Women In Rural Regions Research Articles

ROLE OF COTTAGE INDUSTRIES IN RURAL LIVELIHOODS

Agriculture and traditional handicrafts are deeply ingrained in Indias rural terrain, and cottage businesses have emerged as a key component in maintaining rural livelihoods. This abstract explores the complex aspects of the function that cottage industries play in rural Indias socio-economic structure. Cottage industries, which are sometimes confused with small-scale businesses, cover a broad range of pursuits, from contemporary pursuits like small-scale manufacturing and internet businesses to traditional handicrafts, handloom weaving, ceramics, and agro-processing. These sectors, which have their roots in rural Indias rich cultural legacy, provide major contributions to job creation, income production, and skill development-all of which are critical for reducing poverty. Cottage industries promote inclusive growth by giving people in disadvantaged communities of society more possibilities to find work. For example, women in rural regions frequently use cottage enterprises to achieve financial independence and self-empowerment. The case studies and success stories in this abstract demonstrate how cottage enterprises have a transforming effect on gender dynamics in rural areas. The role of cottage industries in rural livelihoods in India is a dynamic and evolving narrative. This abstract provides insights into the economic, social, and environmental dimensions of cottage industries, emphasizing their potential as catalysts for inclusive and sustainable rural development. Understanding and nurturing these industries is crucial for unlocking the full potential of rural economies and fostering a more resilient and empowered rural India.

Household Gender Roles and Slow-Onset Environmental Change in Morocco: A Barrier or Driver to Develop Migration Aspirations?

We study how slow-onset environmental changes impact the adaptive capacity of rural women living in the Souss-Massa region of Morocco. Given the immobility of many women in rural regions, we especially focus upon the internal migration aspirations of rural woman. In this way our study aims to shed light on the interrelationships between environmental change, gender relations and social and migration aspirations in a gradually environmentally degrading region. Based on Carling’s aspiration/ability model, we analyse how slow-onset environmental changes influence the internal migration aspirations and trajectories of rural women, taking into account important background factors such as household characteristics, land heritage systems and migration networks. Our study is based on 38 interviews with inhabitants of the Souss-Massa region of Morocco that (used to) work in the agricultural sector, of which 15 interviews were conducted with rural women. Our findings show the ambiguous role of slow-onset environmental changes in the development of migration aspirations of rural women in a Moroccan rural context and underscores that environmental changes should be taken into account in migration decision making processes, both for internal and international migration.

Association of Daytime-Only, Nighttime-Only, and Compound Heat Waves With Preterm Birth by Urban-Rural Area and Regional Socioeconomic Status in China

Associations between heat waves and preterm birth (PTB) have been reported. However, associations of daytime-only, nighttime-only, and compound heat waves with PTB have yet to be explored at a national level. Furthermore, possible heterogeneity across urban-rural communities with different socioeconomic statuses needs to be explored. To examine the association between daytime-only, nighttime-only, and compound heat waves and PTB in China and to find variations between urban and rural regions. This case-crossover study used nationwide representative birth data between January 1, 2012, and December 31, 2019, from China's National Maternal Near Miss Surveillance System. This multisite study covered 30 provinces in China and ensured the representation of urban and rural populations across 3 socioeconomic regions. Singleton live births delivered in the warm seasons from April to October during the study period were included. Exclusion criteria consisted of gestational age younger than 20 or older than 45 weeks, maternal ages younger than 13 or older than 50 years, conception dates earlier than 20 weeks before January 1, 2012, and later than 45 weeks before December 31, 2019, and an inconsistent combination of birthweight and gestational age according to growth standard curves of Chinese newborns. Data were analyzed from September 10, 2021, to April 25, 2023. Eighteen definitions of heat waves by 3 distinct types, including daytime only (only daily maximum temperature exceeds thresholds), nighttime only (only daily minimum temperature exceeds thresholds), and compound (both daily maximum and minimum temperature exceeds thresholds) heat waves, and 6 indexes, including 75th percentile of daily temperature thresholds for 2 or more (75th-D2), 3 or more (75th-D3), or 4 or more (75th-D4) consecutive days and 90th percentile of daily temperature thresholds for 2 or more (90th-D2), 3 or more (90th-D3), and 4 or more (90th-D4) consecutive days. Preterm births with less than 37 completed weeks of gestation. Among the 5 446 088 singleton births in the final analytic sample (maternal mean [SD] age, 28.8 [4.8] years), 310 384 were PTBs (maternal mean [SD] age, 29.5 [5.5] years). Compared with unexposed women, exposure of pregnant women to compound heat waves in the last week before delivery was associated with higher risk for PTB, with the adjusted odds ratios (AORs) ranging from 1.02 (95% CI, 1.00-1.03) to 1.04 (95% CI, 1.01-1.07) in 6 indexes. For daytime-only heat wave exposures, AORs ranged from 1.03 (95% CI, 1.01-1.05) to 1.04 (95% CI, 1.01-1.08) in the 75th-D4, 90th-D2, 90th-D3, and 90th-D4 indexes. Such associations varied by rural (AOR range, 1.05 [95% CI, 1.01-1.09] to 1.09 [95% CI, 1.04-1.14]) and urban (AOR range, 1.00 [95% CI, 0.98-1.02] to 1.01 [95% CI, 0.99-1.04]) regions during exposure to daytime-only heat waves in the 75th-D3 and 90th-D3 indexes. In this case-crossover study, exposure to compound and daytime-only heat waves in the last week before delivery were associated with PTB, particularly for pregnant women in rural regions exposed to daytime-only heat waves. These findings suggest that tailored urban-rural preventive measures may improve maternal health in the context of climate change.

