Women, Volume 4, Issue 4 (December 2024) – 15 articles

Geophagy is an ancient widespread practice that is common amongst women of childbearing age globally. Geophagy is one of the leading causes of iron deficiency and pregnancy complications amongst women of childbearing age resulting in maternal, neonatal, and child morbidities and mortalities globally. The concept of geophagy has yet to be incorporated in the reproductive health services in the healthcare facilities. A qualitative study was conducted using focus group discussions and in-depth interviews to explore the views/perspectives of nurses regarding geophagic women of childbearing age accessing healthcare in the reproductive healthcare services in Tshwane District, Gauteng Province. The findings revealed that nurses perceived geophagic women of childbearing age to be iron deficient and lack proper knowledge and understanding of the potential health risks and dangers of soil eating. Mental health and substance use disorders, food and nutrition deficiencies, absence of geophagy health education, and promotion programs were highlighted as some of the aspects that play a role towards the practice of geophagy amongst women of childbearing age accessing healthcare in Tshwane District, Gauteng Province. Thus, a conclusion can be made that geophagy health education and promotion programs in the antenatal care units must be prioritized by government. Full article

Anorexia nervosa is classified by the American Psychological Association as an eating-related mental disorder, which affects mostly young adult women and adolescent girls. Although refeeding programs are often used to recover bodyweight in patients with anorexia nervosa, treatment failures are high, and the determinants of the disorder remain unknown. The present paper uses a nutritional epidemiology perspective to examine determinants of anorexia nervosa from the patients’ point of view. A grounded-theory literature-review method was used to search and review research findings from the peer-reviewed literature related to the etiology of anorexia nervosa, including recent qualitative interviews with patients. Unlike a systematic review, a grounded theory method is more appropriate for developing a new theory to explain phenomena like the cause, recovery, and prevention of anorexia nervosa. Reviewed research suggests that anorexia nervosa may be a problematic body-change strategy rather than a mental disorder. Additionally, the present paper proposes that replacing the drive for thinness in anorexia nervosa with a drive for leanness may help patient recovery, especially when guided by easily accessible body-composition estimates. Fat-free mass restoration in the recovery of anorexia nervosa may also be facilitated by resistance training, which improves patients’ psychological status and body composition. Additionally, replacing a dysfunctional dieting strategy in anorexia nervosa with knowledge, skills, and experience in proper weight management has a potential preventive effect against the disorder. More research is needed to investigate the applied effects of the drive for leanness, body-composition assessments, resistance-training programs, and weight-management skills associated with the recovery and prevention of anorexia nervosa. Furthermore, successful application of the information in this paper may be adapted to peer role model programs to prevent anorexia nervosa. Full article

Although global neonatal mortality rates have significantly decreased, Black infant mortality in the US continues to be a major issue. This study identifies, assesses, and illustrates women’s views on infant mortality and the resources needed to address the problem. Women of diverse demographic backgrounds were recruited via purposive sampling, with 91 participating. Seventy percent of participants were aged 18 to 39 (n = 64), and forty three percent lived in Indiana (n = 39). Access to care, sleeping issues, supporting breastfeeding, awareness, affordability challenges, healthcare provider factors, and creating sustainable programs and policies to address infant mortality emerged as prominent themes in the data. This study highlights the importance of cultural congruency in addressing maternal and child health issues, emphasizing the need for stakeholder involvement to ensure interventions are acceptable, practical, and sustainable. Full article

