BACKGROUND: In countries where abortion laws are stringent, induced abortions are prevalent. The limited availability of abortion services within these regions amplifies the likelihood of maternal complications and mortality. Induced abortions represent a significant public health concern in Iran and are characterized by a multitude of intricate factors that remain largely unexplored. Gaps in knowledge persist pertaining to the influences driving induced abortion within the Iranian context. To adequately address the issue of induced abortion, it is imperative to discern the determinants that shape the decision-making process. The primary objective of this study was to design an intervention program focused on mitigating the occurrence of induced abortion within couples, with an emphasis on identifying the key factors that contribute to this phenomenon.
METHODS: This study comprises three phases. In the first phase, a qualitative approach based on the I-change model will be employed to identify the factors influencing induced abortion. The second phase involves a systematic review to identify the determinants of induced abortion and strategies to prevent induced abortion. In the third phase, the outcomes of the qualitative approach and systematic review will be shared with experts and specialists using the Delphi method to categorize and prioritize strategies. Subsequently, based on the final consensus, a comprehensive program will be developed to prevent induced abortion.
CONCLUSIONS: This study introduces an I-change model-based program for the prevention of induced abortion. The prevention of induced abortion holds great significance in mitigating maternal morbidity and mortality, curtailing healthcare expenses, and fostering population growth rates. The research findings will be disseminated via reputable peer-reviewed journals and communicated to the academic and medical communities. This dissemination aims to provide valuable insights that can contribute to the advancement of induced abortion and abortion prevention programs.
Induced abortion is restricted in Iran, and many married women with unintended pregnancies resort to clandestine procedures, resulting in adverse health outcomes. Induced abortion contributes to 2.3% of maternal mortality rates in the country. Understanding the factors influencing abortion is crucial for designing effective preventive interventions. Due to cultural and political sensitivities, reliable data on the determinants of induced abortion in Iran, particularly from the perspective of male partners, remain scarce. Existing research primarily focuses on women’s views, neglecting the potential influence of men on abortion-related decisions. This study aims to bridge this gap by investigating the determinants of induced abortion in couples and developing a comprehensive couple-based abortion prevention program in Iran. Employing a mixed-methods approach, this study explored the factors associated with couples’ decisions regarding abortion. Subsequently, a systematic review will identify existing knowledge on abortion determinants and preventive strategies. On the basis of this comprehensive understanding, an evidence-informed abortion prevention plan will be devised. The findings of this study can inform policymakers and population/reproductive health experts, ultimately aiming to reduce the burden of negative health and social consequences associated with abortion, leading to cost reductions and improved health outcomes for women, families, and society.

UNASSIGNED: Anemia is highly prevalent globally and disproportionately affects postnatal women. It is a significant cause of maternal mortality and morbidity globally.
UNASSIGNED: The main aim of this study was to determine the extent of postpartum anemia and associated factors among postnatal women in two selected health facilities in Gondar, Northwest Ethiopia.
UNASSIGNED: A facility-based, cross-sectional study was conducted among 282 postnatal women from March to May 2021. A systematic sampling technique was used to recruit study participants from each institute. Sociodemographic, obstetric, and clinical data were collected through a semi-structured questionnaire. A venous blood sample was collected to determine the red blood cell parameters. A thin blood smear preparation was performed to examine blood morphology. In addition, direct wet mount and formalin-ether sedimentation techniques were used for stool examination to identify intestinal parasites. Data were entered into EpiData and exported to Stata 14 for statistical analysis. Descriptive statistics were presented in text, tables, and figures. A binary logistic regression model was used to identify factors associated with postpartum anemia. A p-value <0.05 was considered statistically significant.
UNASSIGNED: The proportion of postpartum anemia was 47.16%; 95% CI; 41.30-53.03 with moderate, mild, and severe anemia accounting for 45.11, 42.86, and 12.03%, respectively. The majority of the anemia (94%) was of the normocytic normochromic type. It was associated with postpartum hemorrhage (AOR = 2.23; 95% CI: 1.24-4.01), cesarean section (AOR = 4.10; 95% CI: 2.11-7.78), lack of iron and folate supplementation during pregnancy (AOR = 2.12; 95% CI: 1.17-4.02), and low diet diversity level (AOR = 1.83; 95% CI: 1.05-3.18).
