusted regression coefficient (β)= -6.48, p=0.036). In nativity-stratified analysis, income, education, and perceived control over pregnancy timing were significant predictors of contraceptive attitudes for both US-born and foreign-born women. Other significant predictors of contraceptive attitude among US-born women were older maternal age, multi-parity, and perceived pregnancy risk; whereas, for foreign-born women, other significant predictors included marital status (married/cohabiting), language spoken predominantly at home (French), and perceived ability to have a baby and still achieve life goals (agree, neither agree nor disagree). CONCLUSION In addressing the contraceptive needs of Black women, it is important to recognize the differences in attitudes towards contraception by nativity and provide culturally sensitive information and education.
Collapse
Affiliation(s)
- Comfort Z Olorunsaiye
- Department of Public Health, Arcadia University, 450 S Easton Road, Glenside, PA, USA.
| | - Larissa R Brunner Huber
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Hannah M Degge
- Department of Health and Education, Coventry University, Scarborough, YO11 2JW, UK
| | - Farida N Yada
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Korede K Yusuf
- College of Nursing and Public Health, Adelphi University, Garden City, NY, USA
| |
Collapse
|
18
|
Powell RM. Reproductive justice for disabled people post-Dobbs: A call-to-action for researchers. Disabil Health J 2024; 17:101572. [PMID: 38071137 DOI: 10.1016/j.dhjo.2023.101572] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/20/2023] [Accepted: 12/02/2023] [Indexed: 04/09/2024]
Abstract
The recent Supreme Court ruling in Dobbs v. Jackson Women's Health Organization endangers reproductive freedom, particularly for marginalized communities, including disabled people. Disability and health equity researchers possess unique insights into the needs and experiences of disabled people, making our involvement crucial in response to the Dobbs decision. Accordingly, guided by disability justice and reproductive justice principles, researchers should undertake disability-inclusive studies on the consequences of abortion restrictions, advocate for policy changes that uphold the reproductive autonomy of disabled people, and collaborate with disability-led movements advocating for reproductive freedom. Indeed, it is imperative for researchers to actively promote the inclusion and self-determination of disabled people regarding their reproductive health and well-being. Given the escalating threats to reproductive freedom and their profound impact on disabled people, there has never been a more pivotal moment for disability and health equity researchers to join the fight for reproductive justice.
Collapse
Affiliation(s)
- Robyn M Powell
- University of Oklahoma College of Law, 300 Timberdell Road, Norman, OK 73019, USA; The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA 02453, USA.
| |
Collapse
|
19
|
Parsons JA, Romanis EC. "All hands on deck": a qualitative study of safeguarding and the transition to telemedical abortion care in England and Wales. Soc Sci Med 2024; 348:116835. [PMID: 38626482 DOI: 10.1016/j.socscimed.2024.116835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 03/12/2024] [Accepted: 03/25/2024] [Indexed: 04/18/2024]
Abstract
The COVID-19 pandemic raised significant challenges for in-person healthcare provision, leading healthcare providers to embrace digital health like never before. Whilst changes were made as part of a public health response, many have now become permanent fixtures of the healthcare landscape, significantly altering the way care is provided not only for patients, but also for the healthcare professionals that provide care. In abortion care in England and Wales, previously stringent regulations on in-person care provision were relaxed to permit the use of telemedicine and self-administration of medications at home. These changes have since been made permanent. However, there remains opposition to remote abortion care pathways on the basis of safeguarding. Opponents argue that it is not feasible to effectively safeguard patients accessing abortion care remotely. We conducted a qualitative study using semi-structured interviews with abortion care providers in England and Wales. Participants were asked about their views and experiences of the transition to remote care provision, with a particular focus on how they adapted their safeguarding practice. In this article, we present three themes that highlight the changing roles of healthcare professionals in abortion care: (1) a challenging backdrop and resulting apprehension, (2) adaptive practices, and (3) the continued importance of professional curiosity. Across all three themes, participants reflected significantly on how changes were made and what they experienced in the period of transition to telemedicine. In particular, they discussed the changing nature of their professional roles amidst digitalisation. Our findings provide a basis for reflection on the increasing introduction of digital approaches to healthcare provision, highlighting points for caution and emphasising the need to involve professionals in the transition process to ensure vital buy-in. Through this, we articulate two novel understandings of digitalisation: (1) the impact of speed-associated pressures on professional adaptation during digitalisation, and (2) off-proforma safeguarding through telemedicine as a form of invisible non-routine work.
Collapse
Affiliation(s)
- Jordan A Parsons
- Birmingham Medical School, University of Birmingham, Birmingham, B15 2TT, UK; Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK.
| | | |
Collapse
|
20
|
Brisson J, Ravitsky V, Williams-Jones B. A Mixed-Methods Study Exploring Colombian Adolescents' Access to Sexual and Reproductive Health Services: The Need for a Relational Autonomy Approach. J Bioeth Inq 2024:10.1007/s11673-024-10356-w. [PMID: 38532187 DOI: 10.1007/s11673-024-10356-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/10/2024] [Indexed: 03/28/2024]
Abstract
This study's objective was to understand Colombian adolescents' experiences and preferences regarding access to sexual and reproductive health services (SRHS), either alone or accompanied. A mixed-method approach was used, involving a survey of 812 participants aged eleven to twenty-four years old and forty-five semi-structured interviews with participants aged fourteen to twenty-three. Previous research shows that adolescents prefer privacy when accessing SRHS and often do not want their parents involved. Such findings align with the longstanding tendency to frame the ethical principle of autonomy as based on independence in decision-making. However, the present study shows that such a conceptualization and application of autonomy does not adequately explain Colombian adolescent participants' preferences regarding access to SRHS. Participants shared a variety of preferences to access SRHS, with the majority of participants attaching great importance to having their parents involved, to varying degrees. What emerges is a more complex and non-homogenous conceptualization of autonomy that is not inherently grounded in independence from parental involvement in access to care. We thus argue that when developing policies involving adolescents, policymakers and health professionals should adopt a nuanced "relational autonomy" approach to better respect the myriad of preferences that Colombian (and other) adolescents may have regarding their access to SRHS.
Collapse
Affiliation(s)
- J Brisson
- Department of Social & Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada.
| | - V Ravitsky
- Department of Social & Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
| | - B Williams-Jones
- Department of Social & Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
| |
Collapse
|
21
|
Martín-Manchado L, Prieto-Huecas L, Piera-Jordán CÁ, De la Cruz-Delgado VS, García-Velert MB, Tordera-Terrades C, Zaragoza-Martí A. [Influence of adherence to a mediterranean diet and nutritional status on ovarian reserve]. Rev Esp Salud Publica 2024; 98:e202403027. [PMID: 38525668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 02/14/2024] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVE Currently, esterility affects between 15% and 20% of couples of fertile age. Female reproductive success is mainly determined by age and ovarian reserve (OR). Recent studies highlight the influence of modifiable factors such as dietary habits and nutritional status on OR. In this regard, the Mediterranean Diet (MD) is postulated as a standard of healthy eating. Therefore, the objective of this paper was to analyze the influence of adherence to DM and nutritional status on the OR of infertile women. METHODS A descriptive cross-sectional study was carried out, lasting one year, between February 2022 and February 2023, in a sample of forty-five female patients who attended the Gynaecology-Esterility consultation at the Marina Salud Hospital in Denia (Spain) due to genital desire older than one year. An exploratory descriptive analysis based on univariate statistics was performed. RESULTS The mean age of the sample (n=45) was 31.84 (±3.99) years, with an average BMI of 26.27 (±6.08) kg/m2, with 44.4% (n=20) having excess body weight. The RO was measured based on AMH, with an average value of 2.32 (±1.59) ng/ml and RFA, with an average of 19.80 (±14.13) antral follicles. A statistically significant association was found between low adherence to DM and lower anti-Müllerian hormone (AMH; p=0.025) levels. In addition, an association was found between low consumption of vegetables (p=0.044), excessive consumption of red meat (p=0.027) and carbonated beverages (p=0.015) with insufficient AMH levels, indicative of low OR. Low fruit consumption was also found to be associated with low oestradiol levels (p=0.045). Statistically significant associations were also found reflecting the influence of nutritional status on OR. CONCLUSIONS One of the main factors conditioning the success of ART (assisted reproductive technology) is the woman's OR. The most widely used parameter to assess OR is AMH. Lifestyle and diet are modifiable factors that can influence OR. High adherence to DM and consumption of vegetables is associated with higher levels of AMH; however, high intake of red meat and carbonated beverages is associated with lower levels. Nutritional status, adherence to DM and dietary habits influence the status of OR, so it would be advisable to promote programmes to improve the population's diet in order to improve reproductive health.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Ana Zaragoza-Martí
- Departamento de Enfermería; Universidad de Alicante. Alicante. España
- Instituto de Investigación Sanitaria y Biomédica de Alicante (Fundación ISABIAL-FISABIO). Alicante. España
| |
Collapse
|
22
|
Jena SK, Dolui M, Ghoshal S, Sarkar S. Demographic and socio-economic correlates of knowledge of the ovulatory cycle among tribal women in India: Evidence from the nationally representative survey (NFHS-5). BMC Public Health 2024; 24:766. [PMID: 38475774 DOI: 10.1186/s12889-024-18296-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/06/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The knowledge of ovulatory cycle (KOC) is the basis for natural family planning methods. The absence of knowledge is a notable issue since the ovulatory cycle plays a crucial role in reproductive health and empowers women to make informed decisions that influence their lives. This study examines the knowledge of the ovulatory cycle among reproductive tribal women in India and its demographic and socio-economic determinants. METHODS The data were derived from the National Family Health Survey conducted in 2019-2021. The effective sample size for the present study was 1,01,914 tribal women aged 15-49 years in India. Descriptive statistics along with bivariate analysis were conducted to find the preliminary results. Additionally, multivariable binary logistic regressions were conducted to determine the likelihood of KOC among tribal women across different characteristics. We conducted statistical analysis in STATA 17.0 (StataCorp) and used ArcGIS 10.8.2 for spatial mapping. RESULTS Out of 1,01,914 tribal women, 78.8 per cent lack correct knowledge of the ovulatory cycle. Notably, Education level significantly influences KOC, with secondary education showing higher odds of KOC (AOR: 1.24, 95% CI:1.006-1.528) compared to no education. Christian women exhibit lower odds of having KOC (AOR: 0.749, 95% CI:0.564-0.996) compared to Hindu women. Husband/partner's education level shows a strong association, with higher-educated partners correlating with higher odds of KOC (AOR: 2.501, 95% CI: 1.807-3.461) for higher education. Knowledge of any contraceptive method and current contraceptive use type are strongly associated with KOC. Additionally, rural residence negatively influences KOC (AOR: 1.545, 95% CI: 1.236-1.932), while exposure to mass media has a positive effect (AOR: 1.152, 95% CI: 0.975-1.362) albeit modest. CONCLUSION The study highlights the need for targeted educational and awareness programs to improve KOC among tribal women in India. By addressing factors such as education, religious influences, and place of residence, we can empower these women to make informed decisions about their reproductive health, ultimately enhancing their overall well-being and quality of life. This knowledge is not only a foundation for natural family planning but also a key driver of women's agency and autonomy in shaping their lives.
