Women's Networks Research Articles

Mapping the landscape of female entrepreneurship in Africa: trends, networks and hot topic through text mining techniques

PurposeThe study examines the characteristics and development trends of female entrepreneurship publications, cooperation networks between countries, journals and individuals, intellectual structure of female entrepreneurship studies in Africa and hot research topics. Future comparative studies in different contexts and interdisciplinary collaboration can enrich the understanding about female entrepreneurship research.Design/methodology/approachThe authors used text mining to analyze 130 peer-reviewed articles published from 1975 to 2022 for keywords and classify them into eight main classes: (1) Paradoxical space and informality, (2) work–family conflict, (3) women's entrepreneurial identity and networking, (4) rural women's entrepreneurial activities in the agricultural sector, (5) religious belief and women's entrepreneurial practice, (6) financial trap and environmental challenges, (7) women's entrepreneurial intentions and capacity building and (8) women in cultural entrepreneurship.FindingsFemale entrepreneurship publications develop significantly. Since 1975, African female entrepreneurship study has grown. Results show 130 publications from 1975 to 2023, with two papers published yearly in 2006–2011 and 23 in 2023, indicating growing interest. Paradoxical space and informality, work–family conflict, women's entrepreneurial identity and networking, religious belief and practice, financial trap and environmental challenges and entrepreneurial intentions and capacity building were hot topics identified by topic modeling analysis.Practical implicationsFemale entrepreneurs have looser intellectual networks. Nation, organization and researcher communication is inadequate. Collaborating researchers from different universities and countries may develop the field.Originality/valueThis study is more data-driven and less biased than earlier reviews because it is based on thousands of citation data rather than a small number of papers pre-selected by the researchers. Displaying the field's structure and evolution enhances previous reviews.

An Approach to Hemequity: Identifying the Barriers and Enablers of Iron Deficiency Reduction Strategies in Low-to-Middle-Income Countries

Background Approximately half a billion women of reproductive age worldwide are anemic, and iron deficiency is the most common cause. Iron deficiency anemia (IDA) is cyclical and compounding with intergenerational transfer of poor iron status, where antenatal and perinatal IDA predisposes to IDA in infancy. While IDA is correctable, it remains under-addressed globally and particularly in low-to-middle-income countries (LMICs), with 85% of cases occurring in LMICs of Africa and Asia. IDA is associated with significant morbidity and mortality. In fact, pre-existing anemia and lack of access to blood components and products are the main drivers of maternal deaths in LMICs. Despite abundant evidence that iron supplementation is an effective and life-saving intervention, there is little understanding of how to deliver it effectively in LMICs and its diverse health systems. Objective The primary objective of this study is to identify the enablers and barriers to effective implementation of IDA reduction strategies in LMICs in the published literature to date. Methods A scoping review was conducted using a comprehensive search of MEDLINE, Embase, Scopus, and grey literature from inception to March 2023. Two reviewers independently screened and performed data extraction. We included studies examining iron supplementation and its implementation amongst women of reproductive age who reside in LMICs, as defined by the World Bank. Behavioral, clinical, patient-oriented and process outcomes were also included. We were guided by the intersectionality-enhanced versions of the Theoretical Domains Framework and Consolidated Framework for Implementation Research in our data synthesis to understand the factors influencing health behaviors. Results Of the 9959 articles screened, 50 studies - primarily randomized control trials (6/50), cohort (19/50), cross-sectional (15/50) and other qualitative study designs (5/50) - were included. 50% of the studies were implemented in Africa, 42% in Asia, 6% in South America and 2% in the Middle East. Barriers and enablers of IDA reduction strategies are summarized in Figure 1. Barriers: Contextual barriers included the gross underestimation and deprioritization of IDA risk in women of reproductive age; gender norms and disparities with women's health ranking as the last priority in family dynamics; and intergenerational influences from mothers-in-law who are unfamiliar with iron supplements. Interestingly, the concept of “pill stigma” emerged as a salient theme where women were fearful that taking iron supplements could be mistaken for taking antiretrovirals, suggesting additive stigma from the HIV/AIDS epidemic. Poverty at the individual, government and stakeholder levels also led to supply chain barriers, further exacerbated by conflict, war and natural disasters undermining food security and community initiatives. Forgetfulness was cited as the most common barrier to individual iron supplement uptake. Enablers: Enablers at the individual level included knowledge of anemia and iron supplements, partner support, early access to care, high socioeconomic status, and maternal literacy. Successful interventions utilized existing infrastructures, such as schools and antenatal clinics, to facilitate delivery of supplements and community initiatives. Moreover, education initiatives that included women and their greater communities increased IDA knowledge and empowered women in community decision making. Community mobilization and the degree of community ownership also determined success and sustainability of IDA reduction strategies. Finally, adherence partners, already part of the woman's social network, helped address social and cultural constraints tailored to her individual context. Conclusion We identified numerous barriers and enablers of IDA reduction strategies at different levels of the socio-ecological model and its interaction with individual-level factors. IDA is not only a medical problem, but one that is rooted in the sociocultural and political context. Both contextual and individual factors contribute to overt and subclinical manifestations of IDA, leading to further iron debt and gender inequity in LMICs. Future interventions must recognize the resilience of LMIC communities and acknowledge the importance of knowledge translation and exchange rooted in local context with community ownership and empowerment.

