Background Immediate postpartum intrauterine contraceptive device insertion is a safe, effective, and reversible long-acting contraceptive method that can reduce unintended pregnancies and short interpregnancy intervals. Despite its benefits, acceptance of PPIUCD remains low in Ethiopia, and national evidence has not been synthesized. Objectives To estimate the pooled prevalence of PPIUCD acceptance and identify factors associated with its acceptance among women in Ethiopian public health facilities. Design Systematic review and meta-analysis. Data Sources and Methods A systematic search of PubMed, Scopus, ScienceDirect, the Cochrane Library, Google Scholar, and other relevant databases was conducted to identify eligible studies. Data were extracted using Microsoft Excel and analyzed using STATA version 11. A random-effects model was used to estimate the pooled prevalence and pooled odds ratios (PORs) with 95% confidence intervals (CIs). Statistical heterogeneity was assessed using Cochran’s Q test and the I 2 statistic. Results Six studies were included in the meta-analysis. The pooled prevalence of PPIUCD acceptance was 21.64% (95% CI: 11.55, 31.74). Women who received counseling on PPIUCD were more likely to accept the method (POR = 7.24, 95% CI: 4.91, 10.67). A positive attitude toward PPIUCD (POR = 8.11, 95% CI: 5.54, 11.87), no intention to have more children (POR = 2.16, 95% CI: 1.39, 3.37), and completion of antenatal care follow-up (POR = 2.22, 95% CI: 1.53, 3.23) were also significantly associated with acceptance. Conclusion Approximately one in five women accepted PPIUCD in Ethiopian public health facilities. Counseling, antenatal care follow-up, positive attitudes toward PPIUCD, and future fertility intentions were significant determinants of acceptance. Strengthening counseling and integrating postpartum family planning into routine maternal healthcare services may improve PPIUCD uptake.
Plain Language Summary Pre-eclampsia is a serious pregnancy condition that requires early recognition and timely care. A recent review by Asiedu and colleagues showed that male partners may support women during pregnancy through financial preparation, shared decision-making, emotional support, household assistance, and information sharing. This Letter acknowledges the importance of that review but qualifies its policy message: partner involvement should be woman-centered, non-coercive, and linked to practical emergency preparedness rather than assumed to be essential or sufficient on its own. Delays in receiving care are influenced not only by knowledge but also by cost, transportation, family decision-making, distance, and the readiness of health facilities. Male partners’ roles differ across households and communities. Some women may rely on other trusted relatives, friends, or community members. Therefore, counseling programs should not assume that involving a male partner will always improve care or make male attendance a condition for receiving services. With the woman’s informed consent, pre-eclampsia counseling may include male partners and other trusted household decision-makers. Programs should ensure equitable access regardless of partner status and monitor for unintended harms, including coercion, increased surveillance, and gender-based violence. Counseling should focus on recognizing danger signs, saving emergency funds, arranging transportation, identifying referral facilities and contact persons, and deciding who may accompany the woman or communicate with health care providers during an emergency. Male partners can be valuable sources of support, but their involvement must respect women’s choices, autonomy, safety, and preferred support networks. The goal is not simply to increase men’s attendance or presence, but to strengthen the practical support that helps women obtain timely, safe, and respectful care.