Collapse
Affiliation(s)
- Sameer Kumar Jena
- Department of Population Studies, Fakir Mohan University, Balesore, Odisha, 756089, India
| | - Mriganka Dolui
- Department of Geography, Central University of Karnataka, Kalaburagi, Karnataka, 585311, India.
| | - Sucharita Ghoshal
- Department of Agriculture, Rural and Tribal Development, Ramakrishna Mission Vivekananda Educational and Research Institute, Morabadi, Ranchi, Jharkhand, 834008, India
| | - Sanjit Sarkar
- Department of Geography, Central University of Karnataka, Kalaburagi, Karnataka, 585311, India
| |
Collapse
|
23
|
Nguyen LT, Minh Giang L, Nguyen DB, Nguyen TT, Lin C. Unraveling reproductive and maternal health challenges of women living with HIV/AIDS in Vietnam: a qualitative study. Reprod Health 2024; 21:34. [PMID: 38468301 DOI: 10.1186/s12978-024-01768-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/04/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Human Immunodeficiency Virus (HIV) remains a significant public health concern worldwide. Women living with HIV/AIDS (WLHA) have the additional and unique need to seek sexual and reproductive health services. WLHA's maternal health journeys can be shaped by the cultural norms and resources that exist in their society. This study sought to understand if and how WLHA's family planning, pregnancy, and motherhood experiences could be influenced by the patriarchal culture, gender roles, and HIV stigma in Vietnam, specifically. METHODS Between December 2021 and March 2022, 30 WLHA with diverse socioeconomic backgrounds and childbirth experiences were interviewed in Hanoi, Vietnam. These semi-structured interviews covered topics including HIV stigma, gender norms, pregnancy experiences, and child-rearing challenges. Interviews were audio recorded, transcribed, and analysed using ATLAS.ti. RESULTS Qualitative analyses of participant quotes revealed how limited information on one's health prospects and reproductive options posed a significant challenge to family planning. Societal and familial expectations as well as economic circumstances also influenced reproductive decision-making. WLHA often encountered substandard healthcare during pregnancy, labor, and delivery. Stigma and lack of provider attentiveness resulted in cases where women were denied pain relief and other medical services. Communication breakdowns resulted in failure to administer antiretroviral therapy for newborns. Motherhood for WLHA was shadowed by concerns for not only their own health, but also the wellbeing of their children, as HIV stigma affected their children at school and in society as well. Many WLHA highlighted the constructive or destructive role that family members could play in their childbirth decision-making and care-giving experiences. CONCLUSIONS Overall, this study underscores the complex ways that cultural expectations, family support, and stigma in healthcare impact WLHA. Efforts to educate and engage families and healthcare providers are warranted to better understand and address the needs of WLHA, ultimately improving their reproductive and maternal health.
Collapse
Affiliation(s)
- Lynn T Nguyen
- David Geffen School of Medicine, University of California, Los Angeles, 855 Tiverton Dr, Los Angeles, CA, USA
| | - Le Minh Giang
- Center for Training and Research On Substance Use and HIV, Hanoi Medical University, Room 211B, Building E3, No.1, Ton That Tung Street, Hanoi, Vietnam
| | - Diep B Nguyen
- Center for Training and Research On Substance Use and HIV, Hanoi Medical University, Room 211B, Building E3, No.1, Ton That Tung Street, Hanoi, Vietnam
| | - Trang T Nguyen
- Center for Training and Research On Substance Use and HIV, Hanoi Medical University, Room 211B, Building E3, No.1, Ton That Tung Street, Hanoi, Vietnam
| | - Chunqing Lin
- David Geffen School of Medicine, University of California, Los Angeles, 855 Tiverton Dr, Los Angeles, CA, USA.
- , 760 Westwood Plaza, 17-369E, Los Angeles, CA, 90024, USA.
| |
Collapse
|
24
|
Elsayed R, Zembe-Mkabile W. Women's access to sexual and reproductive health services and information in Ismailia, Egypt. BMC Womens Health 2024; 24:163. [PMID: 38448850 PMCID: PMC10918981 DOI: 10.1186/s12905-024-02986-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 02/19/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Sexual and reproductive health (SRH) is a right that should be guaranteed to every woman worldwide in order to have a healthy and safe sex life. In most Arab countries, including Egypt, there are different cultural, political, and religious factors that have contributed significantly to how society views and treats women's bodies and sexuality. As a result, it is difficult to provide solid data and information to guide policymakers, policies, and to implement awareness and preventive programmes. This study sought to address this gap by looking at the intersectionality of women's access to SRH services and information in Ismailia, Egypt. METHODS The study utilised qualitative research methods. Semi-structured interviews were conducted with twelve married women and two key informant interviews with health professionals (a gynecologist and a pharmacist) in the study area. RESULTS The study revealed that married women suffer from scarcity of understanding and knowledge of their SRH and lack of access to adequate SRH services and information. Married women's experiences of accessing SRH services and information were influenced by intersecting factors located at the micro and macro levels. These intersected factors (e.g., power dynamics, socioeconomic factors, cultural norms, and religious misconception) shaped oppression and privilege structures which created unequal access to SRH information and services. CONCLUSION There is a need for building quality parental relationships for women before and after marriage in order to promote positive SRH attitudes and behavior. There is an urgent need to empower women before and after marriage with accurate, safe, and affordable SRH services and information that could have life-long benefits to protect them. There is a need to conduct educational programmes, and initiate media awareness campaigns, to equip women with information and knowledge about their SRH services and information.
Collapse
Affiliation(s)
- Reem Elsayed
- Researcher and Technical Officer, Egypt Healthcare Authority, 7th Al Nasr Road, Elforsan Building, Nasr City, Cairo, Egypt.
| | - Wanga Zembe-Mkabile
- Senior Specialist Scientist, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| |
Collapse
|
25
|
Afferri A, Dierickx S, Allen H, Bittaye M, Marena M, Pacey A, Balen J. 'It's about time': policymakers' and health practitioners' perspectives on implementing fertility care in the Gambian health system. BMC Health Serv Res 2024; 24:282. [PMID: 38443896 PMCID: PMC10916196 DOI: 10.1186/s12913-024-10701-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/09/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Infertility is a major health issue worldwide, yet very few examples of interventions addressing infertility in the Global South have been documented to date. In The Gambia, West Africa, infertility is recognised as a burden and the health authorities have included it in several health policies and the new National Reproductive Health Strategy however, a detailed operationalisation plan for fertility care has not yet been established. Here, we aim to understand and document the factors that influence the implementation of fertility care in The Gambia. METHODS We conducted 46 semi-structured interviews with policymakers, implementers, and health practitioners in both the public and private sectors from July to November 2021. The interviews were transcribed, anonymised and analysed with NVivo Pro version 1.6.1. The analysis was initially inductive, with themes arising from the coding categorised according to the WHO health systems building blocks framework. RESULTS This study identified several barriers to a successful implementation of fertility care in The Gambia, including (i) a lack of routinely collected infertility data; (ii) an absence of financial protection mechanisms for patients, and/or a specific budget for infertility; (iii) limited cooperation between the public and private sectors in the provision of fertility care; and (iv) gaps in fertility care training among health practitioners. Conversely, enablers included: (i) strong national infertility leadership; and (ii) the integration of infertility care within public reproductive health services. CONCLUSION The Gambian health system is not yet in the position to support a comprehensive fertility care package in its public health facilities. Several aspects of the implementation of fertility care must be considered in operationalising the health strategy including the systematic collection of infertility data, fertility awareness, and the provision of specialised fertility care training. Furthermore, a stronger partnership between the public and private sectors must be developed. Given the increasing availability of assisted reproductive technologies in the sub-Saharan Africa region, and the tendency to locate these technologies in the private sector, further research is needed to understand and identify the processes underlying the implementation of fertility care and to foster better integration with the existing health system.
Collapse
Affiliation(s)
- Anna Afferri
- School of Health and Related Research- ScHARR, The University of Sheffield, Sheffield, UK.
| | - Susan Dierickx
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Research Centre Gender, Diversity and Intersectionality - RHEA, Vrije Universiteit, Brussel, Belgium
| | - Haddijatou Allen
- Medical Research Council- MRC Unit The Gambia at LSHTM, Fajara, The Gambia
| | - Mustapha Bittaye
- The Gambia Ministry of Health, Banjul, The Gambia
- School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia
| | - Musa Marena
- The Gambia Ministry of Health, Banjul, The Gambia
- School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia
| | - Allan Pacey
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Julie Balen
- Medical Research Council- MRC Unit The Gambia at LSHTM, Fajara, The Gambia
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, UK
| |
Collapse
|
26
|
Xu Y, Chen W, Wu X, Zhao K, Liu C, Zhang H. The Role of Cells and Cytokines in Male Infertility Induced by Orchitis. World J Mens Health 2024:42.e31. [PMID: 38449458 DOI: 10.5534/wjmh.230270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/05/2023] [Accepted: 11/19/2023] [Indexed: 03/08/2024] Open
Abstract
Recent studies on male infertility reveal a growing worry: more infertile men are dealing with inflammation in the testis. Analyzing testicular biopsies from infertile men highlights a significant presence of inflammation. This connection, supported by clinical and pathological evidence, emphasizes that testicular inflammation hampers sperm production, leading to lasting declines in sperm count and quality. However, the exact reasons behind male infertility due to orchitis, a type of testicular inflammation, are still uncertain. Understanding these fundamental aspects of molecular signals and cellular mechanisms in testicular inflammation is crucial. Our review delves into recent literature with a dual objective: elucidating potential mechanisms involving immune cells, non-immune cells, and cytokines that link orchitis to male infertility, while also paving the way for precise interventions and solutions to address the challenges of male infertility.
