Women's Decisions Research Articles

Motivations for and experience with labor induction at 39 weeks in women with obesity-A qualitative study.

Timing of induction of labor (IOL) at term has been investigated in multiple settings. In Denmark, the 'When to INDuce for OverWeight' (WINDOW) study compares IOL at 39 weeks of gestation versus expectant management in low-risk women with obesity. However, knowledge on women's expectations of and experience with IOL is sparse. The aim of this study was to explore women's motivation to join the WINDOW study and their experience when randomized to IOL at 39 gestational weeks. A qualitative interview study of 25 pregnant women with obesity randomized in the WINDOW study to IOL at 39 weeks of gestation was conducted. Participants were recruited from four hospitals in Central Denmark Region and were interviewed four to six weeks after giving birth. A thematic analysis was performed using a phenomenological approach. The analysis resulted in three main themes, (1) Motivation for IOL, (2) The IOL process, and (3) IOL in recollection and in the future. Participants perceived inclusion into the WINDOW study as a "great opportunity," as they hoped to be randomized to IOL at 39 weeks of gestation. Their main motivation for participating was physical discomfort in late pregnancy and a wish for "knowing" the timing of the birth. BMI-related risk factors were mentioned by few as a motivating factor. Some participants described the IOL process as a team effort between the couple and the midwives and were positive towards future IOL. Others associated the IOL process with prolonged labor or described the body as "reluctant" to respond to the induction regime. A desire to experience spontaneous onset of labor in a future pregnancy was mentioned. Physical discomfort and wanting to "control" the onset of labor were main motivations for women's decision to participate in the WINDOW study, hoping they would be allocated for IOL. Comprehensive information and being supported by midwives through the IOL process was crucial for a positive IOL experience. Some participants were positive towards a future IOL. Others speculated if their body was not ready for birth in 39 weeks of gestation and/or associated the IOL process with a challenging labor.

Examining the complex dynamics influencing acute malnutrition in Turkana and Samburu counties: Study protocol.

Acute malnutrition in children under 5 years is persistent in Eastern Africa's arid and semiarid lands. This study aimed to identify the drivers of acute malnutrition in Turkana and Samburu counties, Kenya. This was a population-based longitudinal mixed-methods observational study. Qualitative and quantitative data were collected at Wave 1, but only quantitative data were collected during follow-up. Participants were a representative sample of children and their primary caregivers from households with children under 3 years at Wave 1. Anthropometric measurements of all children under 5 years in the sampled households were taken at Wave 1 (May to July 2021), and one child under 3 years was randomly selected for follow-up about every 4 months over 2 years for six data collection waves. The study also collected data on sociodemographics; child feeding practices and morbidity; household water and food insecurity; shocks; coping strategies, social safety nets and economic safeguards; water, sanitation and hygiene; women's decision-making and food consumption. Qualitative data were collected through community dialogues, focus group discussions, in-depth interviews, photovoice and key informant interviews with mothers and fathers with children under 5 years, community leaders, county officials and staff of nongovernmental organisations. Data collection is complete and analysis is ongoing. The analysis includes thematic analysis of qualitative data and descriptive and multi-variable regression analyses of quantitative data.

Making decisions about antidepressant use during pregnancy: a qualitative interview study of a sample of women in the United Kingdom.