EMPOWERING WOMEN THROUGH TECHNOLOGY: A COMPREHENSIVE STUDY ON THE IMPACT OF DIGITALIZATION ON DECISION-MAKING IN ISLAMABAD, PAKISTAN

Women's Empowerment is a comprehensive and multidimensional idea. It is concerned with the economic, social, political, and other aspects of life. Because it is all-encompassing, it implies that all aspects of life must be empowered. Empowerment with regard to all dimensions of life apparently to be initiated simultaneously. Technological improvements have drastically shaken the status quo of several facets of women's lives in urban areas as compared to rural ones in the last decade in Pakistan.This research examines the influence of contemporary technology on women's decision-making Islamabad utilizing primary data inferred through quantitative methodology. The chances and challenges that women in the post-technological period encountered while making decisions were also noted in this study. According to this study, women feel more empowered to use technology to make decisions about certain issues they face as well as other issues. The study focuses on women's empowerment in Access to information, Financial management and Social communication decision-making. For immediate benefits, the study suggests that women in rural regions who have easy access to technology be made more aware of it. The study also recommends that the government support digital media, low-income training, ICT workshops, cultural inequality, infrastructure spending, and data protection laws. This will help close the gender equality gap and improve Pakistan's overall economic health as half of the population currently has little influence over decision-making. Keywords: Technology, Women's empowerment, Women’s descion making, Digitilization, Decsion making

A Family-Based Collaborative Care Model for Treatment of Depressive and Anxiety Symptoms in Perinatal Women: Results From a Pilot Study

Untreated perinatal depression and anxiety can have detrimental consequences on family function. Logistical barriers prevent many perinatal women from accessing treatment, and these barriers are compounded for women residing in rural areas. This paper describes a Family-Based Collaborative Care Model (FBCCM) that is designed to bypass barriers to increase access to care for depressed and anxious perinatal women in rural regions of the United States. The FBCCM includes the following two components: (1) a 10-session video-delivered family therapy treatment for perinatal depression and anxiety and (2) a video-delivered infant care provider training on addressing the parenting needs of depressed and anxious mothers. This paper describes the feasibility of implementing the FBCCM with families and infant care providers. Findings are presented on the preliminary effectiveness of the video-delivered family therapy treatment in reducing maternal depressive and anxiety symptoms, and family conflict. This pilot study was carried out using an implementation-effectiveness hybrid trial design without a comparison group. Changes in maternal depressive symptoms, maternal anxiety symptoms, and family conflict were measured at posttreatment, 3 months, and 6 months later. On average, mothers (n=24) attended 9.79 (SD 1.02) sessions. On average, their family members (n=24) attended 9.42 (SD 1.28) sessions. A total of 31 infant care providers attended the training on addressing the parenting needs of depressed and anxious mothers. Mothers reported a significant reduction in depressive symptoms (P<.001) and anxiety symptoms (P<.001) from baseline to the 6-month follow-up. Mothers reported a significant reduction in conflict (P<.001), and their family members also reported a significant reduction in conflict (P=.007) from baseline to the 6-month follow-up. The findings from this study provide support for the feasibility and preliminary effectiveness of the FBCCM. The findings will be used to inform a larger study of the FBCCM.