Collapse
Affiliation(s)
- Ying Xu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wanyi Chen
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyu Wu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Zhao
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunyan Liu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Huiping Zhang
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| |
Collapse
|
27
|
Natsuhara KH, Chien AJ. Impact of Systemic Therapy on Fertility in Women with Early-Stage Breast Cancer. Curr Breast Cancer Rep 2024; 16:61-68. [PMID: 38645685 PMCID: PMC11029440 DOI: 10.1007/s12609-023-00516-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 04/23/2024]
Abstract
Purpose of Review Fertility concerns are common among young women diagnosed with breast cancer, as systemic therapy increases the risk of premature ovarian insufficiency and delays family planning. Here, we review the impact of systemic therapies, including chemotherapy, endocrine therapy, HER-2 directed therapy, PARP inhibitors, and immunotherapy, on ovarian reserve. Recent Findings With an improved understanding of disease biology, fewer women are treated with gonadotoxic chemotherapy. There are limited data on the fertility impact of novel targeted treatments and immunotherapy, though preclinical and preliminary studies suggest an impact on fertility is possible. Notably, a recent study investigated the outcomes in women who interrupted adjuvant endocrine therapy to attempt pregnancy. Summary Further research is needed to characterize the fertility impact of novel therapies in breast cancer. Individualized fertility counseling should be offered to all women to discuss the possible impact of therapy on ovarian reserve and options for fertility preservation and timing of pregnancy.
Collapse
Affiliation(s)
- Kelsey H. Natsuhara
- Division of Hematology & Oncology, Department of Medicine, University of California San Francisco, 1825 4th St, San Francisco, CA 94158, USA
| | - A. Jo Chien
- Division of Hematology & Oncology, Department of Medicine, University of California San Francisco, 1825 4th St, San Francisco, CA 94158, USA
| |
Collapse
|
28
|
O'Brien KE, Rosen MW, Ernst SD. Obstetric and Gynecologic Care for Individuals with Disabilities. Obstet Gynecol Clin North Am 2024; 51:43-56. [PMID: 38267130 DOI: 10.1016/j.ogc.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
This article explores the inequities experienced by individuals with disabilities when accessing obstetric and gynecologic care. The unique needs, abilities, and barriers to care are reviewed, as well as recommendations for provision of care to people with disabilities.
Collapse
Affiliation(s)
- Kathleen E O'Brien
- Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48104, USA.
| | - Monica Woll Rosen
- Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48104, USA
| | - Susan Dwyer Ernst
- Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48104, USA
| |
Collapse
|
29
|
Suratana S, Boonchiang W, Apidechkul T, Naksen W, Mulikaburt T, Chomsri P, Matrakul M. A Community-Based Reproductive Health Care Model Effectively Enhances Reproductive Health Among Lahu Women in Northern Thailand. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01959-5. [PMID: 38421508 DOI: 10.1007/s40615-024-01959-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/04/2024] [Accepted: 02/21/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Inadequate and delayed access to sexual and reproductive health services among the Hill Tribe population can be attributed to the intersection of socioeconomic challenges and distinct cultural practices. To address this limitation and create a tailored model capable of addressing it, this study assesses the effectiveness of the Community-Based Reproductive Health Care Model (CRHC) in enhancing reproductive health knowledge, attitudes, and practices among Lahu women, a prominent hill tribe population in Northern Thailand. METHODS Implementing the CRHC model includes training programs for community influencers and subsequent education for Lahu women using culturally adapted courses. The effectiveness of the model is assessed through pre-test and post-test comparisons of knowledge, attitudes, and practices related to reproductive health care and analyzed using paired t-tests and repeated ANOVA. RESULTS The scores for knowledge, attitudes, and practices among Lahu women changed from 8.92 ± 2.02, 52.99 ± 5.54, and 27.76 ± 6.67 to 10.47 ± 2.32 (p < 0.001), 56.61 ± 5.54 (p < 0.001), and 29.47 ± 6.76 (p = 0.030), respectively. Significant improvements are observed in these areas, particularly in maternal health practices among pregnant Lahu women (n = 11). This study additionally evaluates the model's impact on the healthcare system by analyzing changes in government performance indexes, showing increased access to high-quality antenatal care and contraceptive usage. This study highlights the challenges faced by hill tribe populations in accessing healthcare, emphasizing the need for tailored reproductive health education and the importance of addressing health insurance barriers. CONCLUSION The CRHC model's success illustrates the potential of community-based, culturally sensitive interventions in improving reproductive health outcomes, providing valuable insights for similar interventions in other indigenous or marginalized communities.
Collapse
Affiliation(s)
- Soontaree Suratana
- Faculty of Public Health, Chiang Mai University, 239 Huay Kaew Road, Muang District, Chiang Mai, 52000, Thailand
- School of Health Science, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| | - Waraporn Boonchiang
- Faculty of Public Health, Chiang Mai University, 239 Huay Kaew Road, Muang District, Chiang Mai, 52000, Thailand.
| | - Tawatchai Apidechkul
- School of Health Science, Mae Fah Luang University, Chiang Rai, 57100, Thailand
- Center of Excellence for Hill-Tribe Health Research, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| | - Warangkana Naksen
- Faculty of Public Health, Chiang Mai University, 239 Huay Kaew Road, Muang District, Chiang Mai, 52000, Thailand
| | | | - Pimpisa Chomsri
- School of Nursing, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| | - Mullika Matrakul
- School of Nursing, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| |
Collapse
|
30
|
Negri F, Boeri L, Cilio S, Pozzi E, Belladelli F, Corsini C, Raffo M, Fallara G, Ventimiglia E, Candela L, d'Arma A, Montorsi F, Salonia A. The Importance of Discordant Follicle Stimulating Hormone and Inhibin B Levels in Primary Infertile Men: Findings from a Cross-Sectional Study. World J Mens Health 2024:42.e28. [PMID: 38449455 DOI: 10.5534/wjmh.230298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/01/2023] [Accepted: 12/07/2023] [Indexed: 03/08/2024] Open
Abstract
PURPOSE We aimed to investigate the relationship between follicle stimulating hormone (FSH) and inhibin B (InhB). MATERIALS AND METHODS Data from 1,230 consecutive men presenting for primary couple's infertility were analyzed. Health-significant comorbidities were scored with Charlson comorbidity index. Quartiles of FSH and InhB were considered to determine threshold values. Descriptive statistics and logistic regression models tested association between FSH and InhB values. RESULTS Overall, 1,080 (87.8%) men had concordant FSH and InhB values. Conversely, 150 patients (12.2%) had discrepancies in FSH and InhB, with 78 (6.3%) and 72 (5.9%) men reporting both low and high FSH and InhB values, respectively. Infertile men with discordant values were younger (median [interquartile range] 38.0 years [34-41 years] vs. 36.0 years [31-40 years]); had smaller testicular volume (TV) (12 mL [10-15 mL] vs. 15 mL [12-20 mL]); and, had more frequently a sperm DNA fragmentation test >30% (179 [59.1%] vs. 40 [78.4%]) than those with concordant values (all p<0.05). Moreover, a higher frequency of previous cryptorchidism (27.3% vs. 11.9%), lower sperm concentration (3.0 million/mL [0.9-11.0 million/mL] vs. 13.8 million/mL [3.1-36.0 million/mL]), lower progressive sperm motility rates (12.0% [5.0%-25.3%] vs. 20.0% [7.0%-36.0%]), and greater rates of non-obstructive azoospermia (36.4% vs. 23.9%) were found in men with discordant FSH and InhB values (all p≤0.005). At multivariable logistic regression analysis, higher body mass index (odds ratio [OR], 1.08; p=0.001), smaller TV (OR, 0.91; p<0.001), and a history of cryptorchidism (OR, 2.49; p<0.001) were associated with discordant FSH and InhB values. CONCLUSIONS More than one out of ten infertile men had discordant FSH and InhB values in the real-life setting showing worse clinical profiles than those with concordant levels. Smaller TV and history of cryptorchidism could be used as clinical markers to better tailor the need to test InhB.
Collapse
Affiliation(s)
- Fausto Negri
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Experimental Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Luca Boeri
- Department of Urology, Foundation IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Simone Cilio
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples 'Federico II', Naples, Italy
| | - Edoardo Pozzi
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Experimental Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Federico Belladelli
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Experimental Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Christian Corsini
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Experimental Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Massimiliano Raffo
- Division of Experimental Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Giuseppe Fallara
- Division of Experimental Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Eugenio Ventimiglia
- Division of Experimental Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Luigi Candela
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Experimental Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Alessia d'Arma
- Division of Experimental Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Experimental Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Salonia
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Experimental Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy.
| |
Collapse
|
31
|
Toljan K, Briggs FBS. Male sexual and reproductive health in multiple sclerosis: a scoping review. J Neurol 2024:10.1007/s00415-024-12250-2. [PMID: 38416171 DOI: 10.1007/s00415-024-12250-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic neuroinflammatory disease with highest incidence during the period of optimal reproductive health. This scoping review aimed to identify and summarize available data on sexual/reproductive health in males with MS (MwMS). METHODS This review was based on PRISMA extension for Scoping Review. PubMed database was searched for keyword "multiple sclerosis" alongside keywords "sexual health", "reproductive health", "family planning", "male fertility", "male infertility", "sexual dysfunction", and "erectile dysfunction", iteratively using the "AND" logical operator. Descriptive analysis was performed on the included articles. RESULTS Thirty-four studies were included, and four topics emerged: sexual dysfunction, erectile dysfunction, fertility, and family planning. Sexual dysfunction is common in MwMS (35-72%), yet only a minority of MwMS discuss their sexual health with their treatment teams. Both MS disability and depression were associated with sexual dysfunction in MwMS, with erectile dysfunction and decreased libido as the most prevalent aspects of sexual dysfunction. Positively, phosphodiesterase-5 inhibitors appear effective for treating erectile dysfunction and improving sexual quality of life in MwMS. There may also be a relationship between MS and male infertility, though changes in sexual behavior may underlie this association. Finally, a prominent knowledge gap was observed for disease-modifying therapy use and family planning in MwMS. CONCLUSION Sexual dysfunction is common, impacted by MS severity, and associates with decreased quality of life in MwMS. Communication barriers regarding sexual and reproductive health appear to exist between MwMS and providers, as do literature gaps related to MS therapeutics and sexual/reproductive health.
