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Role theory generally predicts that when the demands and norms of two roles are highly contrasted, individuals will construct a strong boundary to separate the roles. However, such predictions are grounded primarily in the Global North, emphasizing role pairings including "work–family" and hybrid "work–work." Comparatively, the Global South is characterized by a lack of public services that creates a highly contrasted, highly salient, and yet understudied role pairing—"work–community." Additionally, the socioeconomic features of the Global South (e.g., dense and overlapping community networks, financial poverty) call into question whether existing predictions surrounding boundary strength are likely to hold. We conducted a qualitative study of 73 Tanzanian participants who had both a self-employed work role and a family planning counselor community role. We found that highly contrasted roles can be simultaneously perceived as both incompatible and compatible. Specifically, the boundaries we observed were neither uniformly strong nor weak, but rather of asymmetric strength: strong when a social interaction was anchored in the community role, but weak when anchored in the work role. The specific role contrasts we identify, and the importance of role anchoring we observe, have important implications for role theory and boundary-setting more broadly. [ABSTRACT FROM AUTHOR]

Introduction: Family planning among female physicians is harmed by high risks of infertility, workload burden, poor family leave policies, and gender discrimination. Many women report feeling unsupported in the workplace, despite national policies to protect against unfair treatment. Methods: This secondary analysis applied a modified version of the rigorous and accelerated data reduction technique to conduct a thematic analysis of comments to an open‐ended prompt. Comments were coded by multiple trained researchers then grouped and merged into illustrative themes via qualitative techniques. Results: Of 1004 responses to the quantitative survey, 162 physicians completed the open‐ended prompt. Initial codes (n = 16) were combined into eight groups including, from which three overarching themes were identified. Institutional barriers were highlighted with comments discussing the increased need for parental leave, part‐time options and the concern for academic or professional punishment for being pregnant and/or having children. Departmental barriers were explored with comments grouped around codes of discrimination/negative culture and challenges with breastfeeding/pumping and childcare. Personal barriers were discussed in themes highlighting the difficulties that female physicians faced around the timing of family planning, challenges with reproductive health and assistance, and alternative circumstances and/or decisions against family planning. Conclusion: Barriers to family planning in oncology exist across career domains from dysfunctional maternity leave to poor education on infertility risk. Solutions include improving institutional support, expanding parental leave, and general cultural change to improve awareness and promotion of family and career balance. Many female physicians report feeling unsupported in the workplace with respect to family planning and gender discrimination, despite national policies to protect against unfair treatment. This mixed‐methods study showed barriers to family planning in oncology exist across career domains from dysfunctional maternity leave to poor education on infertility risk. [ABSTRACT FROM AUTHOR]

Lack of sexual health knowledge among Saudi Arabian adolescents suggests the need for investigation into the sexual health education curriculum provided in schools. This study explored the dominant ideologies that shape sexual health education discourse in Saudi Arabia. To date, there have been few analyses of the ideologies underpinning Saudi Arabia's school curriculum and the approach that is taken to teaching about sexual health. Examining the ideologies informing sexual health education in Saudi schools can assist in a shift towards more comprehensive approaches. In this study, critical discourse analysis was used to identify the underlying ideologies present within Saudi school curricula as they relate to sexual health education. Our findings suggest that conservative ideology dominates sexual health education discourse. Significantly, it is more strongly present in the curricula available to girls and young women. Sexual health education's discourse currently reflects social/cultural perspectives and avoids the inclusion of more comprehensive health-related information that would better enable young people to protect their health. [ABSTRACT FROM AUTHOR]

Low total fertility rates have persisted in East Asian societies, with gender inequality at home identified as a significant barrier to women achieving their desired fertility. However, there is a lack of empirical evidence on the link between housework participation and fertility intentions among married couples in Hong Kong, where the total fertility rate has fallen below 1 since 2020. This study proposes and tests two hypotheses regarding the relationship between couples' housework participation, housework satisfaction, and fertility intentions. The study utilises representative household survey data to show that women's evaluation of housework arrangements plays a role in the indirect association between housework participation and fertility intentions. This indirect relationship is moderated by gender role attitudes and fertility gap. The findings support gender equity theory, which links an uneven housework burden to low fertility. This research highlights the importance of gender equity at home in promoting fertility in East Asia. [ABSTRACT FROM AUTHOR]

Background: This exploratory study aimed to look into public perceptions of Reversible Inhibition of Sperm Under Guidance (RISUG) as a family planning method in the United Kingdom (UK). It also aimed to discover if there were any sex differences in perceptions between males and females. Design: Twelve semi-structured interviews were conducted, six with males and six with females, all residents of the UK. Methods: The audio data from the interviews then was transcribed for analysis. An inductive and a semantic thematic analysis was conducted on the data set. Results: Three main themes were constructed, including: (i) RISUG Hesitancy, (ii) Females perceived benefits of RISUG and (iii) Males perceived concerns regarding RISUG. Hesitancy was related to vaccination hesitancy, females wanted males to have more reproductive autonomy and males placed their concerns through the lens of 'other' males that their may be unintended side effects. Together these three themes represent both perceived risk and overall benefits of the method. However, while randomized control trails have been completed to standard for RISUG, males perceived concerns, suggesting a disconnect between the public's perceptions and professionals understanding of trails. Conclusion: RISUG was perceived as a viable option for family planning in the future, however trust of the new contraceptive method will need to be fostered among the public in order to effectively transfer knowledge on the potential side effects and the standard of pre-market testing for these. Effective public health messages can result in better education of people concerning the new contraceptive method, including the risks and benefits. By using perceptions to inform health messages around RISUG, researchers and practitioners can learn from potential users how to best address misinformation or concerns, while at the same time building an evidence base for when new male methods reach the contraceptive market. [ABSTRACT FROM AUTHOR]

Potential associations between periconception dolutegravir (DTG) exposure and neural tube defects (NTDs) reported in 2018 caused shifting international and national antiretroviral treatment (ART) guidelines. They sometimes required women to use contraception prior to initiating DTG. To better understand the tensions between ART and family planning (FP) choices, and explore the decision-making processes of women living with HIV (WLHIV) and their healthcare providers (HCPs) employed, we conducted interviews with WLHIV exposed to DTG and their providers in western Kenya from July 2019 to August 2020. For the interviews with WLHIV, we sampled women at varying ages who either continued using DTG, switched to a different ART, or became pregnant while using DTG. We utilized inductive coding and thematic analysis. We conducted 44 interviews with WLHIV and 10 with providers. We found four dominant themes: (1) a range of attitudes about birth defects, (2) nuanced knowledge of DTG and its potential risk of birth defects, (3) significant tensions at the intersection of DTG and FP use with varying priorities amongst WLHIV and their providers for navigating the tensions, and (4) WLHIV desiring autonomy, and provider support for this, in such decision-making. Variations in beliefs were noted between WLHIV and HCPs. WLHIV highlighted the impact of community and social beliefs when discussing their attitudes while HCPs generally reported more medicalized views towards DTG utilization, potential adverse outcomes, and FP selection. Decisions pertaining to ART and FP selection are complex, and HIV treatment guidelines need to better support women's agency and reproductive health justice. [ABSTRACT FROM AUTHOR]