The critical role of community networks in building everyday resilience – Insights from the urban villages of Surabaya

The resilience of a community facing hazards and disastrous events is determined by the degree to which the community owns necessary resources and the capacity to self-organise before, during, and after disasters. Social networks are a key aspect of this ability to self-organise and support their participants in the midst of stresses and shocks. Such networks can help address both large-scale and everyday disasters through a range of measures. This research, therefore, aims to understand how community networks can build resilience, using two detailed case studies from urban kampung (village) communities in Surabaya. A variety of methods, including network analysis, are applied to engage and evaluate the resilience of the communities.The analyses of community networks integrate places for interactions, activities, key actors, impacts on community resilience and strategies for strengthening community networks. The findings suggest three important support networks can enhance community resilience. These comprise of neighbours' networks, women's networks and political networks. This research therefore serves as a significant and strategic tool for policy makers, city planners, and researchers to better understand how community networks can contribute to everyday resilience and support communities to survive and ultimately thrive.

Micro-political strategies in negotiating the role of women's networks in organizations

PurposeThe authors aim to contribute to current knowledge on women's networks in organizations by exploring the strategies employed by members of women's networks, Human Resources (HR) management and senior line management to negotiate the role of these networks in their organizations.Design/methodology/approachThe authors employ the theoretical perspective of micro-politics to analyze qualitative data they collected in an action research project using open-ended interviews and participant observation. The interviews were conducted with network board and active members, and members of their organizations' HR departments and senior management. Participant observation of the interviewees' interactions took place during facilitated workshops.FindingsAdding to the literature, the authors find that members of the different parties employ different micro-political strategies. Many senior HR and management members demand that the networks' activities contribute to the organizations' diversity aims and bottom line. They largely avoid strategic cooperation with the networks. Most network members, in turn, resist the restricted role of the networks as an instrument to realize their organizations' business case. They claim some freedom to independently decide on the networks' strategies and activities. They resist being attributed tasks and responsibilities that they consider to reside with their organizations. Moreover, they try to sustain cooperative relationships with senior HR and management in an advisory role.Originality/valueThe action research approach enabled the authors to contribute to existing knowledge and extend the micro-politics theoretical perspective to include the collective agency of members of organizational groups and cooperation between these groups.

Failure in reflective functioning as a key factor in the association between problematic social networking sites use, attachment and childhood maltreatment: A network analysis approach on gender differences.

