This paper explores the use of Housing First services for women experiencing homelessness, focusing on those aged 35 and over, who have multiple and complex needs. The paper draws on an evidence review and the results of a five-year evaluation of a Housing First for Women pilot project (2015–20) and three-year longitudinal study of two further Housing First services for Women in the UK (2021–24), which centred on the lived experience of women using these services. Four main arguments are advanced. The first is that the original Housing First model from the US and the initial deployments of the Housing First approach in Europe and the UK used a model designed in a context in which the nature and extent of middle aged and older women's homelessness was poorly understood. High fidelity Housing First services were less likely to be fully effective because the original model did not properly account for the level of trauma associated with domestic abuse and violence against women in middle age and later life. The second argument is that there is, on current and emergent evidence, a clear case for developing Housing First that is designed, managed and run by women for women which includes safeguarding as one of its key operating principles. The third argument is that Housing First for Women, with its comprehensive co-productive support and intensive case management, may offer important advantages over Sanctuary Schemes1 and other services that are designed to counteract middle aged and older women's homelessness that is associated with abuse, violence and multiple and complex needs. The paper concludes by arguing that in order to fully meet the needs of middle aged and older women experiencing long term and repeated homelessness with multiple and complex needs, an integrated and preventative strategy, including preventative approaches like Domestic Abuse Housing Alliance (DAHA) Accreditation and Housing First for Women must be developed. If Housing First for Women is to be effective, it must be situated within a wider integrated strategy to counteract women's homelessness to reach its full potential.

BackgroundDespite global advancements in reproductive healthcare, the utilization of modern contraceptives in Somalia remains critically low, marked by significant regional and sociodemographic disparities. This study assessed the prevalence and identified key predictors of modern contraceptive use among Somali women of reproductive age using data from the 2020 Somali Health and Demographic Survey (SHDS).MethodsA nationally representative cross-sectional analysis was conducted on a sample of 2,704 women aged 15–49 years. Descriptive statistics and multivariable logistic regression were employed to identify factors associated with the use of modern contraceptives.ResultsThe majority of participants were aged 26 years or older (57.6%), resided in urban areas (85.1%), and belonged to the highest wealth quintile (62.4%). The prevalence of modern contraceptive use among the study participants was exceptionally low at 1.8%. The most commonly reported methods were oral contraceptive pills (0.6%) and implants (0.2%), while the use of intrauterine devices (IUDs) was minimal (0.04%). A significant gap in exposure to family planning information was observed, with only 13.6% of women reported to have received it at health facilities. Key predictors for modern contraceptive use included the age of the women and exposure to family planning education at a health facility. Women aged 26 years and older demonstrated significantly higher odds of using contraception compared to their younger counterparts [adjusted odds ratio (AOR): 10.13; 95% confidence interval (CI): 2.39–42.97]. Furthermore, women who received family planning information from health facilities were twice as likely to use modern contraceptive methods (AOR: 1.99; 95% CI: 1.02–3.88).ConclusionThe findings underscore an urgent need to enhance both the accessibility and knowledge of modern contraceptives in Somalia. Targeted interventions focusing on health facility-based education and expanding the limited variety of available contraceptive methods are crucial to improving uptake and addressing the reproductive health needs of Somali women.

BackgroundAccording to the WHO, violence is the intentional use of force or power against oneself, another person, or a community, causing injury, death, or harm. National data from 2021 reveal that as many as 70.1% of women in Mexico have experienced some form of violence. Pregnancy represents a period of heightened vulnerability, with negative impacts on material and infant health.Material and methodsThis cross-sectional observational study was conducted on women during the immediate postpartum period. Domestic violence was assessed using the Woman Abuse Screening Tool (WAST) scale, the Affective Bonding and Prenatal Adjustment Assessment Scale survey, and postpartum depression was evaluated through the Centre for Epidemiological Studies-Depression Scale (CES-D) scale.ResultsFour hundred women were included using the short version of the WAST scale, with 31.5% (126) testing positive for the screening questions. Women who experienced abuse showed higher odds of postpartum depression (OR = 2.95; 95% IC: 1.87–4.63; p = 0.000) and tobacco use (OR = 2.28; 95% IC: 1.31–3.94; p = 0.003). Adverse perinatal effects, such as preterm delivery (35.7%), admission to intensive care (40.5%), and low birth weight (19.8%), were frequent but without statistical significance.ConclusionsOne-third of the pregnant women in the study suffered intimate partner violence, mainly psychological and economic. Unwanted pregnancy, lack of emotional bonding, postpartum depression, alcohol/smoking, and low education levels were frequent factors.