Collapse
Affiliation(s)
- Karlo Toljan
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
| | - Farren B S Briggs
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| |
Collapse
|
32
|
Singh P, Singh KK. Trends, patterns and predictors of high-risk fertility behaviour among Indian women: evidence from National Family Health Survey. BMC Public Health 2024; 24:626. [PMID: 38413929 PMCID: PMC10900591 DOI: 10.1186/s12889-024-18046-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 02/08/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Numerous studies have demonstrated that high-risk fertility behaviour (HRFB), which includes maternal age below 18 or above 34 years, short birth intervals (less than 24 months), and high parity (birth order above 4), is associated with adverse maternal and child health outcomes. There is a substantial research gap in the domain of high-risk fertility behaviour in the Indian context. Therefore, this study is designed to investigate the current trends and patterns in the prevalence of high-risk births among Indian women, with a primary focus on identifying contributing factors associated with this prevalence. METHODS The study utilized data from the nationally representative National Family Health Survey (NFHS), which has been conducted in five rounds since 1992-93. Data from all rounds were used to assess the overall trend. However, data from the most recent round of NFHS, conducted during 2019-21, were employed to evaluate current levels and patterns of HRFB prevalence and to identify socio-economic and demographic predictors of HRFB using binomial and multinomial logistic regression models. RESULTS The prevalence of HRFB has exhibited a consistent decreasing pattern from 1992 to 93 to 2019-21 in India. However, 29.56% of married women continue to experience high-risk births with notably higher rates in several states (e.g., 49.85% in Meghalaya and 46.41% in Bihar). Furthermore, socio-demographic factors like wealth index, educational level, social group, religion, mass media exposure, family size, age at marriage, type and region of residence, and reproductive factors like birth intention, place and type of delivery, ANC visits and current contraceptive use were identified as significant predictors of high-risk births among women in India. CONCLUSION Despite a 20.4 percentage point decline in HRFB prevalence over the past three decades, a significant proportion of women in specific regions and demographic subgroups continue to experience high-risk births. Therefore, the present study recommends interventions aimed at preventing high-risk births among women in India, with particular emphasis on states with high HRFB prevalence and women from socioeconomically disadvantaged backgrounds.
Collapse
Affiliation(s)
- Pooja Singh
- Department of Statistics, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
| | - Kaushalendra Kumar Singh
- Department of Statistics, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| |
Collapse
|
33
|
Osborne A, Bangura C. Proximal factors influencing the likelihood of married and cohabiting women in Sierra Leone to use contraceptives. A cross-sectional study. Contracept Reprod Med 2024; 9:7. [PMID: 38414059 PMCID: PMC10898058 DOI: 10.1186/s40834-024-00269-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 02/18/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND In the tapestry of reproductive health in Sierra Leone, where maternal mortality remains a poignant thread, understanding contraceptive use intentions among married and cohabiting women emerges as a vital motive. This study examines the intention to use contraceptives among married and cohabiting women in Sierra Leone. METHODS The study analysed the 2019 Sierra Leone Demographic and Health Survey data. A total of 7846 married and cohabiting women comprised the study. A multivariable binary regression analysis was used to examine the predictors of intention to use contraceptives. The regression results were presented using an adjusted odds ratio (AOR) with 95% confidence intervals (CI). RESULTS The proportion of intention to use contraceptives among married and cohabiting women was 47% in Sierra Leone. Married and cohabiting women living in the eastern region (AOR = 1.65, 95% CI = 1.18, 2.30), southern region (AOR = 1.45, 95% CI = 1.04, 2.01), secondary education (AOR = 1.42, 95% CI = 1.00, 2.01), listen to the radio at least once a week (AOR = 1.30, 95% CI = 1.08, 1.55), and four or more births (AOR = 2.97, 95% CI = 2.23, 3.96) had higher odds of being associated with intention to use contraceptives. The propensity to utilise contraceptives among married and cohabiting women in Sierra Leone declined as their age increased, especially women aged 45-49 (AOR = 0.07, 95% CI = 0.04, 0.11) who had the least intention of using contraceptives. Married women (AOR = 0.53, 95% CI = 0.39, 0.72) and women who read magazines or newspapers at least once a week(AOR = 0.61, 95% CI = 0.36, 1.o4) had lower odds of contraceptive use intention. CONCLUSION The findings of this study indicate that there is a moderate yet encouraging intention to use contraception among married and cohabiting women in Sierra Leone. Factors like residing in the eastern and southern regions, having secondary education, having more children and regular radio listening are associated with higher contraceptive use intentions. Older women, especially those nearing the end of their childbearing years, have the lowest intention. Married women and regular magazine or newspaper readers were less likely to intend to use contraceptives. These findings call for targeted interventions focusing on rural areas, women with lower education, and older women.
Collapse
Affiliation(s)
- Augustus Osborne
- Department of Biological Sciences, School of Basic Sciences, Njala University, PMB, Freetown, Sierra Leone.
| | - Camilla Bangura
- Department of Biological Sciences, School of Basic Sciences, Njala University, PMB, Freetown, Sierra Leone
| |
Collapse
|
34
|
Ntinga X, Isehunwa OO, Msimango LI, Smith PM, Matthews LT, Van Heerden A. Perceptions of Pre-exposure Prophylaxis (PrEP) for HIV prevention among men living with HIV in the context of reproductive goals in South Africa: a qualitative study. BMC Public Health 2024; 24:553. [PMID: 38389039 PMCID: PMC10882859 DOI: 10.1186/s12889-024-18118-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/15/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Pre-exposure Prophylaxis (PrEP) and Treatment as Prevention (TasP) are effective strategies to prevent HIV transmission within serodifferent couples. However, limited usage of PrEP, knowledge and interest has been amongst the barriers for men, alongside testing and treatment adherence. We explored the perceptions of PreP for HIV prevention with Men living with HIV (MWH) who have reproductive goals, to understand awareness and experiences related to PrEP use in the context of HIV prevention with their partners. METHODS We undertook a qualitative study with 25 MWH aged 18 to 65 between April and September 2021 in South Africa. Potential participants were screened for eligibility and scheduled to participate in telephonic interviews. Interviews were audio recorded, transcribed, translated and thematically analysed. RESULTS Themes were organized into opportunities and barriers that men with HIV articulate as important for using PrEP to meet individual, couple, and community reproductive goals. At the individual level, some men were willing to discuss PrEP with their partners to protect their partners and babies from acquiring HIV. Lack of knowledge about PrEP among men was a potential barrier to promoting PrEP among their female partners. At the couple level, PrEP use was seen as a way to strengthen relationships between partners, signifying care, trust, and protection and was seen as a tool to help serodifferent couples meet their reproductive goals safely. At the community level, PrEP was viewed as a tool to promote HIV testing and prevention efforts, especially among men, but participants emphasized the need for more education and awareness. CONCLUSION Despite PrEP implementation in South Africa, awareness of PrEP among men with HIV in rural areas remains low. Engaging MWH to support their partners in accessing PrEP could be an innovative strategy to promote HIV prevention. Additionally, providing men with comprehensive reproductive health information can empower them to make more informed decisions, adopt safer sexual practices, and challenge societal norms and stigmas around HIV.
Collapse
Affiliation(s)
- Xolani Ntinga
- Centre for Community Based Research, Human Sciences Research Council, Old Bus Depot, Sweetwaters, Pietermaritzburg, 3201, South Africa.
| | - Oluwaseyi O Isehunwa
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lindani I Msimango
- Centre for Community Based Research, Human Sciences Research Council, Old Bus Depot, Sweetwaters, Pietermaritzburg, 3201, South Africa
| | - Patricia M Smith
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lynn T Matthews
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Alastair Van Heerden
- Centre for Community Based Research, Human Sciences Research Council, Old Bus Depot, Sweetwaters, Pietermaritzburg, 3201, South Africa
- SAMRC/WITS Developmental Pathways for Health Research Unit, Department of Pediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| |
Collapse
|
35
|
Sikaluzwe M, Phiri M, Lemba M, Shasha L, Muhanga M. Trends in prevalence and factors associated with unintended pregnancies in Zambia (2001-2018). BMC Pregnancy Childbirth 2024; 24:148. [PMID: 38383354 PMCID: PMC10880343 DOI: 10.1186/s12884-024-06311-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/01/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Unintended pregnancies can pose significant public health concerns for both maternal and child health because of their associated risks and implications. Experience of unintended pregnancies may lead to delay in seeking antenatal care, thus leading to increased risk of complications during pregnancy and childbirth. Globally, the prevalence of unintended pregnancies has declined. However, the problem remains acute in sub-Saharan Africa. This study was conducted to examine the factors associated with an experience of unintended pregnancy among women of reproductive ages in Zambia. METHODS This study used secondary data from the Zambia Demographic and Health Surveys (ZDHSs) which were conducted between 2001 and 2018. A pooled weighted sample of 4,090 pregnant women of reproductive age 15-49 years at the time of the survey was included in the analysis. Multivariable binary logistic regression model was employed to examine the association between independent correlates and experience of unintended pregnancy. All statistical analyses were conducted using Stata software. RESULTS Findings show that the proportion of women of reproductive age who experienced unintended pregnancy in Zambia declined from 50.4% (95% CI: 47.1, 53.8) in 2001 to 45.2% (95% CI: 40.5, 49.9) in 2018. The decline in the prevalence of unintended pregnancy is more pronounced among women age groups 25-29 years and 30-34 years. Increasing age was associated with an increased risk of experiencing unintended pregnancies. On the other hand, women who were living in rural areas (aOR = 0.76; 95% CI: 0.58, 1.00) and those with tertiary education (aOR = 0.46; 95% CI: 0.26, 0.80) were less likely to experience an unintended pregnancy. Women who desired a large family (aOR = 0.45; 95% CI: 0.24, 0.85) and those who watched television (aOR = 0.75; 95% CI: 0.59, 0.94) had lower odds of experiencing unintended pregnancies. CONCLUSIONS The study has established that the prevalence of unintended pregnancy is still high in Zambia. Women's age, place of residence, level of education, desired family size and exposure to media were associated with the risk of experiencing an unintended pregnancy. Enhancing access to family planning services and commodities targeting women with low education levels will be key to further reduce unintended pregnancies.