Stigmatizing attitudes, beliefs, and actions of women towards abortion in rural regions with high fertility

Objectives: The study aims to determine the stigmatizing attitudes, beliefs, and actions of women towards abortion in rural and conservative areas where fertility is high. Methods: The research is cross-sectional. It was carried out in Mus State Hospital between 28 March-28 April 2022. The sample of the study consisted of 499 women. Introductory information form and stigmatizing attitudes, beliefs, and actions scale towards abortion were used as data collection tools. Findings: The participants’ mean score of stigmatizing attitudes, beliefs, and actions towards abortion scale 69.5, negative stereotypes 28.3, discrimination and exclusion 29.1, and fear of contagion sub-dimension 11.9. The mean score of the scale was found to be significantly higher in women who are single, between 20-35 ages, live in the city center and nuclear family, have an undergraduate or above education level, work (p<0.05). There was a negative correlation between the scale mean score of women and the number of pregnancies, births, living children; and a positive correlation between the scale mean score and the number of abortions (p<0.05). Conclusions: It was found out that stigmatizing and negative attitudes, beliefs, and actions towards abortion are high among women in rural regions with high fertility.

Assessment of lactate dehydrogenase and lipid profile in premenopausal and postmenopausal women in rural regions (Kirkuk government)

The aim of this study aims to measure the levels of lipid profile in in after menopausal women which is an signal of the rise the probability of heart and blood vessels disease the research included 100 women included 50 after-menopausal women aged between 50-60 years and the second group included 50 pre-menopausal women aged 33-43 years Samples were collected from December 2021 to march 2022, and estimated whoever LDH, TC, TG and HDL, LDL and VLDL The results showed increase (p≤0.01) in the level of lactate dehydrogenase enzyme for the after menopausal group (317.63±17.22) U\L compared with the before menopausal group (188.5±15.07)U\L and the outcomes of the research showed that there are significant differences for total cholesterol which showed outcomes rise (p≤0.05) in after menopausal women when contrasted to before menopausal women in which the outcomes were (197.1±9.52) mg\dl (197.105±9.52) mg / dl respectively and a rise (p≤0.01) within triglyceride level of within the after menopausal group (191.94±17.62)mg\dl compared with the before menopausal group (132.47±14.37)mg\dl As for high-density lipoprote (HDL) it has appear a decline (p≤0.05) within after menopausal women (43.69±1.1) mg\dl when compared with before menopausal women (56.64±5.19)mg\dl Regarding low-density protein lipids (LDL) where there was a significant increment (p≤0.05) with revealed outcomes (115.02±9.11)mg\dl in after menopausal women and (88.86±6.48) mg\dl in women before menopause, and the outcomes appear a rise (p≤0.01) in the standard of very low-density lipoprotein concentration for the after menopausal group (38.38±3.10)mg\dl compared with the before menopausal group (26.49±3.17) mg\dl and the results showed a significant increase(p≤0.01)in body mass index in the after menopausal group (31.32±1.17)compared with the before menopausal group (27.25±0.91) kg/m2

Role of Income Generating Activities in Empowering Rural Women of Bangladesh

In Bangladesh, women in rural regions are largely responsible for agricultural production, food security, and household upkeep. This study was carried out to examine the variables affecting the income of rural women, gauge women's empowerment, and pinpointthe main issues they confront. Both quantitative and qualitative data were collected through a pre-tested interview schedule from sixty women involved with income-generating activities. The multistage sampling procedure was used, and primary data were collected from Mymensingh Sadar, Muktagacha, and Bhaluka Upazila of Mymensingh district of Bangladesh from April to June 2021. Tabular analysis, Ordinary Least Square (OLS) method, Women Empowerment Index (WEI), and Problem Confrontation Index (PCI) were usedfor data analysis. The result shows that family size, farm size, work experience, and availability of credit have a significant positive influence on rural women's income. The estimated value of the WEI of the respondents is 1.23 which implies that women are empowered in the study area. Their capacity for decision-making has gradually enhanced as they are involved in income-generating activities.The major concerns faced by rural women include lack of capital, training facilities, credit availability and proper education, the higher price of the input, high-interest rates, etc. However, the survey still shows that rural women's involvement in income-generating activities has improved their quality of life more than at any prior point in the past.