Breast cancer incidence is on the rise regardless of several interventions available for its management. This scenario may be worse in resource-limited countries. This study, therefore, aimed to evaluate the knowledge and attitude of women towards Breast Cancer Screening (BCS) in Aminu Kano Teaching Hospital (AKTH), Kano State, a typically resource-limited state in Nigeria. This was a cross-sectional study. The study population comprised female individuals aged 18–45 years attending the Antenatal and Postnatal clinics of AKTH. An adopted questionnaire instrument was used to extract vital information on the knowledge and attitude of women towards breast cancer screening in the Antenatal and Postnatal clinics of AKTH. Our findings showed that there is much awareness about BCS, even though most participants’ knowledge about the methods and timing of the scan is low. Much enlightenment is achieved through the availability of print and electronic media on BCS. A better attitude is shown when trained personnel conduct BCS. A good number of participants who have knowledge are yet to translate their knowledge and attitudes into practice. Based on our findings, coordinated and timely awareness campaigns should be organized by local health authorities to improve knowledge and attitude towards BCS. Full article

Introduction: The COVID-19 pandemic brought myriad challenges and disruptions to societies worldwide. The impact of the pandemic on immigrant women living in Canada and who experience intimate partner violence (IPV) was very concerning during lockdowns specifically. As Canada implemented social distancing measures and stay-at-home orders to curb the spread of the virus, immigrant women—already at a heightened risk of IPV due to factors such as language barriers and immigration status—faced an increased likelihood of being trapped in abusive situations, with limited access to essential support services such as shelters, counseling centers, and legal aid. This narrative review aims to illuminate the experiences of IPV including the challenges and strategies used to cope during the pandemic among immigrant women. While this narrative review aims to obtain an extensive understanding of the IPV experiences among immigrant women during the pandemic, it also highlights the need for developing culturally sensitive interventions to address IPV challenges for immigrant women in similar contexts. A search was undertaken of multiple databases: Medline, CINHAL, Google Scholar, and PsycINFO. To identify studies related to IPV and COVID-19, various search terms were used including “abused women”, “COVID-19”, and “IPV” and their synonyms. This review employs the social–ecological model and intersectionality to illuminate the IPV experiences of immigrant women during the COVID-19 pandemic. Four themes emerged from this study including the realities of COVID-19 restrictions; IPV vulnerabilities during the COVID-19 pandemic; the impacts of IPV and the COVID-19 pandemic; and the strategies for addressing IPV (women and system perspectives). We draw on past research and the knowledge of our multidisciplinary team of researchers to recommend culturally sensitive resources and health services for abused women living in Canada as well as highlight effective intervention strategies to address the varied and complex needs of these women. Full article

The initial presentation of COVID-19 to the world left many in the medical community perplexed about its true nature and potential impact on individuals. Many investigations into the pathology of the virus resulted from this; however, studies were limited in the obstetric community, especially in high-risk communities. Each pandemic wave (Alpha, Delta, Omicron) had different transmission rates and inflicted different COVID-19 severity levels among those infected. This study aimed to determine if the effects of COVID-19 on maternal and infant outcomes varied by pandemic waves. This is an observational cohort study utilizing women enrolled in a COVID-19 pregnancy study. A review of 374 electronic medical records of women who received care at the University of Mississippi Medical Center after testing positive for SARS-CoV2 was conducted. During the Alpha pandemic wave, women contracted COVID-19 significantly earlier in pregnancy; however, higher rates of COVID-19 infection occurred during the Omicron pandemic wave. During the Delta pandemic wave, more women were morbidly obese and were likely to deliver significantly earlier, and, when compared to infants born during the Omicron pandemic wave, the infants born during the Delta wave weighed significantly less. The effects of COVID-19 on high-risk pregnant patients may deviate from previous reports, indicating a need for further investigation of the biological and social factors that may lead to these differences. Studies into the effects of COVID-19 in pregnancy remain limited and this study provides valuable insight into how varying COVID-19 strains affected a high-risk obstetric community. Full article

