While You Are Sleeping: Marital Ambivalence and Blunted Nocturnal Blood Pressure.

Marital relationships offer health benefits, including a lower risk of cardiovascular disease (CVD). However, quality of the relationship matters; ambivalent behaviors may increase CVD risk by affecting blunted nocturnal blood pressure (BP) dipping. This study tracked daytime and nocturnal SBP and DBP in 180 normotensive individuals (90 couples; participant mean age 25.04; 91.58% white) over a 24 h period using ambulatory blood pressure monitors to explore the impact of martial quality. Results showed that perceptions of spousal ambivalence were associated with blunted nocturnal BP dipping. Perceptions of one's own behavior as ambivalent also showed blunted nocturnal dipping. When in an ambivalent relationship, a gender interaction was found such that women were most likely to have blunted SBP dipping, but men were more likely to have blunted nocturnal DBP dipping. Overall, this study found an association between ambivalence and BP dipping, thus uncovering one virtually unexplored pathway by which marital relationships may have adverse effects on health.

Determinants of teenage pregnancy in Malawi: a community-based case-control study.

BACKGROUND: Teenage pregnancies are a global concern. Malawi is one of the countries with the highest teenage pregnancy rates despite government efforts to reverse the situation and yet studies on determinants of teenage pregnancy are rare with some factors remaining unexplored. Therefore, this study aimed to identify factors associated with teenage pregnancies in Malawi. METHODS: This was a community-based case-control study that used secondary data from the 2015-16 Malawi Demographic and Health Survey from all 28 districts of Malawi. The study population comprised women aged 20-24 who participated in the survey. The study ran from September 2021 to October 2022 and used a sample size of 3,435 participants who were all women aged 20-24 in the dataset who met the inclusion criteria. Data were analysed using Stata 16 software. Logistic regression analyses were used to determine factors. Variables with a P value of < 0.1 in the univariable analysis were included in the multivariable analyses, where statistical significance was obtained at a P value < 0. 05. RESULTS: Data on 3435 participants were analysed. In multivariable analyses: no teenage marriage (AOR 0.13); secondary education (AOR 0.26); higher education (AOR 0.39); richest category of wealth index (AOR 0.51), use of contraception (AOR 3.08), domestic violence by father or mother (AOR 0.37) were found to be significant factors. CONCLUSION: This study identified determinants of teenage pregnancy. The government has to sustain and expand initiatives that increase protection from teenage pregnancy, reinforce the implementation of amended marriage legislation, introduce policies to improve the socioeconomic status of vulnerable girls and increase contraceptive use among adolescent girls before their first pregnancy. Further research is also recommended to resolve inconclusive results.

The impact of sociocultural and psychological stress on the outcome of assisted reproductive technology in remarried families.

OBJECTIVE: In China, there is a unique type of second marriage (SM) family where the woman is remarried, and the man is experiencing his first marriage. Additionally, the woman is older than the man. Therefore, these families experience many challenges: psychological, emotional, and societal pressure. Such family is a typical sample for studying sociocultural and psychological stress influencing on outcome of assisted reproductive technology (ART). This study aimed to investigate the impact of social psychological stress on the live birth outcomes AR. METHODS: In this retrospective cohort, second marriage (SM) families who visited the Second Hospital of Hebei Medical University reproductive center between January 2012 to December 2022 were screened, and 561s marriage families (the SM group) with 5600 first marriage (FM) families (the FM group) were included undergoing their first ART cycles. The primary outcome of this study was the live birth rate (LBR). RESULTS: The live birth rate (LBR) of SM group (30.7%) is lower than that of the FM group (43.6%) (p < 0.01). After adjustment by logistic regression, the second marriage group (OR = 1.269, 95%CI 1.031-1.562, p = 0.025) were independent factors associated with the outcome of live birth. After propensity score matching (PSM), the live birth rate of SM group (28.7%) is lower than the FM group (35.9%) (0 = 0.011). CONCLUSION: The SM family experience higher levels of social and psychological pressure, which lead to lower level of LBR than FM family.

Illuminating health aspects for immigrant Thai women in Swedish transnational marriages.

