Reproductive Health Challenges Research Articles

Psychosexual well-being following spinal cord injury: Perspectives of adults with spinal cord injury and rehabilitation clinicians.

This study aimed to identify important mental health topics for people with spinal cord injuries (PwSCI) and garner insights from health care clinicians working with this population. In doing so, we identified psychosocial adaptations in the context of sexuality, intimacy, and reproductive health. A qualitative, phenomenological approach was used, with 60-90-min virtual focus groups involving PwSCI, rehabilitation clinicians, and psychologists. Themes were identified through deductive and inductive transcript analysis. Eligibility for PwSCI included: (a) SCI for ≥ 1 year, (b) 18+ years, (c) U.S. residency, (d) conversational English skills, and (e) cognitive capacity to provide informed consent. Clinicians required ≥ 5 years of rehabilitation experience. Sixteen PwSCI, eight rehabilitation clinicians, and four psychologists participated. Three major themes emerged: (1) The effects of SCI on relationships with noninjured significant others with subthemes of (a) internalized and partnered ableism in intimate relationships and (b) navigating care partner dynamics and resource gaps; (2) sexual self-esteem with subthemes of (a) gender role adaptation and (b) body image concerns; and (3) challenges in sexual and reproductive health with subthemes of (a) family planning and self-advocacy in health care settings, (b) access to specialized care, and (c) health care provider competence. This report illuminates the complex effects of SCI on their relationships with noninjured partners, revealing how internalized and partnered ableism can heighten feelings of inadequacy and alter relationship dynamics. These findings underscore the need for more research, support, and services in sexual and reproductive health for all PwSCI. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Adolescent reproductive health care services: knowledge, perspectives, and challenges among service providers in Makurdi, Benue State Nigeria

Adolescence is a phase of life characterized by several reproductive health challenges that require support to navigate. However, access to adolescent and youth-friendly health service (AYFHS) centers to provide this support is limited. Perspective of healthcare workers (HCW) towards understanding the challenges to service provision has not been systematically documented. This study therefore documents the perspectives of HCWs on the types of services accessed by adolescents, and associated challenges in Makurdi, Benue State, Nigeria. The facility-based descriptive qualitative study used an in-depth interview guide among program officers in the 11 youth-friendly health centers. The interviews were recorded, transcribed, and analyzed thematically. The provision of HIV prevention services and AYFHS was appropriate while adolescents have preferences for facilities where their confidentiality is protected, and other needs are met. Reported challenges were lack of privacy, high cost of transportation to facilities, high staff attrition, poor awareness of the facilities and services, and parental consent. Suggestions for improvement included prolonged retention of youth-friendly trained staff, better client confidentiality, and economic empowerment of the adolescents to access services when needed. While the providers’ perspective on AYFHS for adolescents was positive, related challenges were also identified. Government and other stakeholders should collaborate to ensure the right environment for accessibility and utilization of AYFHS.

Sexual and reproductive health challenges and service use among internally displaced persons in Benue and Kaduna states of Nigeria: a comparative study

This study investigates the sexual and reproductive health (SRH) challenges and access to SRH services among internally displaced persons (IDPs) in two Nigerian states: Benue (North-central) and Kaduna (Northwest). The research focuses on understanding how different contexts and variation in the management of displacement in these contexts influence SRH outcomes for IDPs and use of SRH services within and outside camp settings. We conducted face-to-face survey interviews with 581 sexually active IDPs residing in camps for at least 6 months. The questionnaire covered contraception, gender-based violence, sexually transmitted infection (STI) services, and SRH service utilization. Our findings reveal significant contextual differences between the two states. Benue reported higher rates of transactional sex, while Kaduna had higher rates of intimate partner violence and contraceptive use. SRH service use was generally higher in Benue than in Kaduna. We found statistically higher odds of SRH service use one camp in Benue (β = 2.7; p < 0.001) and significantly lower odds in a camp in Kaduna ((β = 0.1; p < 0.001) in comparison with a camp in Benue. By showing how different approaches may shape displaced persons’ access to SRH services within and outside camps, our study highlights the importance of understanding the nuances in humanitarian contexts in designing responses. This study provides valuable insights into the SRH needs and experiences of IDPs in different Nigerian contexts, informing targeted interventions and policies to improve service provision for displaced populations.