The world of science is increasingly looking for answers to the question of how specific dietary components affect the risk of chronic diseases and assessing their potential to alleviate the severity of individual diseases. This research concerns both the assessment of the benefits of using individual dietary components and those of nutritional models. Endometriosis, due to its chronic and inflammatory nature, is also a topic of interest among scientists, who seek to support its course through proper nutrition. In endometriosis, great interest is focused on dietary patterns such as an anti-inflammatory diet, a gluten-free diet, a low-FODMAP diet, or a Mediterranean diet. An anti-inflammatory diet primarily focuses on fresh vegetables, fruits, seeds, nuts, whole grain products, and healthy sources of protein and fats, including mono- and polyunsaturated fatty acids, eliminating highly processed products, meat products, trans fats, and refined sugars. It is believed that this type of diet may contribute to reducing the severity of endometriosis symptoms and help reduce inflammation. The aim of the review is to identify the main trends in the field of diets supporting the treatment of endometriosis in the last 5 years. Full article

Gender-based violence (GBV) is an age-long issue plaguing societies all over the globe. Over the years, GBV perpetrated against women has been justified and legitimized by patriarchal and hegemonic masculine structures. This study explored the role of hegemonic masculinities and transnational cultural conflicts in creating a suitable environment for GBV against women newcomers from the continent of Africa. The study gathered perspectives of African immigrants and of the service providers working in immigrant-serving organizations. The paper adopts a qualitative approach and hinges on the transnationalism framework. This framework argues that immigrants maintain connections while transitioning to their destination countries. In such processes, immigrants carry with them their beliefs about cultural norms and hegemonic masculinity, of their country of origin. A total of 13 women immigrants and 20 service providers were purposively recruited to participate in the semi-structured interview. The interviews were recorded and transcribed verbatim. The data were analyzed thematically and organized using Nvivo version 12. Findings show that African immigrant women in Canada disproportionately bear the burden of GBV due to hegemonic masculinities. The construction of masculinity in immigrant populations is heavily reliant on the communities of origin. As such, the prevailing systems during and post migration such as—unstable residency status, fear of deportation, fear of social and family sanctions and stigmatization, economic dependence on their spouses, and fear of retaliation from their spouses creates an environment that supports toxic masculinity. The study recommends comprehensive and culturally sensitive programmes and services to support African immigrants affected by hegemonic masculinity and GBV. Full article

Many gender differences in mental and physical health, along with accompanying social needs have been reported by those suffering with schizophrenia. The goal of this review is to explore the literature on migrant and culturally diverse women suffering with schizophrenia to develop and implement effective strategies in specialized clinics. In general, we found higher rates of mental health symptoms among migrant and refugee women when compared to men. Several factors contribute to this vulnerability, suggesting that women may experience more pre- and post-migration-related trauma. In clinical populations, migrant status, region of origin, age at the time of migration, migration with family or alone, and migration to join family determine the risk of schizophrenia and the clinical course of the illness. Refugee migrant women have a higher risk of schizophrenia than non-refugee migrants and native-born populations. Migration is associated with poor access to mental health services; low social support, lack of awareness of services, and language barriers may mediate this association. These findings call for specific assessments on migrant women, interventions (e.g., focus groups), and improvement in current programs. In our clinics, we have recently incorporated assessment and intervention strategies that may be effective in our programming. Full article

Women who receive substance use treatment have a particular classification of sensitivity to European drugs and drug use (according to the EMCDDA). The average level of women’s treatment is lower than men’s across Europe, while women’s abandonment is higher than men’s. The purpose of this study was to examine the factors associated with problems for women who use drugs, analyzing several psychological and social factors (gender, substance use, mental health, source of economic support, legal status, and abuse). Methodology: This was a quantitative study. Data on 2179 people receiving rehabilitation treatment were obtained from the EuropASI survey. The dependent variables in this study were (1) a patient’s known history of addiction and mental illness; (2) primary drug use; (3) drug use in their lifetime and the past month; (4) mood in their lifetime and the past month, physical condition, and sexual abuse history; (5) mental illness in their lifetime and the past month (including suicide attempts); (6) legal status in their lifetime and the past month; (7) and source of income in the past month and (8) and the number of patients. The factor of gender was taken as a dichotomous variable (male–female). The confidence interval used was 95%. Results: In summary, we found that women had consumed more alcohol, used more drugs, and suffered more from depression, anxiety, and suicidal ideation than men, both during their lifetimes and in the past month. In addition, women were more likely than men to be stigmatized for prostitution because their financial support came mainly from colleagues, friends, and family, as well as from prostitution. Finally, women had experienced more violence (emotional, physical, and sexual) during their lifetimes and in the last month than men. Conclusion: There appears to be a need to develop a comprehensive treatment network for addictive behaviors from a multifactorial perspective, including harm reduction, psychosocial support, and recovery programs; furthermore, targeting specific groups with special needs, such as women, especially those with mental health problems, women with alcoholism, and abused women, it also seems important to develop adaptive recovery programs within addictive behavior treatment networks. Full article