BACKGROUND: Women who are migrants experience discrimination and face major risks, including sexual exploitation, trafficking, and violence, which affect their health and well-being. This study explored critical health incidents experienced by immigrant Thai women in marriage migration. METHODS: A qualitative explorative approach with in-depth interviews was used. Forty immigrant Thai women who currently or previously had a Swedish spouse were recruited for the study. An inductive critical incident technique was used to collect and analyze the data as the first step. In a second deductive step, the Newman system model was used to categorize health dilemmas. RESULTS: The women reported 438 critical health incidents in five main areas. Psychological health dilemmas included emotional abuse, feeling overwhelmed due to family responsibilities and the stress of leaving family behind. Sociocultural health dilemmas included transnational family duties or not performing family duties. Physiological health dilemmas included experiencing physical violence and environmental, domestic or work accidents. Developmental health dilemmas included failing health, difficulties upholding the duties expected of a spouse in the target culture and caring for an elderly husband. Spiritual health dilemmas included critical incidents in which the women perceived themselves to have failed in their hopes and duties as a wife, which intensified their dependence on faith, particularly the Buddhist concept of karma. CONCLUSION: Professionals in health and welfare practices in Thailand together with professionals in Western countries who work with women in marriage migration situations need to recognize the psychological, sociocultural, physiological, developmental, and spiritual health dilemmas experienced by these women. Furthermore, civil organizations that meet Thai women in foreign countries, such as Buddhist cultural associations, would benefit from the multicultural knowledge revealed by the present study. This knowledge can facilitate healthcare and welfare support for women in marriage migration situations.

Social protection as a strategy for HIV prevention, education promotion and child marriage reduction among adolescents: a cross-sectional population-based study in Lesotho.

BACKGROUND: Lesotho's government has shown consistent efforts to implement social protection programmes. However, while recent evidence established a positive causal relationship between some of these programmes and food security there is little evidence on the extent to which these initiatives are associated with better educational and sexual and reproductive health outcomes among vulnerable adolescents in Lesotho. METHODS AND FINDINGS: The study uses cross-sectional, nationally representative data from the 2018 Lesotho Violence Against Children and Youth Survey. Our research examined the association between social protection receipt and educational and sexual and reproductive health outcomes among adolescents and young people (13-24 years) living in poverty. We employed multivariate logistic regression controlling for age, orphanhood, HIV status and sex. Social protection receipt was defined as household receipt of financial support from a governmental, non-governmental, or community-based program that provides income. Additionally, we fitted a marginal effects model by sex. Among the 3,506 adolescent females and males living in the two lowest poverty quintiles, receipt of social protection was associated with improvements in multiple adolescent outcomes: higher odds of consistent condom use (aOR 1.64, 95% CI 1.17-2.29), educational attainment (aOR 1.79, 95% CI 1.36-2.36), and school enrolment (aOR 2.19, 95% CI 1.44-3.34). Stratified analyses by sex showed that social protection receipt was also associated with reduced likelihood of child marriage among females (aOR 0.59, 95% CI 0.42-0.83) and higher odds of educational attainment and school enrolment among males (aOR 2.53, 95% CI 1.59-4.03 and aOR 3.11, 95% CI 1.56-6.19, respectively). CONCLUSIONS: Our study provides evidence that social protection programs are associated with improved educational, sexual and reproductive health and child marriage prevention outcomes among adolescents living in poverty. Implementing and expanding such social protection initiatives could prove instrumental in improving the well-being of vulnerable adolescents. CONTRIBUTIONS: Social protection programs have been increasing in sub-Saharan African countries, playing a pivotal role in poverty reduction, with Lesotho being no exception. Despite the optimistic outlook brought about by the implementation of the National Social Protection Strategy Lesotho I (2014-19) and II (2021-2031), the impact of these programs on some specific outcomes that concern the lives of the most vulnerable adolescents in Lesotho remains to some extent unexplored. Additionally, Lesotho grapples with high rates of HIV, adolescent pregnancy, child marriage and early school dropout, which can further contribute to poor long-term health and social outcomes among adolescents. In this study, we used data from the 2018 Lesotho Violence Against Children and Youth Survey (VACS) to examine the association between receiving social protection and multiple adolescent outcomes: educational, sexual and reproductive. The findings revealed that social protection programs, particularly the existing government-provided cash transfers, are significantly associated with multiple better outcomes among adolescents living in the poorest households in Lesotho. Such cash transfer schemes in Lesotho are associated with improved sexual and reproductive health outcomes for adolescent females, including reduced child marriage rates, and improved educational outcomes for males. These findings indicate that government-led social protection programmes are positively associated with favourable outcomes that can improve the quality of life for adolescents in resource-limited settings.

