Mondéjar-Jiménez, José; Vargas-Vargas, Manuel; Mondéjar-Jiménez, Juan-Antonio; Bayot-Mestre, Agustín
Disabled women suffer socio-labour discrimination because of both their gender and their disability. The situation is gradually improving, thanks to the national and supranational organisations, which in the past few decades have made considerable progress in improving the legislation, providing financial resources and encouraging social awareness. Despite this, few studies quantify this double discrimination in order to permit the evaluation of the socio-labour situation of this group of people. This scarcity is even more pronounced for rural areas, where many other factors hinder the integration of disabled women into the labour market and generate some specific problems that the specialist literature seldom addresses. The current work presents the results of a survey on the socio-economic situation of disabled women in a strongly rural area: the Spanish region of Castilla-La Mancha. It stresses the fundamental difficulties of these women in integrating into the labour market and the most urgent political measures needed to help this group.
Fratoe, Frank A.
Because some rural women underutilize their increased schooling while others are disadvantaged by low educational attainment and underdeveloped skills, and in order to help determine policy alternatives to meet rural women's educational needs, the educational attainments and labor force participation of rural white and minority women were studied.…
Rural America, Inc., Washington, DC.
In rural America 34 million culturally and economically diverse women share the common problem of unfair treatment based on sex. Although in recent years women have begun to question the social attitudes limiting their aspirations, a formidable gap exists between their expectations and the archaic legal, social, and economic policies that continue…
The integration of women in rural development means something more than mere labor involvement, but there has never been a clear definition of what it means. 4 principal concerns of policy-makers are briefly described as they affect women: unemployment and inadequate employment; 2) the satisfaction of basic needs and women's participation in decision-making; 3) population issues; and 4) rural-to-urban migration. The actual inter-household and inter-personal distribution of more work and higher productivity work could result in some hard-working people working even longer hours because of additional tasks with others losing their intermittent employment opportunities due to mechanization. These contradictions can be particularly acute for women. The non-material basic need of decision-making powers is more important in the case of women than of men, yet the personal status of women is being threatened by the institution-building that accompanies peasant-based agricultural intensification plans and anti-poverty programs. The education of females has been seen as a possible factor favoring family planning. In addition, education for women can mean access to public information and new expectations from life for themselves. At this time more women than men seem to be migrating to towns and cities in a number of countries with varied economic structures. 3 cases studies of agricultural development in Kenya, Bangladesh and Java, Indonesia are presented.
Crosato, Kay E; Leipert, Beverly
Informal caregiving within rural contexts in Canada is increasing. This is due in part to a number of factors related to the restructuring of the Canadian health care system, the regionalization of services to urban locations, the increased population of people 65 years and older, and the desire of this population to age within their rural homes. Most often, the informal caregiving role is assumed by rural women. Women tend to fall into the role of informal caregiver to elders because of the many societal and gender expectations and values that are present within the rural culture. The purpose of this literature review is to identify the context in which women provide care for an elder in rural Canada. Illustrating these issues will help to uncover challenges and barriers rural women face when providing care and highlight recommendations and implications for rural women caregivers and nurses employed within rural settings. Many rural women share similar caregiving experiences as urban informal caregivers, but rural women are faced with additional challenges in providing quality care for an elder. Rural women caregivers are faced with such issues as limited access to adequate and appropriate healthcare services, culturally incongruent health care, geographical distance from regionalized centers and health services, transportation challenges, and social/geographical isolation. In addition to these issues, many rural women are faced with the multiple role demands that attend being a wife, mother, caregiver and employee. The pile up of these factors leaves rural women caregivers susceptible to additional stresses and burn out, with limited resources on which to depend. Through reviewing pertinent literature, appropriate implications and recommendations can be made that may assist rural women caregivers and rural nurses. Nurses working within rural communities are in ideal settings to work collaboratively in building supportive relationships with rural women in order to
70-90% of Africans still live in rural areas, and 25-30% of rural households are headed by women. Standards of living in rural areas are lower than in urban areas. Rural African women's involvement in development is in its initial stages, and social development for women is likely to be slow. Increasing women's opportunities for education is a means of promoting social justice and fairness. Schools should offer courses of practical value for those not planning on higher education and special programs and career counseling for gifted girls. Women's organizations, African leaders, and other influential parties should aggressively create awareness about the oppressive aspects of traditional attitudes, beliefs, and views about women. Laws on ownership of property, inheritance, access to credit, and employment must be equitable and enforced. Consciousness-raising among rural women is an effective means of encouraging rural women to seek and assume new roles and for questioning unreasonable expectations and norms. Women's professional associations serve important functions and fulfill the need for role models. The quality of rural women's life is effectively improved through formulation of policies relevant to women's needs and problems and improve rural conditions. Women should have fair representation at local and national levels of government. Women's role in agriculture is likely to be enhanced through improved transportation systems, electricity supply, and introduction of intermediate technology. This assessment of rural African women's contributions to economic growth emphasizes women's involvement in farming and the informal sector and their lack of equal remuneration or low wages. Illiteracy places women in a disadvantaged position when competing for employment in the formal sector. Lack of access to credit and limits on credit are other obstacles in the informal sector. The reduced participation of rural women in the formal and informal sector is due to lack of
Center for Rural Pennsylvania, Harrisburg.
Pennsylvania has the largest rural population in the nation, and more than 50 percent of this population is female. Overall, Pennsylvania's rural women are doing well in education, family life stability, and health, relative to comparison groups of rural men and urban women and men. Educational attainment is greater among urban women and men, but…
Arrowsmith, Heather E.; Cole, Henry P.; Mazur, Joan M.
Objective: A Spanish language version of an exercise about adolescent horseback riders' exposure to traumatic brain injuries was integrated into the Spanish curriculum in a rural Kentucky high school. Design: An exploratory case study design with two groups of students. Setting and Method: Thirty-eight students, enrolled in intermediate Spanish IV…
34. View of the Women's lounge (Spanish room) looking northwest. A Mural by Merlin Hardy depicts a "Spanish dance theme in a 19th century setting." (removed 1997) - Fort Ord, Soldiers' Club, California State Highway 1 near Eighth Street, Seaside, Monterey County, CA
This article is about the lives of nineteenth-century Spanish deaf girls and women. The research presented is contained in a larger work, a book titled "Portraits from the Spanish National Deaf-Mute School," to be published by Gallaudet University Press. These "portraits" are in fact biographical essays on nineteenth-century…
This paper examines the gender order that operates in rural areas of Australia, ensuring that women are accorded secondary status, that their contributions are discounted, and that their concerns are trivialized. Women are disadvantaged by patriarchal gender relations that dominate rural society and that are reinforced by ideologies of family and…
Although women are a crucial element in national rural development, their role continues to be neglected in plans and programs for change--especially in Third World countries. In addition to the burden faced by rural people generally in developing countries, women carry a double burden because of their low social status, high illiteracy rate, lack…
Freixas, Anna; Luque, Barbara; Reina, Amalia
Our research has been aimed at understanding the experience, practice, and sexual life in a group of Spanish women over 50 years of age. We studied a sample of 729 women between 50 and 80 years old. Our results provide qualitative and quantitative information and important insights about the sexual life of Spanish women and identify differences in the experience and reality of sexual life after the age of 70. The status of having or lacking a partner, and a personal interest in emotional relationships and sexual practices, are elements that determine the possibility of enjoying a satisfying postmenopausal sexuality.
The Country Women's Association (CWA) is a nationwide Australian group that started in the 1920s in response to isolated women's need to socialize. The group's activities have expanded greatly over time. It distributes essential food and clothing to needy rural families, and its extensive involvement in incidental education for women includes…
The author points out the multifaceted aspects of the problems associated with rural women's need for money and financial services and outlines innovative schemes in this area such as the bank for the landless in Bangladesh, a savings and loan cooperative for market women in Nicaragua, and a savings development movement in Zimbabwe. (CT)
Colle, Royal D.; Fernandez de Colle, Susana
Although not often considered in the past by planners because their economic contributions are not performed for money, rural women are contributors to the development of their countries. The urgency of reaching women with important information to break the cycle of poverty is now being recognized by the major development agencies. While there are…
Vaughn, Jennie; Harrell, Allen; Dayton, Amy E.
This qualitative study looks at how rural women in the American South have obtained access to digital technologies for reading and writing. Using the "life history" approach (Brandt; Hawisher and Selfe), we interviewed five women. We look at the challenges caused by the Digital Divide, at economies of access, including the financial…
Varela Moreiras, Gregorio
Women have proved vulnerable with regard to their nutritional status at all stages of life and in a variety of physiological situations. In response to the need for more up-to-date and accurate information about the determinants of nutritional status and the quantification of diet specifically, the ANIBES (Anthropometry, Intake and Energy Balance in Spain) study was carried out among a representative group of Spaniards aged 9 to 75. To describe and evaluate some of the results available on energy intake and food sources from the ANIBES Study related to Spanish women. Using a representative sample (n = 2009, 996 women/1013 men) of the Spanish population (9-75 years old), the following studies were conducted: anthropometry, diet (using new technology--tablet computers), physical activity (using accelerometry and a validated questionnaire), and perceptions regarding different aspects related to food, nutrition, physical activity and energy balance. Energy intake was 1660 ± 426.7 kcal/d, significantly lower than among males. When analysed by age group, only girls (9-12 years old) and adolescents (13-17 years old) meet the recent recommendations established by the European Food Safety Authority (EFSA). In particular, the average energy intake among older women (65-75 years old), 1476 ± 359.9 kcal/d, is problematic with regard to adequate nutritional density. The caloric profile is unbalanced (17% E from protein; 41.2% from carbohydrates; 38.7% from lipids) for all age groups. The main source of energy comes from grains and their derivatives (27%), meat products and their derivatives (14.1%), oils and fats (13.1%) and milk and its derivatives (12.4%). The results are presented in tables and charts in accordance with their potential repercussions for the nutritional quality of the Spanish female diet to day, and compared with other Spanish and European studies. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Ugbomeh, George M. M.
Discusses the concepts of agricultural education, women empowerment, and sustainable rural development. Suggests that, because women make up more than half of Nigeria's population, their empowerment would assist the efforts for sustainable rural development. (Contains 48 references.) (JOW)
Cornellana, M J; Harvey, X; Carballo, A; Khartchenko, E; Llaneza, P; Palacios, S; Mendoza, N
One of the most common complaints among postmenopausal women is a change in sexual drive. The aim of this study was to assess the current state of sexual health in Spanish postmenopausal women who present at outpatient gynecology clinics. In this multicenter, observational, cross-sectional, questionnaire-based study, a survey was conducted that included 3026 Spanish postmenopausal women in a routine clinical setting in outpatient gynecology clinics at public and private institutions throughout Spain. We used the Women's Sexual Function questionnaire, which has been validated in Spain. In the multivariate analysis, we found that the best indicators of sexual health in postmenopausal women were a higher education (p < 0.001), working or previously worked (p < 0.001), a stable partner (p < 0.001), living in an urban area (p < 0.01), healthy habits and received information about menopause (p < 0.001). These results indicate that it is important to provide health education and information about menopause and the complaints associated with this period in a woman's life.
This study describes the status of 34 million rural women and analyzes how they and their families will be directly affected by cuts in the 1983 federal budget in the areas of legal services, vocational education, domestic violence intervention, energy assistance and alternative energy development, public housing, unemployment compensation, social…
Lichtman, Marilyn; Rothschild, Susan J. S.
Data drawn from the National Longitudinal Study of the High School Class of 1972 and follow-up surveys through 1979 were used to explore career and educational patterns of two groups of women: those who received their high school education in rural areas and remained, and those who left for larger communities. Over 40% of the sample were…
Matthews, Hollie L.; Laya, Mary; DeWitt, Dawn E.
Context: Little is known about rural women's knowledge about osteoporosis. Purpose: To explore what women from high-prevalence rural communities know about osteoporosis and to assess their learning preferences. Methods: We surveyed 437 women in rural Washington and Oregon. Findings: The response rate was 93% (N = 406). The mean age of respondents…
Gjesfjeld, Christopher D.; Weaver, Addie; Schommer, Kathryn
Social support protects women from various negative consequences, yet we have little understanding of how rural women acquire and utilize social support. Using interviews of 24 women in a North Dakota community, this research sought to understand how rural women were supported as new mothers. One, familial women and partners were vital supports to…
Martínez Pérez, José Antonio; Palacios, Santiago; García, Felipe Chavida; Pérez, Maite
(1) To assess the prevalence of osteoporosis risk factors in Spanish menopausal women; (2) to detect medical and lifestyle risk factor differences between perimenopausal and postmenopausal women; (3) and to identify the main factors responsible for osteoporosis. Cross-sectional descriptive study encompassing women aged 45-65 across Spain. The study population sample was collected through random sampling and a total of 10,514 women were included. Socio-demographic, medical history, and lifestyle data were assessed. The prevalence of osteoporosis risk factors was 67.6%. The most common risk factors were physical inactivity (53.6%), use of medication related to osteoporosis risk (45.9%), and low calcium intake (30.1%). There were statistically significant differences between peri- and postmenopausal women in terms of smoking status, alcohol intake, personal history, poor dairy product intake, and medication use that could increase risk. Logistic regression analysis showed that osteoporosis was significantly associated with age, family history, age at onset of menopause, Kupperman Index, prolonged immobilization, weight loss, and other diseases that increase the probability of developing osteoporosis. A high prevalence of women taking osteoporosis risk-related medication was observed in our study. There was correlation between the menopausal symptoms' degree of severity and the risk of suffering from osteoporosis.
Tudiver, Fred; Edwards, Joellen Beckett; Pfortmiller, Deborah T.
Context: Rates and types of screening for depression in rural primary care practices are unknown. Purpose: To identify rates of depression screening among rural women in a sample of rural health clinics (RHCs). Methods: A chart review of 759 women's charts in 19 randomly selected RHCs across the nation. Data were collected from charts of female…
Rural American Women, Inc., Washington, DC.
At the White House Consultation with Rural Women held in June 1980, over 250 women from all walks of rural life and from 12 other nations responded to the Carter Administration's rural policy on small farms, health, employment, communications, education, housing, food, agriculture, and land and energy issues and made recommendations for action for…
Baena-Cañada, José M; Rosado-Varela, Petra; Expósito-Álvarez, Inmaculada; González-Guerrero, Macarena; Nieto-Vera, Juan; Benítez-Rodríguez, Encarnación
Participants in breast cancer screening programmes may benefit from early detection but may also be exposed to the risks of overdiagnosis and false positives. We surveyed a sample of Spanish women to assess knowledge, information sources, attitudes and psychosocial impact. A total of 434 breast cancer screening programme participants aged 45-69 years were administered questionnaires regarding knowledge, information sources, attitudes and psychosocial impact. Scores of 5 or more (out of 10) and 12 or less (out of 24) were established as indicating adequate knowledge and a positive attitude, respectively. Psychosocial impact was measured using the Hospital Anxiety and Depression Scale and the Cancer Worry Scale. Only 42 women (9.7%) had adequate knowledge. The mean (SD) knowledge score was 2.97 (1.16). Better educated women and women without previous false positives had higher scores. The main sources of information were television, press, Andalusian Health Service documentation and family and friends. Most participants (99.1%) had a positive attitude, with a mean (SD) score of 3.21 (2.66). Mean (SD) scores for anxiety, depression and cancer worry were 1.86 (3.26), 0.72 (1.99) and 9.4 (3.04), respectively. Women have a very positive attitude to breast cancer screening, but are poorly informed and use television as their main information source. They experience no negative psychosocial impact from participation in such programmes. Copyright © 2014 Elsevier Ltd. All rights reserved.
Aparicio, Virginia A; Ortega, Francisco B; Heredia, José M; Carbonell-Baeza, Ana; Delgado-Fernández, Manuel
To describe the anthropometric profile and body composition of women from Southern Spain diagnosed with fibromyalgia (FM) and to compare the observed values with values from other studies conducted on FM patients and with national reference values. The body composition of 104 women diagnosed with FM was assessed using an eight-electrode impedance meter. The reliability of the body composition measurement was tested in a randomly selected sub-sample (n=28). The reliability study showed a test-retest systematic error close to zero in most of the parameters studied. The women with FM who were studied had a mean weight of 71.3±13.4 kg, height of 158±6 cm, body mass index of 28.6±5.1 kg/m(2), body fat mass of 38.6±7.6%, total body water of 31.6±3.8 l and muscle mass of 23.4±3.0 kg. In general, there were no substantial differences in weight and body mass index between women with FM and those analyzed in other Spanish and European studies involving FM patients, nor when they were compared with regional or national reference values. However, the prevalence of obesity in the women with FM under study was 33.7%, a higher figure than that from the national reference data for obesity in similarly aged women (i.e. 26,4%). The results suggest that obesity is a common condition in women diagnosed with FM, its prevalence in this population being higher than the national reference values. This study provides detailed information about the body composition characteristics of women with FM. Copyright © 2010 Elsevier España, S.L. All rights reserved.
Flecha Garcia, C
This study looks at the topic of women's education as considered by the first two women to receive the degree of Doctor in Medicine from a Spanish university. Delores Aleu and Martina Castells decided to present as a doctoral thesis the development of an issue of particular relevance during the final decades of the 19th century. The importance given to public education and the difficulties young women encountered in participating under the same conditions as young men led these two women--who both held a bachelor's degree--to raise the issue and defend personal and social reasons that justified their full participation in different levels of education.
Rajuladevi, A K
The assessment of poor women in India as dependent and exploited regardless of poverty focused strategies is reflected in this review of relevant literature. The scholarly approaches to the problems of poor women involve redirection and expansion of resources to women (increase bank credit) through policy and institutional changes, and involve improving women's welfare through changes in class and gender hierarchies; both pertain to restructuring power groups. A little ascribed to belief is that the organization of women's numbers will empower women; the constraints are stated. There is also some argument over whether to design women-specific programs or integrate women into existing programs; some examples are given of successes and difficulties. The regionalization of poverty in eastern and central India is discussed. The growth of the poor has been among the landless, wage-dependent households. 9.6% of households (7.5 million) are headed by women. Women work fewer hours and at lower wage scales and have fewer employment opportunities. Lower earnings are coupled with differentials in demand for female and male labor in agriculture and a crowded labor market. There is a concentration of women in less visible, nonmonetary subsistence production and domestic work. Women are undercounted in employment studies. Women predominate in agricultural activity. Women's status is influenced by economic status, caste, and ethnic background. Domestic work increases status for women and households. The poorer households have greater labor force participation, particularly as wage laborers rather than unpaid family workers. Regional factors affecting rural household strategies are factors affecting the economy (topography, rainfall, climate) and the degree of development, plus sociocultural variables (kinship and religious beliefs which affect the social domain of women), and the degree of dependence on hired vs. family labor. There are sharp contrasts in the value and survival
Morrison, J; Colbourn, T; Budhathoki, B; Sen, A; Adhikari, D; Bamjan, J; Pathak, S; Basnet, A; Trani, J F; Costello, A; Manandhar, D; Groce, N
There is strong evidence that participatory approaches to health and participatory women's groups hold great potential to improve the health of women and children in resource poor settings. It is important to consider if interventions are reaching the most marginalized, and therefore we examined disabled women's participation in women's groups and other community groups in rural Nepal. People with disabilities constitute 15% of the world's population and face high levels of poverty, stigma, social marginalization and unequal access to health resources, and therefore their access to women's groups is particularly important. We used a mixed methods approach to describe attendance in groups among disabled and non-disabled women, considering different types and severities of disability. We found no significant differences in the percentage of women that had ever attended at least one of our women's groups, between non-disabled and disabled women. This was true for women with all severities and types of disability, except physically disabled women who were slightly less likely to have attended. Barriers such as poverty, lack of family support, lack of self-confidence and attendance in many groups prevented women from attending groups. Our findings are particularly significant because disabled people's participation in broader community groups, not focused on disability, has been little studied. We conclude that women's groups are an important way to reach disabled women in resource poor communities. We recommend that disabled persons organizations help to increase awareness of disability issues among organizations running community groups to further increase their effectiveness in reaching disabled women. © The Author 2015. Published by Oxford University Press.