The ability to make informed decisions about reproductive health is a cornerstone principle of the practice of prenatal medical genetics. Unfortunately, these reproductive health decisions have become entangled in the current, contentious political climate. This debate reached an inflection point in 2022 with Dobbs v. Jackson when the Supreme Court of the United States (SCOTUS) overturned the national right to abortion previously established in Roe v. Wade. This decision prompted a reassessment of the opinions of medical students on reproductive health and abortion. Our study focused on a medical school in Alabama, a conservative state that enacted a restrictive abortion ban following the Dobbs ruling. Two surveys, conducted in 2015 and 2022, explored students' viewpoints on reproductive health topics, including abortion. The comparison revealed a significant shift toward more pro‐choice perspectives among medical students. Notably, religious affiliation did not consistently align with opinions, as many Christian students supported pro‐choice views. Our results suggest that medical students' reproductive health opinions at our institution have shifted to a more pro‐choice position over the last decade. [ABSTRACT FROM AUTHOR]

Despite a wide range of family policies, marriage and fertility rates in Japan remain very low among developed countries. Drawing on data from a national survey experiment, this study aims to examine whether dissemination of existing family policies can increase marriage and fertility intentions of Japanese young individuals and whether the effect depends on their gender‐role preferences. The results show that informing and/or reminding respondents of the existing family policies can significantly increase their marriage intention, but not their fertility intention. Moreover, the effect on marriage intention is moderated by their gender‐role expectations for future spouses. Specifically, the policy information effect is more pronounced among women who expect a relatively equal share of financial responsibilities and among men who expect their future wives to assume the primary housework responsibilities. This suggests that although existing family policies may lower marriage costs for economically independent women, the same policies could potentially exacerbate domestic gender inequalities and women's work‐life conflicts by helping less domestically engaged men enter into marriage. Overall, these findings contribute to the feminist literature on gender and family by highlighting the potential consequences of family policies on the pre‐marriage mechanisms of domestic gender inequalities and calling for actions to change men's traditional gender ideology. [ABSTRACT FROM AUTHOR]

Background: Reproductive health and mental health are intertwined, but studies investigating family planning needs and desire for children in mental healthcare are scarce. Methods: We studied the experiences of (former) patients, those with close relationships with the (former) patients (close ones) and mental health professionals (MHP) on discussing family planning and desire for children in mental healthcare. We combined quantitative (two nationwide surveys) and qualitative data (four focus groups) in a mixed‐methods approach with sequential analytical design. Results: Combined data from focus groups (n = 19 participants) and two surveys (n = 139 MHPs and n = 294 (former) patients and close ones) showed that a considerable group of MHPs (64.0%), patients (40.9%) and close ones (50.0%) found that family planning should be discussed by a psychiatrist. However, several obstacles impeded a conversation, such as fear of judgment, lack of time and knowledge and limited opportunity for in‐depth exploration of life themes in therapeutic relationships. Conclusions: To increase the autonomy of patients in discussing family planning, we suggest MHPs explore the desire to discuss family planning with all patients in the reproductive phase of life, prior to discussing contraceptive care. MHPs should receive education about psychiatric vulnerability in relation to family planning and desire for children, and patients and close ones should be empowered to initiate a conversation themselves. [ABSTRACT FROM AUTHOR]

As the most commonly used side-channel analysis method, Correlation Power Analysis (CPA) usually uses the divide-and-conquer strategy to guess the single-byte key in the scenario of block cipher parallel implementation. However, this method cannot effectively use the power consumption information, resulting in a large number of power consumption traces. Therefore, genetic algorithm-based CPA is proposed, which can efficiently extract keys by multi-byte power analysis. However, genetic algorithm-based CPA tends to sacrifice computational cost to achieve a high key guessing success rate. To solve the above problems, this article focuses on bitwise linear leakage and proposes a multi-byte power analysis architecture based on the raindrop ripple algorithm. First, we propose to complete the key initialization by multiple linear regression. Second, we propose a novel swarm intelligence algorithm, the raindrop ripple algorithm, tailored for multi-byte power analysis based on the principles of "family planning" and "eugenics," which greatly improves the probability of producing individuals with high fitness values. Third, we further enhance the possibility of the correct key being recovered by traversing the candidate key space in specific conditions. To verify the key guessing efficiency of the multi-byte power analysis architecture based on the raindrop ripple algorithm, comparative experiments are conducted on SAKURA-G with three power analysis methods based on genetic algorithms. Experimental results show that our proposal not only has the efficient power information utilization of multi-byte power analysis but also has a convergence speed comparable to or even faster than that of single-byte CPA. Its efficiency of key guessing is improved by 85.64% compared to EfficiencyGa-CPA, and its convergence speed is even faster than that of single-byte CPA at 725 power traces, and 83.87% faster than single-byte CPA at 1000 power traces, which is astonishing as a multi-byte power analysis. [ABSTRACT FROM AUTHOR]

We examine population-level associations between birth spacing and child maltreatment using birth records and child welfare records for 1,099,230 second or higher parity children born in North Carolina between 1997 and 2013. Building upon previous research, administrative data linkages were used to address out-of-state migration and family-level heterogeneity in birth spacing and child maltreatment risk factors. Findings provide the strongest evidence to date that very short birth spacing of zero through 6 months from last birth to the index child's conception is a prenatal predictor of child maltreatment (indexed as child welfare involvement) throughout early childhood. Consequently, information about optimal family planning during the postpartum period should become a standard component of universal and targeted child maltreatment prevention programs. However, challenging previous empirical evidence, this study reports inconsistent results for benefits of additional spacing delay beyond 6 months with regard to child maltreatment risk reduction, especially for children of racial and ethnic minorities. These findings call for further inquiry about the mechanisms driving the connections between birth spacing and Child Protective Services assessments. [ABSTRACT FROM AUTHOR]

Background: Despite decades of a call to action to engage men in reproductive health, men are often left out of programs and interventions. In India, where half of pregnancies are reported as unintended, patriarchal gender norms and still dominant patterns of arranged marriages make engaging men in family planning and strengthening couples communication critical in increasing reproductive autonomy and helping young couples meet their reproductive goals. This study explores the feasibility and acceptability from the men's perspective of the pilot of a gender transformative intervention for newly married couples in India. Methods: A pilot study was conducted of TARANG, a 4 month intervention for newly married women, with light touch engagement of husbands (4 sessions). A total of 41 husbands participated in the pilot, and we collected baseline knowledge and endline feasibility and acceptability data from them, along with in depth qualitative interviews with 13 men. The study was conducted in June 2023-January 2024. Results: Men had low levels of knowledge about biology, family planning, with the majority of men reporting that no one had provided them information about these topics. Most men wanted to delay the first birth by at least 2 years, yet less than a quarter had discussed childbearing plans with their partner or engaged in family planning methods. While all men reported high acceptability (satisfaction and usefulness), feasibility (participation) was low, with only 43% attending 2 or more sessions. Main barriers to participation included commitments due to work and migration. Men reported that the intervention led to improvements in their relationships with their wives, gave them a sense of empowerment, and led them to become resources for other men in their community. Conclusions: Men in these rural communities are not receiving the information that they need to meet their reproductive goals, however, they greatly desire this information and ways to improve relationships with their new wives. Such an intervention appears to have the potential to help change norms and spread information in the community and provide men with positive, life affirming feelings. Providing information through technology could address barriers to in-person engagement. Trial registration clinicaltrials.gov : 03/13/24.NCT06320964 Plain language summary: Despite many years of calls to engage men in reproductive health programming, there are still a paucity of interventions that engage men. In the Indian context, with high prevalence of arranged marriages, strict gender norms, and patrilocal marriage patterns where women move into their husbands family's home, engaging men is especially important as they are critical decision-makers. With this in mind, we designed an intervention for newly married women, with an add on component for their husbands, to help young couples meet their reproductive goals. In this paper we report on the feasibility and acceptability of a 6 month pilot of this intervention with 40 newly married men in Rajasthan, India using mixed methods. We find that the intervention was highly feasibility and acceptable, and men felt that the intervention had value and should be considered. However, attendance was low due to work commitments and migration. The intervention appeared to change norms and increase knowledge about family planning and communication about childbearing. Men reported that the intervention led to improvements in their relationships with their wives, gave them a sense of empowerment, and led them to become resources for other men in their community. This suggests that engaging newly married men is possible, but interventions must be designed carefully to be sure to be able increase participation. [ABSTRACT FROM AUTHOR]

