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https://ajrh.info/index.php/ajrh/issue/feed 2026-05-24T17:16:52+00:00 Professor Friday E. Okonofua feokonofua@yahoo.co.uk Open Journal Systems African Journal of Reproductive Health https://ajrh.info/index.php/ajrh/article/view/7035 2026-05-24T17:16:52+00:00

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Friday Okonofua feokonofua@yahoo.co.uk

<p>The article published in this issue of the journal titled “Examining implementation of health exception laws in six countries”¹ arrives at a critical juncture in global reproductive health discourse. Across much of the developing world, abortion law - often framed around narrow “health exceptions” - exist in statute but fail in practice. This disjuncture between legal permission and lived access is not merely a technical gap; it is a profound social justice failure with implications for women’s health, autonomy, and dignity.</p>

2026-05-15T13:03:29+00:00 Copyright (c) 2026 African Journal of Reproductive Health https://ajrh.info/index.php/ajrh/article/view/7037 2026-05-24T16:32:33+00:00

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(mysql): SELECT * FROM author_settings WHERE author_id = '20476'  

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(mysql): SELECT * FROM author_settings WHERE author_id = '20477'  

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(mysql): SELECT * FROM author_settings WHERE author_id = '20478'  

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Khansa Chaabouni chaabouni_khansa@medecinesfax.org Dana Jallouli chaabouni_khansa@medecinesfax.org Khouloud Mzid chaabouni_khansa@medecinesfax.org Wassim Guidara chaabouni_khansa@medecinesfax.org Fatma Khanfir chaabouni_khansa@medecinesfax.org Khansa Ben Hassen chaabouni_khansa@medecinesfax.org Madiha Frikha Mseddi chaabouni_khansa@medecinesfax.org Aida Elleuch chaabouni_khansa@medecinesfax.org Fatma Makni Ayadi chaabouni_khansa@medecinesfax.org

Trace elements may play a role as initiating environmental factors in polycystic ovary syndrome (PCOS). This study was designed to assess the relationship between circulating levels of zinc (Zn) and copper (Cu) and the pathophysiological features of PCOS<strong>. </strong>A cross-sectional study was conducted. Clinical data were recorded and blood samples were taken to analyze biochemical and hormonal parameters. The subgroup of participants defined with abnormal background had body mass excess, insulin resistance, or subclinical inflammation. In PCOS patients with insulin resistance, elevated Cu, Zn, and Cu/Zn ratio levels were observed. However, the Zn/Cu ratio was lower in those with body mass excess and subclinical inflammation. Significant correlations within PCOS patient subgroups, linking trace elements to anthropometric, metabolic, inflammatory, and hormonal variables, were revealed. Interactions of trace elements in PCOS pathophysiology are likely complex. Hence, supplementation, if considered, should be approached cautiously<em>.</em>

2026-05-15T13:03:29+00:00 Copyright (c) 2026 African Journal of Reproductive Health https://ajrh.info/index.php/ajrh/article/view/7039 2026-05-24T16:33:33+00:00

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(mysql): SELECT * FROM author_settings WHERE author_id = '20482'  

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(mysql): SELECT * FROM author_settings WHERE author_id = '20484'  

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(mysql): SELECT * FROM author_settings WHERE author_id = '20485'  

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(mysql): SELECT * FROM author_settings WHERE author_id = '20486'  

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(mysql): SELECT * FROM author_settings WHERE author_id = '20487'  

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Emily C. Fortman buwiman1@alumni.jh.edu Catherine R. Stratis buwiman1@alumni.jh.edu Jean Berchmans- Uwimana buwiman1@alumni.jh.edu Lilian Sepúlveda buwiman1@alumni.jh.edu Wendy Chavkin buwiman1@alumni.jh.edu Dorothy Shaw buwiman1@alumni.jh.edu Koku Awoonor-Williams buwiman1@alumni.jh.edu

<p>Exceptions to abortion restrictions on the grounds of protecting life or health enable essential care for pregnancy complications but are often underutilized or inconsistently applied. Through a narrative study, Global Doctors for Choice (GDC) aimed to identify barriers and facilitators to implementing these exceptions. We conducted literature and desk reviews and 15 semi-structured interviews (May-August 2025) with physicians, lawyers, and advocates from six countries: Colombia, Ghana, Ireland, Peru, Rwanda, and South Korea. Interviews were transcribed, de-identified, and analyzed for common themes. Implementation depended on disparate, often narrow or incorrect, interpretations by clinicians and institutions. Barriers included lack of training, geographic obstacles, personnel and supply constraints, stigma, and logistical delays, which push patients toward unsafe abortion. Facilitators involved comprehensive training with values clarification, patient awareness campaigns, unambiguous guidelines, and committed advocacy. Ultimately, clear legal frameworks, provider education, advocacy, and patient empowerment could improve access in diverse clinical and legal settings.</p>

