International Journal of Environmental Research and Public Health

Editorial

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4 pages, 270 KiB

Open AccessEditorial

The Relegated Goal of Health Institutions: Sexual and Reproductive Health

by Juan Miguel Martínez-Galiano and Miguel Delgado-Rodríguez

Int. J. Environ. Res. Public Health 2021, 18(4), 1767; https://doi.org/10.3390/ijerph18041767 - 11 Feb 2021

Cited by 5 | Viewed by 2415

Abstract

Sexual and reproductive health does not always receive the attention it deserves and frequently is not supported with the necessary resources to guarantee its maintenance [...] Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

Research

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13 pages, 923 KiB

Open AccessArticle

Elaboration and Validation of Two Predictive Models of Postpartum Traumatic Stress Disorder Risk Formed by Variables Related to the Birth Process: A Retrospective Cohort Study

by Antonio Hernández-Martínez, Sergio Martínez-Vazquez, Julián Rodríguez-Almagro, Miguel Delgado-Rodríguez and Juan Miguel Martínez-Galiano

Int. J. Environ. Res. Public Health 2021, 18(1), 92; https://doi.org/10.3390/ijerph18010092 - 24 Dec 2020

Cited by 6 | Viewed by 2985

Abstract

This study aimed to develop and validate two predictive models of postpartum post-traumatic stress disorder (PTSD) risk using a retrospective cohort study of women who gave birth between 2018 and 2019 in Spain. The predictive models were developed using a referral cohort of [...] Read more.

This study aimed to develop and validate two predictive models of postpartum post-traumatic stress disorder (PTSD) risk using a retrospective cohort study of women who gave birth between 2018 and 2019 in Spain. The predictive models were developed using a referral cohort of 1752 women (2/3) and were validated on a cohort of 875 women (1/3). The predictive factors in model A were delivery type, skin-to-skin contact, admission of newborn to care unit, presence of a severe tear, type of infant feeding at discharge, postpartum hospital readmission. The area under curve (AUC) of the receiver operating characteristic (ROC) in the referral cohort was 0.70 (95% CI: 0.67–0.74), while in the validation cohort, it was 0.69 (95% CI: 0.63–0.75). The predictive factors in model B were delivery type, admission of newborn to care unit, type of infant feeding at discharge, postpartum hospital readmission, partner support, and the perception of adequate respect from health professionals. The predictive capacity of model B in both the referral cohort and the validation cohort was superior to model A with an AUC-ROC of 0.82 (95% CI: 0.79–0.85) and 0.83 (95% CI: 0.78–0.87), respectively. A predictive model (model B) formed by clinical variables and the perception of partner support and appropriate treatment by health professionals had a good predictive capacity in both the referral and validation cohorts. This model is preferred over the model (model A) that was formed exclusively by clinical variables. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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9 pages, 350 KiB

Open AccessArticle

Spanish Nursing Students’ Attitudes toward People Living with HIV/AIDS: A Cross-Sectional Survey

by María Adelaida Álvarez-Serrano, Encarnación Martínez-García, Adelina Martín-Salvador, María Gázquez-López, María Dolores Pozo-Cano, Rafael A. Caparrós-González and María Ángeles Pérez-Morente

Int. J. Environ. Res. Public Health 2020, 17(22), 8672; https://doi.org/10.3390/ijerph17228672 - 22 Nov 2020

Cited by 4 | Viewed by 2660

Abstract

Human immunodeficiency virus (HIV) infection is still a public health issue. Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) creates, in society, stigmatizing attitudes, fear, and discrimination against infected people; even health professionals do not feel trained enough to adequately take care of these [...] Read more.

Human immunodeficiency virus (HIV) infection is still a public health issue. Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) creates, in society, stigmatizing attitudes, fear, and discrimination against infected people; even health professionals do not feel trained enough to adequately take care of these patients, which affects the quality of care provided to such patients. The purpose of this study was to explore nursing students’ attitudes and other related factors toward people with HIV/AIDS, as well as their evolution in subsequent academic years. A cross-sectional study was performed with students in four academic years from four Spanish health sciences institutions (n = 384). Data were collected voluntarily and on an anonymous basis, utilizing the “Nursing students’ attitudes toward AIDS” (EASE) validated scale. The students’ attitudes toward people with HIV/AIDS were relatively positive, with a total mean EASE value of 85.25 ± 9.80. Statistically significant differences were observed according to the academic year (p = 0.041), in 4 out of 21 items of the scale and among students with no religious beliefs. By adjusting every variable, only the weak association with religion was maintained (p = 0.045). Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

12 pages, 966 KiB

Open AccessArticle

Ethnic Disparities in Utilization of Maternal and Child Health Services in Rural Southwest China

by Chaofang Yan, Charuwan Tadadej, Kanittha Chamroonsawasdi, Natkamol Chansatitporn and John FC Sung

Int. J. Environ. Res. Public Health 2020, 17(22), 8610; https://doi.org/10.3390/ijerph17228610 - 19 Nov 2020

Cited by 5 | Viewed by 2597

Abstract

Background: Studies in China on ethnic disparities in access to health care in remote and rural population remain insufficient. This study aimed to assess the disparities in utilization of maternal and child health (MCH) services, including antenatal care (ANC), hospital birth, child growth [...] Read more.