Background: Emergency contraceptive pills (ECPs) are significantly underutilized in many parts of the world, especially in South-Asia. Within Pakistan, despite the population surge, the utilization of ECPs remains alarmingly low. The purpose of this study was to investigate the knowledge and practices regarding ECPs amongst married women and men in Karachi, Pakistan and the possible barriers hindering access to and use of these contraceptives. Methodology: A multi-centric cross-sectional study was conducted in Karachi, Pakistan. Interviews were conducted with participants using validated questionnaire involving different sections on demographics, knowledge, practices, and barriers to ECP use. Categorical variables were summarized as frequencies and percentages while continuous variables were characterized using mean and standard deviation. A chi-square test of variance was used for association between knowledge scores and different categorical values. A p-value of < 0.05 at 95% CI was statistically significant. Results: Over half of the respondents (52.5%) were not using any method of contraception. 11.1% of respondents had used ECP at some point in their life. 337 (85.8%) participants had low knowledge, 55 (14%) had moderate while only 1 (0.25%) had high knowledge regarding ECPs. There was no significant association of knowledge scores with gender, age, employment status or parity. However, participants who had received counseling for family planning in the past or had previously used ECPs had significantly higher knowledge regarding ECPs. A majority 58% (221) of the participants expressed concerns about the potential side effects and 128 (33.9%) of them believed that ECPs were in contradiction to their religious and moral values. Conclusion: Our study in Karachi, Pakistan, highlights critical challenges in ECP awareness, utilization, and family planning. Although the results show improved ECP usage than studies previously done in Pakistan, there is a further need to increase the reach of ECPs through a variety of methods. Persistent myths and misconceptions and a severe lack of awareness further hinders their use. [ABSTRACT FROM AUTHOR]

While many frameworks exist for building person-centered and equitable systems of contraceptive care, evidence indicates that the reality of patients' experiences of care is often not in alignment with these ideals. Historical and current contexts of racism in the healthcare system contribute to negative perceptions and experiences of care, as well as reduced care-seeking behavior, for those who identify as Black, Indigenous, and people of color (BIPOC). Our objective in this analysis is to examine whether people's past experiences of contraceptive care are a driver of subsequent barriers to contraceptive access, and whether this relationship differs across racial and ethnic identity. We draw on panel data from five waves of surveys collected between 2018–2023 among patients ages fifteen and older seeking family planning care at sites that receive public funding for these services in Arizona, Iowa, and Wisconsin. Overall and stratified by race/ethnicity, we examine cross-sectional and longitudinal associations between patients' experiences of high-quality, person-centered contraceptive care and three contraceptive access outcomes: use of preferred contraception, satisfaction with contraceptive method, and experience of no barriers to accessing preferred contraception. We find longitudinal associations between patients experiencing higher-quality, more person-centered contraceptive care and subsequent satisfaction with contraceptive methods. Among non-Hispanic white-identifying patients, we find similar associations between shifting to higher-quality contraceptive care and use of preferred contraception, but we find no statistical relationship between experiencing higher-quality care and subsequent contraceptive outcomes for patients who identify as Black, Indigenous, or Person of Color (BIPOC). Highlighting the dissonance between clinical guidance for quality contraceptive care and patient experiences of care, and especially whether similar experiences across racial and ethnic identity lead to differential outcomes, is a crucial step toward bringing contraceptive care systems into alignment with principles of sexual and reproductive health equity. [ABSTRACT FROM AUTHOR]

The struggle women face in balancing work and family roles is a significant factor contributing to the decline in their fertility intentions. Therefore, work-family conflict serves as a crucial determinant influencing women's fertility intentions. This study aims to explore the internal mechanism between work-family conflict and the fertility intentions of Chinese women, using data obtained from 334 questionnaires. Data analysis was conducted using Mplus 8.0. The following conclusions were drawn: (1) There is a negative correlation between work-family conflict and women's fertility intentions. (2) Fertility attitudes play a mediating role in the relationship between work-family conflict and women's fertility intentions. (3) The relationship between work-family conflict and women's fertility intentions is moderated by income class. (4) The relationship between work-family conflict and women's fertility intentions is moderated by women's child-rearing burden. The findings of this study provide a foundation for governments at all levels to formulate population policies. [ABSTRACT FROM AUTHOR]

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

Background: Unintended teenage pregnancies are associated with greater health and socio-economic risks for teenage mothers and newborns. In Kenya, the government has declared a target for ending teenage pregnancy by 2030. However, the prevalence of teenage pregnancy has only decreased slightly, demonstrating the need for further efforts. Understanding teenage mothers' own experiences and perspectives is necessary to design appropriate interventions. Methods: A community-based qualitative study was conducted from March to May 2023. Two focus group discussions were conducted with community health volunteers and the mothers of teenage girls. Semi-structured interviews were conducted on the case histories of 19 teenage mothers and 18 key informants. Thematic analysis was subsequently performed using MAXQDA 2022. Findings: Four major reasons emerged for unintended teenage pregnancies: (1) lack of knowledge or awareness about the human reproductive system, (2) lack of knowledge about family planning (FP), (3) financial challenges, and (4) low access to FP. At the study site, cultural norms and stereotypes, such as "infertility caused by FP," "freedom of sex by promoting FP," and "cultural taboos on having sex before marriage and talking about sexuality," were observed as barriers in promoting FP to teenagers. In addition, teenagers from low socio-economic backgrounds were found to be more vulnerable because they can be easily exploited by men who can afford to provide for some of their basic needs. Regarding the influences of unintended teenage pregnancy on teenage mothers' lives, the 19 cases were classified into four categories: (1) dropping out of school, (2) financial challenges, (3) changing relationships with parents, and (4) no major influence. Crucially, unintended teenage pregnancies negatively influenced most study participants. Continuing education, supportive parental attitudes, positive perceptions of the relationship with the child's father, and having future perspectives were identified as factors mitigating the negative influences. Conclusions: Strengthening culturally appropriate comprehensive sexuality education and the school re-entry policy with a supportive environment may prevent unintended teenage pregnancy and mitigate its negative influences. As financial challenges can be both a reason for and a negative influence of unintended teenage pregnancy, economic empowerment interventions are necessary. Plain English summary: Teenage girls becoming pregnant unexpectedly face higher health and socio-economic risks, which can affect both the lives of teenage mothers and newborns. In Kenya, the government has targeted ending teenage pregnancies by 2030, but the decrease has been limited. Although understanding teenage mothers' experiences and perspectives is important for designing appropriate interventions, only a few studies have been conducted. This study focused on 19 teenage mothers and other key participants to gain a deeper understanding of their backgrounds. Four major reasons were identified for unintended teenage pregnancies: (1) lack of knowledge or awareness about the human reproductive system, (2) lack of knowledge about birth control methods, (3) financial challenges, and (4) low access to birth control methods. At the study site, cultural norms and stereotypes were observed as barriers in promoting the use of birth control methods to teenagers. In addition, teenagers from poor backgrounds were found to be more vulnerable because they can be easily taken advantage of by men who can afford to provide for some of their basic needs. Regarding the influences of unintended teenage pregnancy on teenage mothers' lives, the 19 cases were classified into four categories: (1) dropping out of school, (2) financial challenges, (3) changing relationships with parents, and (4) no major influence. In this study, unintended teenage pregnancies negatively influenced most participants. Continuing education, supportive parental attitudes, positive perceptions of the relationship with the child's father, and having future perspectives were identified as factors mitigating the negative influences. [ABSTRACT FROM AUTHOR]