Cost-Effectiveness of Cervical Cancer Screening in Rural Bengaluru with Demographic Analysis of Epithelial Cell Abnormalities

Aim: Cervical cancer is the fourth-most common cancer in women worldwide and ranks third among all the malignancies for women. In contrast to developed countries, cervical cancer is a public health problem in developing countries like India and accounts for a quarter of the global disease burden. It is also one of the leading causes of cancer mortality in India, accounting for 17% of all cancer deaths among women aged between 30 and 69 years. The aim of this study is to perform a demographic analysis of cervical cancer by using Papanicolaou (PAP) test as a screening modality in Doddaballapur, rural Bengaluru, Karnataka. Materials and Methods: A cross-sectional descriptive study was conducted on cervical cancer screening utilizing PAP smear screening. Camps were organized in Doddaballapur, rural Bengaluru, organized by Non-Profit Organization, Sahaya Hastha Trust between December 2017 and 2018. The PAP smears were stained and evaluated for epithelial cell abnormality using Bethesda System criteria free of cost at The Oxford Medical College and Hospital, Bengaluru. Results: A total of 647 patients were evaluated in this prospective study and abnormal epithelial cell abnormalities (ECA) were observed in 24 (3.7%) cases. Among the 24 cases, 2 cases (8.3%) of squamous cell carcinoma, 11 cases (45.8%) of atypical squamous cell of undetermined significance, 5 cases (20.8%) of Atypical Squamous cells - cannot rule out high-grade squamous intraepithelial lesion (HSIL), 3 cases (12.5%) of low-grade squamous intraepithelial lesion (3), 2 cases (8.3%) of high-grade squamous intraepithelial lesion (HSIL), and a single case (4.2%) of atypical glandular cells of undetermined significance were noted. Of the remaining 623 smears (96.2%) diagnosed with negative for intraepithelial lesion or malignancy, 428 cases (68.7%) were reported as nonspecific inflammation, while 56 smears (8.9%) showed atrophic smears and 20 cases (3.1%) were unsatisfactory for evaluation. 119 cases (19.1%) displayed a specific infectious etiology; coccobacilli (bacterial vaginosis) being the most common 66 cases (55.5%), followed by Trichomonas vaginalis 46 cases (38.6%) and Candida infection has 7 cases (5.8%). Conclusions: In Dodabullapur, a rural Bengaluru suburb, 3.7% of cervical cancer patients had ECA. It is hypothesized that a low-cost screening program is exceptionally beneficial in lowering the disease burden of cervical cancer, especially among middle-aged women and those living in low-income areas. This humanitarian purpose might motivate women in rural regions to be educated with the sole goal of uplifting the impoverished.

Identifying Genital Hygiene Behaviours of Pregnant Women in Rural and Urban Regions: A Cross-Sectional Study

Objective: The research was done to identify the genital hygiene behaviors pregnant women in rural and urban regions.Methods: This research was done in analytical cross-sectional design at a maternity and children hospital in Aegean Region between April 15-October 2019. 278 pregnant women, who applied for follow-up and accepted to participate in the research, were included in the research. The data were collected through personal information form and Genital Hygiene Behavior Inventory. Descriptive statistics, chi-square test, Mann Whitney U test and Kruskal Wallis test were used in data analysis. Significance was accepted as p &amp;lt;0.05.Results: It was identified that 26.9% of pregnant women in rural regions were primary school graduate and 44.4% were secondary school graduate. It was found that 32.4% of pregnant women living in urban regions were high school graduate and 31.2% had bachelor’s degree. A statistically significant relationship was identified between educational status and genital hygiene behaviors of pregnant women (p&amp;lt;0.05). Depending on their living places, Genital Hygiene Behavior Inventory mean score was calculated as 77.98±12.19 those living in rural regions and 81.29±11.22 for those living in urban regions. It was found that Genital Hygiene Behavior Inventory levels of pregnant women living in urban regions was higher than those living in rural regions at a statistically significant level (p&amp;lt;0.05).Conclusion: It was identified that living place, educational status, employment status, age status and marriage year affected genital hygiene behavior. it is suggested that health professionals provide genital hygiene training to the pregnant women living in rural regions and with a low level of income through protective and preventive approach.