Background An increasing number of pregnant women now take antidepressants. Many pregnant women experience 'decisional conflict' when deciding whether to take antidepressants, but little is known about the attitudes and experiences influencing these decisions. Aim To explore the attitudes and experiences influencing women's decisions about antenatal antidepressant use. Design and setting A qualitative study using in-depth interviews with a sample of UK women who experienced antenatal depression or took antidepressants antenatally within the preceding three years. Method Recruitment adverts were placed by a perinatal mental health charity and on parenting forums and social media platforms, resulting in a convenience sample. Interview data was coded and analysed with thematic analysis using QSR NVivo. Results Twenty-two women were interviewed; half had taken antidepressants during pregnancy. Most women had concerns about adverse effects and viewed antidepressants as adjunctive to non-pharmacological treatments, which were reported as difficult to access. Some women reported that professional advice was insufficiently detailed. Women described the need to cope with their symptoms, their baby, and existing responsibilities, and related their decisions to their perceived ability to cope. This perception was influenced by physical and emotional challenges relating to pregnancy. Women's decisions were influenced by their previous experiences and by the perceived societal expectations placed on pregnant women. Conclusion Decision-making is a complex and dynamic process, personal to each woman's circumstances. Perceived ability to cope is an important factor in decision-making. Detailed information should be offered to women to support with decision-making in relation to antenatal medication use.

Attitudes towards Maternal Immunisation of Polish Mothers: A Cross-Sectional, Non-Representative Study.

Vaccination protects pregnant women against dangerous infectious diseases and contributes to disease prevention for the child until their vaccination schedule begins. Vaccination behaviour is related to attitudes concerning vaccine prevention. This cross-sectional, non-representative study was conducted among Polish mothers using a diagnostic survey. We used the Vaccination Attitudes Examination (VAX) Scale. The author's questionnaire included questions concerning experiences with adult and maternal vaccinations, as well as sociodemographic data. Among the 375 respondents, more than half (n = 208, 55.47%) received at least one vaccine during pregnancy. The majority of respondents had a university education (n = 356, 94.93%). There was no statistically significant difference in terms of receiving vaccines during pregnancy between respondents with and without a healthcare education (p = 0.230). A logistic regression model indicated that women who were vaccinated outside pregnancy for COVID-19 (OR 4.61, 2.60-8.22) and influenza (OR 7.14, 3.58-14.25) were statistically significantly more likely to be vaccinated during pregnancy. There were statistically significant differences between women who were vaccinated during pregnancy and those who did not receive maternal immunisation in three subscales of the VAX Scale: Mistrust of Vaccine Benefit, Concerns about Commercial Profiteering, and Preference for Natural Immunity (p < 0.001). The most frequently indicated reason for a woman's decision to be vaccinated was concern for the health and safety of the unborn child (n = 196, 94.23%). In contrast, women who were not vaccinated reported fear for the health and safety of the unborn child (n = 88, 52.69%). A key point may be to contribute to the vaccinology education of healthcare professionals, who play an important role in pregnant women's decision to be vaccinated. However, our results may be disrupted because the majority of the women in our study had a university education.

Caesarean section vs vaginal birth: a narrative review of decision making and postnatal outcomes

Background/Aims Few studies have mapped decision-making factors behind mode of birth to postpartum outcomes. This review's aim was to compare factors that drive women's decision making on mode of birth and postnatal outcomes. Methods This narrative literature review of Google Scholar, PubMed, Medline and Wiley Online Library explored studies published from 2000 onwards that compared caesarean section and vaginal birth in relation to decision-making factors and postnatal quality of life. Extracted data were analysed thematically. Results A total of 10 articles were included. Most women favoured vaginal birth, associating it with satisfaction, fear of surgery and cultural norms. Caesarean sections were favoured because of a fear of pain, previous caesarean section experience and the perception that it was easier. There were poorer physical and mental postpartum quality of life outcomes for caesarean sections and assisted vaginal birth, even after 10 years. Conclusions Healthcare professionals require more exposure to supporting women to decide on mode of birth. Routine checks for new mothers require a holistic, person-centred approach as opposed to generalised care. Implications for practice Healthcare workers can and should make every contact with intending and present mothers count. Open conversations about childbirth need to be had, even outside of women's health spaces, with appropriate referrals and signposting to best available evidence for informed decisions to be made regarding mode of childbirth and expected outcomes.