UNASSIGNED: The prevalence of anemia was found to be a major public health concern. Iron and folate supplementation during pregnancy, improved management of PPH, an effective cesarean section with post-operative care, and taking a diversified diet will reduce the burden. Therefore, identified factors should be considered to prevent and control postpartum anemia.

Indonesia was one of the countries with the highest COVID-19 positive cases. Understanding the length of hospitalisation is critical for anticipating bed demand and resource allocation, such as oxygen. This study aims to examine the determinants of oxygen saturation and the length of hospitalisation in Hermina Mekarsari Hospital, West Java, Indonesia.
This cross-sectional study uses medical records from June to August 2021. The inclusion criteria were: COVID-19 patients aged between18 and 65, fully conscious, and not using mechanical ventilation. Participants who passed away during hospital stay were excluded. We used demographic information, laboratory data, and the clinician\'s assessments of the patients admitted to the hospital. Linear regression was performed for oxygen saturation on day seven, while logistic regression analysis was conducted to predict the length of hospital stay.
In total, 371 participants with an average age of 47.2 (standard deviation 15.8) years were included. Most participants were female (57.7%) and smoking (78.4%). The results indicated that decreasing oxygen saturation was reported in vomiting patients (β = 1.63, p-value = .001), hypertensive patients (β 1.18 with, p-value = .034), and patients with the increased respiratory rate (β = 0.28, p-value = .000). In the logistic regression, we found that respondents who experienced dyspnoea, headache, fever, an increasing number of D-Dimer and blood glucose, and those with diabetes mellitus were more likely to stay more than 14 days.
Oxygen saturation was influenced by vomiting, hypertension, and increasing respiratory rate. Length of hospitalisation of more than 14 days was influenced by dyspnoea, headache, fever, increased number of D-Dimer, blood glucose, and diabetes mellitus. Identifying the determinants of oxygen saturation and length of stay can inform health professionals in designing a suitable intervention to reduce mortality and length of stay among COVID-19 patients in Indonesia.

The burden of HIV is disproportionately higher among women of reproductive age contributing more than half of the global share. The situation in Ethiopia is not exceptional. The present study was done to determine the proportion of HIV among pregnant women in Amhara Regional State, Ethiopia.
Institutions-based cross-sectional study was conducted from October 2020 to December 2020. Systematic random sampling technique was used to select 538 study participants from pregnant women who had ANC follow-up in Referral Hospitals of the Amhara Regional State. Data on socio-demographic, clinical, obstetric, behavioral as well as psychosocial characteristics were gathered using an interviewer administered structured and standardized instruments. The data was entered into Epi-Data Manager V4.6.0.0 and exported to STATA version 14 for data analyses. Descriptive statics were computed to summarize the participant\'s characteristics. Bi-variable and multivariable logistic regression analyses were conducted to identify the association between dependent and independent variables. Independent variables with a p-value of less than 0.05 were considered to be statistically significant at 95% confidence level (CI).
The proportion of HIV infection among pregnant women was 8.68% (95% CI: 6.5, 11.4). Completing secondary school education (Adjusted Odds Ratio (AOR = 0.15; 95% CI: 0.04-0.53), graduated from college (AOR = 0.03; 95% CI: 0.01-0.22), and family monthly income greater than 8001 ETB (1 USD = 56 ETB) (AOR = 0.19; 95% CI: 0.04-0.87) were protective factors associated with maternal HIV. On the other hand, history of previous abortion (AOR = 7.73; 95% CI: 3.33-17.95) and positive syphilis status (AOR = 10.28; 95% CI: 2.80-37.62) were risk factors associated with maternal HIV status.
The proportion of HIV infection among pregnant women was found to be high. Advanced level of education, relatively higher monthly income, history of abortion and previous syphilis status were associated factors with HIV status. Strengthening women\'s formal education; empowering women in all spheres of life (especially improving their economic standing that prevents women from engaging in risky sexual practices); educating women about HIV transmission methods and HIV prevention and control strategies using behavior change intervention strategy prepared for women to reduce their vulnerability; advocating for the use of family planning to reduce unsafe abortions and syphilis; as well as regular screening and testing for syphilis are recommended.