Background: As women increasingly delay childbearing for educational and career pursuits, understanding the age-related decline in ovarian reserve becomes crucial to avoid infertility. Egg freezing offers a solution, extending the window for achieving pregnancy with a biological child. However, awareness and acceptance of age-related fertility decline and elective egg freezing vary across countries and social groups. Methods: This descriptive cross-sectional study investigates fertility awareness, childbearing intentions, and attitudes toward elective egg freezing among 138 undergraduate female students at a private university in Kumasi, Ghana. Data were collected via a Google App-based questionnaire. Results: The majority of respondents were below 28 years old (76.3%), Christians (79.26%), and single (57. 78%). Many respondents overestimated their knowledge of age-related fertility decline, with almost half (48.89%) incorrectly believing it occurs after age 40. Primary sources of fertility education included health professionals, the Internet, and television. While most (62.96%) considered childbearing necessary, they would not have a child without a partner. Acceptance of donor egg in vitro fertilisation (IVF) varied based on circumstances, and a significant portion was open to donating their eggs (41.48%). Awareness of elective egg freezing was low, but nearly half (48.89%) expressed interest in it, primarily to retain the option for a biological child. The cost of elective egg freezing was a significant deterrent. Conclusions: The study revealed a significant lack of awareness regarding age-related fertility decline and elective egg freezing among female university students in Kumasi. Most prefer having a biological child only with a partner. While few were open to donating their eggs or accepting the same to achieve a pregnancy, interest in elective egg freezing was notable, albeit hindered by cost. The study recommends enhanced education by health professionals using social media and television to address these gaps. [ABSTRACT FROM AUTHOR]

Pregnancy complications are far more common in young women. This could inhibit their personal growth and development, take away them of their youth and education, and decline the general health of the country in the process. Focusing on this problem is an ideal matter. Education, family planning, raising community awareness, and teaching adolescents the importance of delaying marriage, reproductive health, and involvement of parents will surely help transform today's teenage girls into healthy, responsible adults who will bear a healthy future generation. The study emphasizes the lived experiences, challenges, coping mechanisms, and parent's role. Moreover, the study's findings which were based on the Thematic Analysis, were as follows: (1) Teenage Mothers have maternal adjustment difficulties, adolescent reproductive health knowledge gaps, and fear of negative evaluation. (2) Teenage Mothers struggles to discrimination, social rejection anxiety, parenting efficacy, academic disengagement, and financial stress. (3) Lastly, when talking about their coping techniques, Teenage Mothers found support system such as family functioning, where they feel positive, peer influence that uplifts them, maternal identity development through fellow teenage mothers, parent-infant attachment as a source of their motivation, and spiritual well-being where they offer, they overall life to God. [ABSTRACT FROM AUTHOR]

We conduct a randomized controlled trial that provides pregnant and immediate postpartum women with improved access to family planning through counseling, free transportation to a clinic, and financial reimbursement for family planning services over two years. We study the effects of our intervention on child growth and development outcomes among 1,034 children born to participating women directly before the intervention rollout. We find that children born to mothers assigned to the family planning intervention arm were 0.28–0.34 standard deviations taller for their age and 10.7–12.0 percentage points less likely to be stunted within a year of exposure to the intervention. Children born to mothers assigned to the intervention arm also scored 0.17–0.20 standard deviations higher on a caregiver-reported measure of cognitive development after two years of intervention exposure. Although the nonmeasurement of children is a challenge in our study, our estimates are robust to multiple methods of correcting for potential attrition bias. Our results are consistent with models of fertility that link couples' fertility decisions to child health and human capital. Our results also suggest that improved access to family planning might have positive downstream effects on child health beyond contraceptive use and fertility outcomes. [ABSTRACT FROM AUTHOR]

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Copyright of Medic.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of DOMES: Digest of Middle East Studies is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: The fertility health of the migrating population has attracted significant attention. This article examines the impact of parental retirement on the fertility intentions of the offspring among the internal migrant population. Methods: This study utilizes the mandatory retirement age system as an exogenous shock within a fuzzy regression discontinuity (FRD) experimental design to investigate the influence of parents' retirement on the fertility intentions of their migrant offspring and potential mechanisms. Results: The research findings indicate that parents' retirement significantly reduces the fertility intentions of the migrant population by 34.4%. Mechanism analysis attributes this adverse effect to the reduction in intergenerational wealth transfer due to parent's retirement. As the family's economic situation worsens, the negative impact of retirement on fertility intentions becomes more pronounced. The childcare support mechanism provided by retired grandparents can partially offset the adverse effects of the income mechanism. Conclusions: This study provides recommendations for enhancing policies related to delaying retirement age and childcare. [ABSTRACT FROM AUTHOR]

Background: In Pakistan, family planning has traditionally been perceived as primarily a women's concern, resulting in the exclusion of men from relevant initiatives. This situation is further exacerbated by cultural and social barriers that hinder men's access to family planning services. This study addresses a significant research gap by assessing the extent of family planning service provision for men in urban areas of Karachi. It delves into the exploration of men's involvement in family planning service delivery, identifies existing gaps in services catering to men, records men's perceptions of accessibility and acceptability of these services, and ultimately offers recommendations to enhance men's involvement and strengthen service provision to better meet their needs. Methods: We employed a qualitative exploratory research design using semi-structured interviews to investigate perceptions regarding family planning service provision to men. This approach involved 25 interviews, comprising eight key informant interviews with stakeholders, eight with service providers, and nine in-depth interviews with married men. Results: This study highlights the limited engagement of men in family planning programs, primarily due to entrenched sociocultural norms that confine female healthcare providers to serving women, hindering men's involvement. While national and provincial policies endorse men's participation, they lack defined roles for male providers. Behavioral and information-sharing barriers at the community level discourage male healthcare providers from collaborating with females. Family planning programs, except for NGO-led vasectomy projects, fail to adequately address men's needs. Despite policy recognition, implementation remains inadequate. Bridging the men's involvement gap necessitates more male providers and improved contraceptive stigma combat training. Further research is vital to explore effective methods for involving men in community and service delivery in family planning. Conclusion: There is a need to change the perception that contraception is solely the responsibility of women, as men's participation in family planning in Karachi is limited. Engaging men can yield positive health and non-health outcomes. Culturally sensitive services, developed with community input using a couple-centered approach, are crucial for equitable family planning. Further research is needed to explore men's inclusion strategies in service provision and utilization. Plain English Summary: Many family planning efforts focus solely on women, leaving out men, especially in Pakistan, due to cultural and social barriers. This study aimed to explore men's involvement in family planning programs in Karachi. We talked to 25 different people, such as those who run family planning programs, provide services, and married men. We found that men aren't much involved in these programs. Female health providers usually help women, which discourages men from participating or getting involved in such programs. Even though there have been policies to include men since 2002, they don't have specific roles defined. Men don't discuss family planning much with female providers due to behavioral differences and lack of open communication. Men mostly prefer condoms, and apart from a small NGO-run vasectomy project, there are few programs-tailored to their needs. Although policies exist, they're not fully in practice. To change this, we need more male providers and improved training to reduce the stigma around contraception. Future research should explore more effective ways to involve men in family planning, both in communities and service levels. Overall, getting men involved in family planning is important, and services need to be developed with input from communities and couples to ensure fairness. More research is needed to figure out the best ways to do this. [ABSTRACT FROM AUTHOR]