Colbourn, T.; Budhathoki, B.; Sen, A.; Adhikari, D.; Bamjan, J.; Pathak, S.; Basnet, A.; Trani, J. F.; Costello, A.; Manandhar, D.; Groce, N.
Abstract There is strong evidence that participatory approaches to health and participatory women's groups hold great potential to improve the health of women and children in resource poor settings. It is important to consider if interventions are reaching the most marginalized, and therefore we examined disabled women's participation in women's groups and other community groups in rural Nepal. People with disabilities constitute 15% of the world's population and face high levels of poverty, stigma, social marginalization and unequal access to health resources, and therefore their access to women's groups is particularly important. We used a mixed methods approach to describe attendance in groups among disabled and non-disabled women, considering different types and severities of disability. We found no significant differences in the percentage of women that had ever attended at least one of our women's groups, between non-disabled and disabled women. This was true for women with all severities and types of disability, except physically disabled women who were slightly less likely to have attended. Barriers such as poverty, lack of family support, lack of self-confidence and attendance in many groups prevented women from attending groups. Our findings are particularly significant because disabled people's participation in broader community groups, not focused on disability, has been little studied. We conclude that women's groups are an important way to reach disabled women in resource poor communities. We recommend that disabled persons organizations help to increase awareness of disability issues among organizations running community groups to further increase their effectiveness in reaching disabled women. PMID:26519006
Deere, C D; León de Leal, M
On the basis of experience gained in researching the economic roles of rural women in a national level study in Colombia and in a regional level study in Peru, some of the methodological problems of measuring rural women's economic participation by sample survey are considered. The specific objective of the sample surveys was to quantify the existing sexual division of labor among the peasant population. The rural household was the unit of analysis, and the focus of measurement was the division of labor by sex in such activities as daily maintenance, household production, and income-generating activitives pursued outside the household. The focus of the survey questionnaire is on the sexual division of labor, but it necessarily must be related to another series of socioeconomic or cultural variables for analysis. The selection of these variables needs to be derived from the hypotheses guiding the study, yet much attention must be given to narrowing the range of inquiry. The time constraint on the length of the questionnaire requires that certain choices be made in terms of the complementary variables to be included. The most important problem in the design of a representative sample survey is the selection of the population to be sampled. The choice of population needs to be compatible with the theoretical framework. Since the interest was to measure the sexual division of labor in terms of class formation, the sample had to be representative of the different class strata in the rural areas. The measurement of access to means of production ideally should be quantitative and qualitative. The choice of the population to be sampled is also constrained by the available data base, a particular problem in rural areas.
Frossard, Frédérique; Trifonova, Anna; Barajas Frutos, Mario
The isolation of rural communities creates special necessities for teachers and students in rural schools. The present article describes "Rural Virtual School", a Virtual Community of Practice (VCoP) in which Spanish teachers of rural schools share learning resources and teaching methodologies through social software applications. The article arrives to an evolutionary model, in which the use of the social software tools evolves together with the needs and the activities of the VCoP through the different stages of its lifetime. Currently, the community has reached a high level of maturity and, in order to keep its momentum, the members intentionally use appropriate technologies specially designed to enhance rich innovative educational approaches, through which they collaboratively generate creative practices.
Moore-West, Maggi; Lucero, Susan
Personality and a social support system are two factors that may influence women medical students' choice of a rural primary care specialty. The 2-year study of 11 University of New Mexico School of Medicine women students engaged in 4-month rural primary care preceptorships included interviews and a personality inventory. Three women had…
Sinharoy, Sheela S; Waid, Jillian L; Haardörfer, Regine; Wendt, Amanda; Gabrysch, Sabine; Yount, Kathryn M
The relationship between women's empowerment and women's nutrition is understudied. We aimed to elucidate this relationship by quantifying possible pathways between empowerment and dietary diversity among women in rural Bangladesh. In 2015, we conducted a cross-sectional survey of 2,599 married women ages 15-40 (median: 25) living in 96 settlements of Habiganj District, Bangladesh, as a baseline for the Food and Agricultural Approaches to Reducing Malnutrition trial. We collected data on women's empowerment (highest completed grade of schooling and agency), dietary diversity, and demographic factors, including household wealth. We used exploratory factor analysis and confirmatory factor analysis on random split-half samples, followed by structural equation modelling, to test pathways from schooling, through domains of women's agency, to dietary diversity. Factor analysis revealed 3 latent domains of women's agency: social solidarity, decision-making, and voice with husband. In the adjusted mediation model, having any postprimary schooling was positively associated with voice with husband (β 41 = .051, p = .010), which was positively associated with dietary diversity (β 54 = .39, p = .002). Schooling also had a direct positive association with women's dietary diversity (β 51 = .22, p < .001). Neither women's social solidarity nor decision-making mediated the relationship between schooling and dietary diversity. The link between schooling and dietary diversity was direct and indirect, through women's voice with husband but not through women's social solidarity or decision-making. In this population, women with postprimary schooling seem to be better able to negotiate improved diets for themselves. © 2017 John Wiley & Sons Ltd.
Reviews problems facing rural women and minorities, the special educational needs of these populations, and strains on resources of rural community colleges. Provides a context for improving educational services, suggesting that rural colleges emphasize collaboration and coalition building with constituencies in their service areas. (20 citations)…
Jimenez, T.; Olson, K.
Esta es la primera de una serie de guias de aplicaciones que el Programa de Energia de Villas de NREL esta comisionando para acoplar sistemas comerciales renovables con aplicaciones rurales, incluyendo agua, escuelas rurales y micro empresas. La guia esta complementada por las actividades de desarrollo del Programa de Energia de Villas de NREL, proyectos pilotos internacionales y programas de visitas profesionales.
Ely, Andrea C.; Befort, Christie; Banitt, Angela; Gibson, Cheryl; Sullivan, Debra
Objective: To explore weight control beliefs, attitudes, knowledge, and practices among rural Kansas women, and to characterize the relationship of these women with their primary-care providers around weight control. Design: Qualitative research using focus groups. Setting: Three separate communities of rural Kansas. Participants: Six focus groups…
This presentation examines the history of women teachers in the rural United States. The earliest classrooms in America were a male environment modeled after European schools. But in the mid-19th century, the Civil War and westward expansion depleted the number of male teachers and brought rural women teachers to the helm of American education.…
Lope, Virginia; García-Pérez, Javier; Pérez-Gómez, Beatriz; Pedraza-Flechas, Ana María; Alguacil, Juan; González-Galarzo, Mª Carmen; Alba, Miguel Angel; van der Haar, Rudolf; Cortés-Barragán, Rosa Ana; Pedraz-Pingarrón, Carmen; Moreo, Pilar; Santamariña, Carmen; Ederra, María; Vidal, Carmen; Salas-Trejo, Dolores; Sánchez-Contador, Carmen; Llobet, Rafael; Pollán, Marina
The association between occupational exposures and mammographic density (MD), a marker of breast cancer risk, has not been previously explored. Our objective was to investigate the influence of occupational exposure to chemical, physical and microbiological agents on MD in adult women. This is a population-based cross-sectional study based on 1476 female workers aged 45-65 years from seven Spanish breast cancer screening programmes. Occupational history was surveyed by trained staff. Exposure to occupational agents was assessed using the Spanish job-exposure matrix MatEmESp. Percentage of MD was measured by two radiologists using a semiautomatic computer tool. The association was estimated using mixed log-linear regression models adjusting for age, education, body mass index, menopausal status, parity, smoking, alcohol intake, type of mammography, family history of breast cancer and hormonal therapy use, and including screening centre and professional reader as random effects terms. Although no association was found with most of the agents, women occupationally exposed to perchloroethylene (e β =1.51; 95% CI 1.04 to 2.19), ionising radiation (e β =1.23; 95% CI 0.99 to 1.52) and mould spores (e β =1.44; 95% CI 1.01 to 2.04) tended to have higher MD. The percentage of density increased 12% for every 5 years exposure to perchloroethylene or mould spores, 11% for every 5 years exposure to aliphatic/alicyclic hydrocarbon solvents and 3% for each 5 years exposure to ionising radiation. Exposure to perchloroethylene, ionising radiation, mould spores or aliphatic/alicyclic hydrocarbon solvents in occupational settings could be associated with higher MD. Further studies are needed to clarify the accuracy and the reasons for these findings. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Zimmermann, Kristine; Khare, Manorama M.; Huber, Rachel; Moehring, Patricia A.; Koch, Abby; Geller, Stacie E.
Background: Cardiovascular disease is the leading cause of death in women in the United States. Rural women have an increased risk of cardiovascular disease due to both behavioral and environmental factors. Models of prevention that are tailored to community needs and build on existing resources are essential for effective outreach to rural women.…
Crosby, Richard A.; Casey, Baretta R.; Vanderpool, Robin; Collins, Tom; Moore, Gregory R.
Purpose: To contrast rates of initial HPV vaccine uptake, offered at no cost, between a rural clinic, a rural community college, and an urban college clinic and to identify rural versus urban differences in uptake of free booster doses. Methods: Young rural women attending rural clinics (n = 246), young women attending a rural community college (n…
Date-bah, E; Stevens, Y
The attempt is made in this discussion to highlight some of the important sociological and technical issues relating to rural women in Africa and technological change which appear to have been underplayed, misconceived or overlooked in the past. Attention is directed to the rural woman as a member of the family unit, the image of the rural man, rural women as a diversified group, community and national governmental commitment to rural technology innovations, the use of already existing traditional groups and institutions to effect rural technological change, and design specifications and shortcomings of equipment and tools (manufacturing costs, exploitation of locally available energy resources, the simplicity of the devices), and infrastructural and marketing problems. Numberous projects aimed at improving the lot of women in the rural areas have focused only on women, rather than the woman as a member of an extended as well as a nuclear family unit. Consequently, they have failed, for rural women do not exist or operate in isolation. It is difficult to believe the overall image in much of the literature that the husbands of rural women show no sympathy or regard for their wives. In the effort to attract investment to improve upon the position of rural women, reality should not be distorted with this one-sided view. Men should be involved in the technology planned for rural women, and the technological change should be planned and implemented in such a way that it results in an improvement in the relationship between the rural couple and generally between members of the rural family and between males and females in the village. Another problem is overgeneralization, and it must be recognized that considerable differentiation exists between rural women themselves. The importance of community, governmental and political commitment to rural technology innovations in order to ensure their success is neglected in the literature. The government and polictical leadership
Nagarajan, P.; Jiji, G. Wiselin
This paper is intended as a gender issue to the rural finance practitioners. It highlights the questions that need to be asked and addressed to the gender mainstream. It will also be useful to gender experts to wish to increase their understanding on specific gender issues in rural finance through mobile services. It focuses on rural microfinance…
Chikani, Vatsal; Reding, Douglas; Gunderson, Paul; McCarty, Catherine A
To compare psychological stress, quality of marital life, and disruptive homelife due to work among rural women of central Wisconsin who take vacations frequently and those who do not. Women were recruited from 1996 to 2001 for a prospective cohort study from the Marshfield Epidemiologic Study area, a geographic area in central Wisconsin. Stratified sampling was used to select a random sample of 1500 farm and non-farm resident women. The odds of depression and tension were higher among women who took vacations only once in 2 years (Depression: OR=1.92, 95% CI=1.2,3.0; Tension: OR=1.7, 95%CI=1.2, 2.3) or once in 6 years (Depression: OR=1.97, 95% CI=1.2, 3.2; Tension: OR=1.9, 95% CI=1.3,2.8) compared to women who took vacations twice or more per year. The odds of marital satisfaction decreased as the frequency of vacations decreased. Women who take vacations frequently are less likely to become tense, depressed, or tired, and are more satisfied with their marriage. These personal psychological benefits that lead to increased quality of life may also lead to improved work performance.
Suicides by young females in rural China contribute substantially to the high rate of suicide and the total number of suicides in China. Given the traditional familial structure that remains largely intact in rural China, this research focuses on whether being married is a risk or protective factor for suicide by young women. I examined 168 rural…
Iglesias, Carlos; Banker, Manish; Mahajan, Nalini; Herrero, Leyre; Meseguer, Marcos; Garcia-Velasco, Juan A
To investigate differences in ovarian reserve markers (antimüllerian hormone [AMH] and antral follicle count [AFC]) in Indian and Spanish women. Cross-sectional study. In vitro fertilization (IVF) clinics. Infertile Spanish (n=229) and Indian (n=236) women who underwent controlled ovarian stimulation for IVF from January to October 2012. None. Data on ovarian reserve markers and results after ovarian stimulation were collected. The mean age of women undergoing their first or second IVF cycle was significantly higher in Spanish than in Indian women (37.5±3.3 years vs. 31.5±3.8 years). Despite this 6-year age gap, AFCs were similar (9.5±4.7 vs. 9.9±4.6), as were day 3 FSH levels (7.5±4.5 IU/L vs. 6.9±2.3 IU/L). AMH levels were slightly lower in Spanish women (1.6±1.7 ng/mL vs. 2.5±1.6 ng/mL). Multivariate regression analysis showed that being Indian decreased AFC by 2.3, such that AFC in Indian women was similar to that in Spanish women 6.3 years older (95% confidence interval 3.39-1.10). Similar ovarian reserve markers and ovarian response were observed in women with a 6-year age difference in favor of the Spanish, suggesting ethnic differences in ovarian aging. Further research is needed to understand whether these differences are genetically induced or are caused by other variables, such as nutrition. Our results may help clinicians to counsel infertile women when discussing assisted reproductive technology outcomes according to age and ethnic background. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Association of American Colleges, Washington, DC. Project on the Status and Education of Women.
Educators are increasingly seeking information about minority women as they attempt to develop realistic, viable programs to benefit them. This paper summarizes some of the relevant data concerning the educational and economic status of Spanish speaking women. Whenever possible, ethnic variations are noted. In general, the data are divided into…
Basher, M S; Kabir, S; Ahmed, S; Miah, M A; Kamal, M S
The expected outcome of pregnancy is a healthy mother with a healthy child. The single most important care which could prevent the negative outcomes of pregnancy is Antenatal Care (ANC). Proper and timely antenatal care can significantly reduce the risks of maternal mortality. In pregnancy, total cost is about 80,000 Kcal, and above normal energy requirements. To find out prenatal nutrition an exploratory study was carried out in seven villages of the Ward-2 of Jamtoil Union of Kamarkhand Upazila under Sirajganj District. Thirty pregnant women of different trimesters, gravida and parity had been studied employing the methods and techniques of "Ethnographic Field Work." Mean daily calorie consumption of the Key Informants (KIs) was 1480.49 Kcal without reference to their religious affiliation, family resource base, education, occupation, gravidity, parity and duration of pregnancy. This is indicated that the mean calorie intake of the Key Informants did not meet not only their prenatal nutritional need but also their requirement during pre-pregnancy period. It was observed that food intake was in no way different from that of the non-pregnant status. Antenatal care of rural inhabitants analyzed almost exclusively from biomedical perspectives, its cultural, socio-economic, gender, ecological and other relevant perspectives are mostly ignored. In order to have safe motherhood up through compliance of prenatal advice, nutritional one in particular, these factors should be taken into consideration.
Employment Standards Administration (DOL), Washington, DC. Women's Bureau.
March 1971 data are given for women of Spanish origin in the United States. Country of origin, population, family composition, educational attainment, labor force participation, type of work, income, and low income level are covered. Where separate data for women are not available, data for both sexes are shown. (KM)
Navarro, Raúl; Serna, Cristina; Martínez, Verónica; Ruiz-Oliva, Roberto
Cyberbullying victimization research on individual and familial correlates is scarce in Spain. By building upon previous studies, this research examines the role of Internet usage and parental mediation in online victimization. Spanish children from rural public schools (10-12 years; n?=?1068) completed a self-report questionnaire which measured…
Wendt, Sarah; Hornosty, Jennie
Research on family violence in rural communities in Australia and Canada has shown that women's experience of family violence is shaped by social and cultural factors. Concern for economic security and inheritance for children, closeness and belonging, and values of family unity and traditional gender roles are factors in rural communities that…
RESPIRATORY HEALTH OF RURAL AND FARM WOMEN IN THE KEOKUK COUNTY RURAL HEALTH STUDY
Allison L. Naleway*, Nancy L. Sprince?, Erik R. Svendsen?, Ann M. Stromquist?, James A. Merchant?
*Marshfield Medical Research and Education Foundation, Marshfield, WI; ?University of Iowa Co...
Champion, Jane Dimmitt; Kelly, Pat
Studies of adolescent risk and protective behaviors have focused on identifying modifiable psychosocial variables that predict differential outcomes for subsequent intervention efforts. Research has been scarce in studies of rural minority adolescent women. This study examined the protective and risk behaviors of these women and their relationship to physical or sexual abuse. Rural minority adolescent women endured high levels of psychological distress and many high risk behaviors, yet experienced many protective behaviors. Barriers to health care included access and confidentiality. Physically or sexually abused adolescents endured relatively greater risk and fewer protective behaviors than nonabused adolescents. The prevalence of risk behaviors and abuse among rural minority adolescent women presents a need for development of psychotherapeutic interventions as part of behavioral interventions for risk reduction. These women may benefit from confidential identification and assessment of abuse history and risk and protective behaviors so that appropriate psychological treatment can accompany accessible medical treatment.
Sánchez-Borrego, Rafael; García-Calvo, Carmen
The main objective of this survey was to explore the attitude of Spanish women towards menstruation, as well as their acceptability of a daily, continuous, combination oral contraceptive regimen. National survey carried out in Spain in 2006. A total of 588 women aged between 18 and 45 years old answered an anonymous questionnaire that included questions regarding menstruation and acceptability of new contraceptive regimens. Overall, 24.5% of women expressed interest in using the continuous oral contraceptive regimen. This percentage increased up to nearly 50% in women younger than 25 years old and those not using any contraceptive method but willing to use them in the future. The attitude of Spanish women towards menstruation observed in this survey seems to be more conservative than that obtained in other recent international surveys. An improvement in the education provided by practitioners would help women to make informed decisions.