Socioeconomic determinants of male contraceptive use in South Africa: a secondary analysis of the 2016 SADHS data

BackgroundHistorically, family planning discussions have predominantly centred on women, overlooking the crucial role men play in contraception. This is particularly concerning in regions like Sub-Saharan Africa (SSA), where reproductive health challenges are pronounced. South Africa, a key country within SSA, continues to grapple with issues such as high unintended pregnancy rates and increasing pregnancy-related mortality. Understanding the factors that deter male contraceptive use is essential for achieving universal access to sexual and reproductive health (SRH) services. This study investigates the socioeconomic disparities influencing male contraceptive use in South Africa, drawing on data from the 2016 South Africa Demographic Health Survey.MethodsThe study utilised data from the 2016 South African Demographic and Health Survey, which employed a stratified, two-stage sampling design across all provinces based on the 2011 Census. The survey focused on men aged 15–59 using the “Man’s Questionnaire.” Various socio-demographic and attitudinal variables were analysed using STATA 17. The analysis included multinomial logistic regression to identify determinants of male contraceptive use and the Erreygers Normalized Concentration Index to assess socioeconomic inequalities in contraceptive uptake.ResultsAmong the surveyed men, 47% reported not using any contraception, 40% used male methods, and 13% relied on their partners’ contraceptive use. A majority began sexual activity between the ages of 14–17 (54%), resided in urban areas (56%), were unmarried (67%), and had attained secondary education (70%). Notably, 78% disagreed that contraception is solely a woman’s responsibility, and 64% expressed positive attitudes toward contraception. Age, marital status, and education level emerged as significant factors influencing contraceptive use. The study revealed a slight pro-rich inequality in male contraception use, with socioeconomic status (SES) being the most significant contributor to this disparity (223.22%). This suggests that higher SES is associated with increased inequality in the adoption of modern male contraceptive methods.ConclusionThese findings highlight the impact of socioeconomic disparities and entrenched cultural beliefs on male contraceptive use in South Africa. To address these challenges, comprehensive strategies that prioritise education, expand family planning media campaigns and ensure equitable access to contraception are urgently needed.

Indigenous Knowledge on the Management of Ungomwa among the Ndau of South-Eastern Zimbabwe

The article explores the indigenous Ndau people’s conceptualisation of ungomwa (infertility) and its management. More specifically, I investigated the Ndau beliefs and practices around ungomwa. I conducted a literature review, informal conversations and made observations for data collection. I delimited the study to causes of infertility among Ndau males, its detection, effects, and how it is managed within Ndau cosmology. The findings showed that, although beliefs on ungomwa were varied, it is an undesirable condition. It results in childlessness, which presents serious problems; victims suffer personal grief and frustration, social stigma, and ostracism. Using an indigenous knowledge perspective in a patriarchal Ndau community, I argue that men want to maintain their ego and masculine grandstanding in the community and usually blame women for the infertility. More important to note is that there are indigenous knowledge systems that can be employed to (mis)manage infertility if detected early at youth. If detected when a man is already in marriage, measures are put in place to ensure children are born in the family. I argue that ungomwa is a gendered, cultural, and psycho-social sexual reproductive health challenge that can be innovatively managed for human flourishing.

Therapeutic potential of Sertoli cells in vivo: alleviation of acute inflammation and improvement of sperm quality

BackgroundInflammation-induced testicular damage is a significant contributing factor to the increasing incidence of infertility. Traditional treatments during the inflammatory phase often fail to achieve the desired fertility outcomes, necessitating innovative interventions such as cell therapy.MethodsWe explored the in vivo properties of intravenously administered Sertoli cells (SCs) in an acute lipopolysaccharide (LPS)-induced inflammatory mouse model. Infiltrating and resident myeloid cell phenotypes were assessed using flow cytometry. The impact of SC administration on testis morphology and germ cell quality was evaluated using computer-assisted sperm analysis (CASA) and immunohistochemistry.ResultsSCs demonstrated a distinctive migration pattern, importantly they preferentially concentrated in the testes and liver. SC application significantly reduced neutrophil infiltration as well as preserved the resident macrophage subpopulations. SCs upregulated MerTK expression in both interstitial and peritubular macrophages. Applied SC treatment exhibited protective effects on sperm including their motility and kinematic parameters, and maintained the physiological testicular morphology.ConclusionOur study provides compelling evidence of the therapeutic efficacy of SC transplantation in alleviating acute inflammation-induced testicular damage. These findings contribute to the expanding knowledge on the potential applications of cell-based therapies for addressing reproductive health challenges and offer a promising approach for targeted interventions in male infertility.

