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IJERPH
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Addressing Reproductive and Maternal Health Disparities: Identification, Measurement, and Solutions
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Special Issue "Addressing Reproductive and Maternal Health Disparities: Identification, Measurement, and Solutions"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: 29 February 2024 | Viewed by 4860

Special Issue Editors

Dr. Joan Combellick

E-Mail Website
Guest Editor
School of Nursing, Yale University, Orange, CT 0647, USA
Interests: women’s health; high quality maternity care; reproductive health disparities; mental health conditions and reproductive health outcomes; practice-based research; birth and microbiome outcomes; the midwifery model of care
Dr. Bridget Basile Ibrahim

E-Mail Website
Guest Editor
School of Nursing, Yale University, Orange, CT 0647, USA
Interests: maternal health equity; respectful maternity care; high quality maternity care; social determinants of health; physiologic birth

Special Issue Information

Dear Colleagues, 

Global disparities in reproductive and maternal health outcomes are pervasive, whether between and within countries, or across communities. These disparities are stubbornly persistent and follow lines of race and ethnicity, socioeconomic level, immigration and language status, health conditions, and geography. The dire outcomes of sub-populations, such as racialized and other marginalized individuals in high-income countries, are often obscured by reporting that does not disaggregate marginalized groups from the majority population or otherwise face their situation being overly simplified because of a lack of validated instruments to measure structural racism. Entrenched differences, such as those between maternal outcomes in the global North and South, can be overlooked due to complacency about the status quo. Health conditions that are exacerbated by pregnancy but manifest in the late postpartum period, such as mental health conditions leading to suicide, homicide and overdose, may remain unseen and uncounted because they occur beyond standard reporting periods. 

In this Special Issue, we seek to focus on populations who suffer a disproportionate burden of reproductive and maternal morbidity and mortality, but who often remain unseen. We intend to represent the entire reproductive span, as well as broad and long-term maternal health outcomes such as mental health, birth trauma, and health care utilization. We hope to dialog across communities, countries, and regional boundaries to describe new approaches to identifying and measuring the needs of these populations. We especially endeavor to bring forward ‘lessons learned’ from novel interventions. We invite the submission of your current research, review articles, or commentary.

Dr. Joan Combellick
Dr. Bridget Basile Ibrahim
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • health equity
  • maternal mortality
  • maternal morbidity
  • infant mortality
  • racial/ethnic
  • rural
  • disability
  • maternal mental health
  • respectful maternity care
  • reproductive health
  • reproductive health justice

Published Papers (4 papers)