Stress-related experiences and intentions to quit studies among female married postgraduate distance education students in Ghana.

BACKGROUND: Although postgraduate studies have been shown to be associated with stressful experiences, students reading programmes through the distance and e-learning mode experience greater levels of stress due to several reasons. These stressful encounters might be heightened in female married postgraduates on distance education programmes due to other family-work-related engagements. This study investigated the stress-related experiences and intentions to quit studies among female married students on a distance education programme in Ghana. METHODS: Using a sequential explanatory mixed-methods design, 164 married postgraduate distance education students were sampled to participate by responding to a questionnaire. Follow-up interviews were conducted with 10 participants to offer insight into the quantitative findings. Quantitative data were analysed using descriptive statistics, including frequency and percentages, while the qualitative data were thematically analysed. RESULTS: Stress was prevalent among the female married distance education students, with the majority having intentions of quitting their studies. The stressors identified ranged from personal (i.e., work and family demands) to institutional ones (i.e., academic load, unresolved complaints and high financial demands from the programme). CONCLUSIONS: Key findings suggest that female married postgraduate distance education students perform multiple roles as full-time employees with family and academic demands that can negatively impact their health and academic work. Implications and recommendations of the findings are discussed.

Jalinan Kasih android mobile phone application improves knowledge, attitude, and practice regarding early marriage among high school students: Evidence from quasi-experimental study.

Child marriage has a significant health impact on young mothers and their offspring. This study aims to compare the effectiveness of the Jalinan Kasih Android-based application, the Marriage Age Maturity (PUP) module, and the lecture method in improving knowledge, attitude, and practice regarding early marriage among high school students. A quasi-experiment with control groups was conducted, involving 72 students selected from three high schools in Bengkulu City, Indonesia who met the inclusion criteria. The participants were divided into three groups: 24 individuals in the application intervention group, 24 individuals in the module intervention group, and 24 individuals in the control group. The Jalinan Kasih application group showed an increase in average scores before and after the intervention, in terms of knowledge (6.46), attitude (6.79) and practice (1.75), with a p-value of 0.000, 0.000 and 0.17, respectively, The Jalinan Kasih application had a greater influence on knowledge, attitude and practice compared to the PUP module and the lecture method with a p-value of 0.000. In other words, the Jalinan Kasih mobile application was effective in improving the knowledge, attitude, and practice of high school students regarding early marriage through the use of its contents and consultation feature. It is recommended that the Jalinan Kasih application be used as an educational medium to prevent early marriage and improves family planning.

Le mariage des enfants a un impact significatif sur la santé des jeunes mères et de leur progéniture. Cette étude vise à comparer l'efficacité de l'application basée sur Android Jalinan Kasih, du module Marriage Age Maturity (PUP) et de la méthode magistral pour améliorer les connaissances, l'attitude et la pratique concernant le mariage précoce chez les lycéens. Une quasi-expérience avec des groupes témoins a été menée, impliquant 72 étudiants sélectionnés dans trois lycées de la ville de Bengkulu, en Indonésie, qui répondaient aux critères d'inclusion. Les participants ont été divisés en trois groupes : 24 personnes dans le groupe d'intervention d'application, 24 personnes dans le groupe d'intervention du module et 24 personnes dans le groupe témoin. Le groupe d'application Jalinan Kasih a montré une augmentation des scores moyens avant et après l'intervention, en termes de connaissances (6,46), d'attitude (6,79) et de pratique (1,75), avec des valeurs p de 0,000, 0,000 et 0,17, respectivement. L'application Jalinan Kasih a eu une plus grande influence sur les connaissances, l'attitude et la pratique par rapport au module PUP et à la méthode magistral avec une valeur p de 0,000. En d'autres termes, l'application mobile Jalinan Kasih a été efficace pour améliorer les connaissances, l'attitude et la pratique des lycéens concernant le mariage précoce grâce à l'utilisation de son contenu et de sa fonction de consultation. Il est recommandé d'utiliser l'application Jalinan Kasih comme support pédagogique pour prévenir les mariages précoces et améliorer la planification familiale.