Following a network analysis approach, the present study aims to explore the pattern of mutual relationships between failure in reflective functioning (RF) - defined as hypomentalization - problematic social networking sites use (PSNSU), attachment anxiety and avoidance, and childhood maltreatment among emerging adults, with a focus on gender differences. The study sample comprises N = 1,614 emerging adults (Mage = 23.84; SD = 3.21; 50% identified themselves as women) who completed online self-assessment measures. Results showed significantly greater PSNSU, hypomentalization, childhood emotional abuse, and both attachment avoidance and anxiety among women. Indeed, within the network analysis, performed separately for men and women, network-specific associative patterns were observed; yet also similarities have emerged. Within the women's network, differently from males, attachment avoidance connects, through attachment anxiety, to emotional abuse, mood modification related to PSNSU, and hypomentalization. Nonetheless, hypomentalization was central in both networks, functioning as a hub between attachment anxiety, the PSNSU cluster, and the childhood maltreatment cluster. These results shed light on the use of social network sites as a potential maladaptive emotion regulation strategy, particularly among women. In this regard, the role of RF should be considered as a key treatment target to reduce PSNSU and support the use of adaptive emotion regulation strategies.

“Dia Dikader”: Women’s NGOs roles, networks, and the agency of women’s legislative candidates in West Sumatra

ABSTRACT Previous research, on the representation of women in the Indonesian parliament in the 2019 General Election, identifies two common strategies used by women legislative candidates to win. One is to draw on women's networks to mobilize support and the other is to rely on the dynastic power. This paper contributes to existing studies by exploring the vital role of women NGOs in supplying and preparing women's legislative candidates through a case study of the West Sumatra Provincial Parliament in the 2019 General Election. Qualitative research methods were used for this research, drawing on in-depth interviews with women legislative candidates of West Sumatra Provincial Parliament and women activists. This paper reveals that the rise of women candidates in West Sumatra was “prepared” (dikader) by women's NGOs, namely Koalisi Perempuan Indonesia of West Sumatra and Wanita Islam of West Sumatra. These women NGOs have played an important role in getting women elected by providing political training, consultation, moral support, and access to women's networks. Women NGOs' support for these women candidates arose from their long-term socio-political relationship. This research has also revealed that the women candidates exercised a great deal of agency in reaching the voters through these women's NGOs and networks.

Community sense and insurgency perspectives for latin american afrodiasporic women's networks

We analyze the insurgence of black intellectual women’s networks in Latin America with emphasis on their organizational dynamics, besides considering the ongoing identification processes anchored on the idea of Afrodiasporic belonging. We noticed an urgent need to review the scope already consolidated by culture disciplines with regard to studies about networks. Our intention was to promote cross-sectional approaches favoring theoretical frameworks that contemplate the daily traumatic experiences which are recollected as a form of violence. We have also seen how transnational community perspectives are emerging in the debate about black women´s development and culture. It is argued that studies on the African diaspora in Latin America are underrepresented.

Paradoxes in the cultural doula concept for migrant women: Implications for gender-inclusive care versus migrant-friendly maternity care

ObjectiveSwedish healthcare policies promote gender equality, shared parenting and cultural diversity. In response to the risk of adverse outcomes for migrant women, cultural doulas were introduced as support for migrant women during pregnancy and/or labour. The aim is to investigate potential tensions in the cultural doula concept in relation to policies of gender equality and diversity. DesignAn interview study was designed to analyse perceptions of the cultural doula concept among healthcare providers in Swedish sexual and reproductive healthcare. Through the framework of Bacchi's approach ‘What Is the Problem Represented to Be?’ and Hochschild's concept of ‘global care chains’, we analyzed whether the introduction of the cultural doula concept is in line with the policies of gender equality and culturally sensitive care by exploring paradoxes, unintended consequences and what was not reflected upon. Setting and participantsSemi-structured interviews (n = 18) with midwives and obstetricians at hospitals in two Swedish counties during 2022. Measurements and findingsThe interviews were analyzed through thematic analysis. Cultural doulas were perceived as multi-tasking resources for facilitating integration and providing healthcare information and psychosocial support. Respondents did not identify doula support as a cultural practice in migrants’ origin countries. Despite awareness of cultural differences in gender norms, many respondents stated that doula support included male partners. Key conclusionsThe cultural doula concept includes paradoxes in relation to gender equality and diversity. Rather than empowering migrant women, the cultural doula concept is related to gendered patterns of low-educated, underpaid care work. Labour support interventions including migrant women's social network and intensified partner involvement would be more in line with Swedish policies of gender equality, shared parenting and cultural sensitivity when needed. However, doulas may be an imperfect solution for women lacking partners or social networks, for example, newly arrived migrant women, if no support is to be found within the perinatal care system. Implications for practiceMidwives and obstetricians need reflexivity about what the problem is represented to be when it comes to gender equality and cultural sensitivity in their collaboration with cultural doulas, boundaries between roles, how they handle confidentiality, and why cultural doulas are needed in relation to migrant women's integration.