Background: Studies in China on ethnic disparities in access to health care in remote and rural population remain insufficient. This study aimed to assess the disparities in utilization of maternal and child health (MCH) services, including antenatal care (ANC), hospital birth, child growth monitoring, and immunization compliance between Han and ethnic minority women in Yunnan Province. Methods: A multi-stage sampling scheme was used to randomly recruit women from 40 townships in 14 remote prefectures of extremely remote areas in Yunnan. From birth records, we identified and recruited 303 Han women and 222 ethnic minority women who had given birth to a child within 3 years for an interview. Results: Overall, 96% of women used the ANC checkups and more than 95% had infants born in hospitals. However, the proportion of women compliant with early ANC visits (having antenatal care in the first trimester) was 22.5% lower in minority women than in Han women (61.3% vs. 83.8%, p < 0.001) with an adjusted odds ratio (aOR) of 2.04 (95% confidence interval (CI) of 1.13–3.66) for the minority group. The proportion of children under one year old with immunizations completed in a timely manner was also lower in minority families than in Han families (80.2% vs. 86.8%, p < 0.05) with an aOR of 1.99 (95% CI = 1.16–3.40). Conclusions: Ethnic disparities remain in utilization of early ANC visits and timely immunization completion for newborns. Ethnic minority women tended to lag behind for both. Further intervention should focus on assisting minority women living in extremely rural areas to comply with the MCH policy. Culturally-sensitive policies and skills are needed, and priority should be given to improve utilization of early ANC and timely immunization completion. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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13 pages, 1238 KiB

Open AccessArticle

Maternal Dietary Patterns during Pregnancy and Their Association with Gestational Weight Gain and Nutrient Adequacy

by Naomi Cano-Ibáñez, Juan Miguel Martínez-Galiano, Miguel Angel Luque-Fernández, Sandra Martín-Peláez, Aurora Bueno-Cavanillas and Miguel Delgado-Rodríguez

Int. J. Environ. Res. Public Health 2020, 17(21), 7908; https://doi.org/10.3390/ijerph17217908 - 28 Oct 2020

Cited by 15 | Viewed by 4096

Abstract

Several epidemiologic studies have shown an association between Gestational Weight Gain (GWG) and offspring complications. The GWG is directly linked to maternal dietary intake and women’s nutritional status during pregnancy. The aim of this study was (1) to assess, in a sample of [...] Read more.

Several epidemiologic studies have shown an association between Gestational Weight Gain (GWG) and offspring complications. The GWG is directly linked to maternal dietary intake and women’s nutritional status during pregnancy. The aim of this study was (1) to assess, in a sample of Spanish pregnant women, the association between maternal dietary patterns and GWG and (2) to assess maternal dietary patterns and nutrient adequate intake according to GWG. A retrospective study was conducted in a sample of 503 adult pregnant women in five hospitals in Eastern Andalusia (Spain). Data on demographic characteristics, anthropometric values, and dietary intake were collected from clinical records by trained midwives. Usual food intake was gathered through a validated Food Frequency Questionnaire (FFQ), and dietary patterns were obtained by principal component analysis. Nutrient adequacy was defined according to European dietary intake recommendations for pregnant women. Regression models adjusted by confounding factors were constructed to study the association between maternal dietary pattern and GWG, and maternal dietary patterns and nutritional adequacy. A negative association was found between GWG and the Mediterranean dietary pattern (crude β = −0.06, 95% CI: −0.11, −0.04). Independent of maternal dietary pattern, nutrient adequacy of dietary fiber, vitamin B9, D, E, and iodine was related to a Mediterranean dietary pattern (p < 0.05). A Mediterranean dietary pattern is related to lower GWG and better nutrient adequacy. The promotion of healthy dietary behavior consistent with the general advice promoted by the Mediterranean Diet (based on legumes, vegetables, nuts, olive oil, and whole cereals) will offer healthful, sustainable, and practical strategies to control GWG and ensure adequate nutrient intake during pregnancy. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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11 pages, 391 KiB

Open AccessArticle

Sexually Transmitted Infections and Associated Factors in Southeast Spain: A Retrospective Study from 2000 to 2014

by María Ángeles Pérez-Morente, María Gázquez-López, María Adelaida Álvarez-Serrano, Encarnación Martínez-García, Pedro Femia-Marzo, María Dolores Pozo-Cano and Adelina Martín-Salvador

Int. J. Environ. Res. Public Health 2020, 17(20), 7449; https://doi.org/10.3390/ijerph17207449 - 13 Oct 2020

Cited by 3 | Viewed by 2905

Abstract

The World Health Organization estimates that more than one million people acquire a Sexually Transmitted Infection (STI) every day, compromising quality of life, sexual and reproductive health, and the health of newborns and children. It is an objective of this study to identify [...] Read more.