Amodeo, Luiza B.; And Others
Focusing on issues and concerns pertaining to teaching and counseling rural women and minority women living in rural environments, the four papers aim to promote a better understanding and more realistic picture of conditions affecting rural/minority women. "Factors Influencing Educational and Occupational Choices of Rural/Minority…
More than 500 million women live in the rural regions of Third World countries and all are illiterate. This book is intended to give these women a face and a voice. The book contains eight chapters and a list of further readings. Chapter 1, "How is illiteracy defined?", views a literate woman as one "who possesses sufficient…
The great institutional changes in Chinese agriculture over the past 25 years have altered the position of women in the economy and family, one consequence of which has been the emergence of female role models who delay marriage and bear small families. This paper discusses the fertility goals of the rural activist women as one type of response to…
McCarthy, Florence E.; And Others
The bibliography attempts to lift the darkness regarding Bangladeshi women by presenting 207 citations (books, reports, journal articles, and speeches) that review what is known regarding rural women and their involvement in agricultural production and indicate possible trends in employment as represented by literature available on other groups of…
Wilson-Anderson, Kaye; Lee, Holly; Pinnock, Jessi; Sybrandt, Anne; White, Alissa
This qualitative, descriptive, phenomenological study explored how southern, rural women in India (N = 14) view health, how they learned about health, and what health education they desired. Health education classes were offered, based on participants' responses. Recommendations are offered for a best practice model that could potentially enhance the efforts of non-Indian nurses desiring to assist impoverished women and families in India.
Mutanyatta, J. N. S.
Despite their significant role in African economies, women are still the victims of poverty, illiteracy, discrimination, and powerlessness. Most African countries are classified as "low" on the Human Development Index and exhibit a relationship between per capita gross domestic product and the adult literacy rate. Rural women appear to…
Angell, Karyn L; Kreshka, Mary Anne; McCoy, Rebecca; Donnelly, Patricia; Turner-Cobb, Julie M; Graddy, Kathy; Kraemer, Helena C; Koopman, Cheryl
OBJECTIVE This study was initiated by breast cancer survivors living in a rural community in California. They formed a partnership with academic researchers to develop and evaluate a low-cost, community-based Workbook-Journal (WBJ) for improving psychosocial functioning in geographically and economically isolated women with primary breast cancer. DESIGN A randomized controlled trial was used to compare the WBJ intervention plus educational materials to educational materials alone (usual care). SETTING One rural cancer center and several private medical, surgical, and radiation oncology practices in 7 rural counties in the Sierra Nevada Foothills of California. PARTICIPANTS One hundred women with primary breast cancer who were either within 3 months of diagnosis or within 3 months of completing treatment. INTERVENTION A community-initiated, theoretically-based Workbook-Journal, designed by rural breast cancer survivors and providers as a support group alternative. It included compelling personal stories, local rural resources, coping strategies, and messages of hope. RESULTS Community recruiters enrolled 83% of the women referred to the study. Retention at 3-month follow-up was 98%. There were no main effects for the WBJ. However, 3 significant interactions suggested that women who were treated in rural practices reported decreased fighting spirit and increased emotional venting and posttraumatic stress disorder symptoms if they did not receive the WBJ. Among women who receive the WBJ, 74% felt emotionally supported. CONCLUSIONS This community-based Workbook-Journal may be an effective psychosocial intervention for rural, isolated, and low-income women with breast cancer. Community involvement was essential to the success of this project. PMID:12848832
Chikani, Vatsal; Reding, Douglas; Gunderson, Paul; McCarty, Catherine A.
Background: The aim of the present study is to investigate the association between psychosocial work characteristics and health functioning and cardiovascular disease risk factors among rural women of central Wisconsin and compare psychosocial work characteristics between farm and nonfarm women. Methods: Stratified sampling was used to select a…
Peiró, R; Colomer, C; Ashton, J; Alvarez-Dardet, C
To assess the importance of travelling for abortion in Spanish women from 1974 to 1988, a descriptive epidemiologic study was undertaken, based on information from the United Kingdom Office for Population Censuses and Surveys. Additionally, the effect of the democratic restitution in Spain (1978) and of the passing of the Spanish abortion law in Spain is explored. During the study period, close to 200,000 Spanish women travelled to England and Wales to have an abortion. The annual figures range from 2,978 in 1974 to 22,002 in 1983. In 1988, in spite of the partial decriminalization of abortion in Spain, still 3,188 travelled to the UK for an abortion. In average, 1 out 35 Spanish women in fertile ages travelled to England and Wales for this reason in the study period. The likelihood was higher for the cohort of women born between 1955 and 1959, for which the risk was 4.5%. The proportional distribution by age shows that teenagers increased their relative importance from 9.3% in 1974 to 17% in 1988, suggesting less benefits for this age group than for older women from the democratization of the country and the abortion law.
Martius-von Harder, G
A study was conducted in Bangladesh to determine the contribution rural women make to the economic conditions in their country. The study was necessary because little research has been done into the working patterns of rural women and their economic contributions have often been overlooked because they do not produce actual income. This article is a discussion of the problems faced by field researchers in countries like Bangladesh. Certain types of questions cannot be asked of women in rural Muslim areas, e.g., questions dealing with acreage of property, supply and demand in the marketplace, and irrigated land. Secluded women would have no way of knowing answers to these questions. Observation had to be used for a study of time-use, since the women do not live by the clock. Questions on women's ages can never be asked. Questions to females had to concern themselves with activities of females and questions to males, with activities of males. Rural people in Bangladesh do not seem to think in terms of exact measurement; this must be taken into account when analyzing answers. Researchers have to adapt their interviewing to the socioeconomic conditions of the area.
Patterson, Jean; Foureur, Maralyn; Skinner, Joan
Birth in primary midwife-led maternity units has been demonstrated to be a safe choice for well women anticipating a normal birth. The incidence of serious perinatal outcomes for these women is comparable to similarly low risk women, who choose to birth in hospital. New Zealand women have a choice of Lead Maternity Carer (LMC) and birthplace; home, primary birthing unit, or a base hospital, though not all women may have all these choices available locally. Women in rural and rural remote areas can also choose to birth in their rural primary maternity unit. A percentage of these women (approx. 15-17%) will require transfer during labour, an event which can cause distress and often loss of midwifery continuity of care. To explore retrospectively the choice of birth place decisions and the labour and birth experiences of a sample of women resident in remotely zoned, rural areas of the lower South Island of New Zealand. A purposive sample of women living in remote rural areas, recruited by advertising in local newspapers and flyers. Individual semi-structured interviews were digitally recorded using a pragmatic interpretive approach. The data (transcripts and field notes) were analysed using thematic and content analysis. Ethical approval was obtained from the Health and Disability Ethics Committee (HEDC) MEC/06/05/045. Thirteen women consented to participate. Each was resident in a remote rural area having given birth in the previous 18 months. The women had been well during their pregnancies and at the onset of labour had anticipated a spontaneous vaginal birth. Rural remote zoned areas in Otago and Southland in the South Island of New Zealand FINDINGS: Five women planned to birth in a regional hospital and eight chose their nearest rural primary maternity unit. All of the women were aware of the possibility of transfer and had made their decision about their birthplace based on their perception of their personal safety, and in consideration of their distance from
Dixon, Ruth B.
Women's vulnerability to increased landlessness and other economic factors has created a need in most developing nations for year-round, rural, non-agricultural employment opportunities for women. Census data from 56 Third World countries reveal that women are generally underrepresented in the paid labor force and overrepresented in the…
Plazaola-Castano, Juncal; Ruiz-Perez, Isabel; Escriba-Aguir, Vicenta; Montero-Pinar, Isabel; Vives-Cases, Carmen
We aimed to analyze the internal consistency and construct validity of the Spanish version of the Index of Spouse Abuse (ISA) in a representative sample of 8,995 women attending general practice in Spain in 2006-2007. The factor structure analysis shows that the ISA measures four intimate partner violence (IPV) dimensions: emotional, physical, and…
Wooller, Judith; Warner, Lesley
Central Queensland University's Women into Science and Technology program aimed to broaden the access of women to higher education, improve their career opportunities and employment prospects, and address the personnel shortage in engineering and technology by encouraging mature age women to consider these fields. The distance learning program was…
Fagley, R M
Women are the 2nd-class citizens of the developing countries, especially in the rural areas. Not until the status of women is upgraded in these areas will the struggle for better nutrition, for smaller families, and for general social development be successful. The reasons why women have been neglected so far are discussed. Women in developing countries suffer from a lack of power. They can be helped by women in affluent societies. Information on the status of women in various Asian, African, and Latin American countries was solicited and is presented. Obstacles to improvement in the condition of women include: 1) continual childbearing 2) traditional values, 3) social pressures, and 4) the machismo philosophy. Recommendations are made for ways in which to aid the situation of women in Africa, Asia, and Latin America. Some beginning efforts in this direction are mentioned.
Lunde, Britt; Rankin, Kristin; Harwood, Bryna; Chavez, Noel
To examine the prevalence of sterilization among women aged 20-34 years in rural and urban areas in the United States. Data were obtained from the 2006-2010 National Survey of Family Growth, a cross-sectional survey conducted by the Centers for Disease Control and Prevention. The study population included the 4,685 female respondents who did not want to become pregnant at the time of the survey. Women who were not sexually active with men or were infertile for reasons other than contraception were excluded. We performed bivariate and stratified analysis and multivariable logistic regression modeling to determine the associations between place of residence and sterilization after considering other demographic characteristics. Rural women were at increased odds of undergoing sterilization compared with urban and suburban women (22.75% compared with 12.69%, respectively; crude odds ratio [OR] 2.03, 95% confidence interval [CI] 1.44-2.86; risk difference 0.10, 95% CI 0.05-0.16). Education level was found to be a significant effect modifier of the relationship between location of residence and sterilization. In adjusted analysis, controlling for age, parity, race and ethnicity, income, insurance status, history of unintended pregnancy, and relationship status, rural women without a high school degree were more likely to have undergone sterilization compared with urban and rural women with greater than a high school education (OR 8.34, 95% CI 4.45-15.61). Rural women with low education levels have a high prevalence of sterilization. Future studies need to address the reasons for this interaction between education and geography and its influence on contraceptive method choice. II.
Hauenstein, Emily J
Despite the widespread notion of the bucolic life in the country, major depressive disorder (MDD) is common among impoverished women in the rural South. Women with MDD seldom get treated because of the paucity of treatment available, the inability to pay for services because of no insurance, and the distance they must travel to reach care. Even if treatment was available, impoverished rural Southern women are unlikely to seek services because of cultural and social prohibitions. These include incongruence between the biomedical model of MDD and sociocultural explanations for its causes and manifestations, stigma, and traditional viewpoints of women that keep them isolated and invisible. Innovative treatment strategies must be devised for these women that are based on local views of MDD and its treatment, and people and monetary resources available in poor rural economies. Needed research with this population include ethnographic studies to gain understanding of the cultural factors associated with MDD and its treatment and evaluation of outreach, and other novel paradigms of rural service delivery including the use of nonprofessional personnel. Although the problems of treatment and research with this population are daunting, there is an opportunity for imagination, innovation, and creativity in devising local solutions to local problems. Copyright 2003, Elsevier Science (USA). All rights reserved.
Background The combination of eHealth applications and/or services with cloud technology provides health care staff—with sufficient mobility and accessibility for them—to be able to transparently check any data they may need without having to worry about its physical location. Objective The main aim of this paper is to put forward secure cloud-based solutions for a range of eHealth services such as electronic health records (EHRs), telecardiology, teleconsultation, and telediagnosis. Methods The scenario chosen for introducing the services is a set of four rural health centers located within the same Spanish region. iCanCloud software was used to perform simulations in the proposed scenario. We chose online traffic and the cost per unit in terms of time as the parameters for choosing the secure solution on the most optimum cloud for each service. Results We suggest that load balancers always be fitted for all solutions in communication together with several Internet service providers and that smartcards be used to maintain identity to an appropriate extent. The solutions offered via private cloud for EHRs, teleconsultation, and telediagnosis services require a volume of online traffic calculated at being able to reach 2 Gbps per consultation. This may entail an average cost of €500/month. Conclusions The security solutions put forward for each eHealth service constitute an attempt to centralize all information on the cloud, thus offering greater accessibility to medical information in the case of EHRs alongside more reliable diagnoses and treatment for telecardiology, telediagnosis, and teleconsultation services. Therefore, better health care for the rural patient can be obtained at a reasonable cost. PMID:26215155
de la Torre-Díez, Isabel; Lopez-Coronado, Miguel; Garcia-Zapirain Soto, Begonya; Mendez-Zorrilla, Amaia
The combination of eHealth applications and/or services with cloud technology provides health care staff—with sufficient mobility and accessibility for them—to be able to transparently check any data they may need without having to worry about its physical location. The main aim of this paper is to put forward secure cloud-based solutions for a range of eHealth services such as electronic health records (EHRs), telecardiology, teleconsultation, and telediagnosis. The scenario chosen for introducing the services is a set of four rural health centers located within the same Spanish region. iCanCloud software was used to perform simulations in the proposed scenario. We chose online traffic and the cost per unit in terms of time as the parameters for choosing the secure solution on the most optimum cloud for each service. We suggest that load balancers always be fitted for all solutions in communication together with several Internet service providers and that smartcards be used to maintain identity to an appropriate extent. The solutions offered via private cloud for EHRs, teleconsultation, and telediagnosis services require a volume of online traffic calculated at being able to reach 2 Gbps per consultation. This may entail an average cost of €500/month. The security solutions put forward for each eHealth service constitute an attempt to centralize all information on the cloud, thus offering greater accessibility to medical information in the case of EHRs alongside more reliable diagnoses and treatment for telecardiology, telediagnosis, and teleconsultation services. Therefore, better health care for the rural patient can be obtained at a reasonable cost.
Lopez-del Burgo, Cristina; Lopez-de Fez, Carmen Marina; Osorio, Alfonso; Guzmán, José Lopez; de Irala, Jokin
Some methods of family planning, such as oral contraceptives, emergency pill or intrauterine device, may occasionally work after fertilization. These effects may be important to some women. We explored Spanish women's attitudes towards contraceptive choices that may have occasional post-fertilization mechanisms of action. Cross-sectional study in a Spanish representative sample of 848 potentially fertile women, aged 18-49. Data were collected using a 30-item questionnaire about family planning. Logistic regression was used to identify variables associated with women's attitudes towards post-fertilization effects. The majority of women were married, had completed high school and had at least one child. Forty-five percent of women would not consider using a method that may work after fertilization and 57% would not consider using one that may work after implantation. Forty-eight percent of the sample would stop using a method if they learned that it sometimes works after fertilization, increasing to 63% when referring to a method that sometimes works after implantation. Women who believe that human life begins at fertilization, those who believe it is important to distinguish between spontaneous and induced embryo losses and women who report having a religion were less likely to consider the use of a method with some post-fertilization effects. The possibility of post-fertilization effects may influence Spanish women's choice of a family planning method. Information about mechanisms of action of birth control methods should be disclosed to women so that they can make informed choices. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.
Pardillo-Mayora, José M; Domínguez-Lira, Carlos A; Jurado-Piña, Rafael
Crash records and roadside data from Spanish two-lane rural roads were analyzed to study the effect of roadside configuration on safety. Four indicators were used to characterize the main roadside features that have an influence on the consequences of roadway departures: roadside slope, non-traversable obstacles distance from the roadway edge, safety barrier installation, and alignment. Based on the analysis of the effect of roadside configuration on the frequency and severity of run-off-road injury crashes, a categorical roadside hazardousness scale was defined. Cluster analysis was applied to group the combinations of the four indicators into categories with homogeneous effects on run-off-road injury crashes frequency and severity. As a result a 5-level Roadside Hazardousness Index (RHI) was defined. RHI can be used as reference to normalize the collection of roadside safety related information. The index can also be used as variable for inclusion of roadside condition information in multivariate crash prediction models. 2010 Elsevier Ltd. All rights reserved.
Matthews, Hollie L; Laya, Mary; DeWitt, Dawn E
Little is known about rural women's knowledge about osteoporosis. To explore what women from high-prevalence rural communities know about osteoporosis and to assess their learning preferences. We surveyed 437 women in rural Washington and Oregon. The response rate was 93% (N = 406). The mean age of respondents was 63 years (range 16-95) and 74% (n = 301) of women were postmenopausal. While 27% over age 40 (n = 111) reported having a fracture as an adult, less than half of this group (42%, n = 47) considered themselves at risk for osteoporosis. Of the 42% (n = 171) who rated their knowledge of osteoporosis good or excellent, only 18% (n = 30) answered calcium and vitamin D questions correctly. About half (53%; n = 214) exercised 3 or more times per week. Reported sources of osteoporosis information included television, magazines, health care providers, and personal contacts. Over half of the women in this study wanted more information about osteoporosis, most wanted it before age 50, and health care providers were a preferred source. Less than half of participants reported having Internet access. While many participants underestimated their osteoporosis risk, most women wanted to learn more about osteoporosis and health care providers remain a preferred source of information.
Mbah, Blessing Akaraka
This study assessed the functional impacts of adult literacy programme among rural women participants in Ishielu Local Government Area (LGA) of Ebonyi State, Nigeria. Descriptive survey design was used for the study. The population of the study was made up of 115 adult instructors and 2,408 adult learners giving a total of 2,623. The sample…
Rural women engage in a wide range of income-generating activities, but their participation in the labor market is constrained by lack of access to land and other resources, lack of control over labor and income, and lack of physical and occupational mobility. (SK)
Mayes, Robyn; McAreavey, Ruth
This paper explores migrant women's encounters with formal and informal education in what can be termed new immigration rural destinations. We ask to what extent educational opportunities are realized in these new destinations. We show that education aspirations may be jeopardized because of the desire to achieve economic goals and thus require…
Staton, Michele; Strickland, Justin C; Tillson, Martha; Leukefeld, Carl; Webster, J Matthew; Oser, Carrie B
The role of relationships in initiating and maintaining women's risk behaviors has been established. However, understanding factors that may underlie partner relationships and women's risky drug use, particularly in rural contexts, is limited. This study is the first to examine the association between injecting partners and women's risky injection practices as a function of relationship power perception. Female participants were recruited from three rural jails in the Appalachian region. Women were selected randomly, provided informed consent, and screened for study eligibility criteria. This cross-sectional analysis focuses on women who inject drugs during the year before entering jail (n = 199). Approximately three-quarters (76%) reported having a recent main male sexual partner with a history of injection drug use. Although having a risky partner independently increased the likelihood of women reporting shared injection practices, perceptions of relationship power significantly moderated the effect on shared needle (adjusted odds ratio, 0.02; 95% CI, 0.003-0.23; p = .001) and shared works (adjusted odds ratio, 0.17; 95% CI, 0.03-0.95; p = .04) use. This interaction indicated that, for women who inject drugs with a recent injecting male partner, greater perception of relationship power was associated with a decreased likelihood of shared injection practices. Implications for clinical assessment and intervention are discussed. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Monitoring of the environmental differences in the mode of nutrition is especially important in pregnant women, for whom normal body weight gain is especially important for both the course of pregnancy and the normal development of the foetus, and is inseparably associated with rational nutrition. The objective of the study was evaluation of the mode of nutrition of pregnant women according to the place of residence. The investigation comprised 704 women. Information was collected by means of an anonymous survey concerning place of residence, consumption of selected products and beverages, and taking folic acid and other vitamin and/or mineral dietary supplements. In the urban environment, pregnant women more frequently consumed vegetables, milk and dairy products, sea fish and wholemeal cereal products, drank more liquids, as well as more fruit and/or vegetable juices, and more often used the supplementation with folic acid, even before becoming pregnant. No significant differences were found in the consumption of fruits, pulses, products which are the source of complete proteins, confectionery products and sweets, according to the place of residence. The diet of pregnant women from the rural environment compared to that of women from urban areas, was characterized by worse quality. It is necessary to carry out health education in the area of adequate nutrition among pregnant women, and those who plan pregnancy, directed primarily to all women from the rural environment.