Testing the Impacts of Rational-Emotive Couple Intervention in a Sample of Parents Seeking Divorce.

Marital burnout has not been extensively studied despite its huge consequences on family wellbeing and quality of family life. This study, using randomised-controlled trial, tested the impact of rational-emotive couple intervention on marital burnout in a sample of parents seeking a divorce. A total of 67 parents who participated during the rational-emotive couple intervention (RECI) were assessed using the marital burnout scale, Beck depression inventory, and parent rational and irrational beliefs scale. Crosstabulation, multivariate test analysis, and bivariate analysis were used to analyse the data collected. Results show a significant reduction of marital burnout in RECI group participants, and significant improvement was maintained at the follow-up stage. The result of the group and gender interaction effect shows no significant interaction effect of group and gender on participants' marital burnout at Time two and Time 3, respectively. The results indicate that a decrease in parents' irrational beliefs accounts for marital burnout among couples seeking a divorce. Marital burnout is positively associated with depression among couples seeking a divorce. This study concludes that the RECI is an effective intervention that reduces marital burnout which is a direct consequence of irrational beliefs which later metamorphose into depressive symptoms.

[Progress in research of relationship between marital status and cancer].

In recent 30 years, the global burden of cancer has become more serious, and one of social problem is population aging, plus declining birth rate, declining marriage rate and increasing divorce rate. Marriage is one of the most intimate and long-term social relations, and previous research had piecemeal reports of its impact on cancer morbidity and mortality without systematic review of evidence in high-quality population based epidemiological research. This paper summarizes the progress in research of the relationship between marital status and cancer to provide reference for future research and cancer prevention and control.

The effect of counseling based on health promotion awareness on self-care needs and reproductive and sexual health literacy of newly married women: a randomized controlled clinical trial study.

BACKGROUND: Despite the importance of health literacy and the self-care skills in improving individual and social health and health costs reduction, scientific evidence indicates women's poor awareness of self-care needs and low health literacy concerning reproductive and sexual health in most societies. The present study was conducted to specify the effect of health awareness promotion on self-care needs and reproductive and sexual health literacy of newly married women. METHODS: This randomized controlled clinical trial was conducted on 64 newly married women aged 15-45 in Tehran, Iran from August 2021 to the end of December 2021. The participants were randomly assigned into the intervention (n = 32) and control (n = 32) groups. The intervention group received four individual health awareness-promotion education sessions. The reproductive and sexual self-care needs, and sexual health literacy questionnaires, were completed before and 4-week after the intervention through interview. The data were analyzed using SPSS26 software. The independent t-tests and ANCOVA were used to comparison the mean scores and a significance level of P < 0.05 was considered. RESULTS: The results of this study indicated that after counseling, the average overall score of perceived reproductive and sexual self-care needs significantly decreased in the intervention group [Mean (standard deviation(SD)): 125.70 (24.70)] compared to the control group [Mean (SD): 87.1 (23.42)][P = 0.001]. Also, the mean score of sexual and reproductive health literacy significantly increased in the intervention group [Mean (SD): 125.50 (14.09)] compared to the control group [Mean (SD): 97.15 (14.90)] after intervention [P = 0.01]. CONCLUSIONS: The results indicated the positive effect of health promotion awareness educations on reproductive and sexual self-care needs and health literacy among newly married women. Therefore, health promotion interventions should be incorporated in health services provision programs for newly married women in comprehensive health centers to improve the health of women and families. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT): IRCT20171007036615N7 Date of registration: 2021-09-21. URL: https://fa.irct.ir/trial/58597 .

Sexual satisfaction and attitude toward marital infidelity among married people in Iran: the role of social media and entertainment preferences.