Collapse
Affiliation(s)
- Milika Sikaluzwe
- Department of Demography, Population Sciences, Monitoring and Evaluation, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
| | - Million Phiri
- Department of Demography, Population Sciences, Monitoring and Evaluation, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Musonda Lemba
- Department of Demography, Population Sciences, Monitoring and Evaluation, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Liness Shasha
- Department of Demography, Population Sciences, Monitoring and Evaluation, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Mikidadi Muhanga
- Department of the Development and Strategic Studies, College of Social Sciences and Humanities, Sokoine University of Agriculture, Morogoro, Tanzania
| |
Collapse
|
36
|
Bapolisi WA, Makelele J, Ferrari G, Kono-Tange L, Bisimwa G, Schindler C, Merten S. Engaging men in women's empowerment: impact of a complex gender transformative intervention on household socio-economic and health outcomes in the eastern democratic republic of the Congo using a longitudinal survey. BMC Public Health 2024; 24:443. [PMID: 38347559 PMCID: PMC10863082 DOI: 10.1186/s12889-024-17717-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND In the Democratic Republic of the Congo, women in (peri-)urban areas are commonly engaged in small trade, which allows them to meet the basic needs of their families. Microsaving approaches are a low-risk option to obtain financing for economic activities. A project combining men's sensitization on gender equity and women's empowerment through village savings and loan associations were implemented in North and South Kivu to raise the household economic level. OBJECTIVE This study assessed how involving men in gender equity affects women's health and socio-economic outcomes, including food security. METHODS A cohort study was conducted with 1812 women at the baseline; out of them 1055 were retrieved at the follow-up. Baseline data collection took place from May to December 2017 and the follow-up from July 2018 to January 2019. To identify socio-economic changes and changes of gender relations, linear and logistic regressions were run. RESULTS Results showed that the household income improved with intervention (coefficient = 0.327; p = 0.002), while the capacity to pay high bills without contracting debts decreased (coefficient = 0.927; p = 0.001). We did not find enough statistically significant evidence of the influence of the intervention on skilled birth attendance (coefficient = 0.943; p = 0.135), or family planning use (coefficient = 0.216; p = 0.435) nor women's participation in the decision-making (coefficient = 0.033; p = 0.227) nor on couple's cohesion (coefficient = 0.024; p = 0.431). Food insecurity levels decreased over time regardless of being in the intervention or control area. CONCLUSION Empowering women while sensitizing men on gender aspects improves financial well-being (income). Time, security, and strong politics of government recognizing and framing the approach are still needed to maximize the benefit of such projects on social factors such as women's participation in decision-making and social cohesion.
Collapse
Affiliation(s)
- Wyvine Ansima Bapolisi
- Université Catholique de Bukavu, Democratic Republic of the Congo, Bukavu, Sud-Kivu, Democratic Republic of the Congo.
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Jean Makelele
- CARE International, Goma, Democratic Republic of the Congo
| | - Giovanfrancesco Ferrari
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Ghislain Bisimwa
- Université Catholique de Bukavu, Democratic Republic of the Congo, Bukavu, Sud-Kivu, Democratic Republic of the Congo
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sonja Merten
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| |
Collapse
|
37
|
Asrat D, Copas A, Olubukola A. Exploring the association between unintended pregnancies and unmet contraceptive needs among Ugandan women of reproductive age: an analysis of the 2016 Uganda demographic and health survey. BMC Pregnancy Childbirth 2024; 24:117. [PMID: 38326780 PMCID: PMC10851597 DOI: 10.1186/s12884-023-06222-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 12/21/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Unintended pregnancy and unmet contraceptive needs pose significant public health challenges, particularly in developing nations, where they contribute to maternal health risks. While previous research has explored determinants of unintended pregnancies, there remains a gap in understanding the association between unplanned pregnancies and unmet contraceptive needs among Ugandan women of reproductive age. This study aimed to assess unmet contraceptive needs and their correlation with unintended pregnancies and other factors in Uganda, utilizing a nationally representative sample. METHODS Data was extracted from the 2016 Uganda Demographic Health Survey (UDHS), a cross-sectional survey conducted in the latter half of 2016. The study encompassed 18,506 women aged 15-49 with a history of at least one prior pregnancy. The primary outcome variable was the planning status of the most recent pregnancy, while the principal independent variable was unmet contraceptive need. Additional variables were controlled in the analysis. Data analysis was performed using STATA version 17, involving descriptive analysis, cross-tabulation, chi-square testing, and logistic regression. Statistical significance was set at p < 0.05. RESULTS A substantial proportion of women reported unintended pregnancies (44.5%), with approximately 21.09% experiencing an unmet need for contraception. In the adjusted model, women with unmet contraceptive needs had 3.97 times higher odds of unintended pregnancy (95% CI = 3.61-4.37) compared to those with met contraceptive needs. Significant factors linked to unintended pregnancies included women's age, place of residence, household wealth status, decision-making authority regarding contraceptive use, educational attainment, husband's occupation, and educational level. CONCLUSION This study revealed that both the rate of unintended pregnancies and unmet contraceptive needs in Uganda exceeded the global average, warranting urgent policy attention. Addressing unmet contraceptive needs emerges as a potential strategy to curtail unintended pregnancies. Further qualitative research may be necessary to elucidate the sociocultural and behavioral determinants of unwanted pregnancies, facilitating context-specific interventions.
Collapse
Affiliation(s)
- Daniel Asrat
- University College of London, London, UK.
- Institute for Life and Earth Sciences Including Health and Agriculture (PAULESI), Pan African University, Oyo, Nigeria.
| | - Andrew Copas
- Institute for Global Health, Faculty of Pop Health Sciences, University College of London, London, UK
| | - Adesina Olubukola
- Department of Obstetrics & Gynaecology College of Medicine and Pan African University Institute for Life and Earth Sciences Including Health and Agriculture (PAULESI), University of Ibadan, Oyo, Nigeria
| |
Collapse
|
38
|
Obach A, Blukacz A, Sadler M, Carreño Calderón A, Cabieses B, Díaz C. Barriers and facilitators to access sexual and reproductive health services among young migrants in Tarapacá, Chile: a qualitative study. BMC Public Health 2024; 24:386. [PMID: 38317103 PMCID: PMC10845769 DOI: 10.1186/s12889-024-17884-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Chile has become a destination country for immigrants from Latin America, including youth. Guaranteeing access and use of sexual and reproductive health services for young migrants is crucial because of their overlapping experiences of transitioning to a new country and to adulthood. However, the existing evidence shows barriers to accessing sexual and reproductive healthcare among young migrant populations. In this context, the main objective of this article is to identify the barriers and facilitators that young migrants experience to access sexual and reproductive healthcare in the Tarapacá region of Chile. METHODS A qualitative study was conducted in the Tarapacá region of Chile. Semi-structured interviews with 25 young migrants from Venezuela, Colombia, and Ecuador, as well as 10 health workers, were carried out. The interviews were transcribed and thematically analysed. The study was approved by the Ethics Committee of the Universidad del Desarrollo (#2019-22). RESULTS Young migrants face barriers linked to structural shortcomings within the healthcare system, which may be similar to those faced by the local population. Barriers are also derived from reductionist sexual and reproductive health approaches, which prioritise the prevention of pregnancy, sexually transmitted infections, and HIV, with a predominantly heteronormative focus. The prevailing narratives from the health system are those of risk and lack of control and self-care among young people, and they are exacerbated in the case of migrants. Young migrants, especially from the Caribbean, are stereotyped as over-sexualised and liberal in comparison to the local population and believed to be engaging in riskier sexual behaviours that should be kept under check. This may translate into experiences of discrimination and mistreatment when receiving care. Facilitators include good-quality information and community-level interventions. CONCLUSIONS This study shows a limited approach to the sexual and reproductive health of young migrants in Chile, severely hampering their reproductive and sexual rights. Policies and initiatives must work towards removing structural barriers, changing narratives, and empowering young migrants regarding their sexual and reproductive health.
Collapse
Affiliation(s)
- Alexandra Obach
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Alice Blukacz
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile.
| | - Michelle Sadler
- Departamento de Historia y Ciencias Sociales, Facultad de Artes Liberales, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Alejandra Carreño Calderón
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Báltica Cabieses
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Carolina Díaz
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| |
Collapse
|
39
|
Rodríguez-Camacho MF, Sanchís-Ramón MJ, Ortiz-Barreda G, La Parra-Casado D, Gil-González D. Menarche and reproductive health in Spanish Roma women from a reproductive justice perspective: a qualitative study. Reprod Health 2024; 21:17. [PMID: 38308316 PMCID: PMC10837920 DOI: 10.1186/s12978-023-01726-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 12/13/2023] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVES This study aimed to explore the perceptions of Roma women about their experience of menarche and reproductive health considering the principles of reproductive justice. DESIGN Qualitative study based on semi-structured interviews with Roma women ages 18 through 67 in different neighborhoods in the southeast of Spain. Using a thematic analysis, we analyzed experiences related to menarche and menstruation and their significance for reproductive health, the preparation for the phase of menarche and intergenerational support. RESULTS The Roma women interviewed shared their approach to the experiences of menarche and menstruation as children in their family environments with a focus on access to information provided by other women in the family and community for reproductive health management. In their discourses we observed that the onset of menstruation supposes a rupture in the public and private spaces of girls and women. CONCLUSIONS The results of this study suggest that women and girls do not gain access to information that contributes to their reproductive wellbeing through their experience of menarche. Access to resources and skills to manage biological changes in adolescents could contribute to reducing the impact of cultural myths, false ideas and taboos that prevent advocacy and empowerment on issues of reproductive justice.