Background:Dietary diversity is a key proxy indicator of micronutrient adequacy among pregnant women, yet remains suboptimal in many low- and middle-income settings. Limited evidence exists on dietary diversity knowledge and its determinants in Zanzibar. Objective:To assess knowledge of dietary diversity and identify associated factors among pregnant women attending antenatal care (ANC) at Mpendae Health Centre, Zanzibar. Design:Facility-based analytical cross-sectional study. Methods:A facility-based analytical cross-sectional study was conducted among 245 pregnant women attending ANC services using a consecutive sampling approach (March-April 2025). Data were collected using a structured, pretested questionnaire comprising 32 items. Knowledge of dietary diversity was assessed using 9 binary items (Cronbach's α = 0.74) and categorized as adequate (score ≥6/9) or inadequate. Multivariable logistic regression was used to identify independent predictors, with crude odds ratios (CORs), adjusted odds ratios (AORs), 95% confidence intervals (CIs), and p-values reported. Results:Overall, 75.9% of participants had adequate knowledge of dietary diversity. In multivariable analysis, marital status and education were significant predictors. Women who were not married had significantly lower odds of adequate knowledge compared to married women (AOR = 0.28; 95% CI: 0.14-0.56; p < 0.001), while those with secondary or higher education were more likely to have adequate knowledge (AOR = 2.15; 95% CI: 1.18-3.91; p = 0.012). Women at ≥28 weeks gestation had higher odds of adequate knowledge (AOR = 3.42; 95% CI: 1.85-6.32; p < 0.001), and those attending ≥4 ANC visits were four times more likely to be knowledgeable (AOR = 4.11; 95% CI: 2.05-8.24; p < 0.001). Women who did not receive nutrition counselling had significantly lower odds of adequate knowledge (AOR = 0.31; 95% CI: 0.14-0.69; p = 0.004). Conclusion:Dietary diversity knowledge was relatively high but unequally distributed. ANC-related factors, particularly visit frequency and nutrition counselling, were key determinants, highlighting the need to strengthen structured nutrition education throughout pregnancy.
Background Pharmacies and drug shops offer a valuable opportunity to improve access to family planning for adolescents and young women. However, challenges still exist that hinder their ability to obtain these services through such outlets. Objective This study aimed to identify the factors influencing and barriers to accessing family planning services among adolescent girls and young women aged 15–24 years in Debre Tabor Town. Design Convergent Parallel Mixed-Method study. Methods Adolescent girls and young women aged 15-24 were selected through simple random sampling, while key informants were purposively chosen. A structured questionnaire was used for quantitative data collection, and qualitative data were obtained via key informant interviews. Quantitative data analysis was conducted using STATA version 15, whereas qualitative data were analyzed manually through thematic analysis. Results A total of 384 adolescent girls and young women took part in the study, with an average age of 20.74 years. About 41.7% were aged 22-24, while 17% were between 15 and 18 years. Overall, 65.4% reported having access to family planning services. However, those aged 22-24 were 5.6 times more likely to access these services than those aged 15-18 (AOR = 5.6, 95% CI: 1.79–17.38). Additionally, young women who lacked privacy when accessing services were 53% less likely to utilize family planning than those who had privacy (COR = 0.47, 95% CI: 0.11, 1.83). Furthermore, individuals from cultures that disapproved of family planning were 44% less likely to seek these services than those from accepting cultures (COR = 0.44, 95% CI: 0.14, 1.87). Conclusion Age and sexual activity were significant predictors of access to family planning services. Conversely, barriers such as the cost of contraceptives, lack of privacy, and cultural disapproval hindered young women from using these services through pharmacies and drug shops.
Background: Elective Cesarean surgeries (CSs) rates continue to rise worldwide, prompting renewed interest in predictors of prenatal biometrics, which have a central role in recommendations for elective CS. Objective: To develop machine learning (ML) models for predicting neonatal anthropometric measures such as head circumference (HC), birth weight, and the mode of delivery, either vaginal or CS. Design: A retrospective single-center longitudinal cohort cross-sectional study conducted at a big public hospital. Methods: Data were drawn from 5375 pregnant women who underwent routine prenatal ultrasound examinations within 2 weeks of delivery. Dataset curation included exclusion criteria and handling of missing data prior to model development. Formal feature selection for the most predictive variables resulted in the final dataset of 3447 subjects. Four supervised ML algorithms were implemented: stochastic gradient descent, random forest, K-nearest neighbors, and stacking ensemble (SE). The models were trained and evaluated on clinical and ultrasonographic data. Results: The predicted newborn weight (NBW) was of comparable accuracy to the commonly used Hadlock IV formula for the estimated fetal weight. The predicted newborn head circumference (NBHC) was of superior accuracy compared to the last prenatal ultrasound measurement. The classification of the delivery mode revealed a very close association between the predicted CSs and high values of NBHC and NBW. Conclusion: We developed highly accurate ML-based models for prediction of NBHC, NBW, and the mode of delivery using only the three last prenatal ultrasound measurements: biparietal diameter, abdominal circumference, and HC. The predicted mode of delivery demonstrated a very good association between CSs and high values of NBHC and NBW. Future implementation of ML algorithms in risk-based obstetric management will benefit both maternal and fetal health and wellbeing.