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Research

12 pages, 309 KiB  
Article
The Sociocultural Influences on Breast Cancer Screening among Rural African Women in South Africa
by
Nelisha Sarmah
,
Maureen Nokuthula Sibiya
and
Thandokuhle Emmanuel Khoza
Int. J. Environ. Res. Public Health 2023, 20(21), 7005; https://doi.org/10.3390/ijerph20217005 - 01 Nov 2023
Viewed by 982
Abstract
The incidence of breast cancer in South Africa is increasing, with rural South African women presenting with advanced stages of the disease. A woman’s breasts are a symbol of her womanhood; they also constitute a social definition of her femininity. Women with breast [...] Read more.
The incidence of breast cancer in South Africa is increasing, with rural South African women presenting with advanced stages of the disease. A woman’s breasts are a symbol of her womanhood; they also constitute a social definition of her femininity. Women with breast cancer in rural South Africa are heavily stigmatized and suffer from various sociocultural interpretations of the disease. Breast cancer is frequently interpreted in rural South Africa as a symbol of witchcraft, sin, and punishment, and traditionally, it is treated by offering animal sacrifices, consumption of herbs, and prayer to ancestors. Using care-seeking behaviour theory as the theoretical framework, we intend to explore the sociocultural factors influencing breast cancer screening practices among rural South African women. A qualitative exploratory study was conducted using semi-structured interviews with 22 rural South African women selected by purposive sampling. Thematic analysis was used to analyse the data. The study identified four sociocultural factors influencing women’s practices of breast cancer screening in rural South Africa, including psychological factors, habits, beliefs, and perceptions of healthcare. Women in rural South African communities have deep-rooted traditional beliefs and practices regarding breast cancer. Consequently, this influences women’s preventative health behaviours regarding breast cancer screening. The development of culturally appropriate health education programs involving traditional healers and influential community leaders is essential to increasing the number of women being screened for breast cancer in rural South Africa. Full article
(This article belongs to the Special Issue Addressing Reproductive and Maternal Health Disparities: Identification, Measurement, and Solutions)
13 pages, 321 KiB  
Article
Experiences of Women with Disabilities in Accessing Maternal Healthcare Services: A South African Case Study
by
Doreen Mheta
,
Maureen Nokuthula Sibiya
and
Pauline Busisiwe Nkosi
Int. J. Environ. Res. Public Health 2023, 20(21), 6966; https://doi.org/10.3390/ijerph20216966 - 24 Oct 2023
Viewed by 962
Abstract
Access to maternal healthcare services is a challenge in most low- and middle-income countries. South Africa is one of the countries striving to improve the accessibility of maternal healthcare services. Although South Africa has put some interventions in place to improve the accessibility [...] Read more.
Access to maternal healthcare services is a challenge in most low- and middle-income countries. South Africa is one of the countries striving to improve the accessibility of maternal healthcare services. Although South Africa has put some interventions in place to improve the accessibility of maternal healthcare services, vulnerable women including women with disabilities are still facing numerous challenges when trying to access these services. The aim of this study was to explore the experiences of women with disabilities in the province of KwaZulu-Natal in South Africa in accessing public maternal healthcare services. The objectives of this study were to describe the experiences of women with disabilities in accessing maternal healthcare services during pregnancy, childbirth and post-partum care; explore the inhibitors of access to maternal healthcare services for women with disabilities; and explore the facilitators of access to maternal healthcare services for women with disabilities. Twelve women with disabilities (four with physical impairments, four with hearing impairments and four with visual impairments) were interviewed for this study. Data were transcribed verbatim and analysed utilising the Framework of Assessing Access to Maternal Healthcare Services by Peters et al., 2008. Our study found that narrow passages and information in inaccessible formats were a challenge for women with visual impairments. Women with hearing impairments faced communication difficulties due to the lack of sign language interpreters in most facilities. Moreover, healthcare professionals displayed unfavourable attitudes toward women with hearing impairments, and these women were often overlooked when seeking help. The women with physical impairments encountered inaccessible buildings, narrow passages, small consultation rooms and equipment that is not adjustable, such as beds and scales. Full article
(This article belongs to the Special Issue Addressing Reproductive and Maternal Health Disparities: Identification, Measurement, and Solutions)
14 pages, 1573 KiB  
Article
Preventing Perinatal Depression: Cultural Adaptation of the Mothers and Babies Course in Kenya and Tanzania
by
Huynh-Nhu Le
,
Elena McEwan
,
Maureen Kapiyo
,
Fidelis Muthoni
,
Tobias Opiyo
,
Kantoniony M. Rabemananjara
,
Shannon Senefeld
and
John Hembling
Int. J. Environ. Res. Public Health 2023, 20(19), 6811; https://doi.org/10.3390/ijerph20196811 - 23 Sep 2023
Viewed by 1346
Abstract
Pregnant women and mothers in sub-Saharan Africa are at high risk for perinatal depression, warranting a need to develop culturally tailored interventions to prevent perinatal depression. This paper documents the process of adapting an evidence-based preventive intervention developed in the United States, the [...] Read more.
Pregnant women and mothers in sub-Saharan Africa are at high risk for perinatal depression, warranting a need to develop culturally tailored interventions to prevent perinatal depression. This paper documents the process of adapting an evidence-based preventive intervention developed in the United States, the Mothers and Babies Course (MBC), to fit the contexts of rural pregnant women and mothers of young children in Kenya and Tanzania using the updated Framework for Reporting Adaptations and Modifications-Enhanced (FRAME). Data from informant interviews and field observations from the planning and implementation phases were used to make adaptations and modifications of the MBC for perinatal women through the eight aspects of FRAME. Follow-up field visits and reflection meetings with case managers and intervention participants indicated that the adapted version of the MBC was well accepted, but fidelity was limited due to various implementation barriers. The FRAME provided an optimal structure to outline the key adaptations and modifications of a preventive intervention intended to maximize engagement, delivery, and outcomes for high-risk perinatal women in rural settings. Full article
(This article belongs to the Special Issue Addressing Reproductive and Maternal Health Disparities: Identification, Measurement, and Solutions)
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12 pages, 328 KiB  
Article
Pregnant Women’s Views Regarding Maternity Facility-Based Delivery at Primary Health Care Facilities in the Province of KwaZulu-Natal in South Africa
by
Puseletso Ruth Mlotshwa
and
Maureen Nokuthula Sibiya
Int. J. Environ. Res. Public Health 2023, 20(15), 6535; https://doi.org/10.3390/ijerph20156535 - 06 Aug 2023
Viewed by 1085
Abstract
For women giving birth, every moment of delay in receiving skilled care significantly increases the risks of stillbirth, neonatal and maternal death. More than half of all births in developing countries, including South Africa, take place outside a health facility and without skilled [...] Read more.
For women giving birth, every moment of delay in receiving skilled care significantly increases the risks of stillbirth, neonatal and maternal death. More than half of all births in developing countries, including South Africa, take place outside a health facility and without skilled birth attendants. Therefore, this has made it difficult to achieve the Sustainable Development Goals of global reduction in maternal mortality, which is a key health challenge globally, especially in developing countries and sub-Saharan Africa in particular. The study aimed to explore and describe the views of pregnant women regarding facility-based delivery. Focus group discussions were used to gather information from pregnant women. Information was collected from six groups of pregnant women who had delivered babies at the primary health care facilities in the past 5 years. Results showed several factors associated with the failure to use institutional delivery services, such as the lengthy distance from the health care facility, lack of transport, lack of transport fare, shortages of skilled staff, failure to disclose pregnancy, cultural and religious beliefs, and staff attitudes. Full article
(This article belongs to the Special Issue Addressing Reproductive and Maternal Health Disparities: Identification, Measurement, and Solutions)
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