The World Health Organization estimates that more than one million people acquire a Sexually Transmitted Infection (STI) every day, compromising quality of life, sexual and reproductive health, and the health of newborns and children. It is an objective of this study to identify the factors related to a Sexually Transmitted Infection diagnosis in the province of Granada (Spain), as well as those better predicting the risk of acquiring such infections. In this study, 678 cases were analyzed on a retrospective basis, which were treated at the Centre for Sexually Transmitted Diseases and Sexual Orientation in Granada, between 2000–2014. Descriptive statistics were applied, and by means of binary logistic regression, employing the forward stepwise-likelihood ratio, a predictive model was estimated for the risk of acquiring an STI. Sex, age, occupation, economic crisis period, drug use, number of days in which no condoms were used, number of sexual partners in the last month and in the last year, and number of subsequent visits and new subsequent episodes were associated with an STI diagnosis (p < 0.05). The risk of being diagnosed with an STI increased during the economic crisis period (OR: 1.88; 95%-CI: 1.28–2.76); during the economic crisis and if they were women (OR:2.35, 95%- CI: 1.24–4.44); and if they were women and immigrants (OR: 2.09; 95%- CI:1.22–3.57), while it decreased with age (OR: 0.97, 95%-CI: 0.95–0.98). Identification of the group comprised of immigrant women as an especially vulnerable group regarding the acquisition of an STI in our province reflects the need to incorporate the gender perspective into preventive strategies and STI primary health care. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

19 pages, 574 KiB

Open AccessArticle

The Quality of Counselling for Oral Emergency Contraceptive Pills—A Simulated Patient Study in German Community Pharmacies

by Bernhard Langer, Sophia Grimm, Gwenda Lungfiel, Franca Mandlmeier and Vanessa Wenig

Int. J. Environ. Res. Public Health 2020, 17(18), 6720; https://doi.org/10.3390/ijerph17186720 - 15 Sep 2020

Cited by 8 | Viewed by 6448

Abstract

Background: In Germany, there are two different active substances, levonorgestrel (LNG) and ulipristal acetate (UPA), available as emergency contraception (the “morning after pill”) with UPA still effective even 72 to 120 h after unprotected sexual intercourse, unlike LNG. Emergency contraceptive pills have been [...] Read more.

Background: In Germany, there are two different active substances, levonorgestrel (LNG) and ulipristal acetate (UPA), available as emergency contraception (the “morning after pill”) with UPA still effective even 72 to 120 h after unprotected sexual intercourse, unlike LNG. Emergency contraceptive pills have been available without a medical prescription since March 2015 but are still only dispensed by community pharmacies. The aim of this study was to determine the counselling and dispensing behaviour of pharmacy staff and the factors that may influence this behaviour in a scenario that intends that only the emergency contraceptive pill containing the active substance UPA is dispensed (appropriate outcome). Methods: A cross-sectional study was carried out in the form of a covert simulated patient study in a random sample of community pharmacies stratified by location in the German state of Mecklenburg-Vorpommern and reported in accordance with the STROBE statement. Each pharmacy was visited once at random by one of four trained test buyers. They simulated a product-based request for an emergency contraceptive pill, stating contraceptive failure 3.5 days prior as the reason. The test scenario and the evaluation forms are based on the recommended actions, including the checklist from the Federal Chamber of Pharmacies. Results: All 199 planned pharmacy visits were carried out. The appropriate outcome (dispensing of UPA) was achieved in 78.9% of the test purchases (157/199). A significant correlation was identified between the use of the counselling room and the use of a checklist (p < 0.001). The use of a checklist led to a significantly higher questioning score (p < 0.001). In a multivariate binary logistic regression analysis, a higher questioning score (adjusted odds ratio [AOR] = 1.41; 95% CI = 1.22–1.63; p < 0.001) and a time between 12:01 and 4:00 p.m. (AOR = 2.54; 95% CI = 1.13–5.73; p = 0.024) compared to 8:00 to 12:00 a.m. were significantly associated with achieving the appropriate outcome. Conclusions: In a little over one-fifth of all test purchases, the required dispensing of UPA did not occur. The use of a counselling room and a checklist, the use of a checklist and the questioning score as well as the questioning score and achieving the appropriate outcome are all significantly correlated. A target regulation for the use of a counselling room, an explicit guideline recommendation about the use of a checklist, an obligation for keeping UPA in stock and appropriate mandatory continuing education programmes should be considered. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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16 pages, 2290 KiB

Open AccessArticle

Advancing Prevention of STIs by Developing Specific Serodiagnostic Targets: Trichomonas vginalis as a Model

by John F. Alderete

Int. J. Environ. Res. Public Health 2020, 17(16), 5783; https://doi.org/10.3390/ijerph17165783 - 10 Aug 2020

Cited by 4 | Viewed by 2293

Abstract

Point-of-Care (POC) serum antibody screening of large cohorts of women and men at risk for the sexually transmitted infection (STI) caused by Trichomonas vaginalis requires the availability of targets with high specificity. Such targets should comprise epitopes unique to T. vaginalis immunogenic proteins [...] Read more.