Background: Hypertensive disorders of pregnancy (HDP), including gestational hypertension and preeclampsia, increase risk of acute complications, later development of hypertension and coronary artery disease and maternal mortality. Prenatal physical activity (PPA) reduces the risk of HDP development. Obstetric care providers (OCPs) are crucial in advising patients on safe PPA. Despite the belief among OCPs in other developed countries that PPA is beneficial, few are familiar with endorsed guidelines or discuss PPA with their patients. Objectives: This study aimed to explore what a subset of OCPs based in Southwestern Ontario believe, know and practice with respect to PPA and its endorsement for HDP prevention. Design: Virtual, qualitative interview-based study. Methods: Semi-structured virtual interviews were conducted with nurse practitioners ( n = 2; 39.5 ± 4.9 ( X ± SD) years of age) and midwives ( n = 4; 39.5 ± 7.3 years of age) who were actively practising in Southwestern Ontario. Results: Four overarching themes were identified using reflexive thematic analysis: (1) Restricted Scope of PPA Practice for HDP, (2) PPA is Very Important for Health in and Beyond Pregnancy, (3) PPA is a Highly Individualized Patient Experience and (4) Lack of Training in PPA Among Providers. All participants strongly affirmed the benefits and importance of PPA in general, despite constraints imposed by referral protocols for those with HDP. This belief stemmed from experience, knowledge of Canadian PPA guidelines and evidence-based literature. PPA recommendations were individualized yet grounded in national guidelines. Participants identified a gap in PPA training and provided suggestions for improvement. Conclusion: PPA participation may assist in the prevention or management of HDP and promote comprehensive wellbeing for patients. Further exploration of OCP recommendation and patient uptake of PPA for HDP within a Southwestern Ontarian context and beyond is warranted.
Background: Women’s empowerment significantly influences maternal and child health by enhancing access to healthcare and enabling autonomous reproductive decisions, including timely family planning during postpartum. However, in Ethiopia, the specific role of contraceptive empowerment in postpartum family planning (PPFP) use remains insufficiently studied despite the low level of women’s empowerment. Objective: To assess the effect of contraceptive empowerment on PPFP use in Ethiopia. Design: A community-based panel study design. Methods: We used the panel data from Performance Monitoring for Action Ethiopia (2021–2023), which followed 1759 pregnant women aged 15–49 years from four regions of Ethiopia. The analytic sample is restricted to non-pregnant women who completed the interview at 1 year postpartum. Contraceptive empowerment was assessed using five items on a 5‑point Likert scale, whereas PPFP use was measured through yes/no question regarding modern contraceptive use at 1 year postpartum. A mixed-effect multilevel multivariable logistic regression model was employed, and p -value of 0.05 was used to determine the statistical significance. Result: PPFP use at 12 months of postpartum is significantly higher among women reporting high and medium contraceptive empowerment during pregnancy, compared to low contraceptive empowerment (AOR: 1.8, 95% CI: 1.3–2.6) and (AOR: 1.7, 95% CI: 1.2–2.3) respectively. In addition, women whose birth was attended by a skilled birth attendant (AOR: 1.7, 95% CI: 1.3–2.4), lower parity (1: AOR: 4.5, 95% CI: 2.5–8.1, 2–4: AOR: 2.1, 95% CI: 1.3–3.3 compared to ⩾5), and those who previously used contraception (AOR: 3.8, 95% CI: 2.8–5.4) were more likely to use PPFP; women residing in Amhara (AOR: 0.4, 95% CI: 0.1–0.8) and Oromia regions (AOR: 0.4, 95% CI: 0.1–0.8) had significantly lower use of PPFP. Conclusion: Contraceptive empowerment during pregnancy predicted PPFP use at 12 months of postpartum. Higher contraceptive empowerment at pregnancy significantly increases the use of PPFP at 1 year postpartum in Ethiopia. The findings highlight the need for targeted interventions to enhance contraceptive empowerment prior to, during, and after pregnancy; strengthen skilled birth attendance and address regional disparities for equitable and sustained PPFP use.
