Respected but stigmatized: Healthcare workers caring for COVID-19 patients.

BACKGROUND: Healthcare workers (HCWs) caring for Corona Virus Disease 2019 (COVID-19) patients are at increased risk of being stigmatized, which compromises their individual mental well-being and the quality of care they deliver. Stigma-reduction interventions may (partly) prevent this. However, there is a lack of in-depth understanding of the experiences and underlying causes of COVID-19 stigma among HCWs, which is needed to design such interventions. We conducted in-depth semi-structured interviews to assess COVID-19 stigma among COVID-19 HCWs in Ireland, Nigeria, The Netherlands, Pakistan, and The Philippines. METHODS: We used a purposive and snowball sampling to recruit a total of 53 HCWs for online interviews (13 in Ireland; 15 in Nigeria; 6 in The Netherlands; 6 in Pakistan; and 13 in The Philippines (2021). After verbatim transcribing interviews, we used a thematic approach for data analysis. RESULTS: In all countries, stigmatization of COVID-19 HCWs is driven by fear of infection and the perception of HCWs being carriers of the disease amplified by them wearing of scrubs and personal protective equipment. There were differences between countries in the way stigma manifested in self- anticipated and experienced stigma like scolding, discrimination, avoidance, (self-) isolation, and exclusion in public, in the community, at work, and in the household. The stigma resulted in feelings of depression, loneliness, isolation, and the desire to quit one's job. DISCUSSION: COVID-19 HCWs from all countries experienced all forms of stigmatization related to their work as a COVID-19 frontliner. This affected their mental well-being, which in turn affects job performance and quality of care, there is a high need to develop stigma reduction tools for HCWs.

Investigating the pathways from preconception care to preventing maternal, perinatal and child mortality: A scoping review and causal loop diagram.

In recent years, there has been a growing recognition that developing preconception care provides an opportunity to significantly reduce maternal and child mortality and morbidity. This involves targeting multiple risk factors through a large array of medical, behavioural and social interventions. In this study, we created a Causal Loop Diagram (CLD) to describe several pathways by which a set of preconception interventions may lead to women's improved health and better pregnancy outcomes. The CLD was informed by a scoping review of meta-analyses. It summarises evidence on the outcomes and interventions related to eight preconception risk factors. The authors reviewed literature from two databases (PubMed and Embase) and used the framework developed by Arksey and O'Malley. The CLD includes 29 constructs categorised into five different levels (mortality, causes of death, preconception risk factors, intermediate factors, interventions or policies). The model indicates interconnections between five sub-systems and highlights the role of preventing early and rapidly repeated pregnancies, as well as optimising women's nutritional status in the preconception period. It also shows the prevention of preterm birth as a privileged route for lowering child mortality and morbidity. The CLD demonstrates the potential benefits of strategies that address multiple preconception risk factors simultaneously and can be used as a tool to promote the integration of preconception care into efforts to prevent maternal and child mortality. With further improvements, this model could serve as a basis for future research on the costs and benefits of preconception care.

Factors associated with adolescent pregnancy and public health interventions to address in Nigeria: a scoping review.

BACKGROUND: Adolescent pregnancy is a global public health and social problem that affects both developed and developing countries. Reducing adolescent pregnancy is central to achieving sustainable development goals. In 2021 Nigeria's Adolescent pregnancy was 106 per 1000 and showed an increasing rate. This study, therefore, aims to explore the literature to map the risk factors and interventions against adolescent pregnancy in Nigeria. METHOD: A scoping review of studies published between January 2007 and December 2022 using PubMed, Web of Science and Africa Journals Online were searched using the keywords' adolescent pregnancy' AND 'Nigeria'. Studies were screened using the eligibility criteria. RESULTS: A total of 241 articles, of which 229 were identified through the databases and 12 were identified through hand search. After the full-text review, 28 studies met the inclusion criteria and were included in the final review. In Nigeria, the prevalence of adolescent pregnancy is between 7.5 and 49.5%. Associated factors for adolescent pregnancy in Nigeria are multifactorial, including individual, community, societal, school, family, and peer factors. Policies on adolescent sexual and reproductive health exist in Nigeria. Still, the policies need more sponsorship, implementation, and monitoring, while only some interventions on adolescent pregnancy majorly based on contraceptives and education of health providers are available in Nigeria. CONCLUSION: Associated factors for adolescent Pregnancy in Nigeria are multidimensional, with educational attainment and wealth index being the highest associated factor. Intervention strategies aimed at the educational level have been identified as a critical factor in curbing adolescent pregnancy. Thus, policies on sexual, reproductive, and mental health development specifically targeting adolescents to reduce the cycle of societal dependence by empowering this group economically and educationally are justifiably warranted.

Community cohesion and violence against women in Ghana, Pakistan, and South Sudan: A secondary data analysis.

BACKGROUND: Much knowledge has been accumulated on individual-level risks and protective factors of violence against women. However, the influence of factors operating at the community level, such as community cohesion, remains unclear, especially in low- and middle-income countries. This study examined whether community cohesion, a combined measure of mutual trust and tolerance, affects women's likelihood of experiencing intimate partner violence, violence perpetrated by a family member, and violence occurring in public spaces. METHODS: Data on 4785 women aged between 18 and 60 years in Ghana, Pakistan, and South Sudan, initially collected by the 'What Works to Prevent Violence Against Women and Girls' Research and Innovation Programme, were used for this study. Binary logistic regression analyses were used to assess the association between a composite measure of community cohesion and recent experience of physical, sexual, and psychological violence while controlling for different individual-, community-, and state-level variables. RESULTS: Multivariate analyses revealed that community cohesion was associated with lower risks of public spaces violence (adjusted odds ratio = 0.396, 95% confidence interval = 0.312-0.503, P < 0.001) and family member violence (adjusted odds ratio = 0.839, 95% confidence interval = 0.754-0.934, P < 0.001). There was no statistically significant association between intimate partner violence and community cohesion, but adjusted models showed that women with more developed social networks were at higher risks of experiencing intimate partner violence (adjusted odds ratio = 1.104, 95% confidence interval = 1.062-1.148, P < 0.001). CONCLUSION: Our findings suggest that community cohesion may have a protective effect against the most visible forms of violence against women. However, this effect may be attenuated or even eliminated by other individual- or household-level mechanisms in the case of violence between intimates or family members.