Point-of-Care (POC) serum antibody screening of large cohorts of women and men at risk for the sexually transmitted infection (STI) caused by Trichomonas vaginalis requires the availability of targets with high specificity. Such targets should comprise epitopes unique to T. vaginalis immunogenic proteins detected by sera of women and men patients with trichomonosis but not uninfected controls. Three enzymes to which patients make serum IgG antibody were identified as fructose-1,6-bisphosphate aldolase (A), α-enolase (E), and glyceraldehyde-3-phosphate dehydrogenase (G). Epitopes within these proteins were identified that had no sequence identity to enzymes of humans and other pathogens. Therefore, I constructed a chimeric recombinant String-Of-Epitopes (SOE) protein consisting of 15-mer peptides, within which are the epitopes of A, E, and G. This novel protein of ~36-kD is comprised of two epitopes of A, ten epitopes of E, and seven epitopes of G (AEG::SOE2). The AEG::SOE2 protein was detected both by immunoblot and by enzyme-linked immunosorbent assay (ELISA) using highly reactive sera of women and men but not negative serum unreactive to T. vaginalis proteins. Finally, AEG::SOE2 was found to be immunogenic, as evidenced by serum IgG from immunized mice. I discuss how this approach is important in relation to infectious disease diagnostic targets for detection of serum IgG antibody in exposed and/or infected individuals and how such novel targets may have potential as subunit vaccine candidates against microbial pathogens. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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16 pages, 357 KiB

Open AccessArticle

Validation of the Women’s Views of Birth Labor Satisfaction Questionnaire (WOMBLSQ4) in the Spanish Population

by María Dolores Pozo-Cano, Adelina Martín-Salvador, María Ángeles Pérez-Morente, Encarnación Martínez-García, Juan de Dios Luna del Castillo, María Gázquez-López, Rafael Fernández-Castillo and Inmaculada García-García

Int. J. Environ. Res. Public Health 2020, 17(15), 5582; https://doi.org/10.3390/ijerph17155582 - 2 Aug 2020

Cited by 4 | Viewed by 3078

Abstract

The satisfaction of women with the birth experience has implications for the health and wellness of the women themselves and also of their newborn baby. The objectives of this study were to determine the factor structure of the Women’s Views of Birth Labor [...] Read more.

The satisfaction of women with the birth experience has implications for the health and wellness of the women themselves and also of their newborn baby. The objectives of this study were to determine the factor structure of the Women’s Views of Birth Labor Satisfaction Questionnaire (WOMBLSQ4) questionnaire on satisfaction with the attention received during birth delivery in Spanish women and to compare the level of satisfaction of pregnant women during the birth process with that in other studies that validated this instrument. A cross-sectional study using a self-completed questionnaire of 385 Spanish-speaking puerperal women who gave birth in the Public University Hospitals of Granada (Spain) was conducted. An exploratory factor analysis of the WOMBLSQ4 questionnaire was performed to identify the best fit model. Those items that showed commonalities higher than 0.50 were kept in the questionnaire. Using the principal components method, nine factors with eigenvalues greater than one were extracted after merging pain-related factors into a single item. These factors explain 90% of the global variance, indicating the high internal consistency of the full scale. In the model resulting from the WOMBLSQ4 questionnaire, its nine dimensions measure the levels of satisfaction of puerperal women with childbirth care. Average scores somewhat higher than those of the original questionnaire and close to those achieved in the study carried out in Madrid (Spain) were obtained. In clinical practice, this scale may be relevant for measuring the levels of satisfaction during childbirth of Spanish-speaking women. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

15 pages, 1075 KiB

Open AccessArticle

Contribution of Chronic Fatigue to Psychosocial Status and Quality of Life in Spanish Women Diagnosed with Endometriosis

by Antonio Mundo-López, Olga Ocón-Hernández, Ainhoa P. San-Sebastián, Noelia Galiano-Castillo, Olga Rodríguez-Pérez, María S. Arroyo-Luque, Manuel Arroyo-Morales, Irene Cantarero-Villanueva, Carolina Fernández-Lao and Francisco Artacho-Cordón

Int. J. Environ. Res. Public Health 2020, 17(11), 3831; https://doi.org/10.3390/ijerph17113831 - 28 May 2020

Cited by 24 | Viewed by 4153

Abstract

Aim: To analyze the levels of chronic fatigue in Spanish women with endometriosis and its relationship with their psychosocial status and quality of life (QoL). Methods: A total of 230 Spanish women with a clinical diagnosis of endometriosis were recruited. Chronic fatigue (Piper [...] Read more.

Aim: To analyze the levels of chronic fatigue in Spanish women with endometriosis and its relationship with their psychosocial status and quality of life (QoL). Methods: A total of 230 Spanish women with a clinical diagnosis of endometriosis were recruited. Chronic fatigue (Piper Fatigue Scale) and pelvic pain (Numeric Rating Scale) were evaluated. An on-line battery of validated scales was used to assess psychosocial status [Hospital Anxiety and Depression Scale, Scale for Mood Assessment, Pain Catastrophizing Scale, Pittsburgh Sleep Quality Index, Gastrointestinal Quality of Life Index, Female Sexual Function Index and Medical Outcomes Study-Social Support Survey] and QoL [Endometriosis-Health Profile questionnaire-30]. Associations between fatigue and both psychosocial and QoL outcomes were explored through multivariate regression models. Results: One-third and one-half of women showed moderate and severe fatigue, respectively. Fatigue was associated with higher anxiety and depression, poorer sleep quality, poorer sexual functioning, worse gastrointestinal health, higher catastrophizing thoughts, higher anger/hostility scores and lower QoL (p-values < 0.050). Moreover, fatigue and catastrophizing thoughts showed a mediating effect on the association between pelvic pain and QoL. Conclusion: This work reveals the important role of fatigue in the association between pain, psychosocial status, and QoL of Spanish women with endometriosis. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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14 pages, 315 KiB

Open AccessArticle

Laws Restricting Access to Abortion Services and Infant Mortality Risk in the United States

by Roman Pabayo, Amy Ehntholt, Daniel M. Cook, Megan Reynolds, Peter Muennig and Sze Y. Liu

Int. J. Environ. Res. Public Health 2020, 17(11), 3773; https://doi.org/10.3390/ijerph17113773 - 26 May 2020

Cited by 24 | Viewed by 12851

Abstract

Objectives: Since the US Supreme Court′s 1973 Roe v. Wade decision legalizing abortion, states have enacted laws restricting access to abortion services. Previous studies suggest that restricting access to abortion is a risk factor for adverse maternal and infant health. The objective of [...] Read more.