Knowledge and practice of health workers on sexual and reproductive health and rights and gender-based violence: Evidence from three municipalities in Senegal.

Adolescents in low- and middle-income countries face numerous developmental, sexual and reproductive health (SRHR) challenges, including exposure to multidimensional violence. Dealing with gender-based violence (GBV) is of great importance and health personnel are key players. The objective of this work was to study the knowledge and practices of health personnel on SRHR and gender-based violence in Guédiawaye, Kaolack and Kolda communities in Senegal. A descriptive and analytical cross-sectional study was conducted, which consisted of health professionals (general practitioners and specialists, nurses, and midwives) and community health workers (community relays, bajenu gox, matrons). All health facilities in the three communities were included. Data analysis consisted of univariate analysis and logistic regression modeling to investigate the factors associated with the knowledge and practice of health personnels. An alpha risk of 5% was taken. A total of 78 health professionals and 128 community actors were included in the study. More than half of the health personnel (56.3%) had good knowledge of policies, standards and protocols relating to sexual and reproductive health services for women (adolescents) and about 60% on conventions and laws. The level of knowledge was good among 51% of respondents and good practices among 54.9%. The factors associated with good knowledge were the municipality in which the profession was practiced, and the effects of training received in the social construction of gender. The factors associated with the practices were knowledge of policies, standards and protocols through training, training received in the provision of family planning services, and in medico-psychosocial management of cases of sexual violence. We conclude that the knowledge of stakeholders (health professionals and community health workers) about sexual and reproductive health and gender-based violence is important for better service provision and good management of cases of gender based violence.

Unveiling Reproductive Health Challenges: A Qualitative Assessment to Explore Menstrual Hygiene, Breastfeeding, and Complementary Feeding Practices &amp; Restrictions among Women in Himachal Pradesh

Unveiling Reproductive Health Challenges: A Qualitative Assessment to Explore Menstrual Hygiene, Breastfeeding, and Complementary Feeding Practices &amp; Restrictions among Women in Himachal Pradesh

Provider perspectives on adolescent access to contraception in South Africa.

Poor access to contraception influences adolescent health outcomes and may lead to sexual and reproductive health challenges. Unmet sexual and reproductive health should contribute to unplanned adolescent pregnancies, sexually transmitted infections, and other conditions. Therefore, it is crucial to enable adolescents to access appropriate contraceptive methods easily. This study explored factors influencing adolescents' access to contraceptive methods from the perspective of primary healthcare providers in South Africa. This study was conducted in two health districts of the Western Cape province in South Africa: the City of Cape Town Metropolitan Municipality and the West Coast district. Using a qualitative research design, in-depth semi-structured interviews were conducted with 24 healthcare providers who work in primary healthcare clinics. Subsequently, the interviews were transcribed and verified for errors. Braun and Clarke's thematic analysis model guided the data analysis using ATLAS.ti software (version 22). The study adhered to the consolidated criteria for reporting qualitative studies checklist for qualitative research. Four themes emerged through the data analysis: (1) personal influences, (2) community-level influences, (3) health system influences, and (4) policy-level influences. Representative quotations were used to illustrate the themes and sub-themes. Adolescence is shaped by various influences that affect adolescents' ability to access contraception. These factors include their awareness of contraception, social environment, provider biases and school policies. Understanding these influences is crucial for addressing unintended pregnancies and promoting sexual and reproductive health among this age group.Contribution:This study highlights strategies that facilitate and hinder adolescents' access to contraception.