BackgroundObstetric violence is globally acknowledged as a significant public health concern, with women in many countries reporting different types of mistreatment during pregnancy, childbirth, and the postpartum period, that negatively affect their physical and emotional health. Many women are vulnerable to obstetric violenceand without knowledge about their rights, do not identify specific manifestations of violence.AimThis baseline study aimed to assess the current knowledge on obstetric violence in pregnant women and to determine possible associated factors in the central zone, Tanzania.MethodsThe baseline cross-sectional study was conducted on 349 randomly selected pregnant women between February and April 2025. A standard semi-structured questionnaire in a kobo tool box software was used to collect data on knowledge of obstetric violence and associated factors. Both descriptive and inferential analyses were conducted using SPSS software version 29.ResultsOverall, only 120(34.4%) of pregnant women had adequate knowledge of obstetric violence. The most commonly known components of obstetric violence were verbal 216(61.9%) and physical violence 211(60.5%). High levels of education, gravidity, and mobile phone usage for health-related issues were significantly associated with knowledge of obstetric violence. In addition, none of the pregnant woman reported being counselled about obstetric violence during their antenatal care.ConclusionThis baseline assessment offers essential information regarding the current state of knowledge about obstetric violence among pregnant women. The absence of reported counseling about obstetric violence during antenatal care highlights a critical gap. The results highlight the necessity for selective educational initiatives to enhance women's knowledge and their rights during pregnancy, childbirth and after childbirth in promoting respectful maternity care.

ObjectiveSpecialized reproductive mental health services help to alleviate symptoms of mental disorders associated with the reproductive system such as menstrual cycle, infertility, pregnancy or birth. However, people by reproductive mental disorders often do not receive the treatment they need or treatment is initiated after a long delay. The current study examined the process of accessing specialized reproductive mental health services in patients (mostly cisgender women) who just attended their first psychotherapy session in these services. Specifically, we examined the role of self-stigmatization related to mental issues as well as experiences with non-mental healthcare professionals and expectations regarding reproductive mental health services.MethodThe sample consisted of 106 cisgender female and 3 cisgender male patients who recently attended the specialized reproductive mental health service (called gynecospsychiatry). Data were collected using a mixed-methods design based on validated questionnaires and open-ended text questions in an online survey. Additionally, clinical information was obtained from the treating psychotherapists. T-tests and regression analyses were applied to quantitative data. Open ended questions were analyzed qualitatively using thematic analysis.ResultsQuantitatively, self-stigma was not significantly associated with the process of help seeking. Furthermore, our results suggest that merely being approached by primary or reproductive healthcare professionals was not associated with lower levels of self-stigma in our sample. Qualitative-analyses showed two major themes: 1) Not beating around the bush – clear words instead of overlooking or downplaying psychological distress, 2) Wanting to feel understood and accepted as opposed to condemned, judged, and devalued.ConclusionBased on these findings, recommendations were made for psychotherapists as well as primary or reproductive healthcare professionals about how those affected by reproductive mental disorders can best be supported to seek treatment. Further research is recommended with larger clinical samples of patients with reproductive mental disorders.

Cardiovascular disease (CVD) remains the leading cause of mortality in women. Estimating cardiovascular risk using prediction models is essential for guiding preventive strategies. Despite progress, conventional risk models still omit critical women-specific factors, limiting their accuracy. Precision medicine, supported by artificial intelligence, provides a framework to integrate these overlooked determinants. This approach may help close existing gaps in cardiovascular risk prediction. Sex-specific biomarkers that contribute to overall cardiovascular risk can be incorporated into risk assessment tools to improve prevention strategies, early detection, and personalized intervention. The integration of imaging-derived variables enhances diagnosis accuracy. Moreover, pharmacokinetic modeling may help optimize therapy and reduce adverse events. Future research should focus on refining risk prediction algorithms that incorporate women-specific cardiovascular risk. Herein, we explore how addressing the burden of CVD in women through precision medicine requires a tailored approach that considers sex-specific risk factors, hormonal influences, biomarkers, and imaging modalities. This review provides a descriptive synthesis of current evidence and highlights existing knowledge gaps and future directions in precision medicine for cardiovascular risk prediction in women.

Infant mortality, the death of a baby before its first birthday, is a concern in the Hispanic population in Indiana who have higher infant mortality rates than at the national level. Infrastructure and policy issues, effects of systemic racism and bias, lack of knowledge about perinatal health, and insecurity of the Hispanic community are issues challenging Hispanic infant health in Indiana. The purpose of this study was to describe the beliefs that comprise the Hispanic community's understanding about infant mortality. This study used a qualitative descriptive design and data was analyzed using a Constructed Grounded Theory approach. Ten participants were recruited for an in-depth interview through a Hispanic-serving community coalition in northern Indiana. The interviews aimed to understand participants' understanding of what constitutes a healthy pregnancy and a healthy infancy, as well as their understanding of the causes of infant mortality and perceptions of whether it can be prevented and by whom. Three themes emerged from the data and included (1) Parental neglect plays a role in infant mortality; (2) Responsibility in parenting is central to prevention of infant mortality; and (3) Readiness matters when becoming pregnant and keeping child healthy. The Hispanic population may possess a distinct cultural understanding of the causes of infant mortality that does not align with expert knowledge. Results suggest participants place greater emphasis on postpartum care in the prevention of infant mortality and may not fully grasp the importance of prenatal care on postpartum outcomes. Targeted, culturally-salient communication and educational interventions are needed on infant mortality among the Hispanic population to ensure they can readily recognize factors that contribute to infant mortality.