BACKGROUND AND PURPOSE: Sexual satisfaction and attitudes toward marital infidelity are crucial components of marital quality and well-being. This study investigates the impact of social media and entertainment preferences on these aspects among married couples in Iran, acknowledging the sociocultural nuances unique to the region. METHOD AND MATERIAL: A cross-sectional survey design was employed, gathering data from 1,756 married participants through an online questionnaire in Iran. Variables included social media and entertainment preferences, sexual satisfaction, attitude toward marital infidelity, and demographic details. Descriptive statistics, non-parametric tests (Mann-Whitney U test, Kruskal-Wallis test), and GLM (Generalized linear model) were used for exploration. RESULTS: Key results reveal significant associations between demographic factors, social media usage, and attitudes toward marital infidelity. Notable trends include higher sexual satisfaction among younger participants (p < 0.05), those with shorter marital durations (p < 0.01), and those residing outside Tehran (p < 0.001). Attitudes toward marital infidelity were influenced by gender, age, ethnicity, income levels, and social media habits, reflecting a complex interplay of factors. The GLM analysis emphasizes the impact of variables such as marital duration, ethnicity, spouse's education, Iranian social media usage, and attitudes toward marital infidelity on sexual satisfaction. Participants with shorter marriages (p < 0.01), higher spouse education (p < 0.05), and more frequent Iranian social media usage (p < 0.001) reported higher sexual satisfaction. CONCLUSIONS: This study explores the dynamics of marital relationships in Iran, examining the interconnections between demographics, media habits, sexual satisfaction, and attitudes toward infidelity. The findings provide valuable insights into factors influencing marital satisfaction, emphasizing the importance of considering cultural contexts. Robust statistical methods, including Generalized Linear Models, support the reliability of results. The study contributes to understanding non-western marital dynamics, highlighting implications for research and interventions in the digital age.

HIV prevalence and associated factors among married women, Mozambique, 2015: analysis of the 2015 National AIDS Indicator Survey (IMASIDA).

Introduction: epidemiological estimates from the 2021 Joint United Nations Program on HIV/AIDS (UNAIDS) emphasize the existing gender disparities, where women face a higher risk of HIV/AIDS exposure. In Mozambique, as of 2021, the HIV prevalence rate among the adult population stood at 12.5%, with an even more concerning rate of 15.4% among women of reproductive age. Methods: a cross-sectional study was carried out with secondary data from the Survey on National Indicators of Vaccination, Malaria, and HIV/AIDS (IMASIDA 2015), where we included married women, both civil marriage and common law marriage of reproductive age 15-49 years. Statistical analyses, including chi-squared tests and logistic regression models, accounting for survey design, were employed to assess associations. Results: the study findings showed that HIV prevalence was higher among married women aged 35-49 years (aOR=2.5; 95% CI: 1.3-4.6; p=0.005), those without formal education (aOR=7.7; 95% CI: 1.1-52.9; p=0.038) and those with primary education (aOR=9.8; 95% CI: 1.6-60.1; p=0.014), those who experienced domestic violence (aOR=1.8; 95% CI: 1.0-3.2; p=0.04), had an uncircumcised partner (aOR=1.9; 95% CI: 1.2-3.1; p=0.008), and had three or more lifetime sex partners (aOR=3.6; 95% CI: 2.9-7.3; p<0.001). Women who were in one lifelong union had a lower risk of HIV positivity (aOR=0.5; 96%CI: 0.3-0.8, p=0.005). Conclusion: the findings of this study highlight sociodemographic, behavioral, and violent factors associated with HIV prevalence among women. These findings underscore the importance of targeted interventions and education programs aimed at reducing HIV transmission among females and promoting safer sexual practices.

Modern contraceptive utilization and associated factors among younger and older married youth women in Ethiopia: Evidence from Ethiopia Mini Demographic and Health Survey 2019.