Background:Pregnancy is a natural physiological process. However, it significantly affects mothers' health-related quality of life through various physical, psychological, social, and environmental changes. Understanding the determinants of health-related quality of life during antenatal care can guide maternal health interventions. Objectives:To assess health-related quality of life and associated factors among mothers attending antenatal care in South Wollo Zone public hospitals, Northeast Ethiopia. Design:An institution-based cross-sectional study. Methods:Systematic random sampling method was used in five randomly selected hospitals among mothers attending antenatal care from March 1 to 30, 2024. Health-related quality of life was measured using World Health Organization Quality of Life - BREF (WHOQOL-BREF) questionnaire. Data were entered into EpiData 3.1 and exported to SPSS 25 for analysis. Multivariable linear regression analysis was performed by selecting variables with a p-value of <0.25 in simple linear regression. Then, variables having p-value <0.05 at 95% confidence interval with an unstandardized B-coefficient were considered significant predictors. Results:The mean scores for physical, psychological, social relationship, and environmental health-related quality of life domains were 71.0, 72.1, 66.1, and 65.7, respectively. Among the participants, 76.1% rated their health-related quality of life as neither poor nor good, and 42.3% reported being neither dissatisfied nor satisfied in terms of their health satisfaction. Physical health was negatively affected by pregnancy-related illness, older age, and depression. Psychological domain declined with depression, rural residence, and perceived social stigma. Depression and perceived social stigma impaired social relationships. Environmental quality of life was lower among depressed participants, rural residents, and those reporting current alcohol use. Conclusion:Overall, participants demonstrated moderate health-related quality of life across all domains, with most perceiving their health status as neutral. Health professionals should follow holistic care, including physical, psychological, social, and environmental interventions. Targeted interventions are needed to address negatively associated predictor variables for all domains of health-related quality of life.
Background:Obstetric hematology subspeciality represents unique discipline that combines maternal-fetal medicine and hematology expertise to optimize care for pregnancy-associated and pre-existing hematologic disorders. Objective:To describe the implementation and clinical experience of the Obstetric Hematology Joint Clinic at the Women's Wellness and Research Center (WWRC), a specialized tertiary women's hospital in Qatar, since August 2020. Design and Methods:Single-center descriptive service evaluation using routinely collected data from August 2020 to December 2025, including patient encounters, diagnostic categories, and interventions delivered by the multidisciplinary team. Results:A total of 2,564 patient encounters were recorded over the study period, with steady annual growth. The clinic managed hemoglobinopathies, bleeding and thrombotic disorders, and pregnancy-related anemia and thrombocytopenia. Key interventions included intravenous iron therapy, anticoagulation management, transfusion support, and individualized multidisciplinary birth planning. Conclusion:The integrated clinic model improves coordinated care, enhances peripartum preparedness, and supports safe management of complex hematologic conditions during pregnancy and postpartum.
Introduction: Companionship-based care is essential for enhancing maternal and neonatal health services. Despite its importance, studies have shown inconsistent findings regarding the utilization of companionship during childbirth in developing countries, including Ethiopia. Objective: To evaluate the pooled utilization of companionship and identify the factors influencing this practice among women giving birth. Design: A systematic review and meta-analysis Data sources and methods: We conducted our review by searching common databases, including PubMed, Scopus, Wiley Online Library, ScienceDirect, and Epistemonikos, between February 1, 2025, and April 1, 2025. In addition, Google Scholar and unpublished theses from Ethiopian university research repositories were included. Data extraction was performed using an Excel data extraction form and subsequently imported into STATA version 11 for analysis. We employed forest plots, Cochran’s Q tests, subgroup analyses, sensitivity analyses, and meta-regression models to assess the heterogeneity among the included studies. Publication bias was evaluated through funnel plots and Egger’s regression tests. A random-effects model was used to estimate the pooled utilization of companionship. Results: From the 13 studies analyzed, which included a total of 8100 participants, we found that the utilization of companionship during childbirth was 28.86% (95% CI: 22.23, 35.48). Factors associated with higher utilization included the following: higher education level (prevalence and odds ratio (POR): 2.87, 95% CI: 1.81, 4.57), being primiparous (POR: 2.21, 95% CI: 1.82, 2.67), expressing a desire for companionship during delivery (POR: 2.77, 95% CI: 1.79, 4.28), having a history of obstetric complications (POR: 2.77, 95% CI: 1.79, 4.28), access to comfortable healthcare facilities (POR: 2.66, 95% CI: 1.97, 3.59), and possessing good knowledge about companionship care (POR: 2.35, 95% CI: 1.25, 4.41). Conclusion: The utilization of companionship during childbirth in Ethiopia remains low. The factors influencing this practice include higher education levels, being primiparous, the desire for a delivery companion, experiences of complications during pregnancy and labor, access to adequate healthcare facilities, and awareness of the benefits of having a birth companion. To improve this situation, healthcare management teams and providers should prioritize educating expectant mothers about the advantages of companionship during antenatal care. Trial registration: PROSPERO registration: CRD420251020204.