Midwives’ perceptions and experiences of recommending and delivering vaccinations to pregnant women following the Covid-19 pandemic: a qualitative study

BackgroundPregnant women and their unborn babies are at an increased risk of hospitalisation, morbidity, and mortality from illness. However, uptake of influenza, pertussis and Covid-19 vaccinations offered during pregnancy is below the desired rate. This research aims to explore UK midwives’ experiences of approaching and discussing vaccinations with pregnant women, and their perceived role in pregnant women's vaccination decisions. MethodsMidwives in the West Midlands, UK were recruited via participating hospitals and midwife specific social media groups. Interviews were conducted remotely from April to July 2023 and analysed with a deductive codebook coding strategy using thematic analysis. FindingsSemi-structured interviews were conducted with 16 midwives identifying the following key themes: Recommendations to have vaccinations reported on the contents of recommendations and how they are communicated; Messages and guidance included the importance of up-to-date informational needs for midwives to administer vaccinations and the barriers caused by uncertainty and conflicting messages about the Covid-19 vaccine during pregnancy; Delivery of vaccinations included the convenience of offering vaccinations during standard antenatal appointments; and Midwives’ barriers explored the pandemic specific and other barriers midwives face in the administering of vaccinations. DiscussionThese findings contribute to the understanding of how midwives discuss the topic of vaccinations with pregnant women. This research highlights the importance for midwives to receive clear and consistent information. A strong emphasis on why vaccines are important when recommending to pregnant women in addition to standard information on the availability and timing may have a bearing in helping women to make informed decisions about accepting vaccinations.

Gender differences in factors associated with rural health care practice in Minnesota.

To understand gender differences in factors affecting rural health care workforce to inform the development of effective policies and recruitment strategies to address rural health care workforce shortages. A cross-sectional survey of health care professionals (including Advanced practice registered nurses (APRNs), physicians, physician assistants (PAs), and registered nurses (RNs)) in Minnesota was administered by the Minnesota Department of Health from October 18, 2021, to July 25, 2022, during their professional license renewal. The main outcome was whether or not the respondent was practicing in a rural area. The effects of factors associated with rural practice were estimated using binary logistic regression models, and subsequently subgroup analysis was conducted by gender across the four health care professions. Results show that although there were significant gender differences in some factors (growing up in a rural area and family considerations were more likely to influence women's decisions than men's, whereas men were more likely to be influenced by the prospect of having autonomy and broad scope of practice than women), these differences became insignificant when the four health care professionals were analyzed separately suggesting that overall gender differences observed were almost entirely explained by profession differences. Gender differences do not significantly influence the factors impacting rural practice. However, being raised in a rural environment emerges as the most influential predictor of rural practice underscoring the importance of involving rural residents of all genders in health care practice.

Shortcomings of the Bharatiya Nyaya Sanhita, 2023: An Analytical Perspective

The Bharatiya Nyaya Sanhita, 2023 was enacted on December 25, 2023, to supplant the Indian Penal Code of 1860, marking a significant reform in India's criminal justice system. This legislation, along with the Bharatiya Nagarik Suraksha Sanhita as well as Bharatiya Sakshya Adhiniyam, took impact on 1st July 2024. The changes signify a departure from colonial legal frameworks, aiming for a system aligned with contemporary rights and inclusivity. While the Chief Justice of India and various legal experts have praised the BNS as a transformative step, it still exhibits notable shortcomings. For instance, it fails to address necrophilia, leaving serious offences unregulated. Moreover, Section 69's treatment of "deceitful means" in sexual relations raises issues regarding consent, particularly in contexts involving job offers or promotions. Section 152, which deals with threats to national sovereignty, could lead to overly broad interpretations that impede free expression. Additionally, Sections 84 and 88 reveal gender biases and outdated perspectives on marital rights and women's reproductive decisions. These challenges highlight the urgent need for further review and reform to ensure BNS fulfils its goal of creating a just and equitable legal system.

