Search

This systematic review and meta-analysis aim to synthesize the information on menstrual cup adoption among reproductive-age women in India. A comprehensive search was conducted in four databases following PRISMA 2020 guidelines. A total of 18 articles were included in this review. The findings of the studies were described narratively, and meta-analysis and sensitivity analysis were also performed. The pooled prevalence of knowledge regarding menstrual cups among women in the included studies was 35 percent (CI: 0.23–.49). Just 5 percent (CI: 0.02–0.12) of women use menstrual cups. Only 24 percent (CI: 0.17–0.33) of the women who used menstrual cups reported leakage as one of the key barriers or issues to menstrual cup use. Nevertheless, 62 percent (CI: 0.42–0.78) of non-users have a pooled prevalence expressing willingness to use in the future. The price was found to be both a motivating and discouraging factor for using menstruation cups. Currently, menstrual cup use among Indian women and girls is very low. However, user reviews suggest that menstrual cups are an appealing and safer replacement for conventional period supplies. To fully realize the potential of menstruation cups, significant education, and awareness efforts are required to ensure proper usage. Furthermore, initiatives to lower the initial cost of menstruation cups are critical. [ABSTRACT FROM AUTHOR]

Background. Despite global efforts to promote contraceptive use and ensure reproductive health, Somalia continues to face significant challenges in this regard. This study aims to explore the prevalence of contraceptive use in Somalia and identify the determinants influencing its use. Methods. A total of 8,162 reproductive‐aged women's data were analyzed extracted from 2020 Somali Health and Demographic Survey. The outcome variable was contraception use, classified as any contraception use (yes vs. no), any modern contraception use (yes vs. no), and any traditional contraception use (yes vs. no). The explanatory variables were factors at the individual, household, and community level. The multivariate binary logistic regression model was used to explore associations of outcome variables with explanatory variables. Results. The findings revealed low prevalence of contraceptive use among Somalia women, with only 7% reporting its use. Among them, less than 1% utilized modern contraceptive methods. Several determinants of contraception use were identified, including younger age, higher educational attainment (primary and secondary education), higher parity, exposure to family planning messages through mass media, urban place of residence, and residing in the northwest and northeast regions of Somalia. Conclusion. The results underscore the urgent need for substantial efforts to improve contraceptive use in Somalia. Strengthening healthcare facilities to provide comprehensive sexual and reproductive health services, with a particular focus on promoting contraception uptake, is crucial. Public awareness campaigns and educational programs should also be prioritized to enhance knowledge and understanding of contraception among Somali women. [ABSTRACT FROM AUTHOR]

Anaemia in women of reproductive age (WRA) can be effectively addressed if supported by a better understanding of the spatial variations, magnitude, severity and distribution of anaemia. This study aimed to map the subnational spatial distribution of anaemia (any, moderate and severe forms) among WRA in Ethiopia. We identified and mapped (any, moderate and severe) anaemia hotspots in WRA (n = 14,923) at the subnational level and identified risk factors using multilevel logistic regression. Kulldorff scan statistics were used to identify hotspot regions. Ordinary kringing was used to predict the anaemia prevalence in unmeasured areas. The overall anaemia prevalence increased from 16.6% in 2011 to 23.6% in 2016, a rise that was mostly related to the widening of existing hotspot areas. The primary clusters of (any) anaemia were in Somali and Afar regions. The horn of the Somali region represented a cluster of 330 km where 10% of WRA were severely anaemic. The Oromia–Somali border represented a significant cluster covering 247 km, with 9% severe anaemia. Population‐dense areas with low anaemia prevalence had high absolute number of cases. Women education, taking iron‐folic‐acid tablets during pregnancy and birth‐delivery in health facilities reduced the risk of any anaemia (P < 0.05). The local‐level mapping of anaemia helped identify clusters that require attention but also highlighted the urgent need to study the aetiology of anaemia to improve the effectiveness and safety of interventions. Both relative and absolute anaemia estimates are critical to determine where additional attention is needed. [ABSTRACT FROM AUTHOR]