Objectives: Since the US Supreme Court′s 1973 Roe v. Wade decision legalizing abortion, states have enacted laws restricting access to abortion services. Previous studies suggest that restricting access to abortion is a risk factor for adverse maternal and infant health. The objective of this investigation is to study the relationship between the type and the number of state-level restrictive abortion laws and infant mortality risk. Methods: We used data on 11,972,629 infants and mothers from the US Cohort Linked Birth/Infant Death Data Files 2008–2010. State-level abortion laws included Medicaid funding restrictions, mandatory parental involvement, mandatory counseling, mandatory waiting period, and two-visit laws. Multilevel logistic regression was used to determine whether type or number of state-level restrictive abortion laws during year of birth were associated with odds of infant mortality. Results: Compared to infants living in states with no restrictive laws, infants living in states with one or two restrictive laws (adjusted odds ratio (AOR) = 1.08; 95% confidence interval [CI] = 0.99–1.18) and those living in states with 3 to 5 restrictive laws (AOR = 1.10; 95% CI = 1.01–1.20) were more likely to die. Separate analyses examining the relationship between parental involvement laws and infant mortality risk, stratified by maternal age, indicated that significant associations were observed among mothers aged ≤19 years (AOR = 1.09, 95% CI = 1.00–1.19), and 20 to 25 years (AOR = 1.10, 95% CI = 1.03–1.17). No significant association was observed among infants born to older mothers. Conclusion: Restricting access to abortion services may increase the risk for infant mortality. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

15 pages, 1114 KiB

Open AccessArticle

Psychometric Properties of the Condom Use Self-Efficacy Scale among Young Colombians

by Vanessa Sanchez-Mendoza, Encarnacion Soriano-Ayala and Pablo Vallejo-Medina

Int. J. Environ. Res. Public Health 2020, 17(11), 3762; https://doi.org/10.3390/ijerph17113762 - 26 May 2020

Cited by 11 | Viewed by 3278

Abstract

(1) Background: This study evaluated the psychometric properties of the Condom Use Self-Efficacy Scale among Colombian youth. (2) Method: A total of 2873 men and women between 18 and 26 years old (M = 21.45, SD = 2.26) took part in this [...] Read more.

(1) Background: This study evaluated the psychometric properties of the Condom Use Self-Efficacy Scale among Colombian youth. (2) Method: A total of 2873 men and women between 18 and 26 years old (M = 21.45, SD = 2.26) took part in this study. All participants answered a socio-demographic survey, the Condom Use Self-Efficacy Scale, the UCLA Multidimensional Condom Attitudes Scale, The Condom Use Errors and Problems Scale, and the Sexual Assertiveness Scale. Sampling was web-based, and the survey was distributed via Facebook. (3) Results: The Condom Use Self-Efficacy Scale demonstrated adequate reliability (ordinal α ranged = 0.76 to 0.92). Exploratory and confirmatory factor analysis suggested a four-factor structure with an explained variance of 69%. This dimensionality was also invariant across gender. Moreover, positive attitudes toward condom use were significantly associated with appropriation and assertiveness. Two dimensions (appropriation and partner disapproval) showed significant gender differences. (4) Conclusions: The Spanish–Colombian version of the Condom Use Self-Efficacy Scale is a psychometrically adequate instrument to measure perceived condom use self-efficacy. This scale can be used in both research and professional settings to measure self-efficacy at using condoms in young people. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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12 pages, 296 KiB

Open AccessArticle

Son Preference and the Reproductive Behavior of Rural-Urban Migrant Women of Childbearing Age in China: Empirical Evidence from a Cross-Sectional Data

by Xiaojie Wang, Wenjie Nie and Pengcheng Liu

Int. J. Environ. Res. Public Health 2020, 17(9), 3221; https://doi.org/10.3390/ijerph17093221 - 6 May 2020

Cited by 14 | Viewed by 4028

Abstract

Son preference has been shown to influence the childbearing behavior of women, especially in China. Existing research has largely focused on this issue using cross-sectional data of urban or rural populations in China, while evidence from the rural-urban migrant women is relatively limited. [...] Read more.