INTRODUCTION: Utilization of modern contraceptives increases over time but it was still low and varies across ages among married youth woman. This study revealed the prevalence of modern contraceptives and its associated factors among younger and older married youth women. METHODS: A cross-sectional study design was applied to the sample of EMDHS 2019. Multilevel logistic regressions were carried out using STATA version 16 to identify the individual and community-level factors of modern contraceptive utilization. Adjusted odds ratios with a 95% confidence interval and variables with a p-value < 0.05 were considered to be significant determinants of modern contraceptive utilization. RESULT: In the EMDHS 2019, a total of 3290 married women between ages 15 and 34 were included. Among these 1210 (36.7%) and 2080 (63%) women, they were age groups of 15-24 and 25-34 years, respectively. Modern contraceptive utilization among women aged 15-24 and 25-34 years was 54.23% and 52.6%, respectively. Injection is a commonly used modern contraceptive method. In this study, factors associated with modern contraceptive utilization among women aged 15-24 years include women who had primary education [AOR = 2.22; 95% CI: 1.02-4.83], who had three or more children in the household [AOR = 14.29; 95% CI: 1.61-126.25], Protestants [AOR = 0.29; 95% CI: 0.14-0.61], five to seven households [AOR = 0.34; 95% CI: 0.17-0.69], and region [AOR = 6.98; 95%:2.30-21.16]. On other hand, factors associated with modern contraceptive utilization among women aged 25-34 were women who had one or two under-five children in the household [AOR = 1.66; 95% CI: 1.03-2.68] and region [AOR = 3.54; 95%CI: 1.79-6.97]. CONCLUSIONS: More than 50% of participants used modern contraceptives in both age groups and, the associated factor of modern contraceptive utilization varied among this age group. Health managers and policymakers need to consider age group, region, educational status, religion, and fertility level in planning of family planning program.

The impact of positive psychology counseling on sexual and marital satisfaction and anxiety among reproductive-aged women during the COVID-19 pandemic: a randomized controlled clinical trial.

BACKGROUND: Sexual and marital satisfaction is considered one of the important factors in happiness and life satisfaction of couples. COVID-19 pandemic results in psychological effects, such as increased anxiety levels which can affect sexual and marital satisfaction. This study aimed to investigate the impact of positive psychology on women's sexual and marital satisfaction. METHODS: A randomized controlled trial was conducted on 72 married women of reproductive age in Tabriz, Iran between February 2021 and May 2022. The participants were randomly divided into the intervention and control groups. There was no significant difference between the control and intervention groups in terms of the socio-demographic characteristics (p < 0.05). The mean age of the participants in the intervention and control groups was 31.8 ± 6.92 and 30.97 ± 5.09 years, respectively. The intervention group attended seven 60-90 min counseling sessions at weekly intervals. The Spielberger anxiety, sexual satisfaction and marital satisfaction questionnaires were completed before and four weeks after the intervention. RESULTS: The results of this study indicated that after counseling, the average overall score of marital satisfaction [MD: 15.46, 95% CI: 7.47 to 23.41, p = 0.034] and sexual satisfaction [MD: 7.83, 95% CI: 6.25 to 9.41, p = 0.001] significantly increased in the intervention group compared to the control group. Also, the mean score of state anxiety [MD: -2.50, 95% CI: -4.19 to -0.80, p = 0.001] and trait anxiety [MD: -1.03, 95% CI: -2.46 to -0.09, p = 0.032] significantly decreased after counseling in the intervention group compared to the control group. CONCLUSIONS: Using counseling based on a positive psychology approach can improve anxiety, sexual and marital satisfaction, and anxiety of women of reproductive age during the COVID-19 pandemic. However, further randomized clinical trials are needed before making a definitive conclusion. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT): IRCT20171007036615N8. Date of registration: 11/28/21. Date of first registration: 11/28/21. URL: https://www.irct.ir/user/trial/58680/view ; Date of recruitment start date: 12/01/21.

Does Matrilineality Reduce Gender Inequality in Environmental and Social Impact Assessment (ESIA) Public Participation? Some Evidence from Malawi.

This paper reports on Environmental and Social Impact Assessment (ESIA) public participation in Malawi with a focus on the role of women from matrilineal and patrilineal marriage systems. Six rural ESIA projects are explored of which three are in areas of patrilineal and three are in areas of matrilineal systems. Participation space was found to be consistently dominated by men, with no obvious differences between both systems. The key reasons are likely to be lower educational and social status of women in rural areas throughout the country. This is associated with a number of challenges, including chronic poverty and food insecurity. Affirmative action is needed to achieve a better representation of women in ESIA processes.

Examining the decline in modern contraception usage among married women in Bangladesh: Applying Blinder-Oaxaca decomposition analysis.