Zagalaz-Anula, Noelia; Hita-Contreras, Fidel; Martínez-Amat, Antonio; Cruz-Díaz, David; Lomas-Vega, Rafael
This study aimed to analyze the reliability and validity of the Spanish version of the Medical Outcomes Study Sleep Scale (MOS-SS), and its ability to discriminate between poor and good sleepers among a Spanish population with vestibular disorders. In all, 121 women (50-76 years old) completed the Spanish version of the MOS-SS. Internal consistency, test-retest reliability, and construct validity (exploratory factor analysis) were analyzed. Concurrent validity was evaluated using the Pittsburgh Sleep Quality Index and the 36-item Short Form Health Survey. To analyze the ability of the MOS-SS scores to discriminate between poor and good sleepers, a receiver-operating characteristic curve analysis was performed. The Spanish version of the MOS-SS showed excellent and substantial reliability in Sleep Problems Index I (two sleep disturbance items, one somnolence item, two sleep adequacy items, and awaken short of breath or with headache) and Sleep Problems Index II (four sleep disturbance items, two somnolence items, two sleep adequacy items, and awaken short of breath or with headache), respectively, and good internal consistency with optimal Cronbach's alpha values in all domains and indexes (0.70-0.90). Factor analysis suggested a coherent four-factor structure (explained variance 70%). In concurrent validity analysis, MOS-SS indexes showed significant and strong correlation with the Pittsburgh Sleep Quality Index total score, and moderate with the 36-item Short Form Health Survey component summaries. Several domains and the two indexes were significantly able to discriminate between poor and good sleepers (P < 0.05). Optimal cut-off points were above 20 for "sleep disturbance" domain, with above 22.22 and above 33.33 for Sleep Problems Index I and II. The Spanish version of the MOS-SS is a valid and reliable instrument, suitable to assess sleep quality in Spanish postmenopausal women, with satisfactory general psychometric properties. It discriminates well
Ingelse, Kathy; Messecar, Deborah
While the total number of veterans in the U.S. is decreasing overall, the number of women veterans is significantly increasing. There are numerous barriers which keep women veterans from accessing mental health care. One barrier which can impact receiving care is living in a rural area. Veterans in rural areas have access to fewer mental health services than do urban residing veterans, and women veterans in general have less access to mental health care than do their male colleagues. Little is known about rural women veterans and their mental health service needs. Women, who have served in the military, have unique problems related to their service compared to their male colleagues including higher rates of post-traumatic stress disorder (PTSD) and military sexual trauma (MST). This qualitative study investigated use of and barriers to receiving mental health care for rural women veterans. In-depth interviews were conducted with ten women veterans who have reported experiencing problems with either MST, PTSD, or combat trauma. All ten women had utilized mental health services during active-duty military service, and post service, in Veterans Administration (VA) community based-outpatient clinics. Several recurring themes in the women's experience were identified. For all of the women interviewed, a sentinel precipitating event led to seeking mental health services. These precipitating events included episodes of chronic sexual harassment and ridicule, traumatic sexual assaults, and difficult combat experiences. Efforts to report mistreatment were unsuccessful or met with punishment. All the women interviewed reported that they would not have sought services without the help of a supportive peer who encouraged seeking care. Barriers to seeking care included feeling like they were not really a combat veteran (in spite of serving in a combat unit in Iraq); feeling stigmatized by providers and other military personnel, being treated as crazy; and a lack of interest
This paper evaluates effects of community-level women's property and inheritance rights on women's economic outcomes using a 13 year longitudinal panel from rural Tanzania. In the preferred model specification, inverse probability weighting is applied to a woman-level fixed effects model to control for individual-level time invariant heterogeneity and attrition. Results indicate that changes in women's property and inheritance rights are significantly associated with women's employment outside the home, self-employment and earnings. Results are not limited to sub-groups of marginalised women. Findings indicate lack of gender equity in sub-Saharan Africa may inhibit economic development for women and society as a whole.
Del Río, Francisco Javier; Cabello-Santamaría, Francisco; Cabello-García, Marina A; Aragón-Vela, Jerónimo
The impact of pain in sexuality, couple relationships and the quality of life is very well known. The relationship between substance abuse and the presence of sexual pain disorder is assessed, together with anxiety and sexual attitudes . Two samples were selected. One sample for women with a history of substance abuse (n = 129), and another one of women nonconsumers (n = 129). The Golombok Rust Inventory of Sexual Satisfaction (GRISS), the Sexual Opinion Survey (SOS) and the State Trait Anxiety Inventory (STAI) questionnaires were used. The results indicate that women consumers obtained a higher mean scores in sexual pain disorder (4.88 > 2.89, that is 65.12%), plus higher mean scores on state anxiety (23.82 > 14.56) and trait anxiety (30.93 > 16.95), and lower average figure in erotophilia (84.93 < 95.81). It was also verified that the period of abstinence does not improve sexual response. Substance consumption affects sexual response in women negatively. Sexual response does not improve with abstinence period.
As the traditional water carriers and water managers, third world women are crucial to the success of rural water supply projects whose short term goal is increased water quality and quantity and whose long term goal is improved family health. Change depends on the utilization of local learning systems of the society and women are most often the…
Melkus, Gail D'Eramo; Whittemore, Robin; Mitchell, Jessica
The purpose of this secondary analysis was to describe and compare physiological, psychosocial, and self-management characteristics of urban black and rural white women with type 2 diabetes (T2D) in the northeast United States. A descriptive, cross-sectional secondary analysis was conducted with baseline data from 2 independent study samples: rural white women and urban black women. Results revealed the sample were on average educated, working, low-income, mid-life women with poor glycemic and blood pressure control, despite having a usual source of primary care. When compared, black women were younger, had lower income levels, worked more, and were often single and/or divorced. They had worse glycemic control, significantly higher levels of diabetes-related emotional distress, and less support than white women. Despite differences in geography and study findings, both groups had suboptimal physiological and psychosocial levels that impede self-management. These findings serve to aid in the understanding of health disparities, emphasizing the importance of developing and evaluating effective interventions of diabetes care for women with T2D.
Peñacoba-Puente, Cecilia; Carmona-Monge, Francisco Javier; Marín-Morales, Dolores; Écija Gallardo, Carmen
To analyze the change of childbirth expectations over the course of pregnancy as well as their relation to socio-demographic and clinical variables. The study of expectations in pregnant women is gaining more interest from a biopsychosocial approach because of its consequences on pregnant women's wellbeing. To our knowledge there are no previous studies analyzing the evolution of childbirth expectations over the course of pregnancy. Longitudinal study (first trimester and third trimester). Women were evaluated for childbirth expectations in their first trimester (n=285) and third trimester (n=122) of pregnancy. They also completed questionnaires collecting socio-demographic information. Childbirth expectations appear to remain more or less stable over the course of pregnancy, although they tend to become slightly negative at the end of gestation, specifically referring to personal control and delivery circumstances. Multiparity and planned pregnancy are associated with higher positive expectations. It seems essential to explore and to try to adjust childbirth expectations to more realistic ones, in order for them to be fulfilled. Midwives and other maternity healthcare providers play a key role in this regard. Copyright © 2015 Elsevier Inc. All rights reserved.
Staudt, Kathleen A.
Political power tends to overlap with economic power, thus favoring those with access to land, livestock, capital, and other productive resources; in virtually all societies women have fewer of those productive resources than men, which reflects and explains women's limited political power. Growing documentation indicates that men…
Salsberry, Pamela J.; Ferketich, Amy K.; Ahijevych, Karen L.; Hood, Nancy E.; Paskett, Electra D.
Abstract Background This study examined the association between social, demographic, and psychologic factors and smoking status among Appalachian Ohio women. A secondary aim examined whether specific factors could be identified and segmented for future tailored treatment of tobacco dependence. Methods A cross-sectional survey (n=570) obtained information about social, demographic, and psychologic factors and smoking. Logistic regression described associations between these characteristics and smoking status. Chi-square automatic interaction detection (CHAID) analyses identified subgroups at risk for smoking. Results Fifty-two percent never smoked, with 20.5% and 27.5% categorized as former and current smokers, respectively. Women with low adult socioeconomic position (SEP) were more likely to smoke (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.74-5.34) compared to high SEP women. Other factors associated with current smoking included age 31–50 (OR 2.30, 95% CI 1.22-4.33), age 18–30 (OR 3.29, 95% CI 1.72-5.34), Center for Epidemiologic Studies Depression scale (CES-D) score≥16 (OR 1.99, 95% CI 1.31-3.05), and first pregnancy at age<20 (OR 1.74, 95% CI 1.14-2.66). The prevalence of smoking was 50% among those with four or more risk factors compared to 10% for those reporting no risk factors. CHAID analyses identified low adult SEP and depressive symptoms as the combination of risk factors most strongly associated with smoking; 49.3% of women in this subgroup currently smoked. Conclusions Low SEP in adulthood, maternal circumstances, and depressive symptoms are associated with current smoking. Tailored cessation interventions that address these risk factors should be developed and further evaluated in an attempt to reduce disparities in smoking prevalence among this vulnerable group of women. PMID:22360694
Ibraz, T S
The roles of rural Pakistani women in agricultural production are described with numerous examples from a village study by Anwar and Bilquees, and the author's research in a Punjabi village (Rajpur) to show cultural perceptions of women and their work, and the nature of productive activities inside the house and outside on the farm. The cultural perceptions are related to the image of women as dependent/private wives and mothers. A broad definition of production is used to include activities, such as churning milk which generates income and saves expenditures and making butter which fulfills household needs and is sold in the market for cash. Rajpur is a village engaged in social change. Men seek work outside the villages, and women take on work previously assumed by men. Women contribute considerably to the year-round production and processing of major crops. The productive labor of women by major crop type and activity type are described and charted. Tending livestock is performed exclusively by men. Handicraft activity at home reduces expenditure for buying these items in the local markets. Most women were unaware of the savings and "indirect" income their work contributed to the household. Work for wages is viewed as men's work. Women's mobility beyond the fields and home is still limited; market activity must be conducted with a male present and women do not earn cash. The division of labor is conceived by men for women because of women's cultural identity. Women are perceived as "chase daughters/sisters, fertile wives, and nurturing mothers." There are punishments or social rewards for proper behavior. Women in their private domain are expected to "look good within the house," which is viewed as a feminine world. The outside world is masculine. Women are also seen as lacking reasoning ability and their motherhood roles limit their capability to cope with external affairs. There is great value attached to the invisibility of women physically, socially, and
Cuervo, Marta; Sayon-Orea, Carmen; Santiago, Susana; Martínez, Jose Alfredo
The nutritional status and lifestyle of women in preconception, pregnancy and lactation determine maternal, fetal and child health. The aim of this cross-sectional study was to evaluate dietary patterns and lifestyles according the perinatal physiological status in a large sample of Spanish women. Community pharmacists that were previously trained to collect the data recruited 13,845 women. General information, anthropometric measurements, physical activity, unhealthy habits and dietary data were assessed using a validated questionnaire. Mean values and percentages were used as descriptive statistics. The t-test, ANOVA or chi-squared test were used to compare groups. A score that included dietary and behavioral characteristics was generated to compare lifestyles in the three physiological situations. The analysis revealed that diet quality should be improved in the three stages, but in a different manner. While women seeking a pregnancy only met dairy recommendations, those who were pregnant only fulfilled fresh fruits servings and lactating women only covered protein group requirements. In all cases, the consumption allowances of sausages, buns and pastries were exceeded. Food patterns and unhealthy behaviors of Spanish women in preconception, pregnancy and lactation should be improved, particularly in preconception. This information might be useful in order to implement educational programs for each population group. PMID:25333199
Morrison, Joanna; Basnet, Machhindra; Budhathoki, Bharat; Adhikari, Dhruba; Tumbahangphe, Kirti; Manandhar, Dharma; Costello, Anthony; Groce, Nora
Objective there is little evidence about disabled women׳s access to maternal and newborn health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and care seeking. Our study explores disabled women׳s experiences of maternal and newborn care in rural Nepal. Design we used a qualitative methodology, using semi-structured interviews. Setting rural Makwanpur District of central Nepal. Participants we purposively sampled married women with different impairments who had delivered a baby in the past 10 years from different topographical areas of the district. We also interviewed maternal health workers. We compared our findings with a recent qualitative study of non-disabled women in the same district to explore the differences between disabled and non-disabled women. Findings married disabled women considered pregnancy and childbirth to be normal and preferred to deliver at home. Issues of quality, cost and lack of family support were as pertinent for disabled women as they were for their non-disabled peers. Health workers felt unprepared to meet the maternal health needs of disabled women. Key conclusions and implications for practice integration of disability into existing Skilled Birth Attendant training curricula may improve maternal health care for disabled women. There is a need to monitor progress of interventions that encourage institutional delivery through the use of disaggregated data, to check that disabled women are benefiting equally in efforts to improve access to maternal health care. PMID:24768318
Morrison, Joanna; Basnet, Machhindra; Budhathoki, Bharat; Adhikari, Dhruba; Tumbahangphe, Kirti; Manandhar, Dharma; Costello, Anthony; Groce, Nora
there is little evidence about disabled women׳s access to maternal and newborn health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and care seeking. Our study explores disabled women׳s experiences of maternal and newborn care in rural Nepal. we used a qualitative methodology, using semi-structured interviews. rural Makwanpur District of central Nepal. we purposively sampled married women with different impairments who had delivered a baby in the past 10 years from different topographical areas of the district. We also interviewed maternal health workers. We compared our findings with a recent qualitative study of non-disabled women in the same district to explore the differences between disabled and non-disabled women. married disabled women considered pregnancy and childbirth to be normal and preferred to deliver at home. Issues of quality, cost and lack of family support were as pertinent for disabled women as they were for their non-disabled peers. Health workers felt unprepared to meet the maternal health needs of disabled women. integration of disability into existing Skilled Birth Attendant training curricula may improve maternal health care for disabled women. There is a need to monitor progress of interventions that encourage institutional delivery through the use of disaggregated data, to check that disabled women are benefiting equally in efforts to improve access to maternal health care. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Cano-Climent, Antoni; de Vries, Jolanda
Background Fatigue is the most widely reported symptom by women during pregnancy, labour, the postpartum period, and early parenting. The objective was to translate the Fatigue Assessment Scale (FAS) into Spanish and assess its psychometric properties. Methods Instrumental Design. The FAS was translated into Spanish (FAS-e) using forward and back translation. A convenience sample was constituted with 870 postpartum women recruited at discharge from 17 public hospitals in Eastern Spain. Data was obtained from clinical records and self-administered questionnaires at discharge. Internal consistency, factor structure, comparisons between known groups and correlations with other variables were assessed. Results Cronbach’s alpha coefficient was .80. Findings on the dimensionality of the FAS-e scale indicated that it was sufficiently unidimensional. FAS-e scores were higher among women who had undergone caesarean births (p < .05), had a higher level of postpartum pain (p < .01), experienced difficulties during breastfeeding (p < .01) and had lower levels of self-efficacy for breastfeeding (p < .01). Conclusions An equivalent Spanish version of the FAS was obtained with good reliability and validity properties. FAS-e is an appropriate tool to measure postpartum fatigue. PMID:28970968
Sri, B Subha; Ravindran, T K Sundari
To understand how rural and other groups of marginalized women define safe abortion; their perspectives and concerns regarding medical abortion (MA); and what factors affect their access to safe abortion. Focus group discussions were held with various groups of rural and marginalized women in Tamil Nadu to understand their perspectives and concerns on abortion, especially MA. Nearly a decade after mifepristone was approved for abortion in India, most study participants had never heard of MA. When they learned of the method, most preferred it over other methods of abortion. The women also had questions and concerns about the method and recommendations on how services should be provided. Their definition of a "safe abortion" included criteria beyond medical safety. They placed a high priority on "social safety," including confidentiality and privacy. In their view, factors affecting access to safe abortion and choice of provider included cost, assurance of secrecy, promptness of service provision, and absence of provider gatekeeping and provider-imposed conditions for receiving services. Women's preference for MA shows the potential of this technology to address the problem of unsafe abortion in India. Women need better access to information and services to realize this potential, however. Women's preferences regarding information dissemination and service provision need to be taken into account if policies and programs are to be truly responsive to the needs of marginalized women. Copyright © 2012. Published by Elsevier Ireland Ltd.
Weinert, Clarann; Cudney, Shirley; Hill, Wade G
The objective of this study was to determine the differences in the psychosocial status of 3 groups of chronically ill rural women participating in a computer intervention. The 3 groups were: intense intervention, less-intense intervention, and control. At baseline and following the intervention, measures were taken for social support, self-esteem, empowerment, self-efficacy, depression, stress, and loneliness. ANCOVA results showed group differences for social support and self-efficacy among the overall group. The findings differed for a vulnerable subgroup, with significant between-group differences for social support and loneliness. It was concluded that a computer-delivered intervention can improve social support and self-efficacy and reduce loneliness in rural women, enhancing their ability to self-manage and adapt to chronic illness.
Hoang, Ha; Le, Quynh; Terry, Daniel
This study investigates (i) maternity care access issues in rural Tasmania, (ii) rural women's challenges in accessing maternity services and (iii) rural women's access needs in maternity services. A mixed-method approach using a survey and semi-structured interviews was conducted. The survey explored women's views of rural maternity services from antenatal to postnatal care, while interviews reinforced the survey results and provided insights into the access issues and needs of women in maternity care. The survey was completed by n=210 women, with a response rate of 35%, with n=22 follow-up interviews being conducted. The survey indicated the majority of rural women believed antenatal education and check-ups and postnatal check-ups should be provided locally. The majority of women surveyed also believed in the importance of having a maternity unit in the local hospital, which was further iterated and clarified within the interviews. Three main themes emerged from the interview data, namely (i) lack of access to maternity services, (ii) difficulties in accessing maternity services, and (iii) rural women's access needs. The study suggested that women's access needs are not fully met in some rural areas of Tasmania. Rural women face many challenges when accessing maternity services, including financial burden and risk of labouring en route. The study supports the claim that the closure of rural maternity units shifts cost and risk from the health care system to rural women and their families. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
THIS SPEECH WAS DELIVERED TO THE NEW MEXICO CONFERENCE FOR HUMAN DEVELOPMENT AND WAS CONCERNED WITH THE PROBLEMS FACING SPANISH AMERICAN VILLAGE SETTLEMENTS IN NORTHERN NEW MEXICO. IT WAS STATED THAT THE FUNDAMENTAL REASONS FOR THE DECLINE OF THE SPANISH AMERICAN FARM VILLAGE INVOLVE THE PROCESS OF ACCULTURATION AND SOCIOECONOMIC ADJUSTMENT IN A…
Gan, C Y
A survey was conducted to document and bring attention to the use of smokeless tobacco among rural Kadazan women in Sabah, East Malaysia. Of the 472 women interviewed, 59.5% had used tobacco among the ingredients that they habitually chewed. Women with low education were more likely to be chewers. The chewing habit was usually acquired during the teenage years and the practice was perceived mainly as a cultural norm. 73.3% of these smokeless tobacco users were unaware of any adverse health effect of this type of tobacco use as compared to 53.9% of the non-tobacco users. The high prevalence of smokeless tobacco use is easily maintained as tobacco is cheap, locally produced and its use is socially accepted. The low level educational status of the women compounds the problem and intervention programs to curb this form of tobacco use is warranted.