P-491 Reproductive mental health empowerment: enhancing mental health literacy among women with reproductive health issues

Abstract Study question What is the role of mental health literacy and its impact on women’s help-seeking when there are reproductive mental health issues? Summary answer Mental health literacy and attitudes toward seeking professional help significantly predict one’s emotional well-being and help-seeking behaviour. What is known already Women who encounter reproductive health issues can experience an array of physical issues as well as emotional hurdles. There are barriers at the societal level that impede women from addressing these reproductive health-related mental health challenges, such as social stigma, lack of attention on mental wellness and a disproportionate amount of focus on the fertility treatments’ outcomes. There is limited understanding regarding the relationship between women’s reproductive mental health literacy and their tendencies to seek help in the literature. Study design, size, duration This study used cross-sectional data from an online questionnaire that explored the participants’ reproductive mental health literacy, attitudes towards seeking professional help and their actual help-seeking behaviour. Data were collected between July and September 2023. Participants/materials, setting, methods Participants were 356 Chinese women (mean age = 32.64±7.15) recruited through community network and social media. Participants answered questions related to their knowledge of mental illness, ability of seeking professional help, recognition of mental illness, acceptance of patients with mental illness, recognition of need for psychotherapeutic help, stigma tolerance, interpersonal openness, confidence in mental health practitioner, knowledge on community resource and their actual help seeking behaviour. Main results and the role of chance 59% of the participants attained a Bachelor’s degree or above and 74% were married. 43.5% of the participants experienced emotional disturbances triggered by reproductive health issues. Among these participants, 52% chose not to seek help from others. Among different types of reproductive problems, participants with fertility and reproductive health problem scored lowest in terms of help-seeking behavior (M = .28, SD = .45, p&amp;lt;.05., reproductive mental health knowledge (M = 27.29, SD = 4.39, p&amp;lt;.01), recognition of mental illness (M = 16.73, SD = 4.0,p&amp;lt;.05), recognition of need for psychotherapeutic help (M = 17.99, SD = 3.63, p&amp;lt;.01), and interpersonal openness (M = 16.85, SD = 3.35, p&amp;lt;.01). In terms of emotional disturbances, the result indicated that acceptance of patients with mental illness (b = -.035, p &amp;lt;.05) and recognition of the need for psychotherapeutic help (b = .068, p &amp;lt;.05) predicted the numbers of emotional disturbances one experienced. In terms of help-seeking behaviour, knowledge of mental illness (B = 1.30, p &amp;lt; .01), recognition of the need for psychotherapeutic help (B = 1.49, p &amp;lt; .01), and knowledge of community resources (B = 2.15, p &amp;lt; .01) significantly predicted one’s actual help-seeking behaviour. Limitations, reasons for caution There may be potential confounding factors that influenced the results, such as previous mental health history and use of mental health facilities. The ability to establish a causal relationship between reproductive mental health literacy, help-seeking attitude, and actual help-seeking is constrained due to the study’s utilization of a cross-sectional design. Wider implications of the findings Providing counseling for infertility plays a crucial role in addressing the emotional and psychological needs of individuals by reducing the stigma surrounding reproductive mental health challenges. Incorporating infertility counseling into fertility treatment empowers women with information and facilitates open and honest communication on mental well-being. Trial registration number Not applicable

P-353 Perfluorooctanoic acid (PFOA) impacts murine ovarian follicle development through apoptotic signaling pathways and exhibits transgenerational effects