OBJECTIVES: Controlling population expansion and reducing unintended pregnancies through the use of modern contraceptives is a cost-effective strategy. In recent years, the rate of modern contraceptive use in Bangladesh has been declining. So, this study aimed to investigate the associated factors of the deterioration in modern contraceptive usage. METHODS: This study used data from two successive Bangladesh Demographic and Health Surveys (2014 and 2017-18) and applied the Blinder-Oaxaca decomposition analysis to understand the drivers. A popular binary logistic regression model is fitted to determine the factors that influence the use of modern contraceptive methods over the years. RESULTS: This study revealed that highly educated women were more likely to use modern contraception methods, and their use increased by 3 percent over the years. Factors such as women's working status, husband's education, number of living children, and fertility preference were found significantly associated with decreased usage of modern contraception methods over years. The result of the Blinder-Oaxaca (BO) decomposition analysis found a significant decrease between 2014 and 2018. Respondent's age, working status, husband's age, opinion on decision making, region, and media exposure were the most significant contributors to explaining the shift between 2014 and 2018. The two factors that contributed most to narrowing the difference between the two surveys were women's decision on own health (26%), and employment status (35%). CONCLUSIONS: The factors that influence modern contraceptive prevalence are important to know for policy implication purposes in Bangladesh. The findings indicate the need for further improvement of factors for balancing the usage of modern contraception methods.

Marriage and motherhood: Insights on a crucial life course process from the perspective of female arab-palestinian undergraduate students.

Despite changes in women's status in recent decades in Arab-Palestinian society in Israel, marriage and motherhood still play a central role. Moreover, although the increase in the integration rates of young Arab-Palestinian women into the higher education system, as girls belonging to a minority group with traditional structures, they are expected to prioritize family and community expectations over personal aspirations. This study focuses on art projects of female Arab-Palestinian college students in Israel, which serve as a prism for detecting cultural perceptions of pathways to entering adulthood among this population today. These topics are central themes in the projects in question. Working on these projects forced the students to profoundly contemplate their life stage - being engaged or newly married and young mothers. The aim of the study was to decode the artworks in order to explore the students' feelings and thoughts on a topic rarely considered through the eyes of the young women themselves. The study provides a nuanced examination of the social processes that young educated Arab-Palestinian women experience in the current family structure. By analysing the projects using visual tools from semiotics and art history, along with verbal texts provided by the students, we assert that these projects serve as a crucial avenue for students' self-expression regarding topics seldom addressed. Even though the projects cannot be understood as critical of traditional gender expectations, we did find some interesting voices of unease regarding them. The move from their parents' home to their new one is widely described as difficult, where sadness and concern about the future are highly noticeable. In addition to accepting the stages of marriage and motherhood with joy and excitement, they also express fear and hesitation. This tension between fulfilling their expected roles and being unsure and hesitant about them exists in the projects. We claim that even if implicit and careful, these signs are important to recognize. However, it seems that higher education has failed to significantly undermine patriarchal and gender expectations.

Prognostic factors of first intimate partner violence among ever-married women in Sub-Saharan Africa: Gompertz gamma shared frailty modeling.

BACKGROUND: Violence against women, particularly intimate partner violence, is a significant Concern for public health as well as a violation of the human rights of women especially in low and middle-income countries. However, there was limited evidence how soon an ever-married women experience intimate partner violence in Africa. Therefore, this study aimed to investigate the timing of first intimate partner violence (FIPV) among ever-married women in 30 SSA countries and to identify the risk factors of the timing. METHODS: The present study has utilized 125,731 weighted samples, who participated in the domestic violence module of the survey from Demographic and Health Surveys of 30 SSA countries. The Gompertz gamma shared frailty model was fitted to determine the predictors. For model evaluation, the theta value, Akaike Information Criteria (AIC), Bayesian Information Criteria (BIC), and deviance were used. The Adjusted Hazard Ratio (AHR) with a 95% Confidence Interval (CI) was reported in the multivariable Gompertz gamma shared frailty model to highlight the strength and statistical significance of the associations. RESULT: One-third (31.02%) of ever-married women had reported experiencing IPV. The overall incidence rate of FIPV was 57.68 persons per 1000 person-years (95% CI = 50.61-65.76). Age at marriage, age difference, educational status, employment, residence, women's decision-making autonomy, husband who drink alcohol and wealth status were significantly associated with the timing of FIPV. CONCLUSION: The findings show that ever-married women are at high and increasing risk of violence. Thus, we recommend establishing effective health and legal response services for IPV, strengthening laws governing the sale and purchase of alcohol, empowering women, raising the educational attainment of women, and putting policies in place to combat the culture of societal tolerance for IPV all contribute to the empowerment of women.