Introduction: Contraceptive switching from a more effective to a less effective method is a concern, especially in developing countries with high unmet needs for family planning. Indeed, the lack of understanding regarding the reasons behind contraceptive switching behavior in the study area poses a significant challenge in effectively addressing this issue. Objective: This study aimed to assess the magnitude and factors associated with long-acting contraceptive switching in Mizan-Aman town, southwest Ethiopia. Methods: A community-based cross-sectional study was conducted, involving 345 women randomly selected from the population of married women in their reproductive age group. Data collection was conducted through interviewer-administered questionnaires. Bivariate and multivariable logistic regression analyses were employed to ascertain factors linked with contraceptive method switching status. Statistical significance was determined at a P -value of less than.05. Results: Out of the 345 participants interviewed, the prevalence of switching from long-acting to short-acting contraceptives was 28.4%, 95% CI (13.6%, 33.2%). Upon adjusting for confounding variables, factors significantly associated with contraceptive switching included women aged 31–35 [adjusted odds ratio (AOR) = 0.58; 95% CI (0.36, 0.74)] and aged 41–49 [AOR = 0.54; 95% CI (0.48, 0.82)], those with formal education [AOR = 0.79; 95% CI (0.52, 0.87)], those desiring future pregnancy [AOR = 2.12; 95% CI (1.98, 3.38)], experiencing complications from previous method use [AOR = 3.67; 95% CI (2.57, 7.40)], and encountering stockouts of their preferred contraceptive choice [AOR = 2.01; 95% CI (1.39, 3.24)]. Conclusion and recommendation: The study area exhibited a notable prevalence of switching from long-acting contraceptives. Complications arising from prior method use and the unavailability of preferred contraceptive options emerged as significant factors influencing this switching behavior. Thus, it underscores the importance of providing counseling and ongoing support to women, ensuring access to safer and more effective modern contraceptive methods. [ABSTRACT FROM AUTHOR]

Context Food insecurity is an important determinant of health and should be identified by clinicians during routine reproductive healthcare. The procedures used in reproductive healthcare settings to identify people experiencing food insecurity have not been fully researched. Objective The objective of this study was to synthesize evidence from published studies that describe the procedures implemented by clinicians in healthcare settings to identify food insecurity in pregnant women, or women of reproductive age (15 years–49 years). Data Sources Four databases were searched in April 2022 to identify studies that met the eligibility criteria. Data Extraction Studies that used tools that were both validated or newly developed were considered, as were studies that incorporated food insecurity screening as part of a multidomain screening tool. Two authors completed the screening, data extraction, and quality assessment independently. Data Analysis There were 1075 studies identified; after screening, 7 studies were included in the narrative synthesis, including studies relating to women who were pregnant or in the postpartum period; none of the included studies related to women in the preconception stage. Four screening tools were identified: 2- and 6-item tools specifically focused on food insecurity, a 58-item multidomain tool incorporating 4 food insecurity items, and a modified version of the 2-item tool. Methods of implementing screening varied across studies. Three described subsequent processes that supported food-insecure patients once identified. Conclusion Few published studies have investigated optimal screening tools and their implementation within reproductive healthcare settings to address food insecurity for this priority population group. Further research is required to determine: the optimal tool, preferable screening methods from the perspectives of both patients and clinicians, and potential strategies for implementation in countries outside of the United States. An additional evidence gap remains about referral pathways and appropriate supports for this population once food insecurity is identified. Systematic Review Registration PROSPERO registration no. CRD42022319687. [ABSTRACT FROM AUTHOR]

In the present cross-sectional study, the researchers aimed to assess the contraceptive knowledge, practice, and associated factors among 2228 women in Puducherry, India. National Family Health Survey questionnaire was adopted for data collection and about 1924 women participated. Current use of any contraceptive was 78.6% and female sterilization was 62%. The majority (99.8%) knew female sterilization, but below average for other contraceptive methods. About 10.4% were aware of more than three contraceptive methods. Age group, homemaker, with children or one son, aware of less than three methods, residing nearby to health facility were associated with the higher practice of contraceptive methods. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine whether the weight‐adjusted‐waist index (WWI) affected infertility in women of childbearing age in the United States. Methods: In this study, a database from the 2013 to 2018 National Health and Nutrition Examination Survey (NHANES) was used. We analyzed 3374 participants' data cross‐sectionally. The survey used WWI and fertility status as independent and dependent variables. To determine the effect of WWI, an analysis of the independent relationship between WWI and infertility was conducted using weighted multivariable logistic regression and a generalized additive mode (GAM). A smooth curve fitting test was used to calculate whether there was a linear association between WWI and the incidence rate of infertility, as well as subgroup analyses and interaction tests. Results: The prevalence of infertility was 10.19% among 3374 participants. Higher WWI quartiles were associated with higher infertility rates. Based on a fully adjusted model, the effects of WWI on fertility were positive (odds ratio = 1.39, 95% confidence interval: 1.17–1.66). As a result of smooth curve fitting, the association was linear across the entire WWI. Different characteristics were associated with different risks of infertility in subgroup analysis. Conclusion: Among women of reproductive age in the United States, WWI levels were positively associated with infertility. This relationship needs to be confirmed by further studies. [ABSTRACT FROM AUTHOR]