Abstract B034: Assessment of the prevalence and diagnosis of breast abnormalities among adult women in rural Ethiopia

Abstract Background: Breast cancer (BC) is the most frequently diagnosed cancer and the leading cause of cancer death among females in Ethiopia. BC screening programs are lacking and above 80% breast cancer are diagnosed at advanced stages. Ultrasound-guided fine needle aspiration (FNA) is a simple and effective approach to evaluate breast mass in resource limited countries. The aim of this study was to assess the prevalence and diagnosis of breast abnormalities among adult women in rural Ethiopia. Methods: Community based cross-sectional study was conducted among 7,573 adult women, age 15 years and older from March to April 2018 in Butajira Health and Demographic Surveillance Site, South Central Ethiopia. A two stage-stratified cluster sampling method was used to select the population-based study participants. Data were collected using a pretested interviewer-administered questionnaire to inquire about breast abnormalities from eligible respondents. Further clinical assessment with history and physical examination of those reporting breast abnormalities (e.g., lump or breast pain) were assessed by experienced surgeons. If indicated, surgeons ordered the ultrasound-guided FNA performed by pathologist and cytologic analysis was done by an experienced pathologist. Women with BC were referred to Butajira Hospital for oncologic care. Data were analyzed using EPI- Info and SPSS V20. Descriptive statistics were used to summarize clinical and pathology result. Result: Out of 7,573 women surveyed, 258 (3.4%) women with breast abnormality were identified and referred to the Butajira Health Center. Only two women had visited a health facility to seek medical care before the survey was administered. Of those who reported breast abnormalities, 246 (95.3%) women had physical examinations. Forty-nine women had findings requiring ultrasound-guided FNAs. The median age of women was 30 years old with interquartile range of 25-40 years. Of the FNAs performed, 13 (26.5%) were benign lesions, 8 (16.3%) were fibroadenomas, 9 (18.4%) were reactive lymphoid hyperplasia, and 14 (28.6%) were other noncarcinoma cases. One (2%) was suspicious of BC and required excisional biopsy for diagnosis, and 4 (8.2%) ascertained non-special type carcinoma of the breast. Of BC patients, 2 patients presented with ulcerated and fungating lesion with tumor size greater than 5cm, one patient presented with ulcerating tumor measuring 3 cm, and two patients presented with a breast mass measuring 4 cm. Conclusion: A few women with self-reported breast abnormalities in a rural region of Ethiopia sought medical attention for their problem prior to our survey. We found the prevalence of women with breast abnormalities in our population-based study was similar to reports from Liberia and Rwanda. Raising awareness of health care services available to women in rural regions of Ethiopia could increase earlier detection of breast cancer and improve quality of life. Citation Format: Wondimu Ayele Manamo, Adamu Addissie Nuramo, Ahmedin Jemal, Lesley Taylor, Eva J. Kantelhardt. Assessment of the prevalence and diagnosis of breast abnormalities among adult women in rural Ethiopia [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B034.

Socio-demographic patterning of the individual-level double burden of malnutrition in a rural population in South India: a cross-sectional study

BackgroundThe double burden of malnutrition is the co-occurrence of undernutrition (e.g. underweight, stunting, and micronutrient deficiencies) and over-nutrition (e.g. obesity, type 2 diabetes, and cardiovascular disease) at the population, household, or individual level. The objectives of this study were to determine the extent and determinants of individual-level co-morbid anemia and overweight and co-morbid anemia and diabetes in a population in rural Tamil Nadu, South India.MethodsWe undertook a cross-sectional study of adults (n = 753) in a rural region of Tamil Nadu, South India. A survey assessed socio-demographic factors, physical activity levels, and dietary intake. Clinical measurements included body-mass index, an oral glucose tolerance test, and blood hemoglobin assessments. Multivariable logistic regression analyses were used to determine associations between risk factors and two co-morbid double burden pairings: (1) anemia and overweight, and (2) anemia and diabetes.ResultsPrevalence of co-morbid anemia and overweight was 23.1% among women and 13.1% among men. Prevalence of co-morbid anemia and diabetes was 6.2% among women and 6.3% among men. The following variables were associated with co-morbid anemia and overweight in multivariable models [odds ratio (95% confidence interval)]: female sex [2.3 (1.4, 3.85)], high caste [3.2 (1.34, 7.49)], wealth index [1.1 (1.00, 1.12)], rurality (0.7 [0.56, 0.85]), tobacco consumption [0.6 (0.32, 0.96)], livestock ownership [0.5 (0.29, 0.89)], and energy-adjusted meat intake [1.8 (0.61, 0.94)]. The following variables were associated with co-morbid anemia and diabetes in multivariable models: age [1.1 (1.05, 1.11)], rurality [0.8 (0.57, 0.98)], and family history of diabetes [4.9 (1.86, 12.70).ConclusionThis study determined the prevalence and factors associated with individual-level double burden of malnutrition. Women in rural regions of India may be particularly vulnerable to individual-level double burden of malnutrition and should be a target population for any nutrition interventions to address simultaneous over- and undernutrition.