Building a predictive model of low birth weight in low- and middle-income countries: a prospective cohort study

BackgroundLow birth weight (LBW, < 2500 g) infants are at significant risk for death and disability. Improving outcomes for LBW infants requires access to advanced neonatal care, which is a limited resource in low- and middle-income countries (LMICs). Predictive modeling might be useful in LMICs to identify mothers at high-risk of delivering a LBW infant to facilitate referral to centers capable of treating these infants.MethodsWe developed predictive models for LBW using the NICHD Global Network for Women’s and Children’s Health Research Maternal and Newborn Health Registry. This registry enrolled pregnant women from research sites in the Democratic Republic of the Congo, Zambia, Kenya, Guatemala, India (2 sites: Belagavi, Nagpur), Pakistan, and Bangladesh between January 2017 – December 2020. We tested five predictive models: decision tree, random forest, logistic regression, K-nearest neighbor and support vector machine.ResultsWe report a rate of LBW of 13.8% among the eight Global Network sites from 2017–2020, with a range of 3.8% (Kenya) and approximately 20% (in each Asian site). Of the five models tested, the logistic regression model performed best with an area under the curve of 0.72, an accuracy of 61% and a recall of 72%. All of the top performing models identified clinical site, maternal weight, hypertensive disorders, severe antepartum hemorrhage and antenatal care as key variables in predicting LBW.ConclusionsPredictive modeling can identify women at high risk for delivering a LBW infant with good sensitivity using clinical variables available prior to delivery in LMICs. Such modeling is the first step in the development of a clinical decision support tool to assist providers in decision-making regarding referral of these women prior to delivery. Consistent referral of women at high-risk for delivering a LBW infant could have extensive public health consequences in LMICs by directing limited resources for advanced neonatal care to the infants at highest risk.

Associations between ambient temperature and pregnancy outcomes from three south Asian sites of the Global Network Maternal Newborn Health Registry: A retrospective cohort study.

Growing evidence suggests that environmental heat stress negatively influences fetal growth and pregnancy outcomes. However, few studies have examined the impact of heat stress on pregnancy outcomes in low-resource settings. We combined data from a large multi-country maternal-child health registry and meteorological data to assess the impacts of heat stress. Retrospective cohort study. Three sites based in south Asia as part of the Global Network for Women's and Children's Health research in India (Belagavi and Nagpur) and Pakistan (Thatta). Data from women enrolled between 2014 and 2020 in the Global Network's Maternal Newborn Health Registry (MNHR), a prospective, population-based registry of pregnancies, were used. A total of 126 273 pregnant women were included in this analysis. Daily maximal air temperatures (Tmax ) were acquired from local meteorological records. Associations between averages of daily maximal temperatures for each trimester and main outcomes were analysed using a modified Poisson regression approach. Incidence of stillbirth, preterm birth, low birthweight (<2500 g) or evidence of pregnancy hypertension or pre-eclampsia. In the overall cohort, risk of preterm birth was positively associated with greater temperature in the second trimester (relative risk [RR] 1.05, 95% CI 1.02-1.07, p = 0.0002). Among individual sites, the risk of preterm birth was greatest in Nagpur (RR 1.07, 95% CI 1.03-1.11, p = 0.0005) and associated with second-trimester temperature. The overall risk of low birthweight was associated with ambient temperature in second trimester (RR 1.02, 95% CI 1.01-1.04, p = 0.01). The risk for LBW was associated with first-trimester heat in Thatta and with second-trimester heat in Nagpur. Finally, the overall risk of gestational hypertensive disease was associated with greater temperature in the third trimester among all sites (RR 1.07, 95% CI 1.02-1.12, p = 0.005) and was particularly significant for Nagpur (RR 1.13, 95% CI 1.05-1.23, p = 0.002). These findings highlight the increased risk of detrimental obstetric and neonatal outcomes with greater temperature. In a multi-country, community-based study, greater risk of adverse outcomes was observed with increasing temperature. The study highlights the need for deeper understanding of covarying factors and intervention strategies, especially in regions where high temperatures are common.