Salawu, Oyetunde T; Odaibo, Alexander B
To assess the epidemiology of urogenital schistosomiasis among pregnant women in rural communities of southwestern Nigeria. The present cross-sectional epidemiologic survey of urogenital schistosomiasis was conducted during 2010-2011 among pregnant women in Yewa North Local Government, Ogun State, Nigeria. The women were microscopically screened for infection with Schistosoma haematobium. Of 313 volunteer participants, 20.8% tested positive for S. haematobium infection. The prevalence of infection was highest (31.5%) among women aged 20-24years. The infection intensity did not differ significantly between age groups (t=1.848, P=0.71). Primigravidae and women in the first trimester of pregnancy had the highest intensity of infection with 33.1 and 27.7 eggs/10mL of urine, respectively. There was an association between disease prevalence and parasite intensity across the age groups (χ(2)=68.82, P=0.02). The prevalence of S. haematobium was not associated with age or pregnancy trimester (P=0.06), but associations existed between intensity of infection and gravidity (P=0.001). The prevalence of urogenital schistosomiasis among pregnant women in Nigeria was high, with younger women and primigravidae at the greatest risk. These data can be used to develop a schistosomiasis control program among pregnant women in the study area. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Frye, Margaret; Chae, Sophia
Qualitative evidence from sub-Saharan Africa, where a generalized AIDS epidemic exists, suggests that attractiveness may play a role in shaping individual-level HIV risk. Attractive women, who are often blamed for the epidemic and stigmatized, are believed to pose a higher HIV risk because they are viewed as having more and riskier partners. We examine the association between perceived attractiveness and HIV infection and risk in rural Malawi in the midst of the country's severe AIDS epidemic. We use interviewers' ratings of respondents' attractiveness, along with HIV test results and women's assessments of their own likelihood of infection, to estimate the association between perceived attractiveness and HIV infection and risk for a random sample of 961 women aged 15-35. Results show that women who are rated by interviewers as 'much less' or 'less' attractive than other women their age are 9% more likely to test positive for HIV. We also find that attractiveness is associated with women's own assessments of their HIV risk: Among women who tested negative, those perceived as 'much less' or 'less' attractive than average report themselves to be at greater risk of HIV infection. These results suggest that attractiveness is negatively associated with HIV risk in Malawi, countering local beliefs that hold attractive women responsible for perpetuating the epidemic. This study highlights the need to consider perceived physical attractiveness, and sexual desirability more broadly, as an under-examined axis of inequality in HIV risk in high-prevalence settings.
Nicdao, Ethel G.; Trott, Elise M.; Kellett, Nicole C.
Incarceration and community reentry for rural women reflect gendered processes. We draw upon in-depth semi-structured interviews and focus groups to examine the return of women prisoners to underserved rural communities, while attending to the perspectives of their closest social supporters. Our findings underscore the complexity of the reentry process for rural women and its particular impact on their families. We challenge dominant discourses of personal responsibility that detract from the structura violence and injustice shaping reentry experiences for women and their social supporters. We also consider the policy implications of discharge and reentry planning for rural women and their families, as well as strategies to reduce recidivism. PMID:27274615
Familiar, Itziar; Ortiz-Panozo, Eduardo; Hall, Brian; Vieitez, Isabel; Romieu, Isabelle; Lopez-Ridaura, Ruy; Lajous, Martin
Structure of the Spanish version of the nine-item Patient Health Questionnaire (PHQ-9) has been inconclusive. We report the factor structure of the PHQ-9 in 55,555 women from the Mexican Teachers' Cohort (MTC). Factor structure of the PHQ-9 was assessed by exploratory and confirmatory factor analyses in two sub-samples (n = 27,778 and 27,777 respectively). A one-factor model of the PHQ-9 was the solution with the best fit to the data, exhibiting strong factor loadings (0.71 to 0.90) and high internal consistency (Cronbach's alpha = 0.89). A prevalence rate of moderate to high severity of depressive symptoms of 12.6% was identified. Results suggest that a global score is an appropriate measure of depressive symptoms and commend the use of the Spanish PHQ-9 as a measure of depression for research and clinical purposes. Copyright © 2014 John Wiley & Sons, Ltd.
Most Indian women are low income and self-employed, but women's studies have not focused on this large population. In order to fill in the gap in the literature on women's employment in India, a study was conducted in 1985 among 800 women from 5 "talukas" in Ahmedabad district. This article describes the common social and economic issues faced by poor, rural, self-employed women. Most of the sample belong to lower caste groups. The caste system contributed largely to their poverty, exploitation, and lack of access to facilities. The Harijans are treated the worst and many villages consider them untouchables. The Vaghris and the Dehgam are considered low caste but not untouchables. These groups are not treated much better than the Harijans. Relations between various castes are often strained. In many villages access to information about government programs is controlled by the Sarpanch and Talati and denied to the lower castes. Women's division of labor is determined by caste. The response to the demands of survival among low-income women is to adopt a "contingency" approach to life. These women are mobile, travel with few belongings, and seek shelter anywhere. Children are not sent to school. Many are untrained even in a caste-based occupation. The poor are generally landless and without assets. Work skills are acquired from family or neighbors. Women and poor people lack access to loans and lack awareness of detailed procedures. Cash payment does not usually go to women. Women work in caste-based occupations in addition to two or three seasonal agricultural labor jobs. Development programs do not address the current situation of the poor.
Survey results from two disparate rural areas of Bangladesh, Sirajgong and Gopalpur subdistricts in the north-central part of the country and Abhoynagar and Fultala subdistricts in the southwest, offer the opportunity to assess the changing status of women in rural Bangladesh. The survey, conducted by the Mother and Child Health/Family Planning Extension Project of the International Center for Diarrheal Disease Control during 1982-89, collected data on 7433 ever-married women 15-56 years old. The analysis focused on two indicators: women's freedom to move outside their homes (mobility) and women's authority in household decision making. Although most respondents moved freely between households, they rarely traveled outside their village alone. In addition, respondents had little input in household decisions regarding health or expenditures. 65% felt they should be able to decide whether to see a doctor when they were ill or to buy medicine for a sick child, but only 7% actually made such decisions on their own. The majority approved of women working outside their homes, but only 11% did so. Both mobility and authority tended to increase with a woman's age. Women who lived in households headed by their in-laws had less mobility and much less authority. Women from poor homes had greater mobility, but wealth had little effect on household decision making. Education tended to increase decision-making authority but decrease mobility. Finally, the greater economic development, ecological stability, cultural diversity, and social progressiveness in the southwestern region tended to increase both mobility and authority.
Casas, Lidia; Fernández, Mariana F; Llop, Sabrina; Guxens, Mònica; Ballester, Ferran; Olea, Nicolás; Irurzun, Mikel Basterrechea; Rodríguez, Loreto Santa Marina; Riaño, Isolina; Tardón, Adonina; Vrijheid, Martine; Calafat, Antonia M; Sunyer, Jordi
Phthalate and phenol exposure is prevalent among the general population and of potential concern for pregnant women and children because of their suspected susceptibility to endocrine effects. To evaluate the extent of exposure to several phthalates and phenols in a sample of Spanish pregnant women - according to their individual characteristics (age, social class, education, and body mass index) - and children who participated in the INMA - Infancia y Medio Ambiente (Environment and Childhood) project. One spot urine sample was taken during the third trimester of pregnancy from 120 pregnant women and from 30 4-year old children belonging to 5 Spanish birth cohorts, and analyzed for 11 phthalate metabolites and 9 phenols. Three metabolites of di(2-ethylhexyl) phthalate, mono-2-ethyl-5-carboxypentyl phthalate, mono-2-ethyl-5-hydroxyhexyl phthalate, and mono-2-ethyl-5-oxohexyl phthalate; two metabolites of dibutyl phthalates, mono-isobutyl phthalate and mono-n-butyl phthalate; monoethyl phthalate (MEP), the main metabolite of diethyl phthalate; and two phenols, methyl paraben (M-PB) and 2,5-dichlorophenol were detected in the urine samples of all women. The highest urinary concentrations were for MEP and M-PB. Urinary concentrations of all phthalate metabolites and of 2,4-dichlorophenol, 2,5-dichlorophenol, and bisphenol A were lower in the pregnant women than in the children. Among women, a positive relationship with social class and education was shown for most of the phthalate metabolites and phenols. Almost all phthalate metabolites varied by region even after adjusting for social class and education. Phthalate and phenol exposures are prevalent in a group of pregnant women and young children, two susceptible populations, and these exposures might be positively related to social class. Copyright © 2011 Elsevier Ltd. All rights reserved.
Krankl, Julia Tatum; Shaykevich, Shimon; Lipsitz, Stuart; Lehmann, Lisa Soleymani
patients with limited English proficiency may be at increased risk for diminished understanding of clinical procedures. This study sought to assess patient predictors of comprehension of colposcopy information during informed consent and to assess differences in understanding between English and Spanish speakers. between June and August 2007, English- and Spanish-speaking colposcopy patients at two Boston hospitals were surveyed to assess their understanding of the purpose, risks, benefits, alternatives, and nature of colposcopy. Patient demographic information was collected. there were 183 women who consented to participate in the study. We obtained complete data on 111 English speakers and 38 Spanish speakers. English speakers were more likely to have a higher education, greater household income, and private insurance. Subjects correctly answered an average of 7.91 ± 2.16 (72%) of 11 colposcopy survey questions. English speakers answered more questions correctly than Spanish speakers (8.50 ± 1.92 [77%] vs 6.21 ± 1.93 [56%]; p < .001). Using linear regression to adjust for confounding variables, we found that language was not significantly associated with greater understanding (p = .46). Rather, education was the most significant predictor of colposcopy knowledge (p < .001). many colposcopy patients did not understand the procedure well enough to give informed consent. The observed differences in colposcopy comprehension based on language were a proxy for differences in education. Education, not language, predicted subjects' understanding of colposcopy. These results demonstrate the need for greater attention to patients' educational background to ensure adequate understanding of clinical information. 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc.
Ríos, Roxana; Olmedo, Catón; Fernández, Luis
Abstract: The United States Agency for Development in Bolivia (USAID/Bolivia) created in 2002 PROSALUD- Partners for Development Project (PfD) with the aim of improving the population's well-being. The project used three components: small grant scheme, technical assistance and database system management. Through the small grants scheme, the PfD supported a Community Participation Strategy (CPS) project over a three year period. The project involved the rural areas of six Bolivian departments and suburban areas of three Bolivian cities. The main objective was to increase health service utilization with a particular emphasis on empowerment of women, strengthening of local organizations and increasing the demand for health services. Women from both the urban and rural areas, and from different indigenous groups, were trained in project management, health promotion, reproductive health and family planning, advocacy and community participation. Participatory methodologies have allowed empowering women in decision making and capacity building throughout the entire project process. The experience shows that it is important to work with formally established grass-root community organizations and strengthen leadership within them. Additionally, the sub-projects demonstrated that interventions are more successful when promoters speak and write native languages, women are more motivated and empowered, projects are designed to be responsive to daily necessities identified by the communities and health services are culturally suitable. A preliminary evaluation, in both quantitative and qualitative terms, shows an overall improvement in health knowledge and practice, and utilization of health services.
Cepeda-Benito, A; Doogan, N J; Redner, R; Roberts, M E; Kurti, A N; Villanti, A C; Lopez, A A; Quisenberry, A J; Stanton, C A; Gaalema, D E; Keith, D R; Parker, M A; Higgins, S T
Smoking prevalence is declining at a slower rate in rural than urban settings in the United States (U.S.), and known predictors of smoking do not readily account for this trend difference. Given that socioeconomic and psychosocial determinants of health disparities accumulate in rural settings and that life-course disadvantages are often greater in women than men, we examined whether smoking trends are different for rural and urban men and women. We used yearly cross-sectional data (n = 303,311) from the U.S. National Survey on Drug Use and Health (NSDUH) from 2007 through 2014 to compare cigarette smoking trends in men and women across rural and urban areas. Current smoking status was modelled using logistic regression controlling for confounding risk factors. Regression derived graphs predicting unadjusted prevalence estimates and 95% confidence bands revealed that whereas the smoking trends of rural men, urban men, and urban women significantly declined from 2007 to 2014, the trend for rural women was flat. Controlling for demographic, socioeconomic and psychosocial predictors of smoking did not explain rural women's significantly different trend from those of the other three groups. Rural women lag behind rural men, urban men and urban women in decreasing smoking, a health disparity finding that supports the need for tobacco control and regulatory policies and interventions that are more effective in reducing smoking among rural women. Copyright © 2018 Elsevier Inc. All rights reserved.
Cancela, José María; Varela, Silvia; Alvarez, María José; Molina, Antonio; Ayán, Carlos; Martín, Vicente
Questionnaires designed to assess the level of physical activity among elderly Spanish speaking women usually have problems of reproducibility and are difficult to administer. This study aims to validate a Spanish combined version of two questionnaires originally designed to assess physical activity levels in fibromyalgia women. The leisure time physical activity instrument (LTPAI) and the physical activity at home and work instrument (PAHWI). Both questionnaires were translated to Spanish using translation/back translation methodology, and then were administered to 44 women aged 60-80 twice, with an interval of 2 weeks. During the first administration, participants answered the Yale physical activity questionnaires (YPAS) and performed the 6-min walking test (6MWT). Although the Spanish version of the LTPAI and the PAWHI showed poor test-retest reliability and poor construct validity, the sum of the two questionnaires showed much better associations. The results suggest that the Spanish combined version of LTPAI and PAHWI would seem to be useful tools for assessing the level of physical activity among elderly Spanish speaking women. Nevertheless, such considerations as the cultural adaptation of their content or the link between the intensity of physical activity as perceived and that actually done must be adjusted for greater efficiency. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Research aimed to enhance rural women's access to communication and information technologies and to assess the impact of their technology use on their participation in small business development and community development. Over 200 women throughout Queensland (Australia) were involved. A trial electronic mailing list linking rural women to urban…
Haynes, Deborah C.; Haynes, George W.; Weinert, Clarann
This research was part of a larger longitudinal study of chronically ill rural women to determine if computer technology could be effective in allowing the women to take control of their own well-being, including finances. The current study examined whether chronically ill rural women can effectively use on-line personal finance educational…
Durst, Michelle; Rolfe, Margaret; Longman, Jo; Robin, Sarah; Dhnaram, Beverley; Mullany, Kathryn; Wright, Ian; Barclay, Lesley
To describe the outcomes of a public hospital maternity unit in rural New South Wales (NSW) following the adaptation of the service from an obstetrician and general practitioner-obstetrician (GPO)-led birthing service to a low-risk midwifery group practice (MGP) model of care with a planned caesarean section service (PCS). A retrospective descriptive study using quantitative methodology. Maternity unit in a small public hospital in rural New South Wales, Australia. Data were extracted from the ward-based birth register for 1172 births at the service between July 2007 and June 2012. Birth numbers, maternal characteristics, labour, birthing and neonatal outcomes. There were 750 births over 29 months in GPO and 277 and 145 births over 31 months in MGP and PCS, respectively, totalling 422 births following the change in model of care. The GPO had 553 (73.7%) vaginal births and 197 (26.3%) caesarean section (CS) births (139 planned and 58 unplanned). There were almost universal normal vaginal births in MGP (>99% or 276). For normal vaginal births, more women in MGP had no analgesia (45.3% versus 25.1%) or non-invasive analgesia (47.9% versus 38.6%) and episiotomy was less common in MGP than GPO (1.9% versus 3.4%). Neonatal outcomes were similar for both groups with no difference between Apgar scores at 5 min, neonatal resuscitations or transfer to high-level special care nurseries. This study demonstrates how a rural maternity service maintained quality care outcomes for low-risk women following the adaptation from a GPO to an MGP service. © 2016 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance.
Examines 21 female administrators' accounts of their experience in a rural Nova Scotia school district. Presents preliminary findings of these women's own responses, resistances, and initiatives while attempting to legitimize and implement their preferred leadership styles, which stressed relationships, instructional leadership, communication, and…
Gibbons, Veronique; Lancaster, Gytha; Gosman, Kim; Lawrenson, Ross
INTRODUCTION Rural women face many challenges with regards to maternity services. Many rural primary birthing facilities in New Zealand have closed. The Lead Maternity Carer (LMC) model of maternity care, introduced in 1990, has moved provision of rural maternity care from doctors to independent midwifery services. Shortages of rural midwives in the Midland region led to rural maternity care being seen as a vulnerable service. AIM To understand the views and experiences of rural women concerning maternity care, to inform the future design and provision of rural maternity services. METHODS Participants were drawn from areas purposively selected to represent the five District Health Boards comprising the Midland health region. A demographic questionnaire, focus groups and individual interviews explored rural women's perspectives of antenatal care provision. These were analysed thematically. RESULTS Sixty-two women were recruited. Key themes emerging from focus groups and interviews included: access to services, the importance of safety and quality of care, the need for appropriate information at different stages, and the role of partners, family and friends in the birthing journey. While most women were happy with access to services, quality of care, provision of information, and the role of family in their care, for some women, this experience could be enhanced. CONCLUSION Midwives are the frontline service for women seeking antenatal services. Support for rural midwives and for local birthing units is needed to ensure rural women receive services equal to that of their urban counterparts.
Vives-Cases, Carmen; Gil-González, Diana; Plazaola-Castaño, Juncal; Montero-Piñar, María Isabel; Ruiz-Pérez, Isabel; Escribà-Agüir, Vicenta; Ortiz-Barreda, Gaby; Torrubiano-Domínguez, Jordi
To compare the prevalence of gender-based violence among immigrant and Spanish women. To describe their responses to this problem and the possible differences. To identify specific interventions to deal with gender-based violence in immigrant women in Spain. We performed a cross-sectional survey through a self-administered questionnaire in 10,202 women attending primary care in Spain (2006-2007). A content analysis was performed of the follow-up report of law 1/2004 of integral protection measures against gender violence sent by each Spanish region (2005) and the most recent regional laws and acts. The prevalence of gender-based violence was 14.3% in Spanish women and 27.9% in immigrant women. The likelihood of gender-based violence was higher in immigrant (odds ratio adjusted: 2.06; 95% confidence interval: 1.61-2.64). Immigrant women more frequently reported that they had denounced their intimate partners and that they did not know how to manage the situation. Some Spanish regions have already started interventions to overcome access barriers to social and health services, but only three have provided data on the number of immigrant women who received economic and occupational help up to 2005. Inequalities were observed in the prevalence of gender-based violence according to country of origin, with immigrant women being more frequently affected. Immigrant women more frequently denounce their intimate partners than Spanish women but this action does not guarantee effective results. Other specific interventions have been identified in some autonomous regions of Spain but these interventions need to be evaluated to ensure that they benefit immigrant women.