Collapse
Affiliation(s)
- María Félix Rodríguez-Camacho
- Autonomous Federation of Roma Associations of Alicante, FAGA, Alicante, Spain.
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain.
| | | | - Gaby Ortiz-Barreda
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | | | - Diana Gil-González
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| |
Collapse
|
40
|
Widjiati W, Luqman EM, Kuntjorodjakti S, Aulanni’am A, Shabira Z, Taqwa SF, Mega RL, Chou D, Mubarak AS, Hendrawan VF. The impact of Apis dorsata forest honey administration on follicle-stimulating hormone and luteinizing hormone levels in rats ( Rattus norvegicus) forced swim test as a chronic physical animal model. Open Vet J 2024; 14:738-742. [PMID: 38549577 PMCID: PMC10970116 DOI: 10.5455/ovj.2024.v14.i2.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/27/2024] [Indexed: 04/02/2024] Open
Abstract
Background Chronic physical stress has many effects on the nervous system and can cause structural changes in different parts of the brain and hemomodulatory, including hormonal. Current pharmacotherapeutic treatments have limited efficacy and are associated with many deleterious side effects. Aim The aim of this research is to determine how Apis dorsata forest honey administration affects follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels in rats who are subjected to forced swim tests as a model of chronic physical stress placed in a container filled with water from which it cannot escape. Methods This was an experimental laboratory study with 32 rats divided into four treatment groups: control (C), Treatment 1 (T1) with a forced swim test + honey (2 g/rat/day), Treatment 2 (T2) with a forced swim test + honey (4 g/rat/day), and Treatment 3 (T3) with a forced swim test + honey (6 g/rat/day). All treatments were administered for 14 days. Then, blood was taken for FSH and LH serum tests, and a one-way ANOVA and Duncan test were used to statistically test the data analysis. Results The results of this study indicate that the administration of forest honey had no significant effect (p > 0.05) on the FSH parameter, but there was a significant decrease in LH levels in the T2 and T3 groups (p < 0.05). Conclusion It can be concluded that giving forest honey to rats who were subjected to a 14-day forced swim test had no effect on FSH and LH levels. In rats given a forced swim test as a model of chronic stress, administration at doses of 4 and 6 g/rat/day reduced LH serum levels. Thus, giving forest honey could maintain reproductive health in rat that experience chronic stress.
Collapse
Affiliation(s)
- Widjiati Widjiati
- Department of Veterinary Science, Veterinary Medicine Faculty, Airlangga University, Mulyorejo, Surabaya, East Java, Indonesia
| | - Epy Muhammad Luqman
- Department of Veterinary Science, Veterinary Medicine Faculty, Airlangga University, Mulyorejo, Surabaya, East Java, Indonesia
| | - Suryo Kuntjorodjakti
- Department of Veterinary Science, Veterinary Medicine Faculty, Airlangga University, Mulyorejo, Surabaya, East Java, Indonesia
| | - Aulanni’am Aulanni’am
- Department of Chemistry, Faculty of Medicine, Brawijaya University, Malang, East Java, Indonesia
| | - Zahra Shabira
- Magister Student of Veterinary Reproduction, Veterinary Medicine Faculty, Airlangga University, Mulyorejo, Surabaya, East Java, Indonesia
| | - Sultan Fadhilla Taqwa
- Magister Student of Veterinary Reproduction, Veterinary Medicine Faculty, Airlangga University, Mulyorejo, Surabaya, East Java, Indonesia
| | - Riski Lesta Mega
- Magister Student of Veterinary Reproduction, Veterinary Medicine Faculty, Airlangga University, Mulyorejo, Surabaya, East Java, Indonesia
| | - Dean Chou
- Department of Biomedical Engineering National Cheng Kung University, Tainan City, Taiwan
| | - Ahmad Shofy Mubarak
- Department of Marine, Faculty of Fisheries and Marine Sciences, Airlangga University, Mulyorejo, Surabaya, East Java, Indonesia
| | - Viski Fitri Hendrawan
- Departement of Veterinary Reproduction, Veterinary Medicine Faculty, Brawijaya University, Puncak Dieng, Dau, Malang, East Java, Indonesia
| |
Collapse
|
41
|
Das M, Patidar H, Singh M. Understanding trimester-specific miscarriage risk in Indian women: insights from the calendar data of National Family Health Survey (NFHS-5) 2019-21. BMC Womens Health 2024; 24:63. [PMID: 38263129 PMCID: PMC10804530 DOI: 10.1186/s12905-023-02838-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 12/09/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The primary public health issue, especially in low- and middle-income countries, is early pregnancy loss driven by miscarriage. Understanding early pregnancy losses and the characteristics of mothers who have miscarriages is essential to creating effective reproductive health strategies. Thus, this study's primary goal is to delve into the factors which impact miscarriages that take place prior to and following the first 12 weeks of gestation. METHODS The bivariate analysis was employed to determine the frequency of miscarriages. The factors associated with miscarriages in the first (≤12 weeks) and second & above (> 12 weeks) trimesters of pregnancy were then examined using a generalised linear regression model, with 95% confidence intervals. Finally, we use ArcGIS to illustrate the prevalence of miscarriage in the districts of India. RESULTS Our result shows that miscarriages occur often in India (4.9%), with 23% of cases occurring in the first trimester (≤12 weeks). In our bivariate analysis, we identified several factors associated with a higher prevalence of miscarriages in India. It was found that mothers aged thirty years or older, residing in urban areas, with less than ten years of education, belonging to the richest wealth quantile, expressing a desire for more children, having no demand for contraception, and possessing no parity experienced a higher prevalence of miscarriage in total pregnancies in India. On the other hand, the generalised linear model's findings show that mothers who are thirty years of age or older, practise other religions, live in urban areas, are members of other castes, want more children, marry before the age of eighteen, and meet their contraceptive needs are more likely to have miscarriages in total pregnancy. However, there is a larger likelihood of miscarriage in the first trimester (≤12 weeks) for mothers who follow other religions, live in urban areas, are from Other Backward Class (OBC), get married before the age of eighteen, and fall into the middle and upper wealth quantiles. A mother is more likely to miscarriage in the second & above (> 12 weeks) trimesters if she is older than thirty, from other castes, wants more children, has moderate media exposure, marries before turning eighteen, meets her contraceptive needs, and does not feel the need for contraception. After accounting for socioeconomic characteristics, all results were statistically significant. CONCLUSIONS Given the substantial number of miscarriages in India, police need to improve planning and guidance in order to lower pregnancy loss due to miscarriage. Miscarriage rates may be significantly decreased by enhancing the availability and quality of reproductive health care infrastructure, particularly in rural areas.
Collapse
Affiliation(s)
- Milan Das
- International Institute for Population Sciences, Mumbai, India
| | | | - Mayank Singh
- International Institute for Population Sciences, Mumbai, India.
| |
Collapse
|
42
|
Mathias H, Foster LA, Rushton A. Programs and practices that support pregnant people who use drugs' access to sexual and reproductive health care in Canada: a scoping review. BMC Pregnancy Childbirth 2024; 24:72. [PMID: 38254076 PMCID: PMC10804510 DOI: 10.1186/s12884-023-06225-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Pregnant people who use unregulated drugs (PPWUD) are at high risk of health complications yet experience a range of barriers to sexual and reproductive health care. Given that improving maternal health and access to reproductive health care are key targets underpinning the Sustainable Development Goals (SDG), there is an urgent need to improve access to appropriate supports and services for this population. Little is known about what programs and practices exist to support PPWUD's access to sexual and reproductive health care. This scoping review aimed to identify the available literature on these programs and practices in Canada. METHODS A scoping review was conducted using JBI methodology and reported using PRISMA guidelines. Scholarly databases and grey literature sources were searched to identify literature published between 2016-2023 in English or French that discussed, defined, conceptualised, or evaluated programs and practices that support PPWUD's access to sexual and reproductive health care in Canada. Identified literature was screened using Covidence. Data were extracted from included texts, then analysed descriptively. Frequencies and key concepts were reported. RESULTS A total of 71 articles were included, most of which were grey literature. Of the total, 46 unique programs were identified, as well as several useful practices. Most programs were in urban centres in Western Canada, and most programs offered holistic 'wrap-around services.' Several programs delivered these services on-site or as 'drop-in' programs with the support of staff with lived/living experience of substance use. Most frequent program outcomes included keeping parents and children together, improving connection to other services, and reducing substance use harms. Noted helpful practices included non-judgmental care and the use of harm-reduction strategies. CONCLUSIONS Several programs and practices that support PPWUD exist in Canada, though few focus exclusively on sexual and reproductive health. There remain opportunities to improve access to programs, including expanding geographic availability and range of services. The review has clinical application by providing an overview of available programs that may support clinicians in identifying services for PPWUD. Future research should consider client perspectives and experiences of these programs. REVIEW REGISTRATION NUMBER Open Science Framework https://osf.io/5y64j .