Millions lost their lives for HIV/AIDS while many more live with the virus with significantly compromised degree of quality of life. Women are more affected than men because of various contributing factors. This study was aimed to determine the proportion and associated factors of HIV status among pregnant women attending ANC at referral hospitals of the Amhara Regional State, Ethiopia. The study was conducted from October 2020 to December 2020. A total of 538 pregnant women were included in the study selected from three referral hospitals.  An interviewer-administered questionnaire was used to collect the data. A binary logistic regression analysis was used to identify the association between factors of the study participants and HIV status. The result revealed that the overall proportion of HIV among pregnant women was 8.68%. Women who completed secondary education, graduated from higher education and having a relatively adequate monthly income were found to have less chance of contracting HIV. On the other hand, pregnant women who had history of previous abortion and positive for syphilis had a higher chance to be infected with HIV. Such a high HIV proportion among the participants in the study area implies that there might be lack of awareness about HIV infection transmission methods as well as HIV prevention and control strategies. In this connection, behavior change intervention strategy prepared specifically for women is recommended to reduce their vulnerability. Besides promoting the use of family planning methods to reduce unsafe abortions and syphilis as well as regular screening and testing for syphilis are important to consider.

Violence against women is the most widespread kind of human rights violation, and it has been linked to a wide range of consequences. The most prominent psychosocial and mental health concern that has serious effects for women\'s physical and mental well-being. This study assessed the prevalence and associated factors of women\'s violence by intimate partner among women in the reproductive age group (15-49).
Multistage community-based cross-sectional study was conducted among reproductive age group women in the central Gondar zone. We recruited 845 participants and interviewed by health extension workers using face-to-face interviews. We used a Women\'s Abuse Screening test to outcome variable; it has a total score ranges 0-16, a score > 1 indicates positive for the presence of intimate partner violence within a year. Variables were coded and entered to Epi data version 3.1 and exported to SPSS version 21 for analysis. Descriptive statistics and multivariate logistic regression analysis was run for data analysis. Adjusted odds ratios (AOR) with a 95% confidence level (CI) were declared significant.
Among a total of 845 participants 804 responded to the interviews with a response rate of 95%. The prevalence rate of intimate partner violence is 391(48.6%). From multivariate logistic regression analysis women being married [AOR:3.85; 95% CI (2.38, 6.22)], high school and above educational status [(AOR: 0.43; 95% CI (0.30, 0.61), women\'s having > 3children [(AOR: 1.82, 95% CI (1.0, 3.1)], having a household food insecurity[(AOR: 2.09, 95% CI (1.51, 2.91)], having life threatening events [(AOR: 2.09; 95% CI (1.51, 2.91)], moderate social support [(AOR: 0.60; 95% CI (0.41, 0.83)], depression [(AOR: 3.12; 95% CI (1.60, 6.07) were significantly associated with violence by intimate partner at 95% CI .
Intimate partner violence is common among reproductive-age women. Married, women with several children, food insecurity, life-threatening events, and depression were all found to be significant predictors of violence. Measures should be taken to raise community awareness, particularly among intimate partners, their families, and government officials.

BACKGROUND: The World Health Organization, the United States Society for Maternal-Fetal Medicine, the American College of Obstetricians and Gynaecologists, the Academy of Breastfeeding Medicine, the Food and Drugs Administration, and the Centers for Disease Control recommend COVID-19 vaccination to lactating mothers without discontinuity of breastfeeding. Despite this recommendation, willingness to receive COVID-19 vaccine and its determinant factors among lactating mothers were not studied in Ethiopia. Hence, this study aimed to assess willingness to receive COVID-19 vaccine and its determinant factors among lactating mothers in Ethiopia.