According to the United Nations Population Fund, approximately every two minutes, a woman dies, totalling approximately 800 deaths per day for reasons related to a maternal causes. Therefore, within the Sustainable Development Goals of the 2030 Agenda, the goal is to reduce the global maternal mortality rate to less than 70 deaths per 100,000 live births by 2030. We aim to analyse strategies to reduce maternal mortality in the context of the Sustainable Development Goals, identify barriers that hinder their implementation, and analyse the impact of the COVID-19 pandemic on their achievement. We performed a scoping review of the following databases and distributors of specialised information in the health area: PubMed, Medes, Lilacs, Cuiden, Cinahl, Scopus, SciELO, and websites of the United Nations (UN), United Nations Population Fund (UNFPA), and Cooperanda. A total of 24 articles were reviewed. The results obtainded determined that reviewed studies agree that despite efforts to reduce maternal mortality, significant social and structural barriers still exist in developing countries that slow the implementation of strategies to protect maternal health, especially in the most at-risk populations, and the improvement of the health system. The main strategy consists of increasing the number of deliveries attended by qualified personnel, which is the greatest indicator of progress in reducing maternal mortality. To conclude, Economic, social, and political barriers remain in developing countries in the context of the Sustainable Development Goals. The intervention that has shown the most success is the attendance of deliveries by qualified personnel. It is essential to prioritise maternal care, triangular cooperation, and effective connection between the different Sustainable Development Goals. Full article

Childhood abuse is a significant factor in the development of borderline personality disorder (BPD) and many physical health disorders, including polycystic ovary syndrome (PCOS) and fibromyalgia. This study aimed to examine the prevalence of PCOS and fibromyalgia in women with BPD compared to the general population. Additionally, it compared the prevalence of these conditions in women who experienced different types of childhood abuse (emotional, physical, or sexual). Participants were identified from the Multidisciplinary Alfred Psychiatry research centre’s Women’s Mental Health Clinic database, including 150 women diagnosed with BPD. Clinicians collected information on PCOS, fibromyalgia, and trauma history. Results showed higher rates of PCOS (17.3%) and fibromyalgia (8.7%) in women with BPD compared to general population samples. Emotional abuse was associated with the highest PCOS prevalence (22.8%), while co-occurring physical, sexual, and emotional abuse was linked to the highest fibromyalgia prevalence. These findings highlight the significant prevalence of PCOS and fibromyalgia in women with BPD and their association with childhood abuse. Full article