Collapse
Affiliation(s)
- Holly Mathias
- School of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
| | - Lesley Ann Foster
- Department of Cultural Studies, Queen's University, 99 University Ave, Kingston, ON, K7L 3N6, Canada
| | - Ashleigh Rushton
- Faculty of Health Sciences, The University of the Fraser Valley, 45190 Caen Ave, Chilliwack, B.C, V2R 0N3, Canada
| |
Collapse
|
43
|
Pathak N, Zhang CX, Boukari Y, Burns R, Menezes D, Hugenholtz G, French RS, Gonzalez-Izquierdo A, Mathur R, Denaxas S, Hayward A, Sonnenberg P, Aldridge RW. Sexual and reproductive health and rights of migrant women attending primary care in England: A population-based cohort study of 1.2 million individuals of reproductive age (2009-2018). J Migr Health 2024; 9:100214. [PMID: 38327760 PMCID: PMC10847991 DOI: 10.1016/j.jmh.2024.100214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 02/09/2024] Open
Abstract
Background Evidence on the sexual and reproductive health and rights (SRHR) of migrants is lacking globally. We describe SRHR healthcare resource use and long-acting reversible contraceptives (LARCs) prescriptions for migrant versus non-migrant women attending primary care in England (2009-2018). Methods This population-based observational cohort study, using Clinical Practice Research Datalink (CPRD) GOLD, included females living in England aged 15 to 49. Migration was defined using a validated codelist. Rates per 100 person years at risk (pyar) and adjusted rate ratios (RRs) were measured in migrants versus non-migrants for consultations related to all-causes, six exemplar SRHR outcomes, and LARC prescriptions. Proportions of migrants and non-migrants ever prescribed LARC were calculated. Findings There were 25,112,116 consultations across 1,246,353 eligible individuals. 98,214 (7.9 %) individuals were migrants. All-cause consultation rates were lower in migrants versus non-migrants (509 vs 583/100pyar;RR 0.9;95 %CI 0.9-0.9), as were consultations rates for emergency contraception (RR 0.7;95 %CI 0.7-0.7) and cervical screening (RR 0.96;95 %CI 0.95-0.97). Higher rates of consultations were found in migrants for abortion (RR 1.2;95 %CI 1.1-1.2) and management of fertility problems (RR 1.39;95 %CI 1.08-1.79). No significant difference was observed for chlamydia testing and domestic violence. Of 1,205,258 individuals eligible for contraception, the proportion of non-migrants ever prescribed LARC (12.2 %;135,047/1,107,894) was almost double that of migrants (6.91 %;6,728/97,364). Higher copper intrauterine devices prescription rates were found in migrants (RR 1.53;95 %CI 1.45-1.61), whilst hormonal LARC rates were lower for migrants: levonorgestrel intrauterine device (RR 0.63;95 %CI 0.60-0.66), subdermal implant (RR 0.72;95 %CI 0.69-0.75), and progesterone-only injection (RR 0.35;95 %CI 0.34-0.36). Interpretation Healthcare resource use differs between migrant and non-migrant women of reproductive age. Opportunities identified for tailored interventions include access to primary care, LARCs, emergency contraception and cervical screening. An inclusive approach to examining health needs is essential to actualise sexual and reproductive health as a human right.
Collapse
Affiliation(s)
- Neha Pathak
- Institute of Health Informatics, University College London, London, NW1 2DA, UK
- Institute for Global Health, University College London, London, WC1E 6JB, UK
- Guy's & St Thomas's NHS Foundation Trust, London, SE1 9RT, UK
| | - Claire X. Zhang
- Institute of Health Informatics, University College London, London, NW1 2DA, UK
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, OX3 7LF, UK
| | - Yamina Boukari
- Institute of Health Informatics, University College London, London, NW1 2DA, UK
| | - Rachel Burns
- Institute of Health Informatics, University College London, London, NW1 2DA, UK
| | - Dee Menezes
- Institute of Health Informatics, University College London, London, NW1 2DA, UK
| | - Gregory Hugenholtz
- Institute of Health Informatics, University College London, London, NW1 2DA, UK
| | - Rebecca S French
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Rohini Mathur
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Spiros Denaxas
- Institute of Health Informatics, University College London, London, NW1 2DA, UK
- BHF Data Science Center, Health Data Research UK, London, NW1 2DA, UK
| | - Andrew Hayward
- Inclusion Health, UK Health Security Agency, London, UK
- Institute of Epidemiology and Healthcare, University College London, London, WC1E 7HB, UK
| | - Pam Sonnenberg
- Institute for Global Health, University College London, London, WC1E 6JB, UK
| | | |
Collapse
|
44
|
Izadi N, Aminian O, Ghafourian K, Aghdaee A, Samadanian S. Reproductive outcomes among female health care workers. BMC Womens Health 2024; 24:44. [PMID: 38229075 PMCID: PMC10792822 DOI: 10.1186/s12905-024-02890-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 01/06/2024] [Indexed: 01/18/2024] Open
Abstract
OBJECTIVE Occupational exposures may be associated with reproductive health and pregnancy outcomes. This study investigated the association between occupational exposures and reproductive health, pregnancy outcomes, and the lactation period among hospital staff. MATERIALS AND METHODS Seven hundred thirty-three female healthcare workers from hospitals affiliated with the Tehran University of Medical Sciences were invited to participate in this cross-sectional study. The measurement method for fertility consequences was self-report. Demographic characteristics, occupational data, medical history, and reproductive history were collected via data collection form. Finally, reproductive outcomes were evaluated in different occupational hazard categories. RESULT Chemical exposures (solvents) were a risk factor for stillbirth. Prolonged working hours were associated with spontaneous abortion and breastfeeding periods. Shift workers did not have a higher frequency of reproductive and pregnancy outcomes, but the breastfeeding period was significantly decreased in shift workers. Psychiatric disorders were associated with preterm labour, low birth weight, and stillbirth in sequence with nervousness, depression, and mood disturbance. Furthermore, depression affects the breastfeeding period. Moreover, we found a link between job titles and infertility. In addition, socioeconomic status was related to stillbirth and infertility. CONCLUSION The study revealed that chemical and ergonomic exposures have associations with some reproductive outcomes. We also conclude that shift work could adversely affect the breastfeeding period. So, implementing some organizational strategies to control adverse health effects of occupational hazards and modifying shift work and working hours for nursing mothers is recommended.
Collapse
Affiliation(s)
- Nazanin Izadi
- Center for research on occupational diseases, Tehran University of medical sciences, Tehran, Iran
| | - Omid Aminian
- Center for research on occupational diseases, Tehran University of medical sciences, Tehran, Iran
| | - Kiana Ghafourian
- School of medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - AmirHossein Aghdaee
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shadi Samadanian
- Center for research on occupational diseases, Tehran University of medical sciences, Tehran, Iran.
| |
Collapse
|
45
|
Muralidhar K, Nishimura H, Coursey K, Krupp K, Jaykrishna P, Srinivas V, Madhivanan P. Knowledge and practice of family planning among pregnant tribal women in Southern India: an observational study. Contracept Reprod Med 2024; 9:2. [PMID: 38217011 PMCID: PMC10785510 DOI: 10.1186/s40834-023-00259-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 11/28/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND There are over 700 Scheduled Tribes (ST) living in 30 Indian states. As with other indigenous groups across the world, Indian ST have some of the poorest infant and child health outcomes of any communities in India. A child born to an ST family is 19% more likely to die in the first month of life and has a 45 percent risk of dying in their first year compared with other Indian populations. Research suggests that early conception, high fertility, and low use of family planning methods are large contributors to these disparities. METHODS A cross sectional survey in Kannada was conducted among 303 pregnant tribal women in Mysore, India after obtaining informed consent. Univariate and multivariable analyses were carried out to determine the demographic and psychosocial factors associated with knowledge of contraceptive methods using Stata 14.0. RESULTS There was widespread knowledge about female sterilization, while only 39.3% of women reported hearing about one or more forms of temporary contraception, and 36.3% knew where to get them. The largest proportion of women had heard about copper-T (33.0%), followed by oral contraceptive pills (23.8%), condoms (11.9%), and injectables (4.6%). Only 2.7% of women reported ever using any form of temporary contraception. Results from the multivariable logistic regression indicated that knowledge of at least one form of temporary contraception was linked to higher age (adjusted odds ratio[AOR]: 1.09; 95% CI: 1.02, 1.17), greater number of years of marriage (AOR: 0.90; 95% CI: 0.85, 0.96), and last birth in a government facility (AOR: 3.67; 95% CI: 1.99, 6.82). CONCLUSIONS The study revealed poor knowledge and utilization of temporary contraceptive methods among a tribal population in rural Mysore, India. Interventions aiming to increase knowledge of contraceptive options are important for birth spacing in this population and should target younger women and those without contact with government health facilities.
Collapse
Affiliation(s)
- Kiranmayee Muralidhar
- Public Health Research Institute of India, Mysore, Karnataka, India.
- JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
| | - Holly Nishimura
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kate Coursey
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Karl Krupp
- Public Health Research Institute of India, Mysore, Karnataka, India
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, P.O. Box 245209, Tucson, Arizona, 85724-5209, USA
| | | | - Vijaya Srinivas
- Public Health Research Institute of India, Mysore, Karnataka, India
| | - Purnima Madhivanan
- Public Health Research Institute of India, Mysore, Karnataka, India
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, P.O. Box 245209, Tucson, Arizona, 85724-5209, USA
| |
Collapse
|
46
|
De PK, Tümay M. Education and reproductive health: evidence from schooling expansion in Turkey. Int J Health Econ Manag 2024:10.1007/s10754-023-09364-x. [PMID: 38182808 DOI: 10.1007/s10754-023-09364-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/19/2023] [Indexed: 01/07/2024]
Abstract
We investigate the role of additional years of schooling mandated by a compulsory schooling expansion law in affecting reproductive preferences and safe reproductive health behaviors in Turkey-a middle-to-high-income country with gender inequity in education but overall high levels of safe reproductive health practices at the time of passing the law. Using a fuzzy regression discontinuity design, we find that the additional schooling improved several health behaviors. However, the effects on some outcomes commonly analyzed in the existing literature, such as contraceptive use or fertility, were either weak or insignificant. Overall, our findings complement the current literature on the marginal health benefits of schooling expansion and suggest that policymakers consider the institutional and cultural factors while evaluating the scope and potential non-educational benefits of such expansions.