Members of Women, Population and Development groups, which aim to improve women's status in rural areas of China, will use their embroidery and tapestries to tell their stories at the Fourth World Conference on Women in Beijing in September 1995. Contests were held at the county and provincial levels to decide whose artwork, from over a 1000 groups, would go to the conference. 35 pieces (one group tapestry or embroidery from each county) were judged at the provincial level based on how the artwork and the stories of the women who made it demonstrated the achievements of the women as a result of their group involvement. The criteria included: 1) higher self image, confidence, and desire for personal growth; 2) increased social mobility and creativity; 3) more independence and self-reliance in income generation and other activities; 4) increased ability to make decisions for self; 5) increased respect within family and community; 6) more consciousness of maternal and child health and family planning needs; and 7) more awareness of the need for literacy. The Women, Population and Development Project is funded by the United Nations Population Fund (UNFPA), executed by FAO, and implemented by MOFTEC¿DIR.
Gopalan, Saji S; Durairaj, Varatharajan
Given the increasing need for mainstreaming household financing for women's nonmaternal health care and evidences on community-based financing's contribution to women's health care in general, this study explored their scope for nonmaternal health care in Orissa. A qualitative assessment conducted focus group discussions with rural women who met the eligibility criteria. Community-based financing provided financial access and risk protection for women's nonmaternal health care during the previous 1 year, though not adequately. Schemes covering outpatient care (or mild illnesses) provided relatively more financial access. The major determinants of their restricted financial access were limited sum assured, noncomprehensive coverage of services, exclusion of elderly women, and the lower priority households gave to nonmaternal health care. Community-based financing requires relevant structural changes along with demand-side behavioral modifications to ensure optimal attention to women's nonmaternal health care. © 2012 APJPH.
George, R.; Yadla, V.L.; Zohruailiani, M.
Renewable energy cooking technologies (RECTs) like solar cookers, biogas units and improved cookstoves are promoted by Government of India to combat fuel wood scarcity and ensure a cleaner environment. The value of an energy education software (EES) to generate awareness about cooking energy scarcity and to achieve scientific empowerment of potential end users of RECTs, needs no emphasis. An attempt was made to assess the impact of an EES that consisted of flip charts--visuals with minimum text on rural women. The major objective of the research endeavor was to measure the difference in the selected attributes, namely, attitude towards biomassmore » generation and biomass conservation (BG-BC), cooking management practices (CMP) and knowledge level (KL) of rural women due to exposure to EES. A descriptive research design coupled with a before and after experimental design was adopted for the study. A sample of rural women from Nani Sherkhi village were exposed to EES through a series of three training sessions with pre and post sessions for group discussions. Data on the selected attributes were gathered in the pre and post training periods using descriptive rating scales with reliability coefficients of 0.80, 0.81 and 0.74 respectively. The computed t values showed significant differences at 0.01 level in the pre and post exposure mean scores on attitude, cooking management practice and knowledge scale. The t values revealed that the gain in score in each of the attributes due to exposure to EES were significant. Further, utility of EES, policy implications and strategies for popularizing it as an aid to reach sustainable development are also discussed in brief in the paper.« less
This article presents the findings of a 1995 family planning survey conducted among 657 women aged 18-49 years in rural areas of Tangshan City, Zhoushou City, and Xingtai City in Hebei province, Northern China. 620 were married, 37 were single, and 6 were widowed. 85.8% of married rural women used a contraceptive method (female sterilization or IUD). There were 1219 pregnancies, 230 abortions, 31 miscarriages, and 3 stillbirths. 68.1% received prenatal check-ups at hospitals and health centers. 47.4% received prenatal care during the first trimester of pregnancy. 76.1% received check-ups at township health centers. Women were aware of the need for sound personal hygiene, sanitary napkins, and avoidance of heavy manual work during menstruation. 45.1% had less than 5 years of education; 51.8% had 6-10 years of education; and 3.1% had over 10 years of education. About 54% delivered at home. Home deliveries were due to lack of transportation, high expenses, and other reasons. Deliveries were attended by a doctor or midwife. Postpartum home visits were not assured. 32.4% had routine gynecological check-ups. 48.1% had never received gynecological services. 51.6% of married women had 2 children; 16.9% had more. The author recommended improved socioeconomic and cultural conditions, a women-centered reproductive health security system integrated with education, and legislative change. Reproductive health education should be integrated into family planning programs and include health awareness and more education. Men should participate in programs and share more responsibility for reproduction. Services should improve in quality.
Cepeda, Isabel; Lacalle-Calderon, Maricruz; Torralba, Miguel
Violence against Women (VaW) has come to be recognized as a serious human rights abuse with important consequences not only for women but for whole societies. Since VaW has several manifestations, it is possible to differentiate among different types of violence. In this article, a broad theoretical framework with different dimensions of gender violence was adapted to a Latin American social and cultural context to measure three out of the five main types of violence: economic violence, emotional psychological violence, and coercive control. The goal of this article is to provide empirical evidence to determine whether access to microfinance services plays a role in reducing VaW. To this end, we designed and performed a cross-sectional study with a treatment and a control group in rural Guatemala. A sample of 883 rural women in the "Altiplano" area of Guatemala (448 women with microfinance services and 435 without) was surveyed from May to November 2012. The results of the bivariate logistic regression showed evidence of association between access to microfinance services and reduction of VaW. After adjusting for covariates, global, economic, and emotional psychological violence maintained a negative and statistically significant association with microfinance, while only coercive control showed no statistical association with microfinance services. Access to microcredits showed a very clear relationship to reducing economic and emotional violence but not coercive control, a factor that may be determined by social and cultural norms. In contrast to Status Inconsistency Theory, which has been tested primarily in Asia, our study of Guatemala showed that increased status and economic independence of women due to their participation in microfinance services reduced VaW.
Chhabra, S; Palaparthy, S; Mishra, S
This study covers issues on advanced unwanted pregnancies in rural single women in South-east Asia, with reference to age, education, occupation, person responsible (i.e. baby's father) and reasons for delay in seeking assistance. It describes single women with pregnancy beyond the time for abortion, as set by the Indian abortion law. The study involved 314 girls/women and was set in the Mahatma Gandhi Institute of Medical Sciences, Sevagram, India. The girls/women were admitted, provided with free facilities and had their babies looked after by hospital staff until given up for adoption, or otherwise. The outcomes of the study showed that most individuals (71.01%) were rural, less-literate, working girls. In 94.26% of cases, the baby's father was known; 24 (7.64%) reported rape (13 by a known person). A total of 66 individuals (21.02%) did not inform their parents about the pregnancy for up to 5 months. Five (1.59%) went to unqualified medical practitioners and 16.56% to private practitioners who did not give their services. A total of 47 (14.96%) had waited for the person responsible for their pregnancy before seeking assistance. There was a total of 315 babies born to 310 mothers (five twins); four absconded undelivered; 13 absconded after delivery (two with their babies, 11 leaving babies). The study found that pregnancies were often caused by rape and girls/women with no knowledge of abortion laws, shyness, fear, lack of desired privacy, lack of resources, misleading management at periphery all went beyond 20 weeks. Mostly, the babies were not accepted--the girls married the babies' fathers, but left their babies. Emergency contraception for unprotected sexual intercourse is essential.
Ajah, Leonard Ogbonna; Iyoke, Chukwuemeka Anthony; Nkwo, Peter Onubiwe; Nwakoby, Boniface; Ezeonu, Paul
The perception and prevalence of domestic violence (DV) in rural areas is poorly understood; the result is that most efforts at eradicating this harmful practice are concentrated in urban areas. The objective of the study was to compare the burden and perception of DV among women living in rural and urban Igbo communities of southeast Nigeria. This was a comparative, cross-sectional study of women residing in rural and urban communities in Enugu, Nigeria, who had gathered for an annual religious meeting from August 1-7, 2011. Data analysis involved descriptive and inferential statistics and was conducted with the Statistical Package for Social Sciences, software version 17.0, at a 95% level of confidence. A total of 836 women who met the eligibility criteria participated in the survey. Of these, 376 were from Okpanku, a rural community, while 460 were from Ogui Nike, an urban community. The prevalence of DV among rural women was significantly higher than that among urban women (97% versus 81%, P<0.001). In particular, the prevalence of physical violence was significantly higher among rural women than among urban women (37.2% versus 23.5%; P=0.05). In contrast, rural and urban women did not differ significantly in the proportions that had experienced psychological or sexual violence. The proportion of women who believed that DV was excusable was significantly higher among rural dwellers than among urban dwellers (58.5% versus 29.6%; P=0.03). The burden of DV against women may be higher in rural communities than in urban communities in southeast Nigeria. More rural women perceived DV as excusable; this finding suggests that factors that sustain DV could be strong in rural areas. A comprehensive program to curb DV in this area may need to significantly involve the rural areas.
Ajah, Leonard Ogbonna; Iyoke, Chukwuemeka Anthony; Nkwo, Peter Onubiwe; Nwakoby, Boniface; Ezeonu, Paul
Background The perception and prevalence of domestic violence (DV) in rural areas is poorly understood; the result is that most efforts at eradicating this harmful practice are concentrated in urban areas. The objective of the study was to compare the burden and perception of DV among women living in rural and urban Igbo communities of southeast Nigeria. Methods This was a comparative, cross-sectional study of women residing in rural and urban communities in Enugu, Nigeria, who had gathered for an annual religious meeting from August 1–7, 2011. Data analysis involved descriptive and inferential statistics and was conducted with the Statistical Package for Social Sciences, software version 17.0, at a 95% level of confidence. Results A total of 836 women who met the eligibility criteria participated in the survey. Of these, 376 were from Okpanku, a rural community, while 460 were from Ogui Nike, an urban community. The prevalence of DV among rural women was significantly higher than that among urban women (97% versus 81%, P<0.001). In particular, the prevalence of physical violence was significantly higher among rural women than among urban women (37.2% versus 23.5%; P=0.05). In contrast, rural and urban women did not differ significantly in the proportions that had experienced psychological or sexual violence. The proportion of women who believed that DV was excusable was significantly higher among rural dwellers than among urban dwellers (58.5% versus 29.6%; P=0.03). Conclusion The burden of DV against women may be higher in rural communities than in urban communities in southeast Nigeria. More rural women perceived DV as excusable; this finding suggests that factors that sustain DV could be strong in rural areas. A comprehensive program to curb DV in this area may need to significantly involve the rural areas. PMID:25336992
Torloni, M R; Campos Mansilla, B; Merialdi, M; Betrán, A P
Caesarean section (CS) rates are increasing worldwide and maternal request is cited as one of the main reasons for this trend. Women's preferences for route of delivery are influenced by popular media, including magazines. We assessed the information on CS presented in Spanish women's magazines. Systematic review. Women's magazines printed from 1989 to 2009 with the largest national distribution. Articles with any information on CS. Articles were selected, read and abstracted in duplicate. Sources of information, scientific accuracy, comprehensiveness and women's testimonials were objectively extracted using a content analysis form designed for this study. Accuracy, comprehensiveness and sources of information. Most (67%) of the 1223 selected articles presented exclusively personal opinion/birth stories, 12% reported the potential benefits of CS, 26% mentioned the short-term and 10% mentioned the long-term maternal risks, and 6% highlighted the perinatal risks of CS. The most frequent short-term risks were the increased time for maternal recovery (n = 86), frustration/feelings of failure (n = 83) and increased post-surgical pain (n = 71). The most frequently cited long-term risks were uterine rupture (n = 57) and the need for another CS in any subsequent pregnancy (n = 42). Less than 5% of the selected articles reported that CS could increase the risks of infection (n = 53), haemorrhage (n = 31) or placenta praevia/accreta in future pregnancies (n = 6). The sources of information were not reported by 68% of the articles. The portrayal of CS in Spanish women's magazines is not sufficiently comprehensive and does not provide adequate important information to help the readership to understand the real benefits and risks of this route of delivery. © 2014 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.
Torloni, MR; Campos Mansilla, B; Merialdi, M; Betrán, AP
Objectives Caesarean section (CS) rates are increasing worldwide and maternal request is cited as one of the main reasons for this trend. Women's preferences for route of delivery are influenced by popular media, including magazines. We assessed the information on CS presented in Spanish women's magazines. Design Systematic review. Setting Women's magazines printed from 1989 to 2009 with the largest national distribution. Sample Articles with any information on CS. Methods Articles were selected, read and abstracted in duplicate. Sources of information, scientific accuracy, comprehensiveness and women's testimonials were objectively extracted using a content analysis form designed for this study. Main outcome measures Accuracy, comprehensiveness and sources of information. Results Most (67%) of the 1223 selected articles presented exclusively personal opinion/birth stories, 12% reported the potential benefits of CS, 26% mentioned the short-term and 10% mentioned the long-term maternal risks, and 6% highlighted the perinatal risks of CS. The most frequent short-term risks were the increased time for maternal recovery (n = 86), frustration/feelings of failure (n = 83) and increased post-surgical pain (n = 71). The most frequently cited long-term risks were uterine rupture (n = 57) and the need for another CS in any subsequent pregnancy (n = 42). Less than 5% of the selected articles reported that CS could increase the risks of infection (n = 53), haemorrhage (n = 31) or placenta praevia/accreta in future pregnancies (n = 6). The sources of information were not reported by 68% of the articles. Conclusions The portrayal of CS in Spanish women's magazines is not sufficiently comprehensive and does not provide adequate important information to help the readership to understand the real benefits and risks of this route of delivery. PMID:24467797
Pawan, Faridah; Thomalla, Therese Groff
This article describes a responsive evaluation study of ESL services and Spanish language services for immigrants in a rural county in Indiana. An ESL specialist led the evaluation of language services in the county from the perspectives of language providers and recipients. The responsive evaluation--a form of action research that uses…
Singh, Rakesh K; Patra, Shraboni
Tanzania is the country hit the hardest by the HIV epidemic in Sub-Saharan Africa. The present study was carried out to examine the factors of HIV infection among women who lived in an urban area in Tanzania. The Tanzania HIV/AIDS and Malaria Indicator Survey (2011-12) data was used. The sample size for urban and rural women who had been tested for HIV and ever had sex was 2227 and 6210 respectively. Bivariate and multivariate logistic regression analyses were used. The present study found that rural women were significantly less likely to be HIV-infected compared to urban women (OR = 0.612, p<0.00). About 10% urban women were HIV-infected whereas 5.8% women in rural areas were HIV positive. Women who had more than five sex partners were significantly four times more likely to be HIV-infected as compared to women who had one sex partner (OR = 4.49, p<0.00). The results of this study suggest that less-educated women, women belonging to poor or poorer quintile, women spending nights outside and women having more than one sex partner were significantly more likely to have HIV infection among urban women as compared to rural women. There is an urgent need for a short and effective program to control the HIV epidemic in urban areas of Tanzania especially for less-educated urban women.
Pathak, Yogini; Mankodi, Hina
One of the University of Baroda's (India) Rural/Tribal Block Placement Program's major aims during the year 1988-89 was to develop energy consciousness in women, primary school children and teachers. An experimental project was designed for a rural Indian village. The objectives were to obtain information on rural energy resources; assess the role…
Simkhada, Padam P; Shyangdan, Deepson; van Teijlingen, Edwin R; Kadel, Santosh; Stephen, Jane; Gurung, Tara
What is perceived to be a disability is both culturally specific and related to levels of development and modernity. This paper explores knowledge and attitudes towards people with disabilities among rural women in Nepal, one of the poorer countries in South Asia. Four hundred and twelve married women of reproductive age (aged 15-49 years), from four villages in two different parts of Nepal, who had delivered a child within the last 24 months preceding the study, completed a standard questionnaire. The majority of the participants only considered physical conditions that limit function of an individual and are visible to naked eyes, such as missing a leg or arm, to be disability. Attitudes towards people with disability were generally positive, for example most women believed that disabled people should have equal rights and should be allowed to sit on committees or get married. Most respondents thought that disability could result from: (i) accidents; (ii) medical conditions; or (iii) genetic inheritance. Fewer women thought that disability was caused by fate or bad spirits. There is need to educate the general population on disability, especially the invisible disabilities. There is also a need for further research on disability and its social impact. • There is need to educate the general population on disability, especially the invisible disabilities and its rehabilitation. There is also a need for further research on disability and its social impact.
Bryceson, D F
Western donor agencies in their development projects to increase the income for rural women have neglected the domestic residence as a unit of production of food, water, and fuel: 1) directly produced by sources in the field, 2) physically delivered to the residence, 3) processed, and 4) distributed to household members for consumption. An alternative approach to home economics and market-oriented production is suggested. Homestead economics is the study of women's labor as a scarce resource consisting of daily livelihood management. The detailed mechanics (time, effort, and spatial dynamics) of women's work needs to be dissected in order to determine the appropriate tools or organizational improvements that would improve the satisfaction of basic needs and the standard of living, in specific circumstances. When a participatory research approach is used, women can be involved in self-discovery, and researchers can be a useful resource. Outreach to women must entail more than training courses, publication of practical handbooks for literate women, and activation of women's groups. The influence of Western feminism on donor project design in Africa has not been realized, partly because there are real differences in the role of women and the value of children, and the physical environment. Although reproductive-age women have heavy work schedules, their children, who have completed primary school, are part of the homestead work force, and are waiting for betrothal, do have available time. Some indirect advantages of involving teenaged girls in training are a delay in age at marriage, and an affect on lifetime attitudes. The main components, which would have to be adapted to the local situation, are training in nontraditional skills related to homestead management and maintenance, and promoting formation of female youth groups for support and income-generating activities. Gender stereotyping is not an issue, because improvements in women's homestead work is part of
Cates, Joan R.; Brewer, Noel T.; Fazekas, Karah I.; Mitchell, Cicely E.; Smith, Jennifer S.
Context: Because cervical cancer mortality in the United States is twice as high among black women as white women and higher in rural areas, providing human papillomavirus (HPV) vaccine to rural black adolescents is a high priority. Purpose: To identify racial differences in knowledge and attitudes about HPV, cervical cancer, and the HPV vaccine…
Agbo, Felicia Onyemowo; Isa, Ali A. Muluku
This paper examined scientific skills and concept learning by rural women for personal and national development. The research design employed was a quasi-experimental, one-group pre-test and post-test design. A non-formal science program package to enhance and empower the rural women's knowledge and skills in their daily activities (nutrition,…
This study endeavored to investigate the impact of education on rural women's participation in political and economic activities. Six hundred rural women and 12 gender Activists were selected for this study from three Zones of Amhara Region, Ethiopia using multi-stage random sampling technique and purposeful sampling techniques respectively.…
Bencivenga, Marcyann; DeRubis, Susan; Leach, Patricia; Lotito, Lisa; Shoemaker, Charles; Lengerich, Eugene J.
Context: Multiple national agencies and organizations recommend that women age 40 years and older have an annual screening mammogram. Women who are poor, less educated, lack a usual source of care, and reside in rural Appalachia are less likely to have had a recent mammogram. Purpose: To increase use of mammography among a rural Appalachian…
Bourgeois, Monique; Kirby, Dale
The significance of post-secondary education is investigated for rural Newfoundland women enrolled in undergraduate liberal arts degree programs. Data collection for this research involved comprehensive, detailed semi-structured biographical interviews with rural women studying liberal arts disciplines during the 2006-2007 academic year at…
Cautley, Eleanor; Slesinger, Doris P.