Women's Empowerment and Sustainable Development: A Quantitative Case Study of Ibesikpo Austan Community, Akwa Ibom State, Nigeria

This quantitative case study examines the role of women in promoting sustainable development in the marginalized Ibesikpo Austan Community of Akwa Ibom State, Nigeria. The community has long faced issues of marginalization and disorientation, presenting obstacles to sustainable development. The study investigates the impact of women's empowerment initiatives on sustainable development outcomes within the community. A sample of 116 respondents was randomly selected, and data was collected through a structured questionnaire and interviews. The study analyzes key sustainable development indicators, including economic growth, social equity, and environmental sustainability. Furthermore, it explores the factors influencing women's empowerment and their active participation in sustainable development initiatives. The findings underscore the presence of gender disparities that hinder women's economic productivity and impede sustainable development progress. The study highlights the potential of leveraging traditional women's networks as effective mobilization mechanisms toward desired goals. This research contributes to a deeper understanding of the gender dynamics in sustainable development efforts. It gives valuable insights for policymakers and stakeholders seeking to foster inclusive and sustainable development in marginalized communities. Based on the research findings, recommendations include empowering women through educational training, financial support, and community-based interventions to enhance their socioeconomic status.

The Global Network COVID-19 studies: a review.

With the paucity of data available regarding COVID-19 in pregnancy in low- and middle-income countries (LMICs), near the start of the pandemic, the Global Network for Women's and Children's Health Research, funded by the National Institute of Child Health and Human Development (NICHD), initiated four separate studies to better understand the impact of the COVID-19 pandemic in eight LMIC sites. These sites included: four in Asia, in Bangladesh, India (two sites) and Pakistan; three in Africa, in the Democratic Republic of the Congo (DRC), Kenya and Zambia; and one in Central America, in Guatemala. The first study evaluated changes in health service utilisation; the second study evaluated knowledge, attitudes and practices of pregnant women in relationship to COVID-19 in pregnancy; the third study evaluated knowledge, attitude and practices related to COVID-19 vaccination in pregnancy; and the fourth study, using antibody status at delivery, evaluated changes in antibody status over time in each of the sites and the relationship of antibody positivity with various pregnancy outcomes. Across the Global Network, in the first year of the study there was little reduction in health care utilisation and no apparent change in pregnancy outcomes. Knowledge related to COVID-19 was highly variable across the sites but was generally poor. Vaccination rates among pregnant women in the Global Network were very low, and were considerably lower than the vaccination rates reported for the countries as a whole. Knowledge regarding vaccines was generally poor and varied widely. Most women did not believe the vaccines were safe or effective, but slightly more than half would accept the vaccine if offered. Based on antibody positivity, the rates of COVID-19 infection increased substantially in each of the sites over the course of the pandemic. Most pregnancy outcomes were not worse in women who were infected with COVID-19 during their pregnancies. We interpret the absence of an increase in adverse outcomes in women infected with COVID-19 to the fact that in the populations studied, most COVID-19 infections were either asymptomatic or were relatively mild.