METHODS: An institutional-based cross-sectional study design was employed in southern Ethiopia from February 1 up to March 15, 2021. Multistage sampling technique was used to select study participants. Structured and face-to-face interviewer-administered questionnaire was used to collect data. Data were clean, coded, and entered into Epi-Data version 4.2.0 and exported to SPSS version 23 software package for analysis. Bivariable and multivariable analysis were used to identify associated factors. Adjusted odds ratio along with 95% CI was used to measure the strength of association.
RESULTS: The prevalence of willingness to receive COVID-19 vaccination was found to be 61% (95% CI; 56.9-65.1%). Urban residence [AOR=2.5, (95% CI; 1.62-3.91)], having secondary and above maternal educational status [AOR=2.8, (95% CI; 1.51-4.21)] mothers who had got immunization counselling [AOR=3.4, (95% CI; 1.95-5.91)], good knowledge about vaccine [AOR=2.6, (95% CI; 1.84-3.47)], and good adherence to COVID-19 mitigation measures [AOR=3.2, (95% CI; 1.91-5.63)] were determinant factors of willingness to receive COVID-19 vaccine.
CONCLUSIONS: Urban residence, secondary and above maternal education status, immunization counselling, good knowledge about the vaccine, and good adherence to COVID-19 mitigation measures were determinant factors of willingness to receive COVID-19 vaccine. Therefore, health professionals should counsel about the merits of COVID-19 vaccination, and enhance maternal awareness about the vaccine is recommended.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder triggered by several factors, including those of genetic and environmental nature. ASD can alter communication, behavior, and children\'s nutritional status, placing them at high risk for nutritional imbalances. Therefore, this study aims to assess preschool autistic children\'s nutritional status as compared to that of Typically Developing (TD) children of the same age. The study also revealed some of the ASD risk factors among the Jordanian population. It included 52 ASD and 51 TD children (3-6 years), and considered sociodemographic, obstetric, and nutritional factors of the two groups, stratified by gender. Nutritional status was evaluated through a comprehensive questionnaire, 3-day food record, and anthropometric and biochemical measurements. Differences between groups were identified using the chi-square and independent-sample t-test. The logistic regression model was used after the adjustment of confounders to detect an autistic child\'s determinants. The study showed little difference between ASD and TD children with respect to nutrients\' intake inadequacy and biochemical-nutritional deficiencies, but did reveal gender-based differences. Autistic girls were at higher risk of inadequate carbohydrate intake, while autistic boys were at higher risk of inadequate vitamin E, vitamin K, and fluoride compared to TD children. More autistic children had been treated in neonatal care units after birth than had TD children. The regression analysis revealed that lower maternal education level (OR, 12.25; 95% CI, 1.18-126.91), vaginal delivery (OR, 0.273; 95% CI, 0.105-0.712), family history of autism (OR, 0.189; 95% CI, 0.059-0.612), and taking dietary supplements during pregnancy (OR, 4.665; 95% CI, 1.158-18.79) were all determinants of ASD in children. In conclusion, maternal nutrition, postnatal conditions, and nutritional status might be contributors to ASD in children. Pre-school children are at high risk for developing nutritional deficiencies. It is therefore important to maintain optimal nutritional status in pregnant patients, and in children after delivery and during early childhood. Future studies that investigate the role of nutrient deficiencies and nutritional interventions in ASD are necessary. Also required are studies that focus on gender differences in the prevalence of ASD, types and severity of symptoms, and ASD nutrition-related problems.

Domestic migration poses a challenge for China as migrants have little access to preventive healthcare services and are vulnerable to certain risks and diseases. This research sought to unveil and explore the determinant factors associated with health education utilization as a key aspect in basic public health services for migrants in Beijing, China.
A sample of 863 inter-provincial migrants, 18 years old and above, was selected by three-stage stratified cluster sampling method in urban-rural fringe areas of Beijing during 2016 to 2017. Face-to-face structured interviews were conducted in the questionnaire survey. The effects of the explanatory variables on health education utilization from predisposing, enabling, health behaviors and need variables were used to demonstrate by Anderson health service utilization model.
