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Choices and services related to contraception in the Gaza strip, Palestine: perceptions of service users and providers.

ABSTRACT: BACKGROUND:Reliable contraception enables women and men to plan their family sizes and avoid unintended pregnancies, which can cause distress and anxiety, but also increase maternal mortality. This study explored potential barriers to contraceptive use for women in the Gaza Strip, Palestine from user and provider perspectives. METHODS:A convenient sample was used to recruit women, who were current contraception users, from three healthcare clinics that provide family planning care, two governmental and one non-governmental. A 16-item questionnaire was completed by 204 women, including socio-demographic data, contraceptive use and eight questions exploring user experience. Additionally, 51 women attended focus groups for a deeper insight into their contraceptive use experience and potential barriers. Furthermore, 14 healthcare providers were interviewed about their experience with service provision. Quantitative data are presented as means and frequencies and qualitative data were analysed item by item and are presented in themes jointly with the quantitative data. RESULTS:Women reported usage of only three main modern methods of contraception with 35.2% using intrauterine devices, 25.8% combined oral contraception and 16.4% condoms, while only 3.1% used the hormonal implant. Expectations from family planning services were low with most women attending the clinic having already decided their contraceptive method with decisions being made by husbands (41.2%) or women jointly with their partner (33.3%), only 13.7% took advice from service providers. Healthcare providers experienced high prevalence of beliefs that modern contraceptives cause infertility and cancer. Main barriers to effective family planning services were misconceptions of potential harm, poor availability and limited choice of contraceptive methods. CONCLUSION:Women's contraceptive choices in Gaza are limited by prevalent misconceptions and fears as well as recurring shortages, negatively impacting fertility control. Men are a major factor in choosing a contraceptive method, however, they have limited access to information and therefore, potentially more misconceptions. Therefore, male community members need to be included in the delivery of information on contraceptives to increase women's choice. Furthermore, greater access to long-acting reversible contraceptives, such as the hormonal implant, and improved availability might be key factors in improving contraceptive uptake in Gaza and, thus, reducing unintended pregnancies.

SUBMITTER: Bottcher B

PROVIDER: S-EPMC6923918 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Choices and services related to contraception in the Gaza strip, Palestine: perceptions of service users and providers.

Böttcher Bettina B Abu-El-Noor Mysoon M Abu-El-Noor Nasser N

BMC women's health 20191219 1

<h4>Background</h4>Reliable contraception enables women and men to plan their family sizes and avoid unintended pregnancies, which can cause distress and anxiety, but also increase maternal mortality. This study explored potential barriers to contraceptive use for women in the Gaza Strip, Palestine from user and provider perspectives.<h4>Methods</h4>A convenient sample was used to recruit women, who were current contraception users, from three healthcare clinics that provide family planning care ...[more]

PMID: 31856794

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Project description:BACKGROUND:The prevalence of overweight and obesity among women of childbearing age is considered a public health concern. Few studies have been conducted in the Gaza Strip to determine the magnitude of overweight and obesity. This study aimed to determine the prevalence of overweight and obesity along with their associated factors among women in the Gaza Strip. METHODS:A cross-sectional study was conducted to recruit a total of 357 mothers aged 18-50?years. Interviews were carried out among mothers to collect sociodemographic information, nutritional information, and physical activity. Anthropometric measurements [height, weight and waist circumference (WC)] were conducted with the mothers. Body Mass Index (BMI) was computed to determine the prevalence of overweight and obesity. Multinomial logistic regression was used to examine the associated factors of overweight and obesity. RESULTS:The combined prevalence of overweight and obesity among mothers was (64.1%). The results of multinomial logistic regression showed the risk of overweight and obesity increased with age, the highest risk being in mothers aged >?33.0?years (OR?=?2.7, 95% CI: (1.06,6.86)), and (OR?=?5.72, 95% CI: (2.07,15.78)), respectively, compared to mothers aged <?33.0?years. Moreover, mothers with medium and high educational levels had a slightly higher risk of obesity (OR?=?0.31, 95% CI: (0.15,0.64)), and (OR?=?0.32, 95% CI: (0.12,0.82)) respectively than mothers with low educational level. Household income was positively associated with overweight and obesity. Mothers exposed to higher monthly income were more likely to be overweight or obese (OR?=?2.64, 95% CI: (1.20, 5.83)), and (OR?=?3.06, 95% CI: (1.28,7.29)), respectively. Nutrition knowledge was significantly associated with a high prevalence of obesity (OR?=?1.20, 95% CI: (1.03,1.38)). CONCLUSIONS:This study showed a higher prevalence of overweight and obesity among Palestinian women than previous studies. Age, educational level, monthly income, and nutrition knowledge were associated with the prevalence of overweight and obesity, compared to other variables that were not associated with overweight and obesity such as location, work status, physical activity, and sitting hours. Urgent action is needed to tackle overweight and obesity among women. Effective intervention is required to increase nutrition knowledge among women to improve their eating behaviors.