2026-05-15T13:03:29+00:00 Copyright (c) 2026 African Journal of Reproductive Health https://ajrh.info/index.php/ajrh/article/view/7041 2026-05-24T17:02:05+00:00

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(mysql): SELECT * FROM author_settings WHERE author_id = '20493'  

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(mysql): SELECT * FROM author_settings WHERE author_id = '20496'  

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(mysql): SELECT * FROM author_settings WHERE author_id = '20497'  

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Kai Li 18622686077@163.com Dongyan Cai 18622686077@163.com Zhihua Gao 18622686077@163.com Xuemei Liang 18622686077@163.com Dong Zhang 18622686077@163.com Yufeng Niu 18622686077@163.com

Postpartum hypogalactia is a common condition that may impair breastfeeding and maternal–infant health. This randomized controlled study evaluated the efficacy of a herbal galactagogic decoction combined with auricular acupressure in improving lactation outcomes. A total of 104 women with postpartum hypogalactia were enrolled between July 2023 and June 2025 and randomly assigned to a control group (auricular acupressure alone, n=52) or an intervention group (auricular acupressure plus herbal decoction, n=52) for 2 weeks. Primary outcomes included breast milk production and formula supplementation, while secondary outcomes comprised serum hormone levels (estradiol, progesterone, and prolactin), symptom scores, psychological status, and clinical effectiveness. Both groups showed significant post-treatment improvements (P&lt;0.05). Compared with the control group, the intervention group demonstrated lower estradiol and progesterone levels, higher prolactin levels, increased milk production, and reduced formula supplementation (P&lt;0.05). Symptom scores and anxiety/depression levels were also significantly improved. The overall effective rate was higher in the intervention group (96.15% vs 80.77%, P&lt;0.05), with comparable safety profiles. This combined therapy appears to be a safe and effective complementary approach for improving lactation in women with postpartum hypogalactia.

2026-05-15T13:03:29+00:00 Copyright (c) 2026 African Journal of Reproductive Health https://ajrh.info/index.php/ajrh/article/view/7042 2026-05-24T17:07:42+00:00

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(mysql): SELECT * FROM author_settings WHERE author_id = '20499'  

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Gulsah Kok nazlimudoga@gmail.com Nazli Ozbek nazlimudoga@gmail.com Gulden Guvenc nazlimudoga@gmail.com

<p>Oncology nurses play a key role in addressing sexual health challenges arising from gynaecological cancer. This study aimed to explore oncology nurses’ perceptions and experiences regarding the assessment of sexual problems in women diagnosed with gynaecological cancer. The study was conducted with 12 nurses working in a medical oncology clinic of a research hospital, using a qualitative design with a phenomenological approach. Data were collected through face-to-face semistructured interviews and analysed using the Colaizzi method. Two main categories were derived from the collected data: patient–nurse communication about sexual experiences and barriers faced by nurses in assessing sexual issues. These themes included six subthemes. Nurses reported difficulties initiating conversations about sexuality, feeling inadequate and uncomfortable discussing the topic, and viewed workload as a barrier to providing sexual counselling. This study highlights the obstacles nurses face in integrating sexual health into holistic cancer care</p>

2026-05-15T13:03:29+00:00 Copyright (c) 2026 African Journal of Reproductive Health https://ajrh.info/index.php/ajrh/article/view/7043 2026-05-24T17:09:06+00:00

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(mysql): SELECT * FROM authors WHERE submission_id = 7043 ORDER BY seq  

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(mysql): SELECT * FROM author_settings WHERE author_id = '20501'  

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Peaceful N. Ntshayintshayi arthur.phukubye@ul.ac.za Melita M. Rasweswe arthur.phukubye@ul.ac.za Thabo A. Phukuby arthur.phukubye@ul.ac.za

Despite widespread access to contraceptives, unplanned pregnancies continue to occur among female student nurses, often hindering academic progress. A quantitative descriptive cross-sectional study using a census approach was conducted, with 170 of the 243 eligible students participating (70% response rate). The study investigated their knowledge, attitudes, and practices (KAP) regarding contraceptive use. Data were collected through a self-administered questionnaire and analyzed using SPSS version 28.0. The findings revealed that 99.4% of participants had received education about contraception, with 67% citing healthcare professionals as their primary information source. Approximately 90% of participants demonstrated positive attitudes toward contraceptive use, while about 10% viewed it as sinful or were unsure. Furthermore, 71.2% reported current contraceptive use; among these, condoms (24.8%), injectables (20.7%), and oral pills (18.2%) were the most commonly used methods. Although overall knowledge and attitudes were positive, a minority showed gaps and disinterest, indicating the need for targeted educational support. These findings highlight the importance of integrating focused contraceptive education into nursing curricula.