Collapse
Affiliation(s)
- Prabal K De
- Department of Economics and Business, Colin Powell School, CUNY City College and Graduate Center, 160 Convent Ave, New York, NY, 10031, USA.
| | - Muhammed Tümay
- Department of Economics, Faculty of Economics and Administrative Sciences, Gumushane University, Baglarbasi Mahallesi, Gumushane, 29100, Turkey
| |
Collapse
|
47
|
Wang R, Wang M, Zeng Q, Wang L, Zhang Q, Pu S, Ma X, Wang J, Pan Y. Correlation between microbial characteristics and reproductive status of the yak uterus based on macrogenomic analysis. BMC Vet Res 2024; 20:4. [PMID: 38172906 PMCID: PMC10763020 DOI: 10.1186/s12917-023-03845-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION This study aimed to investigate the microbial characteristics of yak uteri collected using intrauterine cotton swabs (CS) during different reproductive stages and the correlation of these microbial characteristics with reproductive status. METHODS We used a macrogenomic approach to analyze the functional aspects of different microorganisms in samples collected during the pre-estrus, estrus, late estrus, and diestrus stages. RESULTS The results revealed the presence of 1293 microbial genera and 3401 microbial species in the uteri of yaks at different reproductive stages. The dominant bacterial species varied across the different periods, with Micrococcus and Proteus being dominant during pre-estrus; Pseudomonas, Clostridium, Flavobacterium, Bacillus, and Staphylococcus during estrus; Acinetobacter, Bacillus and Proteus during late estrus; and Pseudomonas, Escherichia coli, and Proteus during diestrus. DISCUSSION The primary functions of these bacteria are enriched in various metabolic pathways, including carbohydrate and amino acid metabolism, intracellular transport and secretion, post-translational protein modification, and drug resistance. These findings suggest that the microbial diversity in the uterus of yaks plays a crucial role in reproductive regulation and can help prevent reproductive tract-related diseases.
Collapse
Affiliation(s)
- Rui Wang
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Meng Wang
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
- Technology and Research Center of Gansu Province for Embryonic Engineering of Bovine and Sheep & Goat, Lanzhou, Gansu, China
| | - Qiaoying Zeng
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Libin Wang
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
- Technology and Research Center of Gansu Province for Embryonic Engineering of Bovine and Sheep & Goat, Lanzhou, Gansu, China
| | - Qian Zhang
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
- Technology and Research Center of Gansu Province for Embryonic Engineering of Bovine and Sheep & Goat, Lanzhou, Gansu, China
| | - Sisi Pu
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Xin Ma
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
- Technology and Research Center of Gansu Province for Embryonic Engineering of Bovine and Sheep & Goat, Lanzhou, Gansu, China
| | - Jinglei Wang
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China
- Technology and Research Center of Gansu Province for Embryonic Engineering of Bovine and Sheep & Goat, Lanzhou, Gansu, China
| | - Yangyang Pan
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, Gansu, China.
- Technology and Research Center of Gansu Province for Embryonic Engineering of Bovine and Sheep & Goat, Lanzhou, Gansu, China.
| |
Collapse
|
48
|
Crankshaw TL, Freedman J, Mutambara VM, Rajah Y. "I still don't know how someone gets pregnant": determinants of poor reproductive health among young female refugees in South Africa. BMC Womens Health 2024; 24:10. [PMID: 38172790 PMCID: PMC10765558 DOI: 10.1186/s12905-023-02847-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Studies exploring the sexual and reproductive health (SRH) of refugee women have focused primarily on first generation refugees in humanitarian and crisis settings. There is a paucity of research exploring the reproductive health of girls and young women who are born to refugee parents in a host country or who have migrated with their parents at a very young age and who have since reached sexual maturity. We conducted a qualitative study which aimed to explore the reproductive health and rights' needs and challenges amongst young refugee women in South Africa. METHODS The study was carried out in the city of eThekwini (Durban) in South Africa in 2021 and 2022. A total of 35 semi-structured, in person interviews were conducted amongst young refugee women between the ages of 18 and 24 years living in the city centre. RESULTS Twenty-five participants were 17 years or younger on arriving in South Africa, one of whom was born in South Africa. Eleven of these women had experienced one or more pregnancies while living in South Africa and all of these women had experienced at least one unintended pregnancy. Participants had poor reproductive health knowledge of the role of menstruation and how conception occurs. Economic, social, and legal insecurities intersected in complex ways as determinants of poor reproductive health outcomes. Despite availability, contraceptive use was poor and linked to lack of knowledge, myths and unwanted side effects. There were negative economic and social impacts for young refugee women experiencing early pregnancies irrespective of whether they were intended or not. Being unable to conceive or experiencing an unintended pregnancy negatively impacted sexual relationships which were entered primarily for material support. Desire for confidentiality shaped lack of access to legal termination of pregnancy in the public health sector. CONCLUSION Participants experienced specific vulnerabilities resulting from their position as refugees despite length of stay in South Africa. It is important to better understand these specificities in the design of programmes and policies aimed at ensuring positive health outcomes for these young women. Peer education amongst refugee communities may be an important tool in the provision of culturally acceptable SRH education.
Collapse
Affiliation(s)
- Tamaryn L Crankshaw
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa.
| | - Jane Freedman
- Centre for Sociological and Political Research (CRESPPA), Université Paris 8, Paris, France
| | - Victoria M Mutambara
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | | |
Collapse
|
49
|
Asadisarvestani K, Hulsbergen M. Experiences with family planning and abortion services during the Covid-19 pandemic: a qualitative study in Bangladesh, Iran and Netherlands. BMC Public Health 2024; 24:31. [PMID: 38166967 PMCID: PMC10763037 DOI: 10.1186/s12889-023-17414-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE Access to family planning services is a human right that plays an essential role in society's health, particularly women's health. The COVID-19 pandemic has affected all aspects of human life including access to family planning services. Accordingly, the main goal of this study was to explore the experiences of women and service providers from the main challenges and obstacles of access to family planning services and abortion services in Bangladesh, Iran, and the Netherlands during the COVID-19 pandemic. METHODS In this qualitative study, the data were collected through online, telephone, or in-person semi-structured interviews with key informants. Participants selected by purposive sampling method. The participants included women aged 15 to 49 (n = 63) and service providers (n = 54) in the 3 abovementioned countries. These individuals were included from October 2020 until December 2020. Conventional thematic analysis was employed to analyze the collected data. RESULTS The main extracted themes were challenges (reduction of referral; disruption of access to services; insufficient knowledge; worries among staff; rising prices; and unavailability of some contraceptives), measures (time extension and visit scheduling; telephone, online, and door to door services; and support of the media) and recommendations (health facility improvements; free, online, and closer services; and ongoing trainings and awareness campaigns). CONCLUSION The COVID-19 pandemic has affected family planning and reproductive health services in different ways and has uncovered existing inequalities in access to these services. However, in Iran, the reported challenges were also rooted in new population policies that have further limited access to family planning and abortion services.
Collapse
Affiliation(s)
- Khadijeh Asadisarvestani
- Department of Demography and Geodemography, Faculty of Science, Charles University, Prague, Czechia.
- Department of Social Sciences Faculty of Literature and Humanities, University of Sistan and Baluchestan, Zahedan, Iran.
| | - Myrrith Hulsbergen
- Women's Healthcare Center, Amsterdam, The Netherlands
- Teaching & Learning Center, University of Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Working Party International Safe Motherhood and Reproductive Health, Amsterdam, The Netherlands
| |
Collapse
|
50
|
Jiménez Gómez N, González-Cantero Á, Ruiz-Villaverde R, Llamas-Velasco M, de la Cueva Dobao P, Rivera Díaz R, Martínez Lorenzo E, Alonso Pacheco ML, Baniandrés Rodríguez O, Mollet Sánchez J, Pitarch Bort G, Izu Belloso RM, Jaén Olasolo P. Family Planning Concerns Among Women With Psoriasis: A Descriptive, Cross-Sectional, Multicenter Study. Actas Dermosifiliogr 2024; 115:10-20. [PMID: 37442420 DOI: 10.1016/j.ad.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/21/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVE A significant proportion of women of childbearing age have psoriasis. The aim of this study was to examine family planning concerns in this population. MATERIAL AND METHODS Observational, descriptive, cross-sectional, multicenter study conducted between March 2020 and October 2021. We collected sociodemographic data and analyzed responses to a family planning questionnaire administered to women aged 18 to 45 years with plaque psoriasis who were candidates for systemic treatment. RESULTS We studied 153 patients (mean [SD] age, 35.4 [8.0] years; mean disease duration, 16.7 years) being treated at 11 Spanish hospitals. Overall, 38.4% of women were considered to have moderate to severe psoriasis by their physicians; perceived severity ratings were significantly higher among women. Psoriasis affected the women's desire to become pregnant or led to their delaying pregnancy in 1 in 3 respondents. They were concerned that their condition might worsen if they had to discontinue or switch treatment or that the treatment might harm the baby. Approximately half of the women had not received family planning counseling from their physicians, and this was more likely to be the case among never-pregnant women. Women on biologic therapy (58.7%) had better psoriasis control and a better quality of life than women on other treatments. Their sexual health was also less affected. CONCLUSIONS Women with psoriasis have numerous family planning concerns, which in some cases can lead them to delay pregnancy or affect their desire to become pregnant. Dermatologists need to receive better training regarding family planning in women with psoriasis so that they can provide their patients with more and better information.
Collapse
Affiliation(s)
- N Jiménez Gómez
- Hospital Universitario Ramón y Cajal, Madrid, España; Grupo de Dermatología Pedro Jaén, Madrid, España.
| | - Á González-Cantero
- Hospital Universitario Ramón y Cajal, Madrid, España; Grupo de Dermatología Pedro Jaén, Madrid, España; Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, España
| | - R Ruiz-Villaverde
- Hospital Universitario San Cecilio Granada, Instituto Biosanitario de Granada (Ibs), Granada, España
| | | | | | - R Rivera Díaz
- Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, España
| | | | | | | | | | - G Pitarch Bort
- Hospital General Universitario de Castellón, Castellón, España
| | | | - P Jaén Olasolo
- Hospital Universitario Ramón y Cajal, Madrid, España; Grupo de Dermatología Pedro Jaén, Madrid, España
| |
Collapse
|