Exploring the relationship between intimate partner violence during pregnancy and stillbirths

IntroductionThe relationship between intimate partner violence (IPV) in pregnancy and stillbirths is poorly understood. We aimed to determine if there was any association between stillbirths and IPV during pregnancy. MethodsA community-based, matched, case-control study was conducted in 2014, nested within the Maternal and Newborn Health Registry of the Global Network for Women's and Children's Health Research in Pakistan. Using a WHO questionnaire, IPV in pregnancy was ascertained from 256 cases (women with stillbirths) and 539 controls (women with live births), individually matched on parity. Multivariable conditional logistic regression analysis assessed the association of IPV in pregnancy ending in stillbirths compared to those with live births. ResultsThe effect of physical and psychological IPV was modified by maternal age. Among women 25-34 years old with stillbirths, the odds of experiencing physical IPV in pregnancy were four times greater than those with live births, after controlling for confounders [odds ratio 4.1 (95% CI: 1.5, 11.2)]. A negative association was observed between psychological IPV in pregnancy and stillbirths among women younger than 25 years, and no association was observed between sexual IPV during pregnancy and stillbirths. ConclusionStudy results show that women 25-34 years of age with stillbirths were four times more likely to experience physical IPV during pregnancy. Further studies replicating the effect modification of IPV by maternal age are warranted.

조선 중기 여성의 인적 관계망 고찰

The purpose of this thesis is to examine the aspects of women's personal network in the Miam-ilgi and to clarify the aspects of women's lives in the mid-Joseon Dynasty. Miam-ilgi is a diary written by Yoo Hee-chun, who recorded the personal information of the people he met, the personal relationship network between women, and her activities. Women's personal network was formed through their husband's official colleagues, their wives, and their husband's concubines. The range was extended to the woman's eighth degree of parental family. Women acted as beneficiaries and donors, giving and receiving goods in the personal network. In addition, she made various demands such as exemption from military service, succession to descendants, and government positions. Furthermore, women expanded their networks by including men in their families in their networks. This is different from the late Joseon Dynasty, when women's personal networks were formed mainly through husband's in-laws

The Role of Socioeconomic Factors, Psychological Motivations, and Social Networks in Women’s Participation in Community-Based Fishery Management in Ghana

Women’s participation in community-based decision-making in managing natural resources such as fishery is considered crucial to the sustainability of the fishery industry. However, women experience the brunt of inequality in fishery tasks and decision-making despite their crucial contributions. Using survey data (N = 400) from an ethnographic study on Ghanaian female fisherfolk, we examine the factors affecting women’s participation in community-based fishery decision-making. Findings show that while women attended community meetings, only a few held positions in the fishery associations. Whilst education was not a significant factor in women’s community participation, the age of children, women’s ownership of fishery assets as well as psychological characteristics such as trust, interests and gender role attitudes were very crucial. Results further show that network variables such as women’s position in other associations were more important to their participation in community-based fishery decision-making than mere membership in such associations. This study highlights the need for fishery policies aimed at gender equality to move beyond gender structures and economic models toward examining the complexity of factors affecting different aspects of women’s participation in fishery decision-making.

Fine lines: locating commercial sex work in official data, Dublin 1901 and 1911

Abstract Dublin at the turn of the nineteenth century had limited permanent employment opportunities compared to Belfast, and for poor families financial instability manifested in limited life expectancy. This article focuses on young adult cohorts in Dublin city. By cross-referencing names and addresses from death records with census, court and prison records, it casts new light on the lives of the city's most disadvantaged people. It applies a digital humanities framework and uses historical Geographical Information Systems to explore patterns in cause of death, and to reveal more about household income, casual labour, women's work and community networks. We contend that the cautions about the occlusion of commercial sex work in historical data should be extended to the lowest strata of the working classes more generally and that it is only through granular analyses that the fine lines between poverty and destitution can emerge.