Background Women in their 40s experience significant reproductive health changes, requiring personalised contraception to avoid unintended high-risk pregnancies and adapt to changing health conditions. Objective This article examines optimal contraceptive choices for women in their 40s, considering effectiveness, ease of use, non-contraceptive benefits, side effects, contraindications and re-evaluation or discontinuation timings. Discussion Contraceptive choices for women in their 40s vary depending on their family planning status, underlying health conditions and risk factors. Long-acting reversible contraceptives, permanent sterilisation and progestogen-only methods (excluding depot medroxyprogesterone acetate) are preferred options for women who have completed their families. Hormonal contraceptives can help manage menstrual disorders and bone health issues while providing endometrial protection during menopause. Regular contraceptive reviews should be conducted, and options adapted as needed. [ABSTRACT FROM AUTHOR]

This study aims to examine the changes in family planning methods and sexual behaviors after Türkiye's earthquake and the effect of on quality of sexual life. The study involved a total of 272 women. The multiple regression analysis indicated that having a low educational level, starting to use traditional family planning methods, experiencing a decrease in sexual desire, and having sexual intercourse once a month or less after the earthquake, negatively affected the quality of sexual life in women. Health professionals are recommended to assess women's needs for family planning methods after disasters like earthquakes. [ABSTRACT FROM AUTHOR]

Background: Medical Termination of Pregnancy (MTP) Act legalizes abortion to moderate extent and describes various grounds under which termination of pregnancy can be done. The present study aims to know the proportion of women and to analyse their determinants which lead to seek for MTP services in the family planning unit of a tertiary care hospital Methodology: A retrospective cohort study done between December 2023 to January 2024 for which data of 2 years ie., from January 2022 to December 2023 was retrieved from the MTP registers in the family panning unit. Data was entered in Microsoft Excel and analysed using SPSS Version 21. Results: There were a total of 119 MTPs done in the family planning unit over a period of 2 years, which were all of first trimester abortions. 60.3% fall under socioeconomic causes, 17.2% were due to failure of contraceptive methods. The mean age was 28 years ranging from 17 to 40 years. Conclusion: Most common indication for MTP was found to be socioeconomic causes. Women who did not practice contraception after having desired family size contributes for this unwanted pregnancy. [ABSTRACT FROM AUTHOR]

Planned oocyte cryopreservation (OC) has the potential to address the burden of the biological clock, giving women and individuals with ovaries more autonomy in choosing when to have children and with whom. In the United States, the annual number of OC cycles has grown significantly, yet many questions remain regarding planned OC. The field is starting to gather data on the clinical practice and social perspectives around planned oocyte cryopreservation, including the optimal age range at which to offer planned OC, what factors are most predictive of a successful outcome, and the optimal number of oocytes and ovarian stimulation cycles to achieve a live birth. There is a clear need for setting realistic expectations about the chance of success with OC; however, most patients have yet to return to thaw their oocytes, and outcomes data are limited. Clinical models have been developed to predict OC success based on surrogate markers such as age, number of oocytes retrieved, and anti-Müllerian hormone level. Patient education should emphasize the age-related decline in fertility, that eggs do not equal embryos, and that more than one cycle may be needed to obtain sufficient oocytes to have a reasonable chance of future success. While planned OC is not quite an insurance policy against future reproductive challenges, it provides the best option to date for expanding the reproductive window and maximizing reproductive options while navigating individual life circumstances in the context of family building. [ABSTRACT FROM AUTHOR]

Gestational diabetes mellitus is the most common medical condition in pregnancy, disproportionately affecting overweight or obese women and those from non-White populations. The lack of standardised screening and diagnostic consensus contributes to varying prevalence. Conventional risk factor-based screening can leave women undiagnosed, leading to increased risk of harm. If diet and lifestyle modifications fail to achieve glycaemic targets, prompt treatment should be initiated to manage glucose levels. A planned birth is crucial to ensure the best outcomes. Postpartum, women need screening for type 2 diabetes and other cardiometabolic risk factors, enrollment in diabetes prevention programmes, and counselling on the increased risk of future cardiometabolic disease for themselves and their offspring, highlighting the importance of ongoing prevention and management strategies. [ABSTRACT FROM AUTHOR]

Introduction: Efforts to develop reversible male contraceptives analogous to female oral contraceptives are underway and may be introduced in the next decade. The advent of novel male contraceptives provides an opportunity for an ethical reformulation of the contraceptive paradigm given the relational, rather than individual, nature of sexual relationships, and family planning. For individuals in any sexual relationship that could result in pregnancy, issues of reproductive autonomy, freedom, equality in reproductive decision‐making and risks—both of side effects and of unintended pregnancies—are significant. Historically, however, women have been attributed the greatest responsibilities simultaneously with the most restrictions on their freedom of choice and access to reproductive care. Objectives: In this paper, we extend our prior "shared risk" model of male contraception to one of "shared risk and responsibility" to ethically inform this discourse. Conclusions: This updated framework more fully captures the complexity of this novel technology and may be of use to regulatory and legal agencies grappling with an intervention that poses medical risks to the member of the relationship who does not face risks of becoming pregnant. [ABSTRACT FROM AUTHOR]

Backgrounds: Despite a wide spectrum of contraceptive methods for women, the unintended pregnancy rate remains high (45% in the US), with 50% resulting in abortion. Currently, 20% of global contraceptive use is male‐directed, with a wide variation among countries due to limited availability and lack of efficacy. Worldwide studies indicate that >50% of men would opt to use a reversible method, and 90% of women would rely on their partner to use a contraceptive. Additional reasons for novel male contraceptive methods to be available include the increased life expectancy, sharing the reproductive risks among partners, social issues, the lack of pharma industry involvement and the lack of opinion makers advocating for male contraception. Aim: The present guidelines aim to review the status regarding male contraception, the current state of the art to support the clinical practice, recommend minimal requirements for new male contraceptive development and provide and grade updated, evidence‐based recommendations from the European Society of Andrology (EAA) and the American Society of Andrology (ASA). Methods: An expert panel of academicians appointed by the EAA and the ASA generated a consensus guideline according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system. Results: Sixty evidence‐based and graded recommendations were produced on couple‐centered communication, behaviors, barrier methods, semen analysis and contraceptive efficacy, physical agents, surgical methods, actions before initiating male contraception, hormonal methods, non‐hormonal methods, vaccines, and social and ethical considerations. Conclusion: As gender roles transform and gender equity is established in relationships, the male contribution to family planning must be facilitated. Efficient and safe male‐directed methods must be evaluated and introduced into clinical practice, preferably reversible, either hormonal or non‐hormonal. From a future perspective, identifying new hormonal combinations, suitable testicular targets, and emerging vas occlusion methods will produce novel molecules and products for male contraception. [ABSTRACT FROM AUTHOR]