Livestock farming and women empowerment in rural Bangladesh: a mixed method approach

BackgroundIn Bangladesh, livestock farming is not only a major source of animal protein, but it also provides opportunities for women to contribute to household income. Therefore, this study was undertaken to identify the empowerment status of women livestock farmers, factors influencing women's participation in livestock farming and its impact on women's empowerment.MethodsThe study was conducted in the Mymensingh district (administrative unit) of Bangladesh, due to the active participation of women in livestock farming activities. A total of 200 women were surveyed between May to November 2018. Additionally, prior to the final survey, 02 Focus Group Discussions (FGDs) were performed to gain insight into the context of the study areas. Furthermore, a total of 12 semi-structured in-depth interviews were performed with 12 experienced women livestock farmers to collect data regarding the challenges they encounter in livestock farming. Women empowerment was measured using four domains: decision-making process, ownership of assets, social and political awareness, and freedom of mobility. Descriptive statistics, and Heckman's endogenous treatment effect model were applied to analyze the data.ResultsThe results revealed that majority (75%) of women who are involved in livestock farming had a medium level of empowerment. Women's decision to participate in livestock farming was positively influenced by farm size, knowledge, extension contact, and training. According to the average treatment effect on the treated (ATT) value, the empowerment status of women is 16 points higher among participants in livestock farming compared to non-participants. Furthermore, women in rural areas face several obstacles such as economic issues and inadequate marketing facilities, which may prevent them from engaging in livestock farming.ConclusionsEducating women through raising awareness and providing training is warranted because there is a notable disparity in the empowerment status of women who are and are not involved in livestock farming. This will help women improve their social awareness, decision-making capacity, and mobility. Livestock initiatives that encourage women's involvement could be generated by various rural-focused organizations.

FAKTOR YANG MEMPENGARUHI PENGGUNAAN KONTRASEPSI IUD (Intra Uterine Device) DI PUSKESMAS TINGGEDE

The Family Planning (FP) program has been proven to be one of the most effective efforts to reduce maternal mortality rates. This study aims to identify factors influencing the use of intrauterine device (IUD) contraception in Tinggede Community Health Center, Sigi Regency, Central Sulawesi Province in 2024. The study uses a cross-sectional analytical method with a sample size of 130 FP acceptors at Tinggede Community Health Center. The results show that knowledge, attitude, and the husband's support significantly influence the use of IUD. The higher the knowledge, attitude, and husband's support, the higher the rate of IUD usage. The study also finds that subjective norms do not significantly influence the use of IUD. This indicates that community norms do not greatly affect women's decisions to use IUDs. In conclusion, knowledge, attitude, and the husband's support are important factors influencing the use of IUD at Tinggede Community Health Center, Sigi Regency, Central Sulawesi Province. Therefore, efforts are needed to improve husbands' knowledge and support for IUD to increase the use of this contraceptive method in the community. Keywords: IUD, knowledge, attitude, subjective norms, husband's support

Design of a Tool Capable of Assessing Environmental Sociocultural Physical Factors Influencing Women's Decisions on When and Where to Toilet Within Real-World Settings: Protocol for the Build and Usability Testing of a Mobile App for Use by Community-Dwelling Women.