Son preference has been shown to influence the childbearing behavior of women, especially in China. Existing research has largely focused on this issue using cross-sectional data of urban or rural populations in China, while evidence from the rural-urban migrant women is relatively limited. Based on the data of China Migrants Dynamic Survey in 2015, we used logistic regression models to explore the relationship of son preference and reproductive behavior of rural-urban migrant women in China. The results show that the son preference of migrant women is still strong, which leads women with only daughters to have significantly higher possibility of having another child and results in a higher imbalance in the sex ratio with higher parity. Migrant women giving birth to a son is a protective factor against having a second child compared to women whose first child was a girl. Similarly, the effects of the gender of the previous child on women’s progression from having two to three children showed the same result that is consistent with a preference for sons. These findings have implications for future public strategies to mitigate the son preference among migrant women and the imbalance in the sex ratio at birth. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

11 pages, 955 KiB

Open AccessArticle

Healthcare Providers’ Knowledge and Attitude Towards Abortions in Thailand: A Pre-Post Evaluation of Trainings on Safe Abortion

by Rugsapon Sanitya, Aniqa Islam Marshall, Nithiwat Saengruang, Sataporn Julchoo, Pigunkaew Sinam, Rapeepong Suphanchaimat, Mathudara Phaiyarom, Viroj Tangcharoensathien, Nongluk Boonthai and Kamheang Chaturachinda

Int. J. Environ. Res. Public Health 2020, 17(9), 3198; https://doi.org/10.3390/ijerph17093198 - 4 May 2020

Cited by 14 | Viewed by 4697

Abstract

Although physicians in Thailand can carry out abortions legally, unsafe abortion rates remain high and have serious consequences for women’s health. Training programs for healthcare providers on the ‘Care of unplanned and adolescent pregnancies for the prevention of unsafe abortions’ have been implemented [...] Read more.

Although physicians in Thailand can carry out abortions legally, unsafe abortion rates remain high and have serious consequences for women’s health. Training programs for healthcare providers on the ‘Care of unplanned and adolescent pregnancies for the prevention of unsafe abortions’ have been implemented in Thailand with the aim of providing information and challenging negative attitudes about abortions. This study investigated the participants of the training courses in order to: (i) evaluate their knowledge and attitudes towards safe abortions; and (ii) investigate the factors that determine their knowledge and attitudes. A pre-post study design was applied. Descriptive statistics were calculated to provide an overview of the data. Bivariate analysis, a Wilcoxon signed rank test and a multivariable analysis using multiple linear regression were applied to determine the changes in attitudes and assess the likelihood of behaviour change towards adolescents and women experiencing unplanned pregnancy and abortions, according to demographic and professional characteristics. Having had the training, healthcare providers’ change in attitudes towards adolescents and women experiencing unplanned pregnancies and abortions were found to be 0.67 points for the nine responses of attitudes and 0.79 points for the 14 responses on various abortion scenarios. Changes in attitude were significantly different among the varying health professional types, with non-doctors increasing by 0.53 points, non-obstetricians and non-gynaecologists increasing by 0.46 points and obstetricians and gynaecologists (OBGYN) increasing by 0.32 points. Positive attitudes towards unplanned pregnancies and unsafe abortions and attitudes towards abortion scenarios significantly increased. The career type of the health professional was a significant factor in improving attitudes. The training program was more effective among non-doctor healthcare providers. Therefore, non-doctors could be the target population for training in the future. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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17 pages, 1663 KiB

Open AccessArticle

Government Expenditure on Maternal Health and Family Planning Services for Adolescents in Mexico, 2003–2015

by Leticia Avila-Burgos, Julio César Montañez-Hernández, Lucero Cahuana-Hurtado, Aremis Villalobos, Patricia Hernández-Peña and Ileana Heredia-Pi

Int. J. Environ. Res. Public Health 2020, 17(9), 3097; https://doi.org/10.3390/ijerph17093097 - 29 Apr 2020

Cited by 1 | Viewed by 3192

Abstract

The purpose of this study was to assess whether government policies to expand the coverage of maternal health and family planning (MHFP) services were benefiting the adolescents in need. To this end, we estimated government MHFP expenditure for 10- to 19-year-old adolescents without [...] Read more.

The purpose of this study was to assess whether government policies to expand the coverage of maternal health and family planning (MHFP) services were benefiting the adolescents in need. To this end, we estimated government MHFP expenditure for 10- to 19-year-old adolescents without social security (SS) coverage between 2003 and 2015. We evaluated its evolution and distribution nationally and sub-nationally by level of marginalization, as well as its relationship with demand indicators. Using Jointpoint regressions, we estimated the average annual percent change (AAPC) nationally and among states. Expenditure for adolescents without SS coverage registered 15% for AAPC for the period 2003–2011 and was stable for the remaining years, with 88% of spending allocated to maternal health. Growth in MHFP expenditure reduced the ratio of spending by 13% among groups of states with greater/lesser marginalization; nonetheless, the poorest states continued to show the lowest levels of expenditure. Although adolescents without SS coverage benefited from greater MHFP expenditure as a consequence of health policies directed at achieving universal health coverage, gaps persisted in its distribution among states, since those with similar demand indicators exhibited different levels of expenditure. Further actions are required to improve resource allocation to disadvantaged states and to reinforce the use of FP services by adolescents. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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10 pages, 490 KiB

Open AccessArticle

Economic Crisis and Sexually Transmitted Infections: A Comparison Between Native and Immigrant Populations in a Specialised Centre in Granada, Spain

by María Ángeles Pérez-Morente, Adelina Martín-Salvador, María Gázquez-López, Pedro Femia-Marzo, María Dolores Pozo-Cano, César Hueso-Montoro and Encarnación Martínez-García

Int. J. Environ. Res. Public Health 2020, 17(7), 2480; https://doi.org/10.3390/ijerph17072480 - 5 Apr 2020

Cited by 4 | Viewed by 2719

Abstract

This study aimed to analyse the influence of the economic crisis on the prevalence of sexually transmitted infections (STIs) in the immigrant population compared to the native population. A cross-sectional study was conducted by reviewing 441 clinical records (329 Spanish nationals and 112 [...] Read more.