Cervical cancer screening strategies for evidence-based health care reform in China: a multicentre, open-label randomised trial

BackgroundAs part of China's 2009 health-care system reform, a national cervical cancer screening programme was launched, offering free screening by cytology or visuaI inspection with acetic acid and LugoI's iodine (VIA/VILI). We evaluated high-risk HPV (hrHPV) testing as a new screening modality for the national programme. MethodsThis multicentre, open-label randomised trial was undertaken at nine urban and 11 rural primary-care centres in mainland China. Women aged 35–64 years without history of cervical cancer or hysterectomy, no clinical symptoms of pregnancy, who could understand the study procedures, and voluntarily participated were included. At baseline, women in urban areas were randomly assigned (1:2) to primary screening by cytology or hrHPV, and women in rural areas were randomly assigned (1:1:1) to cytology, hrHPV, or VIA/VILI. Women with baseline hrHPV positive tests were randomly assigned to triage strategies using cytology, VIA/VILI (rural sites), or directly refer to colposcopy. At 24-months, women in urban regions were rescreened with cytology and hrHPV co-testing; rural women received combined hrHPV, cytology, and VIA/VILI screening. Women who showed positive in cytology or VIA/VILI were referred to exams for further colposcopy, and biopsy was then required for participants with abnormal colposcopy results. The primary outcome was cervical intraepithelial neoplasia 2 or worse (CIN2+) and cervical intraepithelial neoplasia 3 or worse (CIN3+). Data analyses were done in the intention-to-screen population (ie, all women assigned to screening). This trial is registered with Chinese Clinical Trial Registry, number ChiCTR1900022530. FindingsBetween May 18, 2015, and Sept 30, 2016, 61 484 women were assessed as eligible and 60 732 were randomly assigned to screening. Among women in urban regions, 8 955 were assigned to cytology and 18 176 to hrHPV-genotyping; among women in rural regions, 11 136 were assigned to VIA/VILI, 7080 to cytology, and 15 385 to hrHPV-testing. Compared with cytology and VIA/VILI-based primary screening, hrHPV without triaging had 2·0–2·7 times higher baseline CIN2+ or CIN3+ detection (risk ratios: urban hrHPV vs cytology CIN2+ 2·2 [95% CI 1·5–3·1], p<0·0001, CIN3+ 2·0 [1·2–3·3], p=0·0084; rural hrHPV vs cytology CIN2+ 2·6 [1·7–4·0], p<0·0001, CIN3+ 2·7 [1·5–4·6], p<0·0001; rural hrHPV vs VIA/VILI CIN2+ 2·0 [1·5–2·8], p<0·0001, CIN3+ 2·3 [1·5–3·6], p=0·00012). At the 24-month follow-up, hrHPV without triage had lower new CIN2+ or CIN3+ than cytology in urban sites (risk ratio: CIN2+ 0·5 [0·3–0·97], p=0·038; CIN3+ 0·2 [0·03–0·8], p=0·026), and lower baseline false negative results in rural sites (risk ratio: cytology CIN2+ 0·3 [0·2–0·6], p=0·00019 and CIN3+ 0·3 [ 0·1–0·6] p=0·0025; VIA/VILI CIN2+ 0·3 [0·2–0·6], p=0·00012 and CIN3+ 0·4 [0·2–0·8], p=0·013). InterpretationHrHPV-testing offered better performance than current cytology and VIA/VILI-based primary screening and could be incorporated into China's national programme, but with the longer screening intervals recommended by WHO. FundingNational Health Commission of China.