Abstract Study question How does Perfluorooctanoic Acid (PFOA) exposure impact ovarian function and the physiological and reproductive health of subsequent offspring? Summary answer PFOA exposure leads to ovarian dysfunction, characterized by follicular depletion and hormonal imbalances, and adversely affects the reproductive health of offspring. What is known already Mass spectrometry reveals higher perfluorinated compound levels in premature ovarian failure patients compared to healthy individuals. PFOA, an environmental contaminant, is known for its endocrine-disrupting effects, but its specific impact on ovarian function and transgenerational health remains less explored. This study addresses the gap by examining PFOA’s direct ovarian effects and its consequential impacts on offspring, using both in vivo and in vitro models. Study design, size, duration This study employs mouse models and ovarian granulosa cells to assess PFOA’s impact. Mice were administered PFOA (50mg/Kg) and evaluated for ovarian function and offspring health. Ovarian tissue underwent histological analysis and hormone assays. RNA transcriptome sequencing identified activated apoptotic pathways post-PFOA exposure. Offspring physiological and reproductive parameters were also examined. Parallel in vitro experiments with ovarian granulosa cells at 50uM PFOA concentration provided insights into cellular apoptosis. Participants/materials, setting, methods Clinically, we collected serum samples from approximately 100 Premature Ovarian Insufficiency (POI) patients and 100 healthy individuals, analyzed using mass spectrometry. In murine experiments, we simulated human environmental exposure to PFOA (particularly in high-exposure professions) using a 50mg/Kg dose administered via gavage. Transcriptome sequencing analyzed potential signaling pathways in both experimental and control mice. Offspring underwent physiological metabolic assessments and fertility evaluations, including fertilization and blastocyst rates. Main results and the role of chance Mass spectrometry results from human samples revealed significantly higher levels of perfluorinated compounds in POI patients compared to healthy controls, suggesting a potential link between PFOA exposure and ovarian dysfunction. In murine models, PFOA administration at 50mg/Kg resulted in notable ovarian changes. Histological analysis showed a reduction in follicle counts and abnormalities in AMH and FSH levels, indicative of premature ovarian failure. Transcriptome sequencing of these mice highlighted the activation of apoptotic pathways, especially the PI3K/Akt/mTOR signaling, post-PFOA exposure. This suggests a mechanistic pathway through which PFOA may induce ovarian dysfunction. Furthermore, offspring of PFOA-exposed mice displayed significant reproductive health challenges. They exhibited irregularities in estrous cycles and a decrease in oocyte fertilization rates, pointing to potential transgenerational effects of PFOA exposure. These findings in murine models align with the elevated perfluorinated compound levels observed in human POI patients, reinforcing the hypothesis of PFOA’s detrimental impact on ovarian health and subsequent generational fertility. The consistency of results across human clinical data and animal models strengthens the argument for a causal relationship between PFOA exposure and reproductive health risks. Limitations, reasons for caution While these findings highlight PFOA’s detrimental effects on ovarian function and offspring health, translating results from animal models to humans necessitates caution. The specific mechanisms and potential variability in human response to environmental PFOA exposure require further investigation. Wider implications of the findings This research underscores the far-reaching impacts of environmental contaminants like PFOA on reproductive health. It emphasizes the need for stringent regulation of such pollutants and further studies to understand their long-term effects on human health, particularly regarding fertility and intergenerational wellbeing. Trial registration number not applicable

Effectiveness of Outreach Clinical Mentoring on Retention in Care and Viral Suppression among HIV Positive Young Persons on Art in North Central Nigeria

Introduction Sexual and reproductive health challenges vis-à-vis Human immunodeficiency virus/Acquired immune deficiency syndrome, constitute a complex phenomenon in young persons. These health complexes have been shown to adversely affect the disclosure of their positive status, their adherence to medications or retention in care and overall quality of life. This study was meant to determine the effectiveness of deliberate clinical mentoring on retention in care, measured by the rate of interruption in treatment and viral suppression among young persons on anti-retroviral therapy.  Methods This study employed a facility-based quasi- experimental design. A multi-stage sampling technique was used to select study participants. The three senatorial zones of Nasarawa state were selected through a purposive sampling method at stage one. One Local Government Area was selected from each of the three senatorial zones through simple random sampling technique at stage two. Five health care facilities were randomly selected from each of the three selected Local Government Areas through balloting at stage three. Baseline data was collected at the beginning of the study; mid-term data mid- way into the study and post-intervention data was collected at the end of the study. The respondents/mentees were mentored for a period of eight months.  Results Difference in means of interruption in treatment rates at baseline and at midterm, which is an estimate of the amount by which intervention changed the outcome was – 0.69605 with a p-value of 0.359. Mean differences in interruption in treatment rates pre- and post-intervention was 0.7333 with a p-value of 0.033, which was statistically significant. In a similar vein, mean differences in viral suppression rates at start of study and mid-term on the one hand, and then pre- and post-intervention on the other hand, were respectively 4.80000 and 3.40000. The corresponding p-values were 0.235 and 0.174, which were not statistically significant.  Conclusion This study showed 100% retention among young persons on anti-retroviral therapy following 8 months of meticulous outreach clinical mentoring. The study also showed improvements in viral suppression rates, but the extent statistically, was not significant. Clinical mentoring should therefore, be prioritized and strengthened for better clinical care outcomes in positive young persons on anti retroviral therapy.