This study aimed to analyse the influence of the economic crisis on the prevalence of sexually transmitted infections (STIs) in the immigrant population compared to the native population. A cross-sectional study was conducted by reviewing 441 clinical records (329 Spanish nationals and 112 non-Spanish nationals) of individuals who, between 2000 and 2014, visited an STI clinic in Granada and tested positive for an infection. Descriptive statistical analyses were performed, and infection rates, odds ratios, and 95% confidence intervals (CIs) were calculated. The mean age was 28.06 years (SD = 8.30; range = 16–70). During the period 2000–2014, the risk of being diagnosed with an STI was higher among non-Spanish nationals than among Spanish nationals (odds ratio (OR) = 5.33; 95% CI = 4.78–6.60). Differences between both populations were less marked during the crisis period (2008–2014: OR = 2.73; 95% CI = 2.32–3.73) than during the non-crisis period (2000–2007: OR = 12.02; 95% CI = 10.33–16.17). This may be due to underreporting of diagnoses in the immigrant population. Immigrants visiting the STI clinic in Granada are especially vulnerable to positive STI diagnoses compared to the native population. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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17 pages, 8176 KiB

Open AccessArticle

Understanding the Experiences and Needs of Migrant Women Affected by Female Genital Mutilation Using Maternity Services in Australia

by Sabera Turkmani, Caroline S. E. Homer and Angela J. Dawson

Int. J. Environ. Res. Public Health 2020, 17(5), 1491; https://doi.org/10.3390/ijerph17051491 - 26 Feb 2020

Cited by 12 | Viewed by 7057

Abstract

Female genital mutilation (FGM) is a cultural practice defined as the partial or total removal of the external female genitalia for non-therapeutic reasons. Changing patterns of migration in Australia and other high-income countries has meant that maternity care providers and health systems are [...] Read more.

Female genital mutilation (FGM) is a cultural practice defined as the partial or total removal of the external female genitalia for non-therapeutic reasons. Changing patterns of migration in Australia and other high-income countries has meant that maternity care providers and health systems are caring for more pregnant women affected by this practice. The aim of the study was to identify strategies to inform culturally safe and quality woman-centred maternity care for women affected by FGM who have migrated to Australia. An Appreciative Inquiry approach was used to engage women with FGM. We conducted 23 semi-structured interviews and three focus group discussions. There were four themes identified: (1) appreciating the best in their experiences; (2) achieving their dreams; (3) planning together; and (4) acting, modifying, improving and sustaining. Women could articulate their health and cultural needs, but they were not engaged in all aspects of their maternity care or considered active partners. Partnering and involving women in the design and delivery of their maternity care would improve quality care. A conceptual model, underpinned by women’s cultural values and physical, emotional needs, is presented as a framework to guide maternity services. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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Review

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13 pages, 759 KiB

Open AccessReview

Prevalence of Intimate Partner Violence in Pregnancy: An Umbrella Review

by Rosario M. Román-Gálvez, Sandra Martín-Peláez, Juan Miguel Martínez-Galiano, Khalid Saeed Khan and Aurora Bueno-Cavanillas

Int. J. Environ. Res. Public Health 2021, 18(2), 707; https://doi.org/10.3390/ijerph18020707 - 15 Jan 2021

Cited by 37 | Viewed by 6558

Abstract

Background: Intimate partner violence (IPV) is a public health concern, especially during pregnancy, and needs to be urgently addressed. In order to establish effective actions for the prevention of IPV during pregnancy, authorities must be aware of the real burden of IPV. This [...] Read more.

Background: Intimate partner violence (IPV) is a public health concern, especially during pregnancy, and needs to be urgently addressed. In order to establish effective actions for the prevention of IPV during pregnancy, authorities must be aware of the real burden of IPV. This review aimed to summarize the existing evidence about IPV prevalence during pregnancy worldwide. Methods: A review of reviews was carried out. All published systematic reviews and meta-analyses published until October 2020 were identified through PubMed, Scopus, and Web of Science. The main outcome was the IPV prevalence during pregnancy. Results: A total of 12 systematic reviews were included in the review, 5 of them including meta-analysis. The quality of the reviews was variable. Physical IPV during pregnancy showed a wide range (1.6–78%), as did psychological IPV (1.8–67.4%). Conclusions: Available data about IPV prevalence during pregnancy were of low quality and showed high figures for physical and psychological IPV. The existing evidence syntheses do not capture the totality of the worldwide disease burden of IPV in pregnancy. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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26 pages, 1740 KiB

Open AccessReview

Relationship Between Prolonged Second Stage of Labor and Short-Term Neonatal Morbidity: A Systematic Review and Meta-Analysis

by Nuria Infante-Torres, Milagros Molina-Alarcón, Angel Arias-Arias, Julián Rodríguez-Almagro and Antonio Hernández-Martínez

Int. J. Environ. Res. Public Health 2020, 17(21), 7762; https://doi.org/10.3390/ijerph17217762 - 23 Oct 2020

Cited by 11 | Viewed by 3640

Abstract

To evaluate the association between prolonged second stage of labor and the risk of adverse neonatal outcomes with a systematic review and meta-analysis. PubMed, Scopus and EMBASE were searched using the search strategy “Labor Stage, Second” AND (length OR duration OR prolonged OR [...] Read more.