DETERMINANTS OF FERTILITY STATUS AMONG REPRODUCTIVE AGE WOMEN IN RURAL ETHIOPIA: EVIDENCE FROM 2016 ETHIOPIAN DEMOGRAPHIC HEALTH SURVEY

Background: Fertility rate is a significant determinant of population growth worldwide. Global population is growing about 80 million people each year. Ethiopia is one of the most heavily populated countries in the world. Objective: The objective of this study was to assess the major determinants of fertility status among reproductive age women in rural Ethiopia . Methods: The study used 2016 Ethiopian Demographic and Health Surveys data . A total of 8464 rural women aged 15 to 49 years included in the analysis . P oison Regression model was used to determine factors moving fertility status of rural women. Results: The overall average children ever born to women in rural regions were 5.1 children per women. Poisson regression analysis revealed that region, age group of respondents, education level, religion, household wealth index, sex of the head of the household, contraceptive use, age at first birth and mass media were found to be statistically significant factors for fertility rate of women. Conclusion: To reduce the gap of fertility rate between regional women, it is important to renovate different factors. These factors could be access to education, informing about contraceptive use, informing about family planning, enhancing to mass media. Therefore, the government and concerned bodies should plan effective strategies to increase the experience of using contraceptive across the country with transport limited regions. In addition to this, it is important to develop and keep the access of family planning services and the government could also uphold an access of education system for those restricted regions. Keywords: Fertility, Women , EDHS, Poisson Regression DOI : 10.7176/MTM/9-10-01 Publication date : October 31 st 2019

Trends in adherence to NCCN guidelines for breast conserving therapy in women with Stage I and II breast cancer: Analysis of the 1998–2008 National Cancer Data Base

ObjectiveTo examine temporal trends in guideline adherence for breast cancer local therapy, by race/ethnicity, socioeconomic and insurance status. BackgroundTreatment guidelines recommend breast conserving therapy (BCT) for women with small cancers, but have been unevenly applied. A better understanding of time-trends in guideline adherence may point to interventions for correction. MethodsPatients with tumors ≤2 cm (n = 1,081,075) were identified from 1123 NCDB hospitals, dividing the interval 1998–2011 into 5 segments. Significant differences in rates of guideline adherence over time for race/ethnicity, quartiles of income, education, and insurance status were identified using Chi-square tests. Random effects logistic regression was used to compute odds ratios (OR) for the likelihood of guideline adherence controlling for sociodemographic and clinical characteristics, hospital type and region. ResultsMultivariate models revealed disparities in use of BCT for women ≤39 years (OR 0.49, 95% CI 0.48–0.50); for Asians (OR 0.67, 95% CI 0.65–0.69); for women in the lowest education quartile (OR 0.89, 95% CI 0.87–0.91); and for women in rural regions, (OR 0.79 95% CI 0.76–0.81). The largest radiotherapy disparity was for the oldest women (OR 0.37, 95%CI 0.37–0.38), and in rural regions OR 0.67, 95% CI 0.63–0.71. Over time, differences persisted in BCT use (for race, income, education, insurance type); and for endocrine therapy (by race and education). ConclusionThere was mixed progress in reducing disparities in guideline adherence. These results are conservative, since the most favorable tumor stages were analyzed in the NCDB, which reflects higher quality of care than non-participating hospitals.

Reproductive and Maternal Health Challenges of Pregnant Women in Ethiopia: An Anthropological Appraisal

A very Poor attention is given to reproductive health issues of pregnant women in rural regions of African countries. Ethiopia is one of the countries in horn of Africa representing highest maternal mortality rate in the continent. The Government of Ethiopia has reformed health policy and program to promote community involvement in maternal health, promotion of emergency obstetric health care, health seeking behavior for optimal utilization of maternal health services by women during pregnancies. The women living in pastoralist and small land holders’ communities are exposed to high risks of reproductive health hazards. Material delays comprising of delay in making the decision for referral, delay in arriving at hospital and delay in receiving appropriate maternal health services are major contributing factors for growing maternal deaths in Ethiopia. The illiteracy of woman, exposure to frequent pregnancies at adolescent age, poor decision making power of women in patriarchal society, poor employment status of women are main predicators of low utilization of maternal services and high ,maternal death in rural regions of the country. This article is based on synthesis of research projects completed by different authors on multiple dimensions of maternal mortality in Ethiopia. The promotion of referral support service and bridging up the referral gaps would address issues of maternal mortality and growing unsafe abortions among young mothers in rural regions of the country. This paper examines critically different socio – cultural barriers that prevent women living in rural area for accessing appropriate utilization of maternal and health services and infrastructure available. Int. J. Soc. Sc. Manage. Vol. 4, Issue-1: 32-37

Locating the Informal in the Formal?