Although surveys and apps are available for women to report urination and bladder symptoms, they do not include their decisions regarding toileting. Real-world factors can interfere with toileting decisions, which may then influence bladder health. This premise lacks data per want of a robust data collection tool. The Prevention of Lower Urinary Tract Symptoms (PLUS) research consortium engaged a transdisciplinary team to build and test WhereIGo, a mobile data collection app for Android and iOS. The design goal was a comprehensive reporting system for capturing environmental, sociocultural, and physical factors that influence women's decisions for toileting. Aims include having (1) an innovative feature for reporting physiologic urge sensation when "thinking about my bladder" and shortly before "I just peed," (2) real-time reporting along with short look-back opportunities, and (3) ease of use anywhere. The development team included a plain language specialist, a usability specialist, creative designers, programming experts, and PLUS scientific content experts. Both real-time and ecological momentary assessments were used to comprehensively capture influences on toileting decisions including perceived access to toileting, degree of busyness or stress or focus, beverage intake amount, urge degree, or a leakage event. The restriction on the maximal number of taps for any screen was six. PLUS consortium investigators did pilot-testing. Formal usability testing relied on the recruitment of community-dwelling women at four PLUS research sites. Women used the app for 2 consecutive days. Outcome measures were the system usability scale (SUS; 0-100 range) and the functional Mobile Application Rating Scale (1-5 range). These scales were embedded at the end of the app. The estimated a priori sample size needed, considering the SUS cut point score set at ≥74, was 40 women completing the study. Funding was provided by the National Institute of Diabetes and Digestive and Kidney Diseases since July 2015. The integrity of the build process was documented through multiple 5-minute videos presented to PLUS Consortium and through WhereIGo screenshots of the final product. Participants included 44 women, with 41 (93%) completing data collection. Participants ranged in age from 21 to 85 years, were predominantly non-Hispanic White (n=25, 57%), college-educated (n=25, 57%), and with incomes below US $75,000 (n=27, 62%). The SUS score was 78.0 (SE 1.7), which was higher than 75% of the 500 products tested by the SUS developers. The mean functional Mobile Application Rating Scale score was 4.4 (SE 0.08). The build and informal acceptability testing were completed in 2019, enrollment for formal usability testing completed by June 2020, and analysis was completed in 2022. WhereIGo is a novel app with good usability for women to report toileting decisions, urination, and fluid intake. Future research using the app could test the influence of real-time factors on bladder health. RR1-10.2196/54046.

Decisions of Women and Society's Elite "Review of Alqur'an Verses (Perspective of Fii Zilalil Qur'an's Interpretation)"

This study aims to explore and analyze the theme of women's deceit and the elite of society presented in the Qur'an, using an interpretive approach from Tafsir Fii Zhilalil Qur'an by Sayyid Qutb. Through this interpretive study, the researcher seeks to understand how the Qur'an describes the character and strategies used by women and the elite of society in the context of deceit, as well as the moral and social implications contained therein. This study uses a qualitative method with a descriptive-analytical approach to examine relevant verses and interpret their meanings in historical, social, and cultural contexts. The results of the study show that the Qur'an acknowledges the existence of women's deceit as a diverse phenomenon, both carried out by women and the elite of society, and teaches humans to recognize and overcome such deceit through wisdom and strong faith.

Predictors of Pregnant Women's Decision to Opt for Cesarean Section in Romania.

In Romania, the latest official report indicates that more than half of the births (80,890 cases, representing 52.88% of the total) are performed by cesarean, a rate significantly higher than the World Health Organization (WHO) recommendation of 15-20%. This study aims to identify the predictors associated with women's decisions to opt for cesarean in Romania. An analytical cross-sectional observational study was conducted in the general population of Romania. The study was carried out over the course of 2023, with a total duration of four months. During this period, researchers targeted pregnant women from various regions of the country, regardless of their place of residence, age, or education level. The primary data collection tool was a self-administered online questionnaire, distributed via Google Forms, an accessible and efficient platform that allows for automatic response collection. The questionnaire was distributed online, particularly on social media platforms frequented by pregnant women, such as Facebook, Instagram, and TikTok. A total of 1,301 participants were validated. Socio-demographic and clinical factors significantly influence women's decisions to give birth by cesarean.Among these participants, 435 expressed a preference for cesarean delivery. Key predictors include fear of pain and concern for the child's health. Fear of pain at birth is the first predictor in Romanian women to choose cesarean (OR=2.09; 95% CI: 1.62-2.68). Concerns about the child's health do not increase the likelihood of opting for a cesarean. By utilizing valuable resources such as midwives and implementing strategies like birth plans, significant contributions can be made toward reducing the cesarean rate and improving the childbirth experience for women worldwide.