To evaluate the association between prolonged second stage of labor and the risk of adverse neonatal outcomes with a systematic review and meta-analysis. PubMed, Scopus and EMBASE were searched using the search strategy “Labor Stage, Second” AND (length OR duration OR prolonged OR abnormal OR excessive). Observational studies that examine the relationship between prolonged second stage of labor and neonatal outcomes were selected. Prolonged second stage of labor was defined as 4 h or more in nulliparous women and 3 h or more in multiparous women. The main neonatal outcomes were 5 min Apgar score <7, admission to the Neonatal Intensive Care Unit, neonatal sepsis and neonatal death. Data collection and quality assessment were carried out independently by the three reviewers. Twelve studies were selected including 266,479 women. In nulliparous women, a second stage duration greater than 4 h increased the risk of 5 min Apgar score <7, admission to the Neonatal Intensive Care Unit and neonatal sepsis and intubation. In multiparous women, a second stage of labor greater than 3 h was related to 5 min Apgar score <7, admission to the Neonatal Intensive Care Unit, meconium staining and composite neonatal morbidity. Prolonged second stage of labor increased the risk of 5 min Apgar score <7 and admission to the Neonatal Intensive Care Unit in nulliparous and multiparous women, without increasing the risk of neonatal death. This review demonstrates that prolonged second stage of labor increases the risk of neonatal complications in nulliparous and multiparous women. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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Other

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12 pages, 569 KiB

Open AccessCommentary

Patient and Public Involvement in Sexual and Reproductive Health: Time to Properly Integrate Citizen’s Input into Science

by Miguel García-Martín, Carmen Amezcua-Prieto, Bassel H Al Wattar, Jan Stener Jørgensen, Aurora Bueno-Cavanillas and Khalid Saeed Khan

Int. J. Environ. Res. Public Health 2020, 17(21), 8048; https://doi.org/10.3390/ijerph17218048 - 31 Oct 2020

Cited by 14 | Viewed by 2927

Abstract

Evidence-based sexual and reproductive health is a global endeavor without borders. Inter-sectorial collaboration is essential for identifying and addressing gaps in evidence. Health research funders and regulators are promoting patient and public involvement in research, but there is a lack of quality tools [...] Read more.

Evidence-based sexual and reproductive health is a global endeavor without borders. Inter-sectorial collaboration is essential for identifying and addressing gaps in evidence. Health research funders and regulators are promoting patient and public involvement in research, but there is a lack of quality tools for involving patients. Partnerships with patients are necessary to produce and promote robust, relevant and timely research. Without the active participation of women as stakeholders, not just as research subjects, the societal benefits of research cannot be realized. Creating and developing platforms and opportunities for public involvement in sexual and reproductive health research should be a key international objective. Cooperation between healthcare professionals, academic institutions and the community is essential to promote quality research and significant developments in women’s health. This cooperation will be improved when involvement of citizens in the research process becomes standard. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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9 pages, 329 KiB

Open AccessBrief Report

Association between Sexual Habits and Sexually Transmitted Infections at a Specialised Centre in Granada (Spain)

by Raquel Casado Santa-Bárbara, César Hueso-Montoro, Adelina Martín-Salvador, María Adelaida Álvarez-Serrano, María Gázquez-López and María Ángeles Pérez-Morente

Int. J. Environ. Res. Public Health 2020, 17(18), 6881; https://doi.org/10.3390/ijerph17186881 - 21 Sep 2020

Cited by 12 | Viewed by 2986

Abstract

Sexually transmitted infections are an important public health issue. The purpose of this study is to analyse the association between different sexual habits and the prevalence of sexually transmitted infections in the population of Granada who consult with a specialised centre. An observational, [...] Read more.

Sexually transmitted infections are an important public health issue. The purpose of this study is to analyse the association between different sexual habits and the prevalence of sexually transmitted infections in the population of Granada who consult with a specialised centre. An observational, cross-sectional study was conducted based on the medical records of 678 people from the Sexually Transmitted Diseases and Sexual Orientation Centre of Granada, who were diagnosed positively or negatively with a sexually transmitted infection, during the 2000−2014 period. Sociodemographic and clinical data, as well as data on frequency and type of sexual habits, frequency of condom use and sexually transmitted infection positive or negative diagnosis were collected. Univariate and bivariate analyses were conducted. The most popular sexual habits were vaginal intercourse, oral sex (mouth–vagina and mouth–penis) and the least popular were anus–mouth and anal sex. The use of condom is frequent in vaginal and anal sex and less frequent in oral sex. Sexually transmitted infection is associated with mouth–penis (p = 0.004) and mouth–vagina (p = 0.023) oral sex and anal sex (p = 0.031). It is observed that there is a relationship between the presence of STIs and oral sex practices, people having such practices being the ones who use condoms less frequently. There is also a relationship between anal sex and the prevalence of STIs, although in such sexual practice the use of condom does prevail. Full article

(This article belongs to the Special Issue Policies and Strategies in Sexual and Reproductive Health)

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