Unveiling the Path: A Qualitative Study on the Initial Sexual Experiences of Cambodian Adolescents.

There still remains a significant gap in understanding the sexual and reproductive health challenges faced by adolescents, particularly in the context of early sexual activity, teenage pregnancy, and sexually transmitted diseases. This study seeks to fill this gap by exploring the initial sexual experiences of Cambodian adolescents, highlighting the complex interplay of cultural, social, and personal influences that shape their sexual health decisions and outcomes. A descriptive qualitative research design was used. Thirty Cambodian adolescents were interviewed from March to June 202 and data were analyzed using thematic analysis. Participants met their sexual partners in school and through friendships and social networking sites. Their motivations for sexual activities ranged from intrinsic desires to influences of inebriation, love, and trust. Consent was crucial but some were influenced by partners. Awareness of sexual protection varied, affecting condom use and information-seeking behaviors. After initial encounters, participants grappled with complex emotions and physical changes. The findings suggest the need for educational interventions that address substance use; promote safe behavior, consensual conduct, open communication, and mutual respect; and provide coping strategies.

A pharmacist's role in increasing access to menstrual products: an education and advocacy approach.

Individuals who menstruate grapple with diverse challenges in menstrual and reproductive health. This includes financial burdens, societal stigmas, and negative mental and physical health implications. Period poverty, marked by insufficient access to menstrual products, education, and sanitation, remains a prevalent and poorly addressed issue. Alarming statistics highlight the extent of this problem and shed light on the staggering number of individuals lacking access to essential menstrual products. The discourse extends to the safety and accessibility of a diverse array of menstrual products. A comprehensive comparison of the cost of available period products was conducted using data obtained from various retail websites. The often-overlooked potential indirect expenses and profound impacts on quality of life were also discussed. Amidst other public health initiatives, pharmacists have emerged as pivotal advocates and educators. Pharmacists are poised to drive initiatives that increase access to menstrual products through public health education and advocacy. By providing education on different menstrual product options, pharmacists can empower individuals to make informed decisions based on their needs. This perspective illuminates the complex impacts of menstruation on individuals and proposes that pharmacists can play a role in overcoming barriers to access. The proposed strategies, rooted in education, research, and advocacy, pave the way for enhancing access, reducing stigma, and elevating the quality of life for those navigating the intricate complexities of menstruation.

Women and Reproductive Health Challenges in Igboland: A Historical Study

The objective of the work is women and reproductive health challenges in south east, Nigeria. The research also treats the nature of reproductive health challenges in Igboland before and after 1970, and the official reaction to reproductive health challenges in contemporary Igboland. The research method employed was the qualitative analytical method which involved content analysis of relevant documentary data on the subject. The approach adopted was also thematic. The research findings indicate that reproductive health challenges in Igboland before and after 1970 can be classified into five, namely: genetic reproductive health challenge, witchcraft and curses, labor and accident, harmful socio-cultural practices, as well as infectious and communicable disease. The government response to reproductive health challenges includes the different frameworks for the protection of the reproductive health rights of women. These include the domestic instruments as well as the international instruments ratified by the government. The study observed that a number of factors inhibit the provision and availability of reproductive health rights in south east Nigeria, and it includes the social and economic factors as well as cultural and religious factors. It also argues that in spite of these challenges, some successes have been recorded as a result of the official responses to reproductive health challenges in Igboland. These include the elimination of child marriages, reduction in the violence against women and reduction of the harmful cultural practices, such as female genital mutilation (known as women circumcision) and polygamy.

Qualitative Study to Explore the Occupational and Reproductive Health Challenges among Women Tobacco Farm Laborers in Mysore District, India.