The study revealed that 61.6% migrants desired to receive health education, while only 53.8% of them received in the past year. There were differences in the utilization and needs of health education among the migrants in different ages and genders. Many migrants desired to gain access to various types of health education information from the internet. Chi-square independence test lists such major determinant factors in migrants whole health education as age, \"Hukou\" registration system, marital status, education level, long-term residence plan in Beijing, one or more children in Beijing, employment status, housing source, average daily working time, exercises, health knowledge, smoking, self-rated health. The binary logistic regression indicates that the migrants with younger age, high education level, one or more children in Beijing, exercises and good self-rated health were more likely to receive whole health education. The results also show that average daily working time of enabling variables and exercise of health behavior variables were the strong and consistent determinants of three types of health education utilization, including communicable, non-communicable and occupational diseases.
Gaps exist between the needs and utilization in health education and more attention should be given to the migrants with heavy workload and low education level. Feasible policies and measures, such as multiple health information channels, should be vigorously implemented to ensure equitable and easy access to health education for migrants.

UNASSIGNED: The postpartum intrauterine contraceptive device (PPIUCD) is an effective, reliable, safe and recommended contraceptive method for the postpartum women. However, only a small proportion of women who gave birth at health facilities in the world have used it. There are limited studies about determinants of PPIUCD utilization. Therefore, this study aimed to assess determinants of postpartum IUCD utilization among mothers who gave birth in Gamo zone health facilities, southern Ethiopia.
UNASSIGNED: A facility based unmatched case-control study was done at Gamo zone public health facilities, southern Ethiopia. Data were collected using a pretested interviewer-administered questionnaire from March 1 to April 15, 2019. The data were coded, cleaned and entered into Epi-Info version 3.5.1 and exported to SPSS version 25 for advanced analysis. Binary logistic regression was performed to identify the determinants of PPIUCD utilization.
UNASSIGNED: A total of 510 (175 cases and 335 controls) participants were involved in the study yielding a response rate of 95.1%. Partner support for IUCD insertion (AOR [95% CI]: 10 [4.03, 24.3]), birth interval (AOR [95% CI]: 9.7 [1.7, 55.1]), fertility plan (AOR [95% CI]: 4 [1.44, 10.84]), and timing of counseling (AOR [95% CI]:1.25 [0.034, 0.46]) are the determinant factors for postpartum IUCD.
UNASSIGNED: Birth interval, fertility plan, timing of counseling, pregnancy plan and partner support were the determinant factors identified in this study. Therefore, counseling of both partners during antenatal follow-up, delivery and immediately after delivery by health professionals are recommended.

Uterine rupture is a major public health problem in low-income countries including Ethiopia. In Ethiopia, its prevalence is low, but it results in devastative health problems of the mother and her baby. Even though the Ethiopian government and nongovernmental organizations tried to strengthen the health care system, significant adverse maternal and fetal outcome is still associated with uterine rupture. The aim of this study was to identify determinants of uterine rupture in Jinka and Arba Minch General Hospitals.
The study was conducted in Jinka and Arba Minch General Hospitals, and the data collection period was 15 to 30 November 2018. A case-control study design was used with simple random sampling of 1:4. Data were collected using data extraction sheets. Variables with p < 0.25 in bivariate logistic regression were entered into multivariable logistic regression. Variables with p < 0.05 in multivariable logistic regression were used to determine significant association between dependent and independent variables.
Uterine rupture occurred in 112 cases with 448 controls. Women referred from health facilities (adjusted odds ratio = 8.0, 95% confidence interval: 3.5-17.8), multiparous women (adjusted odds ratio = 12.7, 95% confidence interval: 4.2-39.0), duration of labor more than 18 h (adjusted odds ratio = 11.5, 95% confidence interval: 5.5-24.1), malpresentation (adjusted odds ratio = 3.5, 95% confidence interval: 1.0-8.0) and gestational age of ⩾37 weeks (adjusted odds ratio = 5.2, 95% confidence interval: 1.4-19.3) were independent factors associated with uterine rupture.
Mothers referred from health facilities, multiparous women, duration of labor more than 18 h, gestational age of ⩾37 weeks and malpresentation were significantly associated with uterine rupture. Early referral, encouraging family planning, proper use of partograph, early identification and appropriate intervention for malpresentation are recommended.