A Quantitative Theory of the New Life Cycle of Women's Employment

“A new life cycle of women's labor force participation has emerged” (Goldin and Mitchell, 2017). Compared to previous cohorts, the employment profile of American college-educated married women born after the mid-1950s is flatter and higher with no hump but with a dip in the middle between ages 30-39. At the same time, these younger cohorts have delayed births, but their completed fertility rate has increased. I develop a quantitative theory to explain the changes in college-educated women's employment and fertility decisions across cohorts. First, I provide reduced-form evidence of a positive correlation between fertility and employment decisions. Second, I build a life-cycle model of labor supply and fertility decisions. My estimates indicate that the marginal returns to experience of college-educated married women increased by 33 percent. Although on-the-job accumulation of experience plays a crucial role in generating employment shifts and birth delays, the model does not generate an increase in the total fertility rate in the absence of infertility treatments. Thus, to understand why college-educated married women's life-cycle employment profiles and fertility decisions are changing, both factors must be considered.

Forgotten Family: The Influence of Women and Children on the Nexus of Wage Earning and Demographic Change in England, 1260–1860

E. A. Wrigley identified the responsiveness of nuptiality and marital fertility to changes in male wages. Others have theorized the importance of women's decision-making in the timing of marriage, but without much empirical evidence. Combining new long-run series of annual wages for men, for married and single women, and for children with existing demographic data, the influence of women and children's remuneration on household formation is investigated. Women played a key role in the functioning of early modern preventive checks. High wages encouraged single women to delay marriage, reducing marital fertility. This counterbalanced the encouragement of nuptiality stimulated by high male earnings, which helped balance population and economic growth. Juvenile earnings had little influence on family formation, challenging links suggested in accounts of protoindustrialization or proletarianization. Demographic evidence suggests that economic circumstances contributed to the timing of medieval marriage, but poverty more often than prosperity prompted celibacy.

Husbands and wives: power, peril and female participation in a Ugandan coffee cooperative

PurposeFemale smallholder farmers in low-income countries face barriers to accessing capital and commodity markets. While agricultural cooperatives provide services that contribute to the income and productivity of small-scale producers, evidence of cooperatives' social and economic empowerment of female smallholders remains limited. We apply Sen's capability approach to female entrepreneurs' socioeconomic empowerment to examine whether women's participation in a coffee and microfinance cooperative from rural western Uganda benefits their social and economic position within their household. First, we study the relationship between women's cooperative participation and their household coffee sales and savings. Second, we investigate the link between women's cooperative participation and their intra-household decision-making and whether the inclusion of the husband in his wife's cooperative strengthens or lowers women's decision-making power.Design/methodology/approachWe carry out a case study of a hybrid coffee and microfinance cooperative that promotes social innovation through the integration and empowerment of female smallholders in rural Uganda. Using a cross-sectional survey of 411 married female cooperative members from 26 randomly selected self-help groups of Bukonzo Joint Cooperative and 196 female non-members from the identical area, employing propensity score matching, this paper investigates the benefits of women's participation in a coffee and microfinance cooperative in the Rwenzori Mountains of western Uganda. We present and discuss the results of our case study within an extensive literature on the role of institutions in collective action for women's empowerment.FindingsOur findings provide new empirical evidence on female smallholders' participation in mixed cooperatives. Our results indicate that women's participation in microfinance-producer cooperatives appears to be a conditional blessing: even though membership is linked to increased women's intra-household decision-making and raised household savings and income from coffee sales, a wife with a husband in the same cooperative self-help group is associated with diminished women's household decision-making power.Research limitations/implicationsThe focus of this study is on female coffee smallholders in an agricultural cooperative in rural western Uganda. In particular, we focus on a case study of one major coffee cooperative. Our cross-sectional survey does not allow us to infer causal interpretations. Also, the survey does not include variables that allow us to measure other dimensions of women's empowerment beyond decision-making over household expenditures and women's financial performance related to savings and income from coffee cultivation.Practical implicationsOur empirical results indicate that female smallholders' cooperative membership is associated with higher incomes and coffee sales. However, husband co-participation in their wives' cooperative group diminishes wives' decision-making, which suggests that including husbands and other family members in the same cooperative group may not be perceived as an attractive route to empowerment for female smallholders. For these reasons, an intervention that encourages the cooperation of both spouses and that is sensitive to context-specific gender inequalities, may be more successful at stimulating social change toward household gender equality than interventions that focus on women's autonomous spheres only.Originality/valueWhile the literature thus far has focused on microfinance's potential for women's empowerment, evidence on agricultural cooperatives' affecting women's social and economic position is limited. First, our findings provide novel empirical evidence on the empowering effects of women's participation in a self-help group-based coffee cooperative in rural Uganda. Second, our data allows us to explore the role of husbands' participation in their wives' cooperative and SGH. We embed our hypotheses and empirical results in a rich discussion of female entrepreneurship, microfinance and cooperative literature.