The present study investigates the relationship between sexuality and spirituality with mental health among Iranian married women of reproductive age. It was a cross-sectional, correlational study with a sample size of 120 Iranian married women in 2022. Goldberg general health, Female Sexual Function Index, and Paloutzian and Ellison spiritual health questionnaires were used to collect data. The level of spiritual health scale (SWBS) in more than half of the married women was high (50.8%) and 49.2% at the average level. Sexual dysfunction was reported at 43.3%. Sexual function, religious and existential well-being was predictors of mental health and its dimensions. The risk of sexual dysfunction was 3.33-fold higher in people who had an unfavorable level of SWBS (β = 3.33, CI: 1.558–7.099, P = 0.002) compared to those who had a favorable level of SWBS. Therefore, adhering to sexual health and relying on spirituality are emphasized in preventing mental health problems. [ABSTRACT FROM AUTHOR]

Background: Complications of abortion are a major contributing factor to maternal mortality, especially in Africa. 31% of maternal deaths in Nairobi are attributed to abortions complications. While Post abortion Care (PAC) is a proven approach in addressing mortality and burden of abortion complications, determinants of use among women who need the service, PAC health seeking behaviours, the health systems capacity to provide PAC and experiences of women and providers on PAC is not well documented. This study sought to address this gap. Objective: To determine factors that influence utilization of PAC services among women of reproductive age in Nairobi County. Design: Cross-sectional survey design which employed a quantitative data collection approach. Setting: Mbagathi hospital and Mama Lucy Kibaki hospital. Subjects and Intervention: Women of reproductive age attending reproductive health services at selected health facilities. The intervention was post abortion care. Results: Single women are 62.5% (OR 0.375) less likely to seek PAC services than married women. Prior knowledge of post abortion care (PAC) services is a statistically significant determinant of seeking of PAC services (P <0.05). Women with prior knowledge about post abortion care (PAC) services are twice likely (O.R 2.318) to seek PAC services. Prior experiences, with Gender of health care provider while seeking PAC services (P-Value 0.044), waiting time (0.008) and service affordability (p<0.05) significantly determines whether one seeks PAC services or not. Conclusion: Utilization of PAC services in Nairobi County is determined by experiences, perceptions, as well as individual level factors such as marital status. [ABSTRACT FROM AUTHOR]