Urban women are better off in labor force participation and poverty than women in central city and rural areas. Differences in access to jobs and welfare benefits explain the urban-rural variation. Finds that the most important factor for not living in poverty is earning income. Recommends policies for reducing poverty among single, working…
The report describes the changing image of women in rural Tanzania and the various agencies responsible for their social, economic, cultural, and political promotion in rural areas, including the Tanganyika African National Union (TANU), and the Union of Women in Tanganyika (UWT). (LH)
Sevilla, Claudia; Wieslander, Cecilia K; Alas, Alexandriah N; Dunivan, Gena C; Khan, Aqsa A; Maliski, Sally L; Rogers, Rebecca G; Anger, Jennifer Tash
This study aimed to assess the effect of the initial visit with a specialist on disease understanding among Spanish-speaking women with pelvic floor disorders. Spanish-speaking women with referrals suggestive of urinary incontinence (UI) and/or pelvic organ prolapse (POP) were recruited from public urogynecology clinics. Patients participated in a health literacy assessment and interview before and after their physician encounter. All interviews were analyzed using Grounded Theory qualitative methods. Twenty-seven women with POP (n = 6), UI (n = 11), and POP/UI (n = 10) were enrolled in this study. The mean age was 55.5 years, and most women had marginal levels of health literacy. From our qualitative analysis, 3 concepts emerged. First, was that patients had poor understanding of their diagnosis before and after the encounter regardless of how extensive the physician's explanation or level of Spanish-proficiency. Second, patients were overwhelmed with the amount of information given to them. Lastly, patients ultimately put their trust in the physician, relying on them for treatment recommendations. Our findings emphasize the difficulty Spanish-speaking women with low health literacy have in understanding information regarding pelvic floor disorders. In this specific population, the physician has a major role in influencing patients' treatment decisions and helping them overcome fears they may have about their condition.
Sibai, Salam Adlbi
This article reports part of a wider investigation which is still being developed and analyzes in depth the lives of female university students who are both Spanish and Muslim. The first part of this research was published in the "Revista Espanola de Educacion Comparada," where the results of the study in Madrid are presented. Here, the…
López-Fuentes, Iratxe; Calvete, Esther
The scientific literature reveals the importance of the resilience process in females who have experienced intimate partner violence (IPV). However, despite the importance of the cultural context in the process of resilience, there are no investigations exploring this phenomenon in Spain. This study used grounded theory to explore the factors that contribute to building resilience in Spanish women who have undergone IPV. A sample of 22 women who had experienced IPV participated in the study (mean age = 46.45 years, SD = 10.49). Findings revealed that these women were capable of using various factors, both individual and external, that promoted resilience. The women employed the following individual factors: physical activity, rediscovering oneself, altruism, control over one's life, creativity, spirituality, focus on the present, sense of humor, introspection, optimism, and projects and goals. The external resilience factors were housing, informal social support, and formal social support. Findings indicate that these factors can vary from one woman to the next and that some of these factors promoted the use of other factors in the development of resilience. The implications for clinical interventions with survivors are discussed. (c) 2015 APA, all rights reserved).
A major stumbling block for the implementation of Mexico's Global Development Plan has been the country's large rural population of Indians. One government strategy to integrate this sector into the mainstream of society has been to teach Spanish, the official language, as a second language, while at the same time fostering ethnic pride. The…
Simmons, Leigh Ann; Anderson, Elaine A; Braun, Bonnie
This study examined the correlates of health service utilization in a sample of low-income, rural women. Self-reported data were from Rural Families Speak (N = 275), a multi-state study of low-income, rural families in the U.S. collected in 2002. Findings indicated that women with health insurance, a regular doctor, and poorer overall physical health had higher incident rates of physician visits. Women who were divorced, separated or widowed and had more chronic health problems had higher incidence rates of emergency department (ED) use, while women living in counties with higher primary care physician rates had lower incidence rates of ED use. Future research and policies should focus on improved access to health insurance, increasing physician availability in rural areas, and providing rural women with a usual source of care, so as to reduce emergency services utilization for non-emergent needs and improve health status for this population.
Hakimi, Sevil; Haggi, Hurieh Badali; Shojai, Shayan Kamali; Farahbakhsh, Mostafa; Farhan, Faranak
Although hormonal changes during menopause are inevitable in this period, the severity of the menopausal symptoms can be controlled. Accepting menopause and having a positive attitude toward it can also help. Given the results of previous studies, and since environmental factors affect the pattern of menopausal symptoms the present study was conducted to compare the pattern of menopausal symptoms, concern and attitudes in urban and rural postmenopausal women. This cross-sectional study was conducted on urban and rural postmenopausal women residing in and around Tabriz, Iran. Cluster sampling was used to select the subjects. The data collection tools used included a demographic questionnaire to assess women's experiences during menopause. This study examined 544 urban and rural postmenopausal women between March and September 2015. The women had a mean age of 51.8 ± 3.1. After adjusting the basic variables, the mean scores of menopausal symptoms and their subscales showed significantly higher scores in the physical and psychological subscales in the urban women, while the rural women had significantly higher scores in the concern subscale. Rural women were significantly different from urban women in terms of menopausal symptoms, concern and attitudes. Hot flushes, a common menopausal symptom, and decreased sexual desire were more common in the urban women; in contrast, the rural women experienced more concern about menopause and its consequences.
Mobley, Sandra C; Thomas, Suzanne Dixson; Sutherland, Donald E; Hudgins, Jodi; Ange, Brittany L; Johnson, Maribeth H
This research examined changes in maternal health literacy progression among 106 low income, high risk, rural perinatal African American and White women who received home visits by Registered Nurse Case Managers through the Enterprise Community Healthy Start Program. Maternal health literacy progression would enable women to better address intermediate factors in their lives that impacted birth outcomes, and ultimately infant mortality (Lu and Halfon in Mater Child Health J 7(1):13-30, 2003; Sharma et al. in J Natl Med Assoc 86(11):857-860, 1994). The Life Skills Progression Instrument (LSP) (Wollesen and Peifer, in Life skills progression. An outcome and intervention planning instrument for use with families at risk. Paul H. Brookes Publishing Co., Baltimore, 2006) measured changes in behaviors that represented intermediate factors in birth outcomes. Maternal Health Care Literacy (LSP/M-HCL) was a woman's use of information, critical thinking and health care services; Maternal Self Care Literacy (LSP/M-SCL) was a woman's management of personal and child health at home (Smith and Moore in Health literacy and depression in the context of home visitation. Mater Child Health J, 2011). Adequacy was set at a score of (≥4). Among 106 women in the study initial scores were inadequate (<4) on LSP/M-HCL (83 %), and on LSP/M-SCL (30 %). Significant positive changes were noted in maternal health literacy progression from the initial prenatal assessment to the first (p < .01) postpartum assessment and to the final (p < .01) postpartum assessment using McNemar's test of gain scores. Numeric comparison of first and last gain scores indicated women's scores progressed (LSP/M-HCL; p < .0001) and (LSP/M-SCL; p < .0001). Elevated depression scores were most frequent among women with <4 LSP/M-HCL and/or <4 LSP/M-SCL. Visit notes indicated lack or loss of relationship with the father of the baby and intimate partner discord contributed to higher depression scores.
Pérez-Ramírez, Francisca; García-García, Inmaculada; Caparros-Gonzalez, Rafael A; Peralta-Ramírez, María Isabel
to describe whether there were differences in sociodemographic, obstetric, perinatal and psychological variables between immigrant women and native-born women in Spain during the first 24 h after delivery. The immediate postpartum period is a critical time when physical and psychological disorders are likely to occur. Immigrant women have, in general, poor perinatal and psychological results during this time. One hundred and three women at the Virgen de las Nieves University Hospital (Granada, Spain) were divided into two groups: 50 Spanish and 53 immigrants. The instruments used were the Life Orientation Test, the Stress Vulnerability Inventory, the Perceived Stress Scale and the Symptom Checklist-90-Revised (SCL-90-R). Sociodemographic and obstetric data were obtained from the healthcare providers reports. During the postpartum period, the immigrant women had higher mean scores on the following subscales: interpersonal sensitivity (F(1,102) = 4.06; p < 0.05); depression (F(1,102) = 7.24; p < 0.01); phobic anxiety (F(1,102) = 4.83; p < 0.05), paranoid ideation (F(1,102) = 7.20; p < 0.01); and psychoticism (F(1,102) = 4.04; p < 0.05). When considering age, education, profession, job situation, immigrant status of the partner and duration of time in Spain as covariates, differences between groups were significant on obsessive-compulsiveness (F(1,102) = 5.37; p < 0.05) and depression (F(1,102) = 6.89; p < 0.05). Immigrant women are in need of more psychological and emotional support from their families, midwives and the rest of healthcare providers than are native Spaniards immediately after delivery.
Marvan, Maria Luisa; Trujillo, Paulina
Women living in rural and urban areas of Mexico answered a questionnaire about what they were told at home about menstruation before their menarche (first menstruation), and answered the Beliefs About and Attitudes Toward Menstruation Questionnaire. Around half of both urban and rural women were told that they were going to experience negative perimenstrual changes. There were fewer urban than rural women who were advised to do or not to do certain activities while menstruating. Menstrual socialization affected the beliefs and attitudes concerning menstruation held by women as adults. These findings are discussed in light of the sociocultural background of the participants.
Ganatra, Bela; Hirve, Siddhi
In a study in rural Maharashtra, India, adolescents constituted 13.1% of the 1717 married women who had an induced abortion during an 18-month period in 1996-1998. The 197 adolescents who were subsequently interviewed had a lesser role in the decision-making process on abortion than women older than them. Most abortions were obtained in the private sector. Though spacing was the main reason for adolescents seeking abortion, prior contraceptive use among them was low. Additionally, they were less likely to receive post-abortion contraceptive counselling or to adopt contraception. Sex selection accounted for more than a fifth of abortions among adolescents. Additional qualitative data from 43 never-married and separated adolescents seeking abortion showed that non-consensual sex made many pregnancies unwanted, and cost, limited mobility, lack of family and partner support and the need for privacy to prevent stigma led many to go to traditional providers, even though safer options existed. Family planning programmes need to address the contraceptive needs of newly married adolescent women as well as unmarried adolescents. Informing adolescents of their legal rights, sensitising providers to adopt an empathetic attitude, and exploring innovative ways of increasing access to safe services for unmarried adolescents are all recommended.
Purtzer, Mary Anne; Overstreet, Lindsey
To use transformative learning to investigate what experiences serve as catalysts for mammography screening, the cognitive and affective responses that result from the catalyst, and how screening behavior is impacted. A descriptive qualitative study. Southeastern Wyoming. 25 low-income, rural women aged 40 years and older. Four focus group interviews. Cancer experiences triggered universal responses of fear by screeners and nonscreeners. The manner in which that fear response was interpreted was a critical factor in the facilitation of, or impedance to, screening. Dichotomous interpretations of fear responses provided the context for screening behavior. Immobilizing and isolating experiences were associated with nonscreening behavior, whereas motivation and self-efficacy were associated with screening behavior. Transformative learning theory is a useful framework from which to explain differences in mammography screening behavior. Creating opportunities that facilitate dialogue and critical reflection hold the potential to change immobilizing and isolating frames of reference in nonscreening women. To help women transcend their fear and become self-efficacious, nurses can assess how cancer and the screening experience is viewed and, if indicated, move beyond standard education and offer opportunities for dialogue and critical reflection.
Gueye, E H
Poultry production has existed for many generations in Africa, and almost every village household keeps chickens. The rural family poultry (RFP) are generally raised in free-range and/or backyard systems, which are traditional extensive husbandry systems. The development of an intensive poultry production has been the goal of the African government over the years. Despite efforts aiming for such goal, RFP is still very important in African countries that are both poor and net importers of food. It is a valuable asset because it can contribute significantly in alleviating poverty, securing food supply, and promoting gender equality. In view of this, interventions to improve RFP production systems should take into account the sociocultural issues, specifically gender-based aspects. It is noted that such interventions might, in addition to food security and poverty alleviation, also serve to promote gender equality. RFP development programs should be more women-friendly in order to facilitate women's participation, as RFP production in the region is generally a woman's business. Moreover, efforts to empower village women has to be envisaged cautiously as there is a serious risk of men taking over once the poultry sector becomes more profitable.
Luque, John S; Tarasenko, Yelena N; Reyes-Garcia, Claudia; Alfonso, Moya L; Suazo, Norma; Rebing, Laura; Ferris, Daron G
This study examined the feasibility and efficacy of Salud es Vida-a promotora-led, Spanish language educational group session on cervical cancer screening (Pap tests)-self-efficacy (belief in ability to schedule and complete a Pap test), and knowledge among immigrant Hispanic/Latina women from farmworker backgrounds. These women are disproportionately burdened with cervical cancer, with mortality rates significantly higher than non-Hispanic whites. The two-arm, quasi-experimental study was conducted in four rural counties of Southeast Georgia in 2014-2015. Hispanic/Latina immigrant women aged 21-65 years and overdue for a Pap test were included as intervention (N = 38) and control (N = 52) group participants. The intervention was developed in partnership with a group of promotoras to create the toolkit of materials which includes a curriculum guide, a brochure, a flipchart, a short animated video, and in-class activities. Twelve (32 %) intervention group participants received the Pap test compared to 10 (19 %) control group participants (p = 0.178). The intervention group scored significantly higher on both cervical cancer knowledge recall and retention than the control group (p < 0.001). While there was no statistically significant difference in cervical cancer screening self-efficacy scores between the group participants, both groups scored higher at follow-up, adjusting for the baseline scores. The group intervention approach was associated with increased cervical cancer knowledge but not uptake of Pap test. More intensive interventions using patient navigation approaches or promotoras who actively follow participants or conducting one-on-one rather than group sessions may be needed to achieve improved screening outcomes with this population.
Employment Standards Administration (DOL), Washington, DC. Women's Bureau.
The report presents data on selected social, economic, and demographic characteristics of women of Spanish origin in the United States. Derived from the population reports of the U.S. Census Bureau and the March 1973 Manpower Report of the President, the statistical data pertain to age, residence, marital status, heads of families and households,…
Gámez, José M; Masmiquel, Luis; Ripoll, Tomás; Barrios, Vivencio; Anguita, Manuel
The relationship between diabetes and the cardiovascular clinical characteristics of Spanish women with stable ischaemic heart disease was studied in a nationwide cross-sectional study. Diabetes was related to a higher burden of risk factors, comorbidity, multivessel disease and coronary surgery. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Aguado, Jaume; Campbell, Alistair; Ascaso, Carlos; Navarro, Purificacion; Garcia-Esteve, Lluisa; Luciano, Juan V.
In this study, the authors tested alternative factor models of the 12-item General Health Questionnaire (GHQ-12) in a sample of Spanish postpartum women, using confirmatory factor analysis. The authors report the results of modeling three different methods for scoring the GHQ-12 using estimation methods recommended for categorical and binary data.…
Wulifan, Joseph K; Mazalale, Jacob; Jahn, Albrecht; Hien, Hervé; Ilboudo, Patrick Christian; Meda, Nicolas; Robyn, Paul Jacob; Hamadou, Saidou; Haidara, Ousmane; De Allegri, Manuela
Given the current low contraceptive use and corresponding high levels of unwanted pregnancies leading to induced abortions and poor maternal health outcomes among rural populations, a detailed understanding of the factors that limit contraceptive use is essential. Our study investigated household and health facility factors that influence contraceptive use decisions among rural women in rural Burkina Faso. We collected data on fertile non-pregnant women in 24 rural districts in 2014. Of 8,657 women, 1,098 used a modern contraceptive. Women having a living son, a child younger than one year, and household wealth were more likely to use modern contraceptives. Women in polygamous marriages and women living at least 5 kilometers from a health facility were less likely to use contraception. We conclude that modern contraceptive use remains weak, hence, programs aiming to encourage contraceptive use must address barriers at both the health facility and the household level.
Churruca, Itziar; Miranda, Jonatan; Lasa, Arrate; Bustamante, María Á; Larretxi, Idoia; Simon, Edurne
The purpose of the present work was both to analyze composition of Spanish celiac women and to study the food habits and gluten-free diet of these celiac patients, in order to determine whether they achieve a balanced and healthy diet as well as to highlight nutritional qualitative and/or quantitative differences. 54 adult celiac women (34 ± 13 years) took part in the six-month study. Height, weight and body composition were measured. An analysis of energy consumption and of the macronutrient distribution of their diet was carried out. Their fulfillment of micronutrient intake recommendations was verified. Participants showed a Body Mass Index of 21.6 ± 2.4 kg/m2. Energy Intake was slightly lower than the Dietary Reference Intakes. Excessive protein apart from over-consumption of fat was observed. More than three quarters of participants consumed meat in excess. Carbohydrate consumption along with that of fiber was below recommended levels. Vitamin D, iron, and iodine had a low percentage of recommendation compliance. In general, participants followed the recommendations of dairy products and fruit intake whereas vegetable consumption was not enough for the vast majority. We conclude that although the diet of celiac women does not differ much from the diet of general population, some considerations, such as reducing fat and protein consumption and increasing fiber intake, must be taken into account.
Fernández-Sola, Cayetano; Martínez-Caba, María Isabel; Hernández-Padilla, José Manuel; Carmona-Samper, Esther; Granero-Molina, José
To describe and understand the experiences and perceptions of women who undergo hysterosalpingography as part of the infertility process. Nurses and midwives should conduct research into the emotional aspects of caring for patients undergoing infertility treatment. The hysterosalpingography is considered to be the most feared test in the infertility process and the one about which very little is known. A phenomenological qualitative study. Ten Spanish women who had undergone hysterosalpingography participated in this study. In-depth interviews were carried out between October 2012-May 2013. Data analysis was performed with the help of atlas.ti software to identify emerging themes. The experience of the participants who underwent hysterosalpingography during the infertility process is represented by the following three themes: (1) becoming a mother to feel complete as a person and as a woman, with the subthemes 'maternity as a life objective' and 'maternity in terms of gender identity'; (2) infertility--an intimate experience which provokes negative feelings, with the subthemes 'negative feelings regarding own infertility' and 'infertility as an experience that is little shared with others'; (3) Undergoing hysterosalpingography, with the subthemes 'feelings regarding hysterosalpingography', 'treatment by medical providers' and 'areas for improvement regarding the service given by the providers'. For women who undergo hysterosalpingography, maternity may be seen as a life objective that could identify them as women. Results suggest that although infertility is experienced with negative feelings such as anxiety, frustration and sadness, hysterosalpingography seems to be related with both hope and fear when facing the test. Knowing the experiences of these women could help nurses, midwives and physicians to provide better patient-centred care. © 2016 John Wiley & Sons Ltd.
Martin, Julie C.; Moran, Lisa J.; Teede, Helena J.; Ranasinha, Sanjeeva; Lombard, Catherine B.; Harrison, Cheryce L.