The Impact of Women Leadership and Decision-Making on Employee Performance with Servant Leadership Style as a Moderating Variable

This study aims to examine the influence of women's leadership and decision making on employee performance, as well as the moderating impact of servant leadership style in the context of the food and beverage subsector manufacturing industry in the Greater Bekasi area. A quantitative approach was used with nonprobability sampling techniques, and data were analysed using Structural Equation Modelling (SEM), involving 219 respondents as research samples. The results showed that female leadership and decision making had a significant effect on employee performance. In addition, servant leadership style moderates the relationship between these variables, suggesting that the application of this leadership style can strengthen the positive impact of women's leadership and decision-making on employee performance. The practical implication of this study is the importance of women's leadership development and the application of servant leadership style in improving employee performance in the industrial sector under study

Qualitative evaluation of a package of implementation strategies codesigned to support the introduction of multiple micronutrient supplementation (MMS) for pregnant women in Bamako, Mali.

Mali national policy recommends that women take iron and folic acid supplements (IFA) from the time of the first antenatal care (ANC) visit, throughout pregnancyand during the first 3 months after delivery. In 2020, the World Health Organization (WHO) updated their ANC guidelines to recommend the United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) formulation of multiple micronutrient supplements (MMS) in the context of rigorous research, including implementation research. In Bamako, Mali, a codesign process was used to tailor antenatal care MMS packaging and counselling materials aimed at optimizing delivery and uptake of and adherence to MMS. This paper presents the codesign process along with the results of a post-intervention qualitative assessment to evaluate the behaviour change intervention. At the conclusion of the intervention, we conducted semistructured qualitative interviews with 24 women who had received the intervention and six pharmacy managers from the six health centres participating in the study. We conducted two focus groups with midwives who had delivered the intervention and two group discussions with family members of women who had received the intervention. Respondent perspectives reveal an easy experience transitioning from previously used IFA. Women and providers concur that the intervention counselling materials and visual aids were instrumental in influencing the perceived benefit and uptake of MMS. Family members play an influential role in pregnant women's decision-making regarding MMS uptake. MMSand the associated implementation strategies developed through the codesign process were found to be a highly acceptable intervention.

Relationship Between Women's Employment and the Pregnancy Rate in Married Women Receiving Services from Health Centers