Background: Unplanned pregnancy continues to be a major public health concern in Sub-Saharan Africa (SSA). Understanding the ovulatory cycle can help women avoid unplanned pregnancy. Though a wide range of factors for ovulatory cycle knowledge in SSA countries has not been well assessed, the influence of health insurance on ovulatory cycle knowledge is largely unknown. As a result, we set out to investigate the relationship between health insurance enrollment and knowledge of the ovulatory cycle among women of childbearing age. This study aims to investigate the relationship between health insurance enrollment and knowledge of the ovulatory cycle among women of childbearing age in sub-Saharan Africa (SSA). Methods: Demographic and Health Surveys (DHSs) data from 29 SSA countries were analyzed. The association between health insurance and ovulatory cycle knowledge was investigated using bivariate and multivariate multilevel logistic regression models among 372,692 women of reproductive age (15–49). The findings were presented as adjusted odds ratios (AOR) with 95% confidence intervals (CI). A p-value of 0.05 was considered statistically significant. Results: The pooled result shows that the prevalence of knowledge of ovulatory cycle in the studied 29 SSA countries was 25.5% (95% CI; 24.4%-26.6%). Findings suggest higher odds of ovulatory cycle knowledge among women covered by health insurance (AOR = 1.27, 95% CI; 1.02–1.57), with higher education (higher-AOR = 2.83, 95% CI; 1.95–4.09), from the richest wealth quintile (richest-AOR = 1.39, 95% CI; 1.04–1.87), and from female headed households (AOR = 1.16, 95% CI; 1.01–1.33) compared to women who had no formal education, were from the poorest wealth quintile and belonged to male headed households, respectively. We found lower odds of ovulatory cycle knowledge among women who had 2–4 parity history (AOR = 0.80, 95% CI; 0.65–0.99) compared to those with history of one parity. Conclusions: The findings indicate that the knowledge of the ovulatory cycle is lacking in SSA. Improving health insurance enrollment should be considered to increase ovulatory cycle knowledge as an approach to reduce the region's unplanned pregnancy rate. Strategies for improving opportunities that contribute to women's empowerment and autonomy as well as sexual and reproductive health approaches targeting women who are in poorest quintiles, not formally educated, belonging to male headed households, and having high parity should be considered. [ABSTRACT FROM AUTHOR]

Background: Spousal or intimate partner violence is the most common form of domestic violence and is a preventable cause of morbidity and mortality in women. The aim of this study was to estimate the prevalence of spousal violence, various types of spousal violence, and the factors associated with it among reproductive age group women. Materials and Methods: This was an analytical cross-sectional study conducted in the Urban Health Training Center area of a tertiary care teaching hospital in Nagpur, India, among married women between 15 and 49 years of age who were selected using systematic random sampling. The data was collected from a sample of 373 women by face-to-face interview and analyzed using Statistical Package for the Social Sciences (SPSS) v21. Results: The prevalence of spousal violence among reproductive age group (15–49 years) women was found to be 59.7%, with emotional violence (54.1%) being the most common, followed by physical (51.2%) and sexual (43.4%) violence in that order. Regular alcohol consumption of husband had the highest odds of spousal violence among women (odds ratio [OR] 12.51, 95% confidence interval [CI] 6.51–24.03). Other factors associated with spousal violence among reproductive age group women were early age at marriage, literacy and employment of women and husband, lack of emotional support from the family members, and dowry-related problems in the family. Conclusion: A multifaceted approach including legal measures, empowerment of women, and sociocultural factors involving families, institutions, governmental, nongovernmental, and civil society organizations is the need of the hour. [ABSTRACT FROM AUTHOR]

Introduction: Despite the advances in modern health care, maternal morbidity and mortality remain major problems in Ethiopia. Repeat-induced abortion is an indispensable contributor to this problem. Even though there are adverse effects on health, a significant proportion of Ethiopian women procure more than one abortion during their reproductive lifetime. This study aimed to determine the prevalence and associated factors of repeat-induced abortion in South Ethiopia, in 2020. Methods: An institution-based cross-sectional study design and a systematic random sampling technique were used to collect data from 410 samples of women. Data were collected using pre-tested and semi-structured interviewer-administered questionnaires. The data were coded and entered into EpiData version 4.6.2.0 before being exported to Statistical Package for Social Sciences (SPSS) version 26 for analysis. Variables with a p-value of less than 0.05 in binary logistic regressions were exported into multivariate logistic regression analysis. Finally, variables with a p-value of less than 0.05 in the multivariate logistic regression analysis were used to declare statistical significance. Result: The prevalence of repeat-induced abortion was found to be 35.4% (95% confidence interval = 30.7–40). Not facing a complication in prior abortion care, having more than two partners in the last 12 preceding months, perceiving abortion procedure as non-painful, having a sexual debut before the age of 18 years, and consuming alcohol have higher odds of repeat-induced abortion when compared with their counterparts. Conclusion: The prevalence of repeat-induced abortion in Hawassa city is high compared to studies conducted in other parts of Ethiopia. Not facing complications during previous abortion care, perceiving the abortion procedure as non-painful, alcohol consumption, having multiple sexual partners, and having a sexual debut before the age of 18 years are found to increase the chance of repeat-induced abortion. [ABSTRACT FROM AUTHOR]