Health disparities, including weight gain and obesity exist between urban and rural dwelling women. The primary aim was to compare diet quality in urban and rural women of reproductive age, and secondary analyses of the difference in macronutrient and micronutrient intake in urban and rural women, and the predictors of diet quality. Diet quality was assessed in urban (n = 149) and rural (n = 394) women by a modified version of the Dietary Guideline Index (DGI) energy, macronutrient and micronutrient intake from a food frequency questionnaire (FFQ) and predictors of diet quality. Diet quality did not significantly differ between urban and rural women (mean ± standard deviation (SD), 84.8 ± 15.9 vs. 83.9 ± 16.5, p = 0.264). Rural women reported a significantly higher intake of protein, fat, saturated fat, monounsaturated fat, cholesterol and iron and a higher score in the meat and meat alternatives component of the diet quality tool in comparison to urban women. In all women, a higher diet quality was associated with higher annual household income (>$Australian dollar (AUD) 80,000 vs. <$AUD80,000 p = 0.013) and working status (working fulltime/part-time vs. unemployed p = 0.043). Total diet quality did not differ in urban and rural women; however, a higher macronutrient consumption pattern was potentially related to a higher lean meat intake in rural women. Women who are unemployed and on a lower income are an important target group for future dietary interventions aiming to improve diet quality. PMID:28594351
Martin, Julie C; Moran, Lisa J; Teede, Helena J; Ranasinha, Sanjeeva; Lombard, Catherine B; Harrison, Cheryce L
Health disparities, including weight gain and obesity exist between urban and rural dwelling women. The primary aim was to compare diet quality in urban and rural women of reproductive age, and secondary analyses of the difference in macronutrient and micronutrient intake in urban and rural women, and the predictors of diet quality. Diet quality was assessed in urban ( n = 149) and rural ( n = 394) women by a modified version of the Dietary Guideline Index (DGI) energy, macronutrient and micronutrient intake from a food frequency questionnaire (FFQ) and predictors of diet quality. Diet quality did not significantly differ between urban and rural women (mean ± standard deviation (SD), 84.8 ± 15.9 vs. 83.9 ± 16.5, p = 0.264). Rural women reported a significantly higher intake of protein, fat, saturated fat, monounsaturated fat, cholesterol and iron and a higher score in the meat and meat alternatives component of the diet quality tool in comparison to urban women. In all women, a higher diet quality was associated with higher annual household income (>$Australian dollar (AUD) 80,000 vs. <$AUD80,000 p = 0.013) and working status (working fulltime/part-time vs. unemployed p = 0.043). Total diet quality did not differ in urban and rural women; however, a higher macronutrient consumption pattern was potentially related to a higher lean meat intake in rural women. Women who are unemployed and on a lower income are an important target group for future dietary interventions aiming to improve diet quality.
Duda, Rosemary B; Bhushan, Devika
Breast cancer has emerged as an important health condition worldwide, including developing countries. Screening is limited or non-existent in resource-poor areas. The purpose of this study was to assess knowledge, attitudes, and practices of self (SBE) and clinical (CBE) breast examinations among 198 rural Nicaraguan women. Ten (5.1%) had performed a SBE, and 16 (8.1%) had a CBE. CBE was significantly associated with a pre-instruction total score of 70% or greater (OR = 13.7, 95% CI = 1.26, 149.70, p = 0.03). Family history of breast cancer was significantly associated with performing a SBE (OR = 5.5, 95% CI = 1.10, 27.81, p = 0.037) and a CBE (OR = 7.1, 95% CI = 1.40, 35.94, p = 0.018). A CBE is a significant determinant of pre-existing breast health knowledge. Physicians or physician extenders should be encouraged to perform a CBE as a routine component of health care delivery and cancer screening for women.
Kandasamy, Niro; Soldatic, Karen; Samararatne, Dinesha
This article draws on grounded qualitative research with rural Tamil women who acquired a disability during the civil war in Sri Lanka and conceptualizes an intersectionality-peace framework. Three main themes were developed from the interviews: narratives of conflict, survival outcomes of social assistance and mobilization of cross-ethnic relationships. With the support of a local women's disability advocacy organization, Tamil women with disabilities were enabled to overcome social stigma and claim a positive identity as women with disabilities. The organization's focus on realizing disability rights created new opportunities for these highly marginalized rural women. The women were also supported to form cross-ethnic relationships with women who similarly faced multiple oppressions. These relationships transformed the women into 'agents of peace', using their newfound disability identity to foster cross-ethnic dialogue and create safe spaces in the post-conflict context.
Schneider, H; Coetzee, D J; Fehler, H G; Bellingan, A; Dangor, Y; Radebe, F; Ballard, R C
This paper reports on a study undertaken in a rural area of South Africa, to develop a non-laboratory tool to screen for sexually transmitted diseases (STDs) among family planning clients. A cross sectional study was performed of 249 consecutive women attending a family planning service between November and December 1994. A questionnaire was administered, and a clinical examination and laboratory tests conducted. Sociodemographic, clinical, and other non-laboratory variables that were significantly associated with laboratory evidence of infection were combined to produce non-hierarchical scoring systems for three "syndromes": gonococcal and/or chlamydial cervical infection, trichomoniasis, and cervical infection and/or trichomoniasis combined. The sensitivity, specificity, and predictive values of the scoring systems as a screening tool were assessed against the gold standard of laboratory tests. The prevalence of reproductive tract infections among the study participants was as follows: Chlamydia trachomatis 12%, Neisseria gonorrhoeae 3%, Trichomonas vaginalis 18%, and bacterial vaginosis 29%. Although vaginal discharge and other symptoms were frequently reported, symptoms bore no relation to the presence of infection. The following independent associations with gonococcal/chlamydial cervical infection were found: age less than 25 years and cervical mucopus and/or friability. Abnormal discharge on examination, visible inflammatory changes of the cervix (increased redness), no recent travel, and unemployment were associated with trichomoniasis. The combination of trichomonas and/or cervical infection ("STD syndrome") was associated with cervical mucopus/friability, unemployment, lack of financial support, and increased redness of the cervix. Of the three scoring systems developed on the basis of these associations, that of the "STD syndrome" achieved the best performance characteristics as a screening tool, with a sensitivity of 62%, specificity of 74%, and
Maninder, Kaur; Kochar, G K
A cross-sectional study was undertaken on 600 Jat women (rural=300, urban=300), aged 40 to 70 years from Haryana state in North India. The aim of the study was to determine the prevalence of anaemia and the dietary intake of rural and urban middle-aged (40-59 years) and older (60 and above) Jat women. The findings indicated that all the subjects exhibited a decline in the mean values of haemoglobin (Hb) concentration with advancement in age. The mean blood Hb concentration of urban middle-aged and older women was 10.1±1.3g/dl and 9.91.4g/dl respectively, which was higher than their rural counterparts at all age groups, although the differences were statistically non-significant (p>0.05). The overall prevalence of anaemia reached 88.7% (rural women= 91.3%, urban women =86%). Daily dietary intake of rural and urban subjects was below the recommended dietary allowances. Physical performance of both groups of the women showed a decline with a decrease in Hb concentration. A significant and positive correlation of Hb status was observed with grip strength and vital capacity while a negative association was witnessed with blood pressure and pulse rate in both the rural and urban women. Anaemia among these women may be attributed to inadequate dietary intake, illiteracy, and poor access to health services.
Kwagala, Betty; Nankinga, Olivia; Wandera, Stephen Ojiambo; Ndugga, Patricia; Kabagenyi, Allen
There is limited research on how the empowerment of women and intimate partner violence (IPV) are associated with skilled birth attendance (SBA) among rural women in Uganda. Therefore, the aim of this paper was to investigate the association between women's empowerment, their experience of IPV and SBA in rural Uganda. Using data from the Uganda Demographic and Health Survey (UDHS), we selected 857 rural women who were in union, had given birth in the last 5 years preceding the survey and were selected for the domestic violence (DV) module. Frequency distributions were used to describe the background characteristics of the women and their partners. Pearson's chi-squared (χ (2)) tests were used to investigate the associations between SBA and women's empowerment; and partners' and women's socio-demographic factors including sexual violence. Multivariable logistic regression analyses were used to examine the association between SBA and explanatory variables. More than half (55 %) of the women delivered under the supervision of skilled birth attendant. Women's empowerment with respect to participation in household decision-making, property (land and house) (co)ownership, IPV, and sexual empowerment did not positively predict SBA among rural women in Uganda. Key predictors of SBA were household wealth status, partners' education, ANC attendance and parity. For enhancement of SBA in rural areas, there is a need to encourage a more comprehensive ANC attendance irrespective of number of children a woman has; and design interventions to enhance household wealth and promote men's education.
Peiró-Pérez, Rosana; Salas, Dolores; Vallés, Guillermo; Abad-Fernandez, Ma Soledad; Vidal, Carmen; Sanchez-Contador Escudero, Carmen; Ascunce-Elizaga, Nieves; Zubizarreta, Raquel; Pedraz, Carmen; Pérez-Gómez, Beatriz; Navarrete-Muñoz, Eva María; Vioque, Jesús; Pollán, Marina
The aim is to analyse physical activity (PA), the fulfillment recommendation of at least 150 min of moderate PA, through walking/biking (W&B), sport, both types of PA and the factors associated with inactivity by Spanish women who attended breast cancer screening programmes. The DDM-Spain is a multicentre cross-sectional study involving 3584 women, aged 45-68, attending screening in seven Spanish cities. Data were collected using a questionnaire, including age, socio-demographic and lifestyle characteristics, family burden and PA. PA was converted into metabolic equivalent of task (METs), categorized as low ≤ 600 METs min per week (m/w), moderate 600-3000 METs m/w and high ≥ 3000 METs m/w. A multivariate logistic regression was performed to identify variables associated with inactivity for each type of PA. No women achieved a high level of PA through sport. 79.2% achieved a high or moderate level of PA by W&B. Lack of sport was associated with being overweight (odds ratio OR = 1.31; 95% confidence interval CI: 1.06 to 1.62), body mass index (BMI) ≥ 30 (OR = 1.85; 95% CI: 1.44 to 2.38), smoking (OR = 1.56; 95% CI: 1.22 to 2.00) and living with a disabled person (OR = 1.64; 95% CI: 1.0 to 2.81), whereas enough sport practice was associated with higher educational or socio-economic level (SEL). Regarding W&B, inactivity was associated with BMI ≥ 30 (OR = 1.91; 95% CI: 1.49 to 2.45) and living with someone >74 (OR = 1.96; 95% CI: 1.48 to 2.58). Inactivity for both types of exercise was associated with a BMI ≥ 30 (OR = 2.13; 95% CI: 1.63 to 2.8), smoking (OR = 1.41; 95% CI: 1.09 to 1.81) and living with someone >74 (OR = 1.69; 95% CI: 1.24 to 2.28). Family burden and BMI ≥ 30 are inversely associated with both types of PA. W&B is the most common type of PA regardless of educational and SEL. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Ene-Obong, H N; Enugu, G I; Uwaegbute, A C
This study was undertaken to determine the effects of socioeconomic and cultural factors on the health and nutritional status of 300 women of childbearing age in two rural farming communities in Enugu State, Nigeria. The women were engaged in farming, trading, and teaching. A cross-sectional survey was conducted using both qualitative and quantitative data-collection methods. The study involved focus-group discussions (FGDs), interviews using a questionnaire, measurement of food/nutrient intake, assessment of activity patterns, anthropometry, and observations of clinical signs of malnutrition. The better-educated women had higher incomes than those with little or no education. Poor education was mainly attributed to lack of monetary support by parents (34%), marriage while in school (27%), and sex discrimination (21%). The teachers had significantly (p < 0.05) better health status, health and nutrition knowledge, food habits, nutrient intake, and self-concept, and adhered less to detrimental cultural practices. However, none of the women met their iron, riboflavin and niacin requirements. More cases of chronic energy deficiency were observed among the farmers (16%) and traders (13%) than among the teachers (5%). Generally, the women worked long hours with reported working hours (6-7 hours) being lower than the observed working hours (11 hours) for the traders and teachers. Income had a significant (p < 0.05) positive correlation with all nutritional variables, except vitamin C, age-at-marriage (r = 0.719), and nutrition knowledge (r = 0.601). Age-at-marriage had a positive correlation with body mass index (BMI) and all nutritional variables but was significant (p < 0.05) for protein (r = 0.362), calcium (r = 0.358), iron (r = 0.362), riboflavin (r = 0.364), and vitamin C (r = 0.476). Workload was negatively correlated with protein intake (r = 0.346; p < 0.05). Meal frequencies for more than 70% of the farmers and petty traders and 42% of the teachers were dependent
Sicras-Mainar, Antoni; Navarro-Artieda, Ruth; Ibáñez-Nolla, Jordi
The objective of the study was to determine the use of resources and costs due to bone fractures in Spanish women above 50 years of age in the population scope. An observational and retrospective study was conducted in six primary care centers and two urban hospitals in Spain. Socio-demographic and co-morbidity data, use of resources (primary care consultations, complementary tests, medications, specialized care, hospitalizations, visits, urgencies), costs and productivity losses were registered. Records of 19 022 women were included, 7% showed some type of fracture between 2003 and 2007. Fractures were mostly associated with osteoporosis (OR: 3.2), fibromyalgia (OR: 2.4) and thyroid changes (OR: 2.2). In the corrected model, the total cost for patients who had a fracture was USD 3727 compared to USD 2705.5 (p<0.001) for those who did not have it. Patients with a fracture generate a greater use of resources, sanitation costs and work productivity losses.
Meyers, Susan V.
Drawing from ethnographic case studies, this article considers issues of women's access to education by exploring the literacy experiences of four women in rural Mexico. Ironically, as physical access to education in this area has increased, women's literacy experiences have become more complex, rather than more libratory. Formal literacy, as it…
Huang, Haigen; Placier, Peggy
Our study sought to understand changes in gender inequality in education across four generations of rural Chinese women's educational experiences in a small community in southern China. The 24 interviews and numerous informal conversations with 12 women showed that gender-based favouritism for men and against women undergirded family expectations,…
Naik, Chitra; And Others
The volume contains two studies from India and Thailand on the education of women, and rural women especially, who are deprived or disadvantaged. The Indian study, "Education of Girls and Women in Deprived Groups," presents a viewpoint on deprivation in society in general, and India specifically. The concomitant of deprivation is defined…
Juárez, Sol; Revuelta-Eugercios, Bárbara A; Ramiro-Fariñas, Diego; Viciana-Fernández, Francisco
Evidence suggests that educational differences in perinatal outcomes have increased in some countries (Eastern Europe) while remained stable in others (Scandinavian countries). However, less is known about the experience of Southern Europe. This study aims to evaluate the association between maternal education and perinatal outcomes derived from birthweight (low birthweight and macrosomia) and gestational age (pre-term and post-term births) among Spaniards living in the Autonomous Community of Andalusia during the period 2001-2011 (around 19 % of births in Spain); and to evaluate whether the educational differences narrowed or widened during that period, which includes both an economic boom (2001-2008) and the global economic crisis (2009-2011). This study uses the Andalusian Population Longitudinal Database and the Vital Statistics Data provided by the Spanish National Statistics Institute. We study live and singleton births of Spanish mothers who lived in Andalusia at the time of delivery (n = 404,951). ORs with 95 % confidence intervals (crude and adjusted) were estimated using multinomial regression models. A negative educational gradient is observed in all perinatal outcomes studied (i.e., the higher the educational status, the lower the risk of negative perinatal outcomes). However, when disaggregating the sample in two periods, the gradient is only statistically significant for pre-term birth during 2001-2008, while a full gradient is observed in all perinatal indicators in the period 2009-2011 with an increase in the educational inequalities in macrosomia and post-term. Further studies are needed in order to confirm whether there is a causal association between the widening of the educational differences in perinatal outcomes and the onset of the economic crisis in Spain, or the widening can be explained by other factors, such as changes in childbearing patterns and the composition of women accessing motherhood.
Rosenwasser, Lara A.; McCall-Hosenfeld, Jennifer S.; Weisman, Carol S.; Hillemeier, Marianne M.; Perry, Amanda N.; Chuang, Cynthia H.
Introduction Colorectal cancer (CRC) is the third leading cause of death among U.S. women. Rural populations have lower rates of CRC screening than their urban counterparts, and rural women have lower screening rates compared with rural men. The purpose of this qualitative study was to identify (1) primary care physicians’ (PCP) beliefs regarding CRC screening in rural communities, (2) factors that may cause gender disparities in CRC screening in rural areas, and (3) solutions to overcome those barriers. Methods Semi-structured interviews were conducted with 17 PCPs practicing in rural central Pennsylvania. PCPs were asked about their CRC screening practices for women, availability of CRC screening services, reminder systems for CRC screening, and barriers to screening specific to their rural communities and to gender. Thematic analysis was used to identify major themes. Results All 17 PCPs endorsed the importance of CRC screening, but believed that there are barriers to CRC screening specific to women and to rural location. All PCPs identified colonoscopy as their screening method of choice, and generally reported that access to colonoscopy services in their rural areas was not a significant barrier. Barriers to CRC screening for women in rural communities were related to: 1) PCPs’ CRC screening practices (e.g., not using alternative screening modalities when colonoscopy is not possible), 2) gender-specific barriers to CRC screening (e.g., patients’ belief that CRC mostly affects men, embarrassment of knowing people at the endoscopy center, prioritization of family issues over personal health), 3) patient-related barriers (e.g., low educational attainment, low health literacy, poverty, under- or uninsured), 4) community-related barriers (e.g., inadequate public education about CRC, “rural culture” that does not emphasize importance of preventive health services), and 5) physician practice-related barriers (e.g., lack of effective reminder systems, lack
Harvey, Desley J
Although Australian rural women appear to be coping well despite a lack of services, harsh environmental conditions and overall rural health disadvantage, there is little research into the factors which promote good health among them. The aim of this article is to document and analyse current understandings about how rural Australian women maintain health and wellbeing, by conducting a metasynthesis of peer reviewed empirical qualitative research. Searches were conducted of CINAHL, MEDLINE, Proquest, Blackwell Synergy, Informit, Infotrac, National Rural Health Alliance and Indigenous Health Infonet data bases. A definition of health and wellbeing as a positive concept emphasising social and personal resources as well as physical capacities, provided a framework for the review. Six studies published in rural health, nursing and sociology journals between 2001 and 2006 were selected. Common and recurring themes from the original studies were identified. Reciprocal translation was used to synthesise the findings among the studies, leading to interpretations beyond those identified in the original studies. Four themes emerged from the metasynthesis: isolation, belonging, coping with adversity, and rural identity. The findings of this study exhibit a tension between a sense of belonging and the experience of social and geographical isolation. The study findings also reveal tension between adherence to a strong gendered rural identity which fosters a culture of stoicism and self reliance and feelings of resistance to societal expectations of coping with adversity. Metasynthesis enabled a deeper understanding of the health and wellbeing of rural women in Australia. The social experiences of rural women influence the way they construe their health and wellbeing. Understanding how women maintain health and wellbeing is critical in ensuring that policies and services meet the needs of rural women and do not entrench existing inequalities.
McNeil, Daniel W; Hayes, Sarah E; Randall, Cameron L; Polk, Deborah E; Neiswanger, Kathy; Shaffer, John R; Weyant, Robert J; Foxman, Betsy; Kao, Elizabeth; Crout, Richard J; Chapman, Stella; Brown, Linda J; Maurer, Jennifer L; Marazita, Mary L
Both oral health problems and depression among pregnant women contribute to maternal-infant health outcomes. Little is known, however, about the potential effects of clinically significant depression on the oral health status of pregnant women. The purpose of the present study was to determine the influence of clinically significant depression and rural- or urban-dwelling status on oral health outcomes among pregnant women. Pregnant women (N = 685) in rural (i.e., West Virginia) and urban (i.e., Pittsburgh, PA) areas of northern Appalachia