This paper explores the influences that led to the development of the Free Health Care Initiative (fhci), which requires the provision of free health services for pregnant women, lactating mothers, and children under the age of five years. The paper will explore the impact of the policy on women actors as both recipients and informal providers of health care in post-war Sierra Leone. Since the end of the Sierra Leone civil war in 2002, there has been much focus on maternal and child health issues due to the staggeringly high maternal and child mortality rates, when compared to the rest of the world. Currently, international considerations exist such as the Convention for the Elimination of All Forms of Discrimination Against Women (cedaw) and the Millennium Development Goals (mdgs) to ensure nations are responsive to women’s health concerns. These often externally driven policies may not be based on internal motivation, and may have negative local consequences. Although the fhci has improved accessibility of clinical services provided by the government by eliminating user fees, a provision was made to eliminate the services of traditional birth attendants (tbas), who historically provided affordable birth services for women in rural regions of Sierra Leone. The new health policy thus criminalizes the actions of tbas, stripping them of the ability to practice their craft and earn a living. This paper examines the sometimes-contradictory results inherent when international laws and mandates get translated into local contexts and problematizes the uni-dimensional ways in which women’s empowerment is often promoted.

Locating the Informal in the Formal

This paper explores the influences that led to the development of the Free Health Care Initiative (fhci), which requires the provision of free health services for pregnant women, lactating mothers, and children under the age of five years. The paper will explore the impact of the policy on women actors as both recipients and informal providers of health care in post-war Sierra Leone. Since the end of the Sierra Leone civil war in 2002, there has been much focus on maternal and child health issues due to the staggeringly high maternal and child mortality rates, when compared to the rest of the world. Currently, international considerations exist such as the Convention for the Elimination of All Forms of Discrimination Against Women (cedaw) and the Millennium Development Goals (mdgs) to ensure nations are responsive to women’s health concerns. These often externally driven policies may not be based on internal motivation, and may have negative local consequences.Although the fhci has improved accessibility of clinical services provided by the government by eliminating user fees, a provision was made to eliminate the services of traditional birth attendants (tbas), who historically provided affordable birth services for women in rural regions of Sierra Leone. The new health policy thus criminalizes the actions of tbas, stripping them of the ability to practice their craft and earn a living. This paper examines the sometimes-contradictory results inherent when international laws and mandates get translated into local contexts and problematizes the uni-dimensional ways in which women’s empowerment is often promoted.

Knowledge and Skill Retention of a Mobile Phone Data Collection Protocol in Rural Liberia

With a large number of births occurring outside the formal health system, it is difficult to determine the number of pregnant women in rural regions of Liberia. The exponential growth of mobile phone use in developing countries provides a potential avenue for data collection on maternal and child health in such rural, remote regions. A pre-, post-, and one-year posttest design was used to collect data on knowledge and skill retention for 7 essential items required for mobile phone use among traditional birth attendants (TBAs) trained in a short message service (SMS) texting data collection protocol (N = 99) in rural Liberia. Sixty-three participants (63.6% retention) completed the one-year posttest and displayed evidence of statistically significant knowledge and skill retention in 6 of the 7 tasks (P < .005), including the ability to: 1) turn on the phone, 2) use the mobile phone to make a call, 3) recognize that they have coverage, 4) recognize that the mobile phone is charged, 5) create a SMS text message without help, and 6) send a SMS text message without help. The TBAs continued to have difficulty with more complex tasks such as adding minutes to a phone. The mobile phone data-collection protocol proved feasible with TBAs demonstrating knowledge retention in a one-year posttest; however, clinical significance needs further investigation. The protocol increased communication and collaboration among TBAs, certified midwives, and clinic staff.

THE STATUS OF WOMEN IN TURKISH LABOR MARKET

Women, who form 50% of Turkey\'s population, have a labor force participation rate of 30%. In connection with the dissimilarity of Turkish labor market from that of the OECD members - existence of informal sector in the urban area, rural-urban migration and the high employment rate of agricultural sector- in 199S the labor force participation rate of the women in rural regions was 50% whereas that of in urban regions was only l5%. The serious oblems the employed women in urban regions confront and the reality that the women in rural regions are at work for family gain is also proved and supported by the detailed statistical data which is gathered by SIS since 1988. As far as it is noticed, both the educated and uneducated women in Turkey have huge problems. Raising the welfare level and the education level of women throughout the whole country and applying appropriate policies to prevent rural-urban migration may be the fundamental steps towards the solution of the labor market\'s problems from women\'s point of view.