Social Networks of Women in Organizations: Evolution of Research and Future Research Agenda

This article carries out a literature review of research on social networks regarding women’s careers in the context of organizations and management for the period of 1970–2021. Our focus is on the conceptualization of social networks, understanding gender, and identification of the network effects that are important for women’s careers. The study enables us to create a comprehensive foundation of research knowledge conducted over several decades and build a profound base of suggestions for further research. Our analysis shows that the field has widened to include individual, organizational, and social environment viewpoints. The research on women’s social networks has evolved from establishing the field, to individualistic understanding, to accounting for sociocultural dynamics. The approach to gender has evolved from gender comparison to gender particularity and then contextualizing gender. Our suggestions for future research avenues include incorporating environmental aspects, virtual social networking, diversity, and leadership perspectives to improve women’s inclusion in social network research.

Women in Networks

Women in Networks

Adverse Childhood Experiences and Lower Urinary Tract Symptoms and Impact Among Women.

This study utilizes CARDIA (Coronary Artery Risk Development in Young Adults) cohort study data to examine whether (1) family-based adverse childhood experiences, recalled by women aged 32 to 47, are associated with lower urinary tract symptoms and their impact, a composite variable with 4 levels (bladder health and mild, moderate, or severe lower urinary tract symptoms/impact), and (2) extensiveness of women's social networks in adulthood attenuates an association between adverse childhood experiences and lower urinary tract symptoms/impact. In 2000-2001, frequency of adverse childhood experiences exposure was retrospectively assessed. In 2000-2001, 2005-2006, and 2010-2011, extensiveness of social networks was assessed; scores were averaged. In 2012-2013, lower urinary tract symptoms/impact data were collected. Logistic regression analyses examined whether adverse childhood experiences, extensiveness of social networks, and their interaction were associated with lower urinary tract symptoms/impact, adjusting for age, race, education, and parity (n=1,302). Recall of more frequent family-based adverse childhood experiences was associated with report of more lower urinary tract symptoms/impact over 10 years later (OR=1.26, 95% CI=1.07, 1.48). Social networks during adulthood appeared to attenuate the association between adverse childhood experiences and lower urinary tract symptoms/impact (OR=0.64, 95% CI=0.41, 1.02). Among women with less extensive social networks, estimated probability of experiencing moderate or severe lower urinary tract symptoms/impact vs bladder health or mild lower urinary tract symptoms/impact was 0.29 and 0.21 for those reporting an adverse childhood experiences frequency corresponding to more than "a little" vs "rarely or none of the time," respectively. Among women with more extensive social networks, estimated probabilities were 0.20 and 0.21, respectively. Family-based adverse childhood experiences are related to lower urinary tract symptoms/impact vs bladder health in adulthood. Additional research is needed to corroborate the potentially attenuating effect of social networks.

Cost-effectiveness of low-dose aspirin for the prevention of preterm birth: a prospective study of the Global Network for Women's and Children's Health Research

Premature birth is associated with an increased risk of mortality and morbidity, and strategies to prevent preterm birth are few in number and resource intensive. In 2020, the ASPIRIN trial showed the efficacy of low-dose aspirin (LDA) in nulliparous, singleton pregnancies for the prevention of preterm birth. We sought to investigate the cost-effectiveness of this therapy in low-income and middle-income countries. In this post-hoc, prospective, cost-effectiveness study, we constructed a probabilistic decision tree model to compare the benefits and costs of LDA treatment compared with standard care using primary data and published results from the ASPIRIN trial. In this analysis from a health-care sector perspective, we considered the costs and effects of LDA treatment, pregnancy outcomes, and neonatal health-care use. We did sensitivity analyses to understand the effect of the price of the LDA regimen, and the effectiveness of LDA in reducing both preterm birth and perinatal death. In model simulations, LDA was associated with 141 averted preterm births, 74 averted perinatal deaths, and 31 averted hospitalisations per 10 000 pregnancies. The reduction in hospitalisation resulted in a cost of US$248 per averted preterm birth, $471 per averted perinatal death, and $15·95 per disability-adjusted life year. LDA treatment in nulliparous, singleton pregnancies is a low-cost, effective treatment to reduce preterm birth and perinatal death. The low cost per disability-adjusted life year averted strengthens the evidence in support of prioritising the implementation of LDA in publicly funded health care in low-income and middle-income countries. Eunice Kennedy Shriver National Institute of Child Health and Human Development.