This perspective provides an overview of issues needed to bring a testosterone‐progestogen combined transdermal male hormonal contraceptive to the market. Large‐scale phase 2b trials are near completion and a pivotal trial to confirm efficacy and safety has been designed. We believe we are close to accomplishing the steps necessary to bring the first male‐directed effective, safe, and reversible pharmaceutical contraceptive approach to the public. If successful, we believe it will provide a new option for couples to consider in their family planning. [ABSTRACT FROM AUTHOR]

The promising results achieved in male hormonal contraceptive trials over the last decades suggest that new male contraceptives could hit the market soon. In shared decision‐making counseling, couples and their healthcare provider collaborate to make decisions about contraception choices. This model of contraceptive counseling could aid men in taking responsibility for contraception and women in trusting their partners in family planning. The shared decision‐making process in contraceptive counseling requires partners to provide input on their preferences, values, and desires, while healthcare professionals share medical knowledge and evidence‐based information.It has been proven that this method leads to higher adherence and satisfaction. To ensure that contraceptive counseling is inclusive, fair, and supportive of different reproductive experiences and needs, it is crucial to incorporate the Reproductive Justice Framework into counseling. [ABSTRACT FROM AUTHOR]

Background: Current options for male contraception are limited to condoms, the withdrawal method, or a vasectomy. Studies indicate that men have expressed growing interest in bearing responsibility for family planning. Objectives: To review prior studies investigating the role of an androgen‐only or androgen with progestin regimen for hormonal male contraception and to provide an update of a promising new hormonal agent, a transdermal gel. Discussion: Thus far, there have been six studies conducted in couples evaluating the contraceptive efficacy of an androgen‐only or androgen co‐administered with a progestin regimen for hormonal male contraception. The only ongoing study is by the National Institute of Child Health and Human Development, in collaboration with the Population Council. They have developed a novel transdermal gel containing testosterone and segesterone acetate (Nestorone), a progestin. An ongoing phase II study enrolling more than 460 couples has shown great potential with respect to the product's efficacy, safety, reversibility, and acceptability. As this agent advances in development, a rapid at‐home test for sperm concentration will provide couples with immediate feedback regarding their potential for pregnancy. Conclusion: There is promise for the first‐of‐its‐kind hormonal male contraceptive, a transdermal gel, to achieve market approval for distribution in the United States and elsewhere. Its safety, efficacy, reversibility, and user‐control are all appealing qualities that make it readily adoptable for clinical practice. [ABSTRACT FROM AUTHOR]

Background: Healthy nutritional status, appropriate gestational weight gain and a balanced diet are important predictors of perinatal health outcomes. However, gaps exist in the translation of nutrition recommendations into dietary practices of women before and during pregnancy. The present study explored the relationship between access to nutrition advice, nutrition knowledge, attitudes and practices among pregnant women. Methods: Pregnant women aged > 18 years in Ireland were eligible to complete a self‐administered survey consisting of four subsections (demographics, nutrition knowledge, attitudes and practices) delivered online through Qualtrics. Results: In this convenience sample (n = 334, median [interquartile range] gestation, 25.0 [16.0, 34.0] weeks), 85% had at least an honours bachelor degree and 88.9% planned their pregnancy. Two out of five women received nutrition advice during their pregnancy, mostly from a midwife. Based on the percentage of correct answers (of 15 questions), women with previous nutrition education (e.g., school home economics) had better median [interquartile range] nutrition knowledge than those with none (80.0% [66.7, 86.7%] vs. 73.3% [60.0, 80.0%], p < 0.001). Those who received nutrition advice during pregnancy did not score higher than those who did not (73.3% [66.7, 80.0%] vs. 73.3% [66.7, 80.0%], p = 0.6). Over three‐quarters of participants considered nutritional supplement use to be very or extremely important. Although 73.6% and 92.4% took supplements prior to and during pregnancy, only 25.7% reported compliance with periconceptional folic acid supplementation guidelines. Half of respondents considered healthy eating during pregnancy as very or extremely important. Conclusions: Access to nutrition advice during pregnancy was inadequate with poor nutrition knowledge, attitudes and practices observed. Accessible, evidence‐based nutrition education for women prior to and during pregnancy is required. Highlights: Access to nutrition advice and support during pregnancy was inadequate with poor nutrition knowledge, attitudes and practices observed in a highly educated, primarily low‐risk population of pregnant women in Ireland.Nutrition education for women both prior to and during pregnancy is essential to improving their own health and that of the next generation.Sources of accurate and easily accessible nutrition education and information outside of healthcare professionals need to be considered, as do methods of how best to reach pregnant women, where promising strategies include the use of validated online sources, new content formats such as short‐form videos or new technologies. [ABSTRACT FROM AUTHOR]

The authors encourage increased support for Title X programs to offer comprehensive early pregnancy confirmation services to promote equitable, patient-centered, evidence-based reproductive health care. Topics include background on Title X program, early pregnancy engagement to improve quality, and significance of early pregnancy assessment clinics (EPACs).

In Bauchi State, northern Nigeria, communities recognise short birth interval (kunika in the Hausa language) as harmful, but family planning is a sensitive topic. This paper describes the development of a culturally safe way to communicate about kunika in a conservative Muslim setting. The objective was to co-design culturally safe communication material, based on local knowledge about short birth interval, to share with women and men in households. Six community co-design groups of women and six of men (total 96 participants) reviewed summaries of their previously created maps of perceived local causes of kunika, categorised as frequent sex, family dynamics and non-use of contraception. They advised how these causes could be discussed effectively and acceptably with women and their husbands in households and suggested storylines for three short video docudramas about the prevention of kunika. The research team created the docudramas with a local producer and fieldworkers piloted their use in households. The design groups advised that communication materials should focus on child spacing rather than on limitation of family size. Even sensitive issues could be covered. People would not change their sexual behaviour but could be advised to use contraceptives to prevent kunika. The groups approved the final videos and six focus groups of visited women and men reported they were acceptable and helpful. Community co-design of communication about kunika was feasible and led to videos about a sensitive topic that were acceptable to ordinary men and women in communities in Bauchi. [ABSTRACT FROM AUTHOR]

This study used the theory of planned behaviour to examine the relationships between companion animal attachment, fertility intention, psychological capital, and parenting sense of competence among 551 young Chinese women. The results indicated that companion animal attachment positively influenced the respondents' fertility intention. For unmarried women and cat caretakers, psychological capital enhanced fertility intention. For married women and dog caretakers, parenting sense of competence played a more significant role in enhancing fertility intention. The study also found that companion animal attachment indirectly affected fertility intention through the sequential mediation of psychological capital and parenting competence. This study provides a framework for understanding how companion animal attachment impacts fertility intention and offers insights for future research and policy making. For instance, its findings can guide government efforts to promote women's fertility intention through courses and activities focused on companion animal attachment. [ABSTRACT FROM AUTHOR]