Unmet need for family planning and associated factors among currently married women in Nepal: A further analysis of Nepal Demographic and Health Survey-2022.

INTRODUCTION: Family planning (FP) is crucial for improving maternal and newborn health outcomes, promoting gender equality, and reducing poverty. Unmet FP needs persist globally, especially in South Asia and Sub-Saharan Africa leading to unintended pregnancies, unsafe abortions, and maternal fatalities. This study aims to identify the determinants of unmet needs for FP from a nationally representative survey. METHODS: We analyzed the data of 11,180 currently married women from nationally representative Nepal Health Demographic Survey 2022. We conducted weighted analysis in R statistical software to account complex survey design and non-response rate. We conducted univariate and multivariable binary and multinomial logistic regression to assess association of unmet need for FP with independent variables including place of residence, province, ecological belt, ethnicity, religion, current age, participant's and husband's education, occupation, wealth quintile, parity, desire for child, and media exposure. RESULTS: The total unmet FP need was 20.8% (95%CI: 19.7, 21.9) accounting 13.4% (95%CI: 12.5, 14.4) for unmet need for limiting and 7.4% (95%CI: 6.8, 8.0) for unmet for spacing. Lower odds of total unmet need for FP were present in 20-34 years and 35-49 years compared to <20 years, women belonging to Madhesi ethnic group (AOR: 0.78; 95%CI: 0.64, 0.95) compared to Brahmin/Chhetri, women from richest (AOR: 0.69; 95%CI: 0.56, 0.84), richer (AOR: 0.82; 95%CI: 0.68, 0.97) and middle wealth quintile (AOR: 0.82; 95%CI:0.70, 0.98) groups compared poorest wealth quintile group and women belonging to rural area (AOR: 0.89; 95%CI: 0.80, 0.99) compared to urban area. Higher odds of unmet need for FP were present among women with basic (AOR: 1.34; 95%CI: 1.17, 1.54), and secondary level (AOR: 1.32; 95%CI: 1.12, 1.56) education compared to women without education, among women from Madhesh (AOR: 1.56; 95%CI: 1.22, 1.98), Gandaki (AOR: 2.11; 95%CI: 1.66, 2.68), Lumbini (AOR: 1.97; 95%CI: 1.61, 2.42) and Sudurpashchim province (AOR: 1.64; 95%CI: 1.27, 2.10) compared to Koshi province and among women whose husband education was basic level (AOR:1.37; 95%CI: 1.15, 1.63), or secondary level (AOR: 1.32; 95%CI: 1.09, 1.60) education. CONCLUSION: Nepal faces relatively high unmet FP needs across various socio-demographic strata. Addressing these needs requires targeted interventions focusing on age, ethnicity, religion, education, and socio-economic factors to ensure universal access to FP services.

Coping styles for sexual dysfunction and stress among married women of reproductive age: a cross-sectional study from Turkiye.

Objectives: To identify sexual dysfunction in married women of reproductive age, and to examine its relationship with stress coping styles. METHODS: The cross-sectional, descriptive study was conducted between February and June 2019 at the obstetrics and gynaecology outpatient clinic of Gulhane Training and Research Hospital in Ankara, Turkiye. The sample comprised married women aged 18-49 years who had an active sexual life over the preceding month, and were neither pregnant nor in the postpartum phase. Data was collected using the Female Sexual Function Index, and the Stress Coping Styles Scale. Data was analysed using SPSS 22. RESULTS: There were 216 women with mean age 33.58±6.77 years. The mean Female Sexual Function Index score was 22.29±6.08. The mean Stress Coping Styles Scale subscale scores were: self-confident 20.71±3.53, helpless 18.07±4.27, submissive 12.13±3.00, optimistic 13.70±2.35, and seeking social support 11.89±2.01. The total Female Sexual Function Index score had a positive, significant correlation with self-confidence (r=0.15; p=0.03) and seeking social support subscales (r=0.18; p=0.01) and a negative, significant correlation with submissive subscale (r=-0.17; p=0.02) of the Stress Coping Styles Scale. CONCLUSIONS: Establishing awareness among women about sexual dysfunction and improving effective coping styles may contribute to improved sexual health among women.