Attention-deficit hyperactivity disorder (ADHD) is a developmental disorder characterized by inattentiveness, hyperactivity, and impulsivity, often treated with amphetamine and methylphenidate agents. There is limited published data to provide established guidelines for stimulant use during pregnancy, and even less data on particular medications. This case study reports maternal-fetal outcomes with lisdexamfetamine (Vyvanse) use during pregnancy and breastfeeding. The patient who received this medication during her second pregnancy experienced significant improvement in her mental well-being compared to her first pregnancy, despite a similar pregnancy course and fetal outcomes, including preterm delivery, neonatal intensive care unit admission, cleft palate, and micrognathia in both pregnancies. In addition, this case demonstrates one instance of successful breastfeeding with maternal use of lisdexamfetamine with no observed side effects in the infant. This report highlights the importance of managing ADHD during pregnancy and the postpartum period and offers an example of breastfeeding without significant side effects or concerns.
Background: Pre-eclampsia is a hypertensive disorder of pregnancy and a major cause of maternal and neonatal mortality worldwide, with a disproportionately high burden in sub-Saharan Africa. Objective: This review synthesised evidence on how men engage with pre-eclampsia in the region. Design: This systematic review included qualitative designs and cross-sectional studies. Data sources and methods: Search was done across five primary databases (PubMed, Scopus, Embase, CINAHL and Web of Science). Additional searches were carried out in online sources like institutional repositories, HINARI, Dimensions AI and Google Scholar for studies published between 2000 and 2025. This review followed PRISMA guidelines and the Joanna Briggs Institute (JBI) framework. Data were appraised using JBI tools and synthesised thematically. Results: Twelve studies from Tanzania, Uganda, Ghana, Nigeria and Mozambique were included. Knowledge of pre-eclampsia varied widely; that is, only 24.8% of men demonstrated high awareness, while misconceptions, such as attributing the condition to stress, cold or supernatural forces, were common. Men’s roles spanned financial provision, decision-making, emotional and household support and information sharing, but overall involvement was moderate. Perceptions were shaped by cultural, social and spiritual narratives, while health system barriers such as unclear roles and exclusionary practices reduced engagement. Conclusion: Male partners’ knowledge, perceptions and roles significantly affect maternal outcomes in sub-Saharan Africa. Findings show the need for targeted education, culturally sensitive interventions and health system reforms that encourage male participation. Strengthening men’s engagement could reduce delays in care-seeking, improve antenatal care utilisation and contribute to lowering maternal and neonatal mortality. Trial registration: Open Science Framework with the DOI: https://doi.org/10.17605/OSF.IO/WHB93 .