2026-05-15T13:03:29+00:00 Copyright (c) 2026 African Journal of Reproductive Health https://ajrh.info/index.php/ajrh/article/view/7044 2026-05-24T17:10:17+00:00

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(mysql): SELECT * FROM author_settings WHERE author_id = '20504'  

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Qiong Luo limin_duan@szcu.edu.cn Limin Duan limin_duan@szcu.edu.cn Ning Liu limin_duan@szcu.edu.cn Chao Zhang limin_duan@szcu.edu.cn Yawei Wang limin_duan@szcu.edu.cn

<p> This study investigates the effects of a digital cultural education intervention, incorporated into Jiangnan cultural tourism, on women's reproductive health outcomes in China. Utilizing a quantitative cross-sectional design informed by theories of cultural capital, experiential learning, and health literacy, a sequential mediation model was evaluated. Data were gathered through structured questionnaires from women involved in the cultural tourism program and analyzed using structural equation modeling. The results demonstrate that digital cultural education significantly boosts cultural capital, which enhances experiential learning and, in turn, improves reproductive health literacy. Health literacy serves as a mediator between experiential learning and improved knowledge, attitudes, and health-seeking intentions regarding reproductive health. The findings highlight the importance of culturally integrated, experiential digital education in empowering women's reproductive health. This research provides policy-relevant insights for incorporating digital cultural education into reproductive health promotion strategies in China and emphasizes the advantages of cross-sector collaboration among health, cultural, and tourism sectors.</p>

2026-05-15T13:03:29+00:00 Copyright (c) 2026 African Journal of Reproductive Health https://ajrh.info/index.php/ajrh/article/view/7045 2026-05-24T17:11:16+00:00

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Fairus P. Idris fairusprihatin.idris@umi.ac.id Suchi A. Sharief fairusprihatin.idris@umi.ac.id Dedy Atmajaya fairusprihatin.idris@umi.ac.id Andi Asrina fairusprihatin.idris@umi.ac.id

Exclusive breastfeeding is scientifically known to reduce child mortality; however, coverage remains low in Bulukumba Regency, which has the lowest rates in South Sulawesi Province, Indonesia. This study aimed to examine the influence of the Theory of Planned Behavior (TPB) on exclusive breastfeeding behavior among mothers in the region. A quantitative cross-sectional study was conducted with 161 mothers of infants aged 6–12 months. Data were collected using a validated and reliable questionnaire and analyzed using Structural Equation Modeling-Partial Least Squares (SEM-PLS). The findings indicate that maternal attitudes towards exclusive breastfeeding (β=0.619) and perceived control (β=0.338) had significantly positive effects on breastfeeding intention, whereas subjective norms were not significantly associated with breastfeeding intention (p=1.000). Furthermore, attitudes, subjective norms, perceived control, and intentions did not have a significant direct effect on exclusive breastfeeding behavior (p&gt;0.05). The results highlight a gap between intention and actual breastfeeding practice, suggesting that strong intentions alone are insufficient to ensure exclusive breastfeeding. These findings underscore the importance of strengthening maternal attitudes and perceived control while addressing contextual and social barriers to behavior change.

2026-05-15T13:03:29+00:00 Copyright (c) 2026 African Journal of Reproductive Health https://ajrh.info/index.php/ajrh/article/view/7046 2026-05-24T17:12:24+00:00

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Fritria D. Anggraini fritria.dwi.anggraini-2023@fkm.unair.ac.id Mahmudah Mahmudah fritria.dwi.anggraini-2023@fkm.unair.ac.id Nunik Puspitasari fritria.dwi.anggraini-2023@fkm.unair.ac.id Nur Masruroh fritria.dwi.anggraini-2023@fkm.unair.ac.id Nur Zuwariah fritria.dwi.anggraini-2023@fkm.unair.ac.id

<p>Labor contractions play an important role in childbirth but can also cause severe pain in the lower back and abdominal area, radiating to the thighs. Appropriate efforts are needed to reduce the pain caused by these contractions. This quasi-experimental study aimed to determine the effect of using a peanut ball in a straddling position on pain levels during the first stage of labor. Before the intervention, most respondents experienced severe pain, whereas after the intervention, most reported a decrease in pain levels. The results showed a p-value of 0.001, which means that the use of a peanut ball in a straddling position is effective in reducing contraction pain during the first stage of labor.</p>

2026-05-15T13:03:29+00:00 Copyright (c) 2026 African Journal of Reproductive Health https://ajrh.info/index.php/ajrh/article/view/7047 2026-05-24T17:13:23+00:00