Background: Increasing access to family planning helps to ensure the reproductive right, decrease unintended pregnancy, improve the health and nutritional status of children, reduction of maternal mortality, and enhance longer birth spacing. However, there is continually low utilization of long acting and permanent contraceptive methods among low and middle-income countries. This study aimed to assess the utilization of long acting and permanent contraceptive methods (LAPMs) and associated factors among women of reproductive age in the West Guji Zone, Ethiopia. Methods: An institution-based cross-sectional study was carried out among 507 women of reproductive age in the West Guji Zone, Southwest Ethiopia from April 15 to May 15, 2018. Data were collected by a structured, pretested, and interview-based questionnaire with open ended and closed ended questionnaire, then entered, and analyzed by SPSS Version 20. Bivariable and multivariate logistic regression analyses were carried out. A 95% confidence interval (CI) AND P-value < 0.05 was considered to declare statistically significant variables. Result: The current utilization of LAPMs at West Guji zone among the reproductive-aged group was found to be 51.1%. More than the median of participants had negative altitude (72.4%) and poor knowledge (57%) towards the LAPMs. Educational status of women, the number of alive children, acceptance of utilization of LAPMs, how treated by other staff, and waiting time during service delivery are significant determinant factors of LAPMs. Conclusion: Overall, more than half of women had a negative attitude and poor knowledge of LAPMs. Educational status of women, the number of alive children, acceptance of utilization of LAPMs, how treated by other staff, and waiting time during service delivery were factors affecting utilization of LAPMs. Therefore, sustained, and appropriate information on LAPMs should be provided to raise knowledge and build the attitude of women and the community. Treating the clients with respect, reducing the waiting time, and collaborative work with health extension worker will enhance utilization of LAPMs. Plain language summary: Low utilization of LAPMs has been continually reported in low- and middle-income countries. Unintended pregnancy and unsafe abortion might be related with unmet need of contraceptive. This study aimed to assess level of utilization of LAPMs among reproductive aged women in West Guji Zone Ethiopia. The findings from this research will help different stake holder by providing the level of current utilization of LAPMs and help them on planning how to strength the utilization by refereeing the associated factors. 507 Respondents were selected systematically: of which 51.1% of them utilize one of LAPMs currently. In conclusion the utilization may be affected by educational status of women, number of alive children, acceptance LAPMs by women, how treated by other staff during service delivery, and waiting time to get the service. [ABSTRACT FROM AUTHOR]

Objective: State medicaid programs provide access to effective contraception for people with lower incomes. This study examined contraception use and pregnancy among reproductive-age women enrolled in the South Carolina Medicaid, by eligibility program and socio-demographic sub-groups. Methods: A retrospective cohort of women aged 15–45 who were newly eligible for South Carolina Medicaid from 2012 to 2016 was examined. Log-binomial regression and average marginal effects assessed relationships between contraception use and pregnancies ending in live and non-live births. Contraception was categorized as permanent, long acting reversible contraception (LARC), short-acting hormonal contraception (SAC), or no contraceptive claims. Women with family planning or full-benefit medicaid coverage were included. Results: Approximately 11% of women used LARC methods, 41% used SAC methods, and 46% had no evidence of contraceptive claims. Method utilization varied by eligibility program, race/ethnicity and age. The likelihood of pregnancy was lower among SAC users and lowest among LARC users compared to women with no evidence of contraception across all three programs (family planning APR = 0.44; 95% CI 0.41–0.49 and APR = 0.13, 95% CI 0.10–0.17; Low income families APR = 0.82; 95% CI 0.77–0.88 and APR = 0.33, 95% CI 0.28–0.38; Partners for Healthy Children APR = 0.72; 95% CI 0.68–0.77 and APR = 0.35, 95% CI 0.30–0.43, respectively). Non-Hispanic Black and Hispanic teens were less likely to experience a pregnancy than non-Hispanic white teens. Conclusions for Practice: The likelihood of pregnancy was lower among women using SAC methods and markedly lower among women using LARC. Variation in contraceptive use among racial/ethnic groups was noted despite Medicaid coverage. As new policies and initiatives emerge, these findings provide important context for understanding the role of Medicaid programs in reducing financial barriers to contraceptive services and ensuring access to effective contraception, while fostering reproductive health autonomy among women. [ABSTRACT FROM AUTHOR]