Background: Pelvic organ prolapse (POP) is a major contributor to gynecological morbidity worldwide, including Ghana, with an estimated global prevalence of 30.9%. Surgery remains the definitive treatment for anatomical correction, but evidence on its functional outcomes in sub-Saharan Africa is limited. Objectives: This study evaluated the impact of surgical repair on pelvic floor symptoms and sexual function among Ghanaian women. Design: A prospective, hospital-based before-and-after study was conducted in Ghana between July 2018 and December 2019. Methods: Women with stage II or higher POP ( n = 96) were assessed preoperatively and 3 months postoperatively via the validated Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (IUGA-Revised (PISQ-IR)) tools. Pre- and postoperative mean scores for the urinary, anorectal, mechanical, and sexual function domains were compared via paired t tests. Statistical significance was defined as p < 0.05. Results: Surgical repair appeared to be linked to improvements across all PFDI-20 subscales: POPDI-6 (28.47–1.91, p < 0.001), UDI-6 (17.14–3.26, p < 0.001), and CRADI-8 (5.01–2.15, p < 0.001). Nearly 87% of the participants were sexually inactive, and among these, the PISQ-IR demonstrated marked gains in condition-specific and condition-impact domains ( p < 0.001), although no significant changes were observed in partner-related or global quality domains. The incidence of perioperative complications was minimal and was limited to urinary retention in 4.2% of the patients. Conclusion: Surgical management of POP among Ghanaian women was associated with substantial improvements in bulge, urinary, and bowel symptoms, with additional benefits in selected aspects of sexual health. These findings reflect initial symptom relief and quality of life improvements and should not be interpreted as long-term efficacy. These findings provide essential local data to fill knowledge gaps and inform preoperative counseling, guide decision-making, and shape postoperative expectations in similar resource-limited contexts.
Background: Stillbirths are a major global health concern. Improving intrapartum quality of care could reduce stillbirths, but there is no synthesized evidence on the impact of different intrapartum interventions on stillbirths. Objectives: The broad aim was to assess whether intrapartum quality improvement packages and related facility-based clinical, technological and health system interventions at maternity units of health facilities led to a reduction of stillbirths. Design: A systematic review and meta-analysis of experimental and analytical studies. Data sources and methods: This systematic review is reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Web of Science, Scopus, ProQuest, Cochrane, China National Knowledge Infrastructure (CNKI) databases were searched during July–August 2024. A comprehensive search strategy was developed using Medical Subject Headings (MeSH) terms and keywords. We conducted database scanning, article screening and data extraction and included experimental, cohort or case-control designs. Risk of bias was assessed using Critical Appraisal Skills Programme (CASP), ROBINS-I and RoB 2 checklists. A random-effects model was used to account for between-study variability. Heterogeneity was assessed using Cochran’s Q test, tau-squared ( τ 2 ) and quantified using the I 2 statistic followed by exploration through sensitivity analysis, subgroup analysis and meta-regression. Results: The final selection included 24 articles involving 4,647,555 intrapartum women for the systematic review and 17 studies for the meta-analysis. Quality improvement intrapartum interventions of foetal heart rate monitoring, capacity building and mentoring of providers and clinical practice improvement seemed to be beneficial in reducing stillbirths. The pooled estimate on meta-analysis yielded an odds ratio of 0.25 (95% CI: 0.06–1.10), suggesting a 75% reduction in the odds of stillbirth with intrapartum interventions, but not statistically significant. Diverse study settings enhanced the generalizability of findings, but the marked heterogeneity and variable methodological quality of the studies call for caution in making conclusions. Conclusion: Comprehensive quality improvement programmes during intrapartum period suggest potential benefits in reduction of stillbirths and can impact intrapartum care practices globally, particularly in low-resource settings. Heterogeneity in study design, study quality and contextual factors underscored the necessity for further research. Review registration: PROSPERO CRD42024503854.