Project description:BackgroundThe COVID-19 pandemic has a great impact on the eating habits, dietary intake, and purchasing behaviours of students. At this critical moment, there is an urgent need to identify the eating habits of school students, in particular, who live in low-income countries, during the lockdown period. Therefore, the present study aims to identify the influence of COVID-19 on the eating habits, quality and quantity of food intake among school students in the Gaza Strip, Palestine.MethodsA cross-sectional study was carried out among 2398 primary and secondary school students aged 6-18 year old through an online questionnaire which included questions on socio-demographic, eating habits as well as quality and quantity of food intake. Students over the age of 11 years completed the questionnaire on their own, whereas for students under the age of 12 years, the students' guardians were instructed to answer the questionnaire on their behalf. A Wilcoxon Signed-Rank and McNemar tests were applied to perform a comparison between general dietary habits before and during COVID-19. Also, a Wilcoxon Signed Rank test was used to compare the median scores of food quality and quantity before and during the COVID-19 pandemic based on student's sociodemographic.ResultsDuring the COVID-19 pandemic, there was a significant increase in eating home-cooked foods (91.6%), avoiding ordering food from outside per week (93.3%) and buying groceries online (7.7%) (p < 0.001). There was a marked increase in the students reporting fear about food hygiene outside the home from 20.8% before COVID-19 to 72.9% during the COVID-19 period (p < 0.001). The results showed that the median score for food quality during the COVID-19 pandemic (11.0/6.0) was significantly higher than the before COVID-19 period (10.0, IQR = 8.0) (p < 0.001). The results revealed that the median score for food quantity before the COVID-19 pandemic (15.0, IQR = 5.0) was significantly higher than the during COVID-19 pandemic (14.0, IQR = 7.0) (p < 0.001). The results showed significant differences between the before and during COVID-19 period for food quality and quantity across socio-demographic variables (gender, age group, parent's highest level of education, monthly household income, and household size). During the COVID-19 pandemic, students from a high-income and a small size family had the highest score in terms of food quality and quantity among other counterparts when compared to other counterparts.ConclusionEating habits have significantly altered among school students during the COVID-19 pandemic. In spite of some good healthy habits enhanced among students, the quantity and the quality of the food was compromised. Therefore, the responsible officials at the Ministry of Education must focus on enhancing school students' awareness towards increased intake of healthy food and adopting good eating habits during the spread of pandemics and health diseases to avoid its negative effects on students.

Project description:IntroductionPhysical activity and energy state balance have fundamentally been related to reproductive system and health. This study explored the relationship between different types, intensities and frequencies of physical activity with primary infertility among women in Gaza Strip, Palestine.MethodsA case-control study was conducted in Gaza Strip with the participation of 320 married couples. 160 infertile couples were chosen from five fertility centers registries from 2016 to 2018 and matched residentially with 160 fertile couples. Cases were selected through systematic stratified sampling of five lists categorized according to residency and the determined percentage selected from each list was proportional. Data were collected through a self-administered questionnaire extended by the short form of international physical activity questionnaire and analyzed through SPSS program version 22 by using descriptive analysis, independent T-test, cross-tabulation, and binary logistic regression.ResultsLow frequency, intensity and duration of physical activity were associated with 3.1 risk of primary infertility (95% CI, 1.60-5.99, P < 0.001). Adjustment for age, marital age, age of menarche, refugee status and monthly income provided 3.2 risk (95% CI, 1.55-6.60, P = 0.002). Women spending more than 300 minutes a day sedentarily were 2.3 times more likely to have fertility problems than physically active females. Measuring energy expenditure in MET-min/w (Metabolic Equivalent) showed vigorous MET-min/w as negatively associated with the infertility status of females (Interquartile range IQR: 480 for cases and 720 for controls, P = 0.010). On the basis of energy expended in kilocalories in relation to weight, results showed the same association (IQR: 564 for case and 864 for controls, P = 0.011). No associations were found between moderate activity levels and primary infertility.ConclusionLow levels of physical activity and sedentary lifestyle endanger the fertility status of females in Gaza Strip. This may offer the need for endorsing and formalizing adequate physical activity education and awareness protocols in the national reproductive health guidelines and empowering environmental capacity building to alter physical activity-related cultural norms.

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Choices and services related to contraception in the Gaza strip, Palestine: perceptions of service users and providers.

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Choices and services related to contraception in the Gaza strip, Palestine: perceptions of service users and providers.

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