Background: Women's employment is a significant factor influencing women's decisions regarding pregnancy, both socially and economically. Objectives: The purpose of this study is to determine the frequency of the decision to get pregnant and the effect of women's employment on this decision. Methods: This descriptive-analytical cross-sectional study was conducted in 2023 in Fereydunkenar, Mazandaran province, Iran. A total of 334 participants were selected using a convenience sampling method. Data were collected using a researcher-made questionnaire, validated and tested for reliability. The validity was confirmed by 4 gynecologists, 3 family medicine specialists, 2 midwives, 1 psychologist, 1 epidemiologist, 1 biostatistics expert, and 1 occupational health expert. Reliability was established through a pilot study with 30 participants, determining Cronbach's alpha. Statistical analysis was performed using SPSS version 26, employing chi-square and multivariate logistic regression tests. Results: The study included 261 working women and 73 housewives. The frequency of deciding to get pregnant was lower among working women compared to housewives (36% vs. 56.2%). The results indicated that having one child increased the odds of not wanting to get pregnant by 2.59 times (OR = 2.59, CI 95%: 1.36 - 4.93, P = 0.004). Having two children increased the odds by six times compared to having no children (OR = 6.00, CI 95%: 2.47-12.70, P = 0.001). Additionally, the desire to migrate increased the odds of not wanting to get pregnant by 3.23 times (OR = 3.23, CI 95%: 1.64 - 6.36, P = 0.001). A distance of more than 5 km from residence to workplace increased the odds by 1.82 times (OR = 1.82, CI 95%: 1.03 - 3.35, P = 0.04), and working more than 7 hours a day increased the odds by 1.95 times (OR = 1.95, CI 95%: 1.10 - 3.43, P = 0.02). Conclusions: The results showed that employment reduces the likelihood of deciding to get pregnant by about half. Therefore, in designing policies to encourage childbirth and address population aging, these barriers should be minimized. Strategies should include reducing the distance between home and workplace, decreasing working hours for women, creating favorable economic and social conditions to reduce migration, and conducting educational programs to shorten the gap between marriage and the birth of the first child.

Male support for cervical cancer screening in Debre Berhan City Ethiopia a community based cross sectional survey

Male partner involvement strongly influences a woman's decision to undergo cervical cancer screening. Women of low socioeconomic status are disproportionately affected by cervical cancer. Women living in low-and middle-income countries often encounter resistance from their partners regarding participation in cervical cancer screening. The lack of men's support for sexual and reproductive health programs, including cervical cancer screening, creates a barrier to women's utilization of health services. To assess Ethiopian men's awareness, knowledge, perceptions, and attitudes toward cervical cancer screening and their support to their female partners during screening. A community-based cross-sectional survey was conducted from June 20, 2023, to August 04, 2023. A multistage sampling procedure was used to recruit 614 male survey participants. Descriptive statistics were used to summarize sociodemographic data. Univariate and multivariate regression analyses were performed to measure the associations between the dependent and independent variables. A p-value of less than 0.05 was considered statistically significant. In this survey, 58.5% (359) of participants supported their partners for cervical cancer screening. More than half 55.9% (343) of the participants had an awareness of cervical cancer disease and 47.2% (290) participants knew the risk factors associated with the development of cervical cancer. In addition to that, 66.8% (410) of men have a positive attitude towards screening and encourage their wives to get screened if they notice symptoms of cervical cancer. Regarding the perceptions of cervical cancer, 37.0% (227) of male participants believed that their female partners were at risk of developing the disease, while 38.3% (235) of men believed that cervical cancer screening was only necessary if the woman showed symptoms. Completion of higher education (AOR = 3.75, 95% CI 1.60–8.79, p = 0.002), living with other people (AOR = 0.09, 95% CI 0.03–0.29, p < 0.0001), not being tested for HIV (AOR = 0.26, 95% CI 0.10–0.74, p = 0.011), and having information about cervical cancer (AOR = 3.33, 95% CI 1.36–8.15, p = 0.009) were statistically significantly associated with men’s support for their partners in cervical cancer screening. Men’s awareness, knowledge, and perceptions of cervical cancer screening were low. On the other hand, men have a positive attitude towards screening and encourage their wives to get screened if they notice symptoms of cervical cancer. This survey will serve as a basis for the development of further strategies and action plans to promote and support male participation in cervical cancer screening in Ethiopia. This can be achieved through the development of strategic plans, including public campaigns, raising awareness among social and community leaders, involving non-governmental organizations focusing on women's health, and community education.