Background: Uterine niches (isthmoceles) are myometrial defects commonly occurring after caesarean sections and may lead to abnormal uterine bleeding, pelvic pain and impaired fertility. Robotic-assisted surgical approaches have emerged as a minimally invasive option for their management, yet data on their efficacy remain limited. Objective: To evaluate the efficacy of robotic-assisted laparoscopic repair of uterine niches in improving clinical symptoms and fertility outcomes. Design: A retrospective observational study conducted at a tertiary university hospital. Methods: All patients who underwent robotic-assisted laparoscopic repair of uterine niches between 2013 and 2023 were included. Preoperative assessments included transvaginal ultrasound and hysterosalpingo-ultrasonography to evaluate residual myometrial thickness (RMT) and niche morphology. The surgical procedure entailed isthmocele resection followed by double-layer myometrial suturing using the Da Vinci Robotic System®. Pre- and postoperative RMT measurements were compared to assess myometrial restoration. Symptom resolution and postoperative fertility outcomes were also evaluated. Results: Fifty-one patients underwent robotic-assisted laparoscopic repair during the study period. The mean RMT significantly increased from 1.75 ± 1.4 mm preoperatively to 4.9 ± 3.4 mm postoperatively ( p < 0.001). While niche diameter reduction was not statistically significant, the healing ratio demonstrated a significant improvement ( p < 0.001). Among symptomatic patients with postoperative symptom assessment ( n = 28), 20 (71.4%) reported complete or partial symptom resolution. Among patients desiring conception postoperatively ( n = 36), 26 conceived; among pregnancies, 17/26 (65.4%) resulted in live birth, 1/26 (3.8%) was ongoing at last follow-up and 3/26 (11.5%) had an unknown outcome. Conclusion: Robotic-assisted laparoscopic repair was associated with improvement in symptoms related to uterine niches. The technique significantly improves myometrial thickness and supports favourable reproductive outcomes. Further prospective studies are warranted to establish standardised treatment guidelines and assess long-term efficacy. Trial registration: Not applicable.
Background: Unsafe induced abortion contributes a significant public health concern in Ethiopia and is one of the leading causes of maternal morbidity and mortality. Previous studies have explored the burden of induced abortion. However, little evidence exists in the context of Hawassa city.Objective: To identify the Risk factors associated with induced abortion among women attending health facilities in Hawassa city, Sidama Region, southern Ethiopia, 2024.Design: An institution-based unmatched case-control study design.Methods: A multistage sampling technique was employed to select 513 women of reproductive age attending public health facilities in Hawassa city from June 25 to August 25, 2024. Data were collected electronically through face-to-face interviews via a structured questionnaire adapted from previous studies. Descriptive analysis was conducted to describe the participants. Bivariable and multivariable binary logistic regression were used to identify risk factors associated with induced abortion.Results: In this study, 513 (172 cases and 341 controls) women were included, for a response rate of 95.4%. Primary education (adjusted odds ratio (AOR) = 2.58, 95% CI: 1.20, 5.53), early sexual debut before age 18 (AOR = 5.40, 95% CI: 2.80, 10.41), previous history of abortion (AOR = 3.50, 95% CI: 1.78, 6.90), poor knowledge about contraceptives (AOR = 5.11, 95% CI: 2.69, 9.72), and alcohol consumption (AOR = 2.76, 95% CI: 1.53, 4.98) were associated with increased odds of induced abortion. Conversely, ever use of contraceptives was associated with lower odds of induced abortion (AOR = 0.38, 95% CI: 0.21, 0.72).Conclusion: The current study points out that early sexual debut before age 18, previous history of abortion, poor knowledge about contraceptives, and alcohol consumption were factors associated with induced abortion. These findings highlight further investigation in longitudinal studies.
Background:Modern contraceptives are effective in preventing unintended pregnancies, which may consequently reduce the risk of unsafe abortions. However, their use among adolescent girls and young women (AGYW) in Tanzania remains low. Despite various national strategies, the fertility rate in the Mara region remains high at 6.1. Objectives:The first objective of this study was to determine the prevalence of modern contraceptive use among postpartum AGYW in rural Mara, Tanzania. The second objective was to identify factors influencing modern contraceptive use among postpartum AGYW. Design:An analytical cross-sectional study was conducted to assess modern contraceptive use among postpartum AGYW in rural Mara, Tanzania. Methods:A random multistage sampling technique was used to select 614 AGYW aged 15-24 years from rural Mara. Data were collected from January 5 to February 27, 2024, using a structured Swahili questionnaire. Analysis was performed using SPSS version 27.0, employing descriptive statistics, bivariate analysis to examine associations between categorical variables, and multivariate logistic regression to identify predictors of contraceptive use (p < 0.05). Results:Modern contraceptive use was reported by 21.7% (95% CI: 18.5%-25.0%) of postpartum AGYW. Women who had primary education were 4.83 times more likely to use contraceptives than those with no or incomplete primary education (AOR = 4.83, 95% CI: 2.61-8.91, p = 0.001). Women in the middle and highest wealth categories had significantly higher odds of contraceptive use (AOR = 1.83; 95% CI: 1.72-4.72; p = 0.04), representing an 83% increase compared to those in the lowest wealth category. In contrast, participants with two to three children were 60% less likely to use contraceptives compared to those with one child (AOR = 0.40; 95% CI: 0.22-0.72; p = 0.002). Conclusion:Modern contraceptive use among AGYW remains low. Education level, wealth status, and number of children significantly influence uptake, highlighting the need for targeted interventions to improve access and informed choice.