Tobacco farm laborers are primarily women and children working for very low wages. The aim of this study was to explore occupational and reproductive health challenges faced by women tobacco farm laborers in Mysore District, India. We conducted interviews and six focus group discussions among 41 women tobacco farm laborers. Codes and themes were generated based on deductive and inductive approaches using the socioecological model. Participants reported symptoms of green tobacco sickness including headaches, back pain, gastric problems, weakness, and allergies during menstruation, pre-natal, and post-natal periods. Participants had poor awareness about the health effects of tobacco farming, and there were gender inequalities in wages and the use of personal protective equipment. Participants received support from family and community health workers during their pregnancy and post-natal period. Women reported wanting maternity benefits from the tobacco board, as well as monetary support and nutritional supplements. There is a need for health education about the environmental dangers of tobacco among farm laborers, and more supportive policies for women farmworkers during pregnancy and post-natal periods.

The magnitude of gender-based violence, health consequences, and associated factors among women living in post-war woredas of North Shewa zone, Amhara, Ethiopia, 2022.

Gender-based violence (GBV) is a pervasive global public health concern and a violation of human rights, particularly pronounced in conflict settings where it is often used as a tool of warfare to instill fear and control populations. Assessment of Magnitude, Associated Factors, and Health Consequences of GBV among women living in war-affected woredas of North Shewa zone, Ethiopia, 2022. A community-based cross-sectional study was conducted, involving 845 randomly selected women living in conflict zones. Data on GBV experiences over the previous 3 months were collected through interviewer-administered questionnaires developed from literature review. The collected data underwent validation, entry into EPI data, and analysis using SPSS. Findings are summarized using descriptive statistics, AOR and 95% confidence interval. The magnitude of GBV in this study was (490, 58.0%) where, (466, 55.0%) psychological violence, (254, 30.1%) physical violence, and (135, 16.0%) reported sexual violence. A majority of the physical violence, (161, 63.4%), occurred during conflict period, with (143, 56.3%) of these cases involving armed forces, and (161, 63.4%) women experiencing physical violence in their homes. Urban Residence AOR = 2.65, CI, (1.82-3.89), Educational status of Secondary education AOR = 0.33, CI, (0.19-0.57, and ≥College AOR = 0.17, CI, (0.09-0.35), Occupation of Housewife AOR = 1.88, CI, (1.20-2.94), Private employee AOR = 6.95, CI, (3.70-13.04), Gov't employee AOR = 5.80, CI, (2.92-11.50), and others (Students) AOR = 3.46, CI, (1.98-6.01), Ever had sexual intercourse AOR = 0.46, CI, (0.25-0.83), Have heard about SRH AOR = 0.59, CI, (0.40-0.89), Have had previous GBV exposure AOR = 0.24, CI, (0.15-0.38), having a previous history of sexual violence AOR = 0.30, CI, (0.16-0.57), and Number of sexual partner AOR = 1.84, CI, (1.13-2.99) were identified to be associated factors of GBV in our study area. The most commonly reported consequences of GBV were Anxiety, depression, physical injuries, self-blame, women had school dropout, and abortion. The study reveals a higher prevalence of GBV, resulting in profound physical, social, mental, and reproductive health challenges for survivors. To address this, multi-sectoral cooperation is advised to enhance women's empowerment, access to information, and psycho-social support in affected areas. Furthermore, national policymakers are urged to implement preventive measures during conflict and establish legal mechanisms to ensure accountability for perpetrators.

Patient satisfaction with nursing care in infertility patients: A questionnaire survey.

Infertility remains a persistent global reproductive health challenge, with causative factors encompassing abnormalities in both the male and female reproductive systems. Typically, female partners seek initial consultations for infertility concerns, often within the context of routine annual well-woman check-ups. Nurses providing preventive care play a crucial role, conducting initial diagnostic assessments, and addressing certain causes of infertility. Patient satisfaction serves as a vital indicator of care quality. Identifying factors contributing to patient satisfaction with nursing services is crucial, yet research in this area has been limited. This study aimed to compare infertility patients' assessments of nurse quality and satisfaction with hospital services. The findings could offer valuable insights for healthcare providers, hospitals, and policymakers, guiding improvements in nursing care delivery and enhancing patient satisfaction in China's infertility treatment sector. By understanding patients' perspectives and experiences, healthcare providers can make necessary adjustments to improve care quality and patient outcomes. The sample included 1200 patients, and data collection utilized a self-assessment questionnaire, with percentages employed for analysis. Nurses are integral to caring for infertility patients during visits and conducting research to advance fertility care practices.