Background: Despite progress in national reproductive health programs, pastoralist regions like Fentale District in Eastern Ethiopia face challenges with low contraceptive coverage, attributed to insufficient positive attitudes and uptake among couples. Methods: This cross-sectional study was conducted from October 1 to December 25, 2021, in Fentale District, Eastern Ethiopia. It involved 1,496 couples selected using multistage sampling. Data were entered into EPI Data and analyzed with SPSS (v23.0) and STATA (v14.0), employing descriptive statistics, bivariate analysis, and binary logistic regression to identify predictors of contraceptive attitudes and use. Results: The study's response rate was 93.8%, with 1,404 pastoralist couples participating, equally split between women and men. A nomadic-pastoralist lifestyle was common (64.6%), and family planning discussions were rare (93.2%). Gender disparities in contraceptive attitudes and use were evident. Contraception use was reported by 27.4%, with women (41.2%) outnumbering men (13.5%). Women showed more positive attitudes towards contraception (87.9% vs. 31.9% for men). Only 33% had favorable attitudes towards different contraceptive methods, with women more likely to be positive. Modern contraception use was low (18.2%), with women (34.8%) predominating over men (1.7%). Among users, women had a more favorable attitude (78.5% vs. 6.6% for men). Health extension workers were key information providers. Predictors of contraceptive attitudes and use included sex, education, occupation, electronic device ownership, migration frequency, treatment preferences, and family planning discussions. Conclusion: The limited positive attitude towards and use of family planning in Fentale District may stem from unfavorable attitudes, low adoption, and couple disparities. Key factors include gender, education, occupation, electronic device ownership, migration, treatment preferences, and family planning discussions. Targeted educational campaigns for men are needed to address these issues and reduce the gender gap in contraceptive attitudes and use. [ABSTRACT FROM AUTHOR]

Background: Mauritania, a lower-middle-income country in Northwest Africa, has one of the highest maternal and infant mortality rates worldwide and struggles to ensure optimal use of maternal healthcare services. Raising health awareness through family planning messages can promote maternal healthcare use, potentially reducing preventable maternal and child mortalities. The objective of the study was to assess the potential impact of exposure to family planning messages through social media on the utilization of maternal healthcare services among Mauritanian women. Methods: Data from the 2019-20 Mauritania Demographic and Health Survey (MDHS) on 7,640 women were analyzed. Multiple logistic regression models were applied to examine the associations between exposure to family planning messages through social media and maternal healthcare services, specifically the timing and adequacy of ANC visits, and facility-based childbirth. Adjusted odds ratios with 95% confidence intervals (CI) were estimated. Results: The percentage of timely initiation and adequate use of ANC among the participants were 65.6% and 45.1%, respectively. Approximately 75.0% of the women reported giving birth to their last child at a healthcare facility. Exposure to family planning messages on social media was significantly associated with increased odds of receiving adequate antenatal care visits (OR = 1.38, 95% CI = 1.12,1.71) and giving birth in a health facility (OR = 1.83, 95% CI = 1.09,3.08), Other factors such as age, health insurance, wealth, and desired timing of the last child were also found to be important predictors of maternal healthcare. Conclusion: The findings suggest that exposure to family planning messages on social media is strongly associated with adequate antenatal care and health facility-based childbirth, but not with early timing of antenatal care. Comprehensive maternal healthcare policies should consider the role of social media in promoting family planning messages. [ABSTRACT FROM AUTHOR]

Background: Teenage pregnancy causes serious health, social, and economic consequences, with 95% occurring in developing countries. A significant number of girls start childbearing at an early age in Ethiopia, which contributes to high infant and maternal morbidity and mortality. However, the information on teenage pregnancy and related variables is limited in the study area. Objective: To assess the prevalence of teenage pregnancy and its associated factors among teenage females in the Hula District, Sidama, Ethiopia. Methods: A community-based cross-sectional study was employed among 518 teenagers, randomly selected between 15 February and 15 March 2023. An interviewer-administered questionnaire was used for data collection. Bivariate and multivariate logistic regression analyses were applied to assess the relationship under study. Results: Living in rural areas compared to urban [adjusted odds ratio (AOR) = 3.90; 95% confidence interval (CI): 1.30-11.3], lack of awareness about family planning methods (AOR = 5.90; 95% CI: 1.60-22.24), unfamiliarity with the availability of family planning services (AOR = 3.20; 95% CI: 1.08-9.24), and inadequate communication about sexual issues with parents (AOR = 3.61; 95% CI: 1.14-11.56) were independently associated with teenage pregnancy. Conclusion: The prevalence of teenage pregnancies in the Hula District was high. Factors such as residing in rural areas, limited access to information on family planning methods and services, as well as a lack of open discussions about sexual health were associated with teenage pregnancy. [ABSTRACT FROM AUTHOR]

Background: Women who have migrated often encounter difficulties in accessing healthcare and experience inequitable sexual and reproductive health outcomes in destination countries. These health inequities include contraceptive access and use. To better understand what influences contraceptive access and use, this scoping review set out to synthesize the evidence on contraceptive access and use and on associated interventions among women with migratory experience in high-income countries (HICs) in Europe, North America and Australasia. Methods: The scientific databases PubMed, Web of Science and CINAHL were searched for peer-reviewed quantitative, qualitative and mixed method articles published between January 2000 and June 2023. Articles were included if they reported on studies exploring contraceptive use to prevent pregnancies among women of reproductive age with migratory experience living in HICs. Two researchers independently screened and extracted data from the articles. Findings were categorized by patient and health system level factors according to Levesque et al.'s framework of access to health care. Results: A total of 68 articles were included, about half (n = 32) from North America. The articles focused on the individual level rather than the health system level, including aspects such as women's contraceptive knowledge, the influence of culture and religion on accessing and using contraception, partner involvement, and differing health insurance coverage. On the health system level, the articles highlighted lack of information on contraceptive services, cultural (in)adequacy of services and communication aspects, contraceptives' side effects, as well as geographic availability and cost of services. The review further identified three articles reporting on interventions related to contraceptive counselling. Conclusions: There is a lack of knowledge regarding how health systems impose obstacles to contraceptive services for women with migratory experience on an organizational level, as research has focused heavily on the individual level. This review's findings may serve as a foundation for further research and advances in policy and practice, specifically recommending early provision of health system related information and contraceptive education, engagement of male partners in contraceptive discourses, cultural competency training for healthcare professionals, and strengthening of interpretation services for contraceptive counselling. [ABSTRACT FROM AUTHOR]

Introduction. Hormonal contraceptives (HCs) are used for birth control, menstrual disturbances, and premenopausal syndrome. Most women stop using hormonal contraceptives due to changes in their mood. The evidence regarding the association of hormonal contraception with depression shows mixed results. Therefore, we aim to establish the association between the use of hormonal contraception and depressive symptoms. Methods. A cross‐sectional study was conducted on 326 women of the reproductive age group (15–49 years) attending the family planning unit of the obstetrics and gynecology department of a medical college in Saudi Arabia. Their sociodemographic and medical details along with the current use of any contraceptives (hormonal, nonhormonal, or not using any) with duration were collected. Beck depression inventory‐II (BDI‐II) was applied to the women to assess for depression along with its severity, and a BDI score of >16 was taken to denote clinical depression. Women were stratified by type of contraceptive used, and its association with depression category was assessed. Results. A total of 326 consenting eligible women in the age group of 15–49 years were enrolled in the study of which 165 (50.6%) were currently using a hormonal contraceptive and 49 (15.0%) were using a nonhormonal contraceptive and the rest 112 (34.4%) were not using any contraceptives. There was no significant difference in the mean BDI scores (p = 0.79) and degrees of depression (p = 0.06) between the HC users and HC nonusers. However, individual symptoms of depression such as sadness (p = 0.01), reduced libido (p = 0.0002), feelings of pessimism (p = 0.02), and failure (p = 0.003) were found to be significantly higher in the HC users than non‐HC users. Conclusion. We conclude that there was no significant difference in mean depression scores between groups. However, a few individual symptoms of depression were high in HC users suggesting depression as a potential side effect of hormonal contraceptive use. [ABSTRACT FROM AUTHOR]