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Susi W. Asih susi.wahyuning.asih-2023@fkp.unair.ac.id Ah Yusuf susi.wahyuning.asih-2023@fkp.unair.ac.id Sriyono Sriyono susi.wahyuning.asih-2023@fkp.unair.ac.id Supriyadi Supriyadi susi.wahyuning.asih-2023@fkp.unair.ac.id Supriyadi Supriyadi susi.wahyuning.asih-2023@fkp.unair.ac.id Luh T. Handayani susi.wahyuning.asih-2023@fkp.unair.ac.id

Flood disasters frequently affect the Jember region, placing school-age children among vulnerable populations due to limited disaster preparedness. This study examined the effect of peer education–based student empowerment on flood disaster preparedness among students at MTsN 2 Jember. This study used a quasi-experimental design with a one-group pretest–posttest approach. The study population was 320 students, with a sample of 180 students selected through a multistage random sampling technique. Data were collected using structured questionnaires assessing knowledge and attitudes toward flood disaster preparedness. Data were analyzed using the Wilcoxon Signed Rank Test. The results showed a significant increase in students’ knowledge and attitudes after receiving empowerment through the peer education method, with a p-value of 0.000. The simulation-based educational approach provided an active, contextual, and enjoyable learning experience, thereby enhancing students’ preparedness in facing flood disasters. These findings suggest that peer education–based empowerment may be an effective strategy to enhance disaster preparedness among students. Implementation of this approach is recommended, particularly in schools located in disaster-prone areas, as part of disaster risk reduction and health promotion efforts.

2026-05-15T13:03:29+00:00 Copyright (c) 2026 African Journal of Reproductive Health https://ajrh.info/index.php/ajrh/article/view/7048 2026-05-24T17:14:32+00:00

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(mysql): SELECT * FROM authors WHERE submission_id = 7048 ORDER BY seq  

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Yingying Cui p120535@siswa.ukm.edu.my Nur Saadah Mohamad Aun p120535@siswa.ukm.edu.my Mohd Suhaimi Mohamad p120535@siswa.ukm.edu.my Surendran Rajaratnam p120535@siswa.ukm.edu.my

Domestic violence during pregnancy represents a serious public health concern. This study conducted a systematic review of quantitative data to examine its prevalence, factors influencing it, and associated health outcomes in Mainland China. Following PRISMA 2020 guidelines, a meta-analysis of 25 studies was performed using random-effects models, alongside assessments of heterogeneity (I²) and publication bias. The analysis revealed a pooled prevalence of approximately 20%, with psychological violence identified as the most prevalent form. Key contributing factors included socio-economic disadvantage, restricted decision-making autonomy, and risky behaviors by partners. Exposure to domestic violence substantially heightened the likelihood of antenatal depression or anxiety, pregnancy complications, and negative birth outcomes such as low birth weight and preterm delivery. Although some heterogeneity was noted, the associations were consistently observed. These findings highlight the significant prevalence and severe health impacts of domestic violence during pregnancy, emphasizing the urgent need for comprehensive maternal healthcare approaches in China. Such strategies should integrate domestic violence screening, mental health services, and initiatives promoting socio-economic empowerment.

2026-05-15T13:03:29+00:00 Copyright (c) 2026 African Journal of Reproductive Health https://ajrh.info/index.php/ajrh/article/view/7049 2026-05-24T17:15:47+00:00

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Huyun Xu wuzhixi015211@163.com Peiying Li wuzhixi015211@163.com Xuping Li wuzhixi015211@163.com Puqian Li wuzhixi015211@163.com Zhenqin Huang wuzhixi015211@163.com Zhixi Wu wuzhixi015211@163.com

<p>This meta-analysis systematically evaluated the effects of probiotic supplementation on vaginal microbiota and inflammatory factors in women. PubMed, Embase, Web of Science, CNKI, and Wanfang were searched from inception to January 2026 for randomized and controlled studies. Outcomes included vaginal pH, Nugent score, and inflammatory cytokines (IL-4, IL-6, IL-10, TNF-α). Fifteen studies were included. Compared with controls, probiotics did not significantly reduce IL-4, IL-6, IL-10, or TNF-α levels, nor did they significantly improve Nugent score. However, probiotic supplementation significantly reduced vaginal pH (OR = 0.36, 95% CI: 0.15–0.89; P = 0.03), indicating improved maintenance of a weakly acidic vaginal environment. Sensitivity analyses showed generally stable results, although heterogeneity remained substantial for several outcomes. Overall, probiotics appear effective in modulating vaginal acid–base balance but show limited evidence for improving inflammatory cytokine profiles or restoring vaginal microbiota structure. Current data are insufficient to support routine probiotic use for optimizing vaginal microbiota and inflammatory status. Further high-quality, well-designed randomized controlled trials are required to clarify their clinical benefits. </p>

2026-05-15T13:03:29+00:00 Copyright (c) 2026 African Journal of Reproductive Health

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