Exploring the multi-level impacts of a youth-led comprehensive sexuality education model in Madagascar using Human-centered Design methods.

Comprehensive sexuality education (CSE) is recognized as a critical tool for addressing sexuality and reproductive health challenges among adolescents. However, little is known about the broader impacts of CSE on populations beyond adolescents, such as schools, families, and communities. This study explores multi-level impacts of an innovative CSE program in Madagascar, which employs young adult CSE educators to teach a three-year curriculum in government middle schools across the country. The two-phased study embraced a participatory approach and qualitative Human-centered Design (HCD) methods. In phase 1, 90 school principals and administrators representing 45 schools participated in HCD workshops, which were held in six regional cities. Phase 2 took place one year later, which included 50 principals from partner schools, and focused on expanding and validating findings from phase 1. From the perspective of school principals and administrators, the results indicate several areas in which CSE programming is having spill-over effects, beyond direct adolescent student sexuality knowledge and behaviors. In the case of this youth-led model in Madagascar, the program has impacted the lives of students (e.g., increased academic motivation and confidence), their parents (e.g., strengthened family relationships and increased parental involvement in schools), their schools (e.g., increased perceived value of schools and teacher effectiveness), their communities (e.g., increased community connections), and impacted broader structural issues (e.g., improved equity and access to resources such as menstrual pads). While not all impacts of the CSE program were perceived as positive, the findings uncovered opportunities for targeting investments and refining CSE programming to maximize positive impacts at family, school, and community levels.

Understanding Adolescent Gynecological Issues: A Cross-Sectional Study at a Tertiary Care Center.

Adolescence is a crucial phase in a woman's life, as it signifies the beginning of her reproductive journey. During this time, there are notable variations in sexual development and a sense of caution that can present challenges for healthcare providers. The rationale for studying adolescent gynecological problems lies in the need to understand and address the unique reproductive health challenges faced by young girls. By investigating these issues, researchers and healthcare professionals can develop effective strategies for prevention, early detection, and treatment of gynecological conditions in adolescents. This knowledge is crucial for promoting the overall well-being and reproductive health of young girls, ensuring they receive appropriate care and support during this critical stage of development. This study focuses on identifying the most common gynecological issues in teenagers, exploring the root causes, examining the available treatment options, and understanding how they are managed at a tertiary care facility. Methods: This cross-sectional observational study took place at a tertiary care center and focused on gynecological issues in adolescent females who sought care at the gynecology department from January 2016 to December 2022. The study participants were categorized into three groups: early adolescence (10-13 years), middle adolescence (14-16 years), and late adolescence (17-19 years) for analysis. Ethical approval was obtained for this hospital-based research, which involved examining, investigating, and treating the study participants. Out of the 49,700 new female patients, 2000 (4.02%) fell within the specified age range. The average age of the participants was 16.87±2.16, and the majority of them sought help for menstrual issues (63.45%), followed by abdominal discomfort (15.6%) and vaginal discharge (7.2%). Menstrual disorders were the most common concern, with dysmenorrhea and puberty menorrhagia being prevalent issues. Abdominal pain was caused by various factors, such as urinary tract infections, ovarian tumors, pelvic inflammatory disease, endometriosis, and endometrial tuberculosis. The majority of cases were treated conservatively, with only a small percentage requiring surgical intervention. The significance of early detection and intervention in addressing gynecological issues among adolescents is highlighted in the findings of this research, underscoring the necessity for specialized healthcare services that cater to the specific needs of this demographic. Adolescent gynecology plays a crucial role in safeguarding the reproductive health and overall well-being of young women, emphasizing the importance of seeking assistance proactively.