Conducting research studies with vulnerable populations on sensitive topics such as adolescent pregnancy can be challenging depending on methodological approaches and ethical issues that may arise before, during, and after data collection. This methodological paper was developed based on experiences and lessons learned from a critical ethnographic study conducted to determine and understand the cultural and personal meaning of unintended adolescent pregnancy in the Rwandan context and to explore the perceived consequences and management of unintended adolescent pregnancy with and for single adolescent mothers. The purpose of this methodological paper is to discuss methodological and ethical challenges encountered while conducting this research, as well as various approaches used to overcome these challenges, and to provide guidance to researchers interested in conducting research about similar or other sensitive topics. Future researchers facing similar challenges should prioritize community engagement strategies, such as building strong relationships with gatekeepers and leaders, to facilitate access to potential participants. Additionally, researchers should engage in continuous ethical reflection and adaptation throughout the study, adjusting strategies if necessary to ensure the well-being and autonomy of participants. As a result of the practical and methodological strategies provided in this reflective paper, researchers could be able to navigate practical, methodological, and ethical challenges effectively while conducting sensitive studies on topics such as adolescent pregnancy. [ABSTRACT FROM AUTHOR]

Background: This study aims to explore the development status of the supply level of professional public health resources in Beijing Municipality, analyze the areal differences and spatial distribution characteristics of the supply level in 16 districts, and provide a scientific basis for promoting the balanced development of the supply level of professional public health resources in each district of Beijing Municipality. Methods: Based on panel data from Statistical Yearbook of Health Work in Beijing Municipality and Health and Family Planning Work in Beijing Municipality from 2014 to 2022. Using the entropy method to measure the supply level of professional public health resources in Beijing, employing the Dagum Gini coefficient and Kernel density estimation method to analyze the spatial differentiation characteristics and dynamic evolution process of the supply level, and using heat maps to display the spatial distribution of the supply level in various districts of Beijing. Results: The Dagum Gini coefficient of the supply level of professional public health resources in Beijing Municipality decreased continuously from 0.3419 in 2014 to 0.29736 in 2020, then gradually increased, showing a trend of initially decreasing and then increasing overall spatial differences. The spatial differences mainly stem from differences between areas. The kernel density curve shows that the supply level of professional public health resources in Beijing Municipality gradually increased, slightly decreased after 2021, and did not form a situation of two or multi-level differentiation. Conclusion: From 2014 to 2022, the supply level of professional public health resources in Beijing Municipality showed an overall upward trend, but attention should be paid to the decline after 2021; spatial differences initially decreased and then increased, and the differences between areas is the main source of the overall difference in Beijing. Therefore, the Beijing Municipal Government should focus on narrowing the differences between areas, determine the allocation and management of public health resources based on the actual situation of core areas, promote coordinated development within and outside areas, and thus enhance the supply level of professional public health resources. [ABSTRACT FROM AUTHOR]

If properly used, condoms can serve as an effective family planning method and preventive tool towards sexually transmitted diseases (STDs). Despite its anticipated effectiveness, there are different myths and misconceptions which have been observed as hindrances to both its use and effectiveness. This review examines the myths and misconceptions of condom use among youths and explores challenges in condom usage in sub‐Saharan Africa (SSA). A narrative review was employed of which different journal articles were reviewed. The search words/phrases were "condom use in SSA, condom use among youths in SSA, myths and misconceptions on condom use among youths in SSA." A total of 1074 studies were identified, 93 were relevant to the topic, and only 71 suited the review. The identified myths and misconceptions of condom use include that males were the ones to decide on the use of condoms during sexual intercourse, economic power determines the use of condoms, condom use reduces sexual pleasure, condom use relates to the spread of HIV/AIDS, and condom use is against God's will. Other identified myths and misconceptions of condom use include that the use of condoms is a sign of lack of trust associated with fornication and adultery, also the use of condoms is only for family planning purposes. The challenges identified were breakage of condom during sexual intercourse, condom slippage, condom leakage, incorrect storage, and reuse of condoms. The identified myths and misconceptions lead to low knowledge of condom use within communities. There is a need for collaboration between governments, researchers, and NGOs to provide education on condom use to communities, particularly youths. [ABSTRACT FROM AUTHOR]

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Background: Unmet need for family planning is a major cause of unwanted pregnancies, which may contribute to the death of mothers and children. The aim of this study is to examine inequalities in the demand and unmet need for contraception among women in four regions (i.e., Afar, Benishangul-Gumzu, Gambela and Somali regions) of Ethiopia. Methods: The study utilized data from the 2016 Ethiopian Demographic Health Survey (EDHS), collected from 3,343 women of reproductive age 15–49 years situated in these study regions. Multilevel binary and multivariable logistic regression analysis, concentration index, and multivariate decomposition analysis were employed. Results: The study revealed that women's employment status, education level, household wealth index, total number of children ever born, and husband's working status had a statistically significant association with the demand for contraception. Furthermore, women's educational level, household size, wealth index and husband's working status had statistically significant association with unmet need for contraception. The results of the concentration index indicated that illiteracy among respondents (56%), being in the richest economic status/ wealth index (41%) and non-working status of respondents (21%) contributed substantially to the inequality in the demand for contraception use. Illiteracy of the husband (197%) and the household size less than or equal to five (184%) contributed positively, but illiteracy of respondent (-249%) and unemployment status of respondents (-119%) contributed negatively to the existing inequality in unmet need for contraception. Conclusion: The findings of this study highlight the presence of unacceptably high inequality in the demand and unmet need for contraception among women in the four study regions. Policymakers should give due attention to reducing existing socio-economic inequality to address the high unmet need for family planning and increase demand for contraception in these regions. The study strongly recommends implementing multidimensional and multisectoral approaches, which will significantly reduce inequalities in the outcome variables. [ABSTRACT FROM AUTHOR]

Background: Short inter-pregnancy interval (IPI) is associated with adverse health outcomes for women and infants, and low-income women experience disproportionate rates of short IPI. An essential solution is providing postpartum (PP) women with timely contraceptive care. However, patient-centered approaches for facilitating care access are needed. Objective: To explore Community Health Center (CHC) staff and provider perspectives on the implementation of a clinical trial offering co-scheduled well-infant/maternal contraceptive care for women with infants 0 to 6 months at the Well-Baby Visit (WBV). Method: Eighteen participants (providers, staff, and administrators) representing 7 diverse CHC sites in 2 U.S. states completed semi-structured telephone interviews. Audio-recordings were transcribed and analyzed using hybrid thematic analysis. Results: Offering co-scheduled visits was perceived as beneficial for facilitating timely PP contraception, convenient care access, and encouraging family planning considerations during the PP period. However, provider and staff discomfort with initiating family planning and contraceptive care conversations at the WBV emerged as a salient barrier. Conclusion: Paired approaches to well-infant/maternal contraceptive care may promote increased access to timely contraception for PP women, possibly reducing unintended short IPI. Comprehensive training, ongoing support, and patient-centered implementation strategies tailored to context and developed with care team input are needed to ensure competency and comfortability with facilitating contraceptive care conversations at the WBV. [ABSTRACT FROM AUTHOR]