Sex-based differences in immune function influence susceptibility to infections and predisposition to autoimmunity, with women showing both stronger immune responses and a higher burden of autoimmune and chronic inflammatory diseases. While sex hormones contribute to these differences, accumulating evidence highlights a central role for the X chromosome, which is enriched in immune-related genes and subject to complex regulatory mechanisms such as X-chromosome inactivation, skewing, escape from inactivation, and imprinting. Within this context, X chromosome-encoded microRNAs (miRNAs) have emerged as key post-transcriptional regulators of immune homeostasis. The X chromosome harbors the highest density of miRNAs in the human genome, many of which target pathways involved in immune activation, tolerance, and tumorigenesis. Notably, some X-resident miRNAs escape X-chromosome inactivation, leading to female-biased expression that may enhance immune reactivity but also predispose to loss of tolerance and autoimmunity. In this minireview, we summarize current knowledge on X chromosome-encoded miRNAs in immune regulation, discuss how their sex-biased expression patterns may contribute to female predominance in autoimmune diseases, and explore their potential utility as biomarkers and therapeutic targets for sex-aware precision medicine in inflammatory, autoimmune disorders and vaccine responses.

Arabic-speaking women newly settled in the UK have different experiences of healthcare in their original countries which influence their engagement with the NHS. Like other migrant women, they are often unaccustomed to the way health services work. Language, religious and cultural barriers, as well as the lack of family and community supports contribute to inequalities in health and wellbeing outcomes during pregnancy and childbirth. To address their needs, the ERicar2 project aimed to produce a co-created antenatal care community information resource with a group of these women. Ten participatory workshops over eleven weeks were conducted to listen to the women's stories of their pregnancy journeys, explore publicly available resources, and work together to produce a prototype of an information resource tailored to their community needs. The qualitative findings from the workshops uncovered their experiences of miscarriage, their health seeking behavior, the role of religious belief and digital media, and the importance to them of their reproductive rights. The messages that they had for a newly arrived Arabic speaking woman were incorporated in a letter illustrated with their drawings, addressed to a fictional character "Dila" and containing QR codes to internet sites for pregnancy support. The letter was digitally animated and recorded in English and Arabic by volunteers among the research participants. The ERicar2 online resource is available for use by UK health providers and Arabic-speaking communities. Engagement with migrant mothers through participatory co-creative workshops (ERicar) is a model that can be replicated. In a safe community space, women sharing their pregnancy journeys have led to mutual support and research insights for maternal healthcare. Employing bricolage and iterative co-creation methods, women have been able to contribute to an antenatal resource tailored to the needs of an expectant mother recently resettled in the UK.

Pregnancy is associated with increased risk of anemia, high psychological stress, and sleep disturbances, yet safe therapeutic options remain limited. Ashwagandha (Withania somnifera) root extract (ARE) possesses adaptogenic and hematopoietic potential, but evidence in pregnant women is scarce. The aim of the current study is to evaluate the efficacy and safety of ARE on hematological parameters and on stress, sleep quality, and laboratory safety markers in pregnant women. This 12-week, prospective, randomized, open-label, comparative trial enrolled 70 pregnant women in the second trimester. Participants received either ARE 300 mg twice daily plus standard hematinic therapy or standard hematinic therapy (standard of care; SOC) alone. Primary endpoints included changes in hemoglobin (Hb) and red blood cell (RBC) indices. Secondary endpoints included perceived stress, sleep quality, and safety assessments (adverse events, liver, renal, cardiac, and thyroid markers). Efficacy was analyzed in the per-protocol population; safety in the intention-to-treat population. Of 70 randomized participants, 63 completed the study (ARE: n = 32; SOC: n = 31). ARE supplementation produced significant improvements in hematological parameters: Hb increased by 1.06 ± 0.44 g/dL vs. 0.78 ± 0.24 g/dL with SOC (between-group difference 0.28 g/dL; p = 0.003), mean corpuscular hemoglobin concentration improved significantly (difference 0.73 g/dL; p = 0.017), and red cell distribution width decreased markedly (difference -0.57%; p < 0.001). RBC count and hematocrit showed favorable but non-significant trends. ARE significantly reduced perceived stress at Week 12 (-10.50 vs. -5.35; p < 0.001) and improved key sleep parameters, including subjective sleep quality at all visits (p = 0.036), sleep duration (Week 8 and 12; p < 0.001), and sleep disturbances (Week 12; p = 0.028). No adverse events or serious adverse events occurred. Laboratory evaluations showed no detrimental effects on hepatic, renal, or thyroid function. ARE supplementation for 12 weeks improved hemoglobin levels, RBC quality, perceived stress, and multiple aspects of sleep in pregnant women, with no adverse events and stable organ-function markers. ARE appears to be a tolerable and suitable adjunct to standard prenatal care for supporting hematological and psychological well-being during pregnancy. https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTIyNjQ2&Enc=&userName=, identifier CTRI/2025/01/079238 on January 22, 2025.