Background:Despite the severe, chronic nature of polycystic ovary syndrome (PCOS), relatively little is known about the lived experience of women with this condition, especially as they transition through menopause. Objective:This mixed-methods study investigated the lived experience of women with PCOS before and after the menopause transition to understand their health literacy, barriers to healthcare management, and desired resources to improve their health and well-being. Design:This was a convergent-parallel mixed-methods study. Methods:Twenty-four participants completed semi-structured interviews and electronic surveys between April 2023 and August 2024. Qualitative data were analyzed using an inductive open-ended approach for thematic analysis. Results:Participants, including 17 pre-menopausal (30.1 ± 4.8 years) and 7 post-menopausal (58.6 ± 6.0 years), self-reported clinical symptoms of PCOS (irregular cycles, hirsutism, and acne) and higher than average anxiety symptoms (pre-menopausal only). Both pre- and post-menopausal women were knowledgeable about the impact of PCOS on their fertility, and expressed low to moderate health literacy to successfully manage the PCOS-related symptoms. Few participants expressed understanding of long-term chronic disease risk. Pre-menopausal participants sought resources for managing symptoms but reported dissatisfaction with provider education and overall patient care. Post-menopausal participants did not view a PCOS diagnosis as a health concern following menopause and internalized PCOS-related health issues as something to be endured. Both pre- and post-menopausal women expressed desires for improved personalized care, life-stage-specific support groups, and better patient-facing resources. Conclusion:Pre-menopausal and post-menopausal women with PCOS exhibit low health literacy about the potential impact of PCOS on metabolic health. Primary care providers should be trained in how to educate women with PCOS, with an emphasis on the impact of the disease beyond reproductive health and through the lifespan. In addition, creating patient-centered resources supporting women throughout the lifespan is needed. Trial registration:This study was registered with ClinicalTrials.gov as NCT05769426.
Background: Adolescents in Africa are experiencing a significant epidemiological shift, characterised by earlier sexual debut and delayed marriage, leading to a longer period of sexual activity outside of marriage. In Chiredzi district, Zimbabwe, this often results in adolescent girls facing pregnancies without adequate access to tailored maternal health services.Objectives: This study aimed to gather quantitative data from health workers on the availability, accessibility and quality of adolescent maternal health services in Chiredzi district.Design: This study employed a quantitative, cross-sectional study.Methods: An exploratory study was conducted at Chiredzi General Hospital's maternity ward, involving all 90 healthcare workers via census sampling. Participants completed a structured, pre-tested questionnaire uploaded to Kobo Collect. A pre-test was conducted on 10% (n = 9) of the sample size. Data analysis involved cross-tabulations and inferential statistics performed in Statistical Package for Social Sciences (SPSS).Results: All 90 targeted health workers completed the questionnaire, offering valuable insights into the challenges faced by adolescent mothers at the hospital. Key findings revealed that over half (53.3%) of facilities lacked specific protocols for pregnant adolescents. A significant gender disparity in training was found, with 70% of female staff receiving adolescent service training compared to only 42% of male staff (p = 0.008). Furthermore, a high proportion of 'Not sure' responses (up to 50%) regarding available services indicated critical gaps in staff awareness and communication.Conclusion: The study underscores the critical need for standardised adolescent-friendly protocols, mandatory and equitable staff training, and the implementation of mobile health services to improve care for adolescent mothers. Investment in these areas is essential to improve health outcomes.