Family planning (FP) services are crucial interventions for improving maternal and child health outcomes and promoting gender equity. However, ensuring equitable access to these services remains a significant challenge, particularly in countries like Pakistan, where sociocultural norms, economic disparities, and geographic barriers hinder FP uptake. This study utilized spatial analysis techniques, including hotspot analysis, to investigate geographic disparities in FP uptake in Pakistan using data from Pakistan Demographic and Health Surveys (PDHS) conducted in 2006–2007 and 2017–2018. ArcMap 10.1 was used for spatial analysis and Stata 12.0 for statistical analysis. Results revealed significant spatial variations in FP uptake, with urban areas exhibiting higher uptake rates than rural regions. Hotspot analysis identified dynamic changes in contraceptive prevalence rates (CPR), with significant clustering in some regions and dispersion in others. It also identified areas with high unmet need, low intention to use FP services, and preference for family size (>3 children), highlighting the need for targeted behavioral change interventions. This innovative spatial approach provides nuanced insights for policymakers and program planners to develop targeted interventions based on localized data to improve FP service delivery, mitigate disparities, and ultimately advance efforts to improve maternal and child health outcomes. The application of geospatial analysis is an effective tool for enhancing program planning, evaluation, and resource allocation in diverse geographical contexts. Full article

Women undergoing breast surgery with axillary lymph node dissection continue to experience complications in the ipsilateral upper limb, impacting their daily lives and quality of life. This study aims to evaluate the relationship between quality of life (overall and specific) and the functional capacity of patients undergoing breast surgery with lymph node clearance before and after implementing a rehabilitation program. This short-term quasi-experimental study included 48 women, and the design did not include control groups. Data collection involved a sociodemographic and clinical characterization questionnaire, the Disabilities of the Arm, Shoulder and Hand questionnaire, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 and Breast Cancer questionnaires. The study revealed a significant negative association between all general functional subscales and the functionality of the ipsilateral upper limb, except for emotional (p 0.941) and cognitive (p 0.927) functional scales. The functional capacity of the ipsilateral upper limb following surgery influences the quality of life of women undergoing breast surgery. The study concluded that monitoring the quality of life is essential to underscore the importance of providing access to rehabilitation to minimize or eliminate these changes, thus contributing to a better quality of life for these women. Full article

Women’s pregnancy increases the odds of developing anxiety, depression, and low self-esteem. Physical activity can reduce the severity of maternal mental disorders and postpartum symptoms. The aim was to evaluate self-esteem, anxiety, and physical activity patterns among healthy pregnant women during three gestational trimesters (GTs). A longitudinal prospective study involving 248 Portuguese pregnant women, monitored for a year during all GTs, was conducted. Self-reported questionnaires were used to collect personal and obstetric data, and Rosenberg’s Self-Esteem Scale, Zung Anxiety Scale, and a Pregnancy Physical Activity Questionnaire were applied. A total of 152 women presented valid follow-up data considered for analysis. All test scores do not present normality (p < 0.001). Over the gestational trimesters, the Zung anxiety scores did not show a significant change between GTs. However, the self-esteem values reduced significantly from 1st to 2nd GT: (1st GT = 43.94 (±9.94) [95%CI: 42.37 to 45.53]; 2nd GT = 27.27 (±9.64) [95%CI: 25.74 to 28.81]; 3rd GT = 25.71 (±10.52) [95%CI: 24.04 to 27.39]; p < 0.001), remaining stable in the last GT. Moderate to vigorous (2nd GT = 73.43 (±88.69) [95%CI: 59.34 to 87.54]; 3rd GT = 65.05 (±82.65) [95%CI: 51.92 to 78.19]; p = 0.008), vigorous (1st GT = 0.45 (±3.95) [95%CI: 0.83 to 2.08]; 2nd GT = 1.63 (±3.52) [95%CI: 1.07 to 2.19]; 3rd GT = 0.81 (±2.16) [95%CI: 0.46 to 1.15]; p = 0.0475), and light (2nd GT = 101.68 (±48.77) [95%CI: 93.93 to 109.44]; 3rd GT = 98.42 (±49.05) [95%CI: 90.62 to 106.22]; p < 0.001) physical activity levels were significantly reduced throughout the GTs, but the time spent in sedentary activities did not change. In this follow-up study, it was possible to identify a critical point in the 2nd GT, when the drastic reduction in physical activity levels coincided with periods of lower self-esteem scores. However, anxiety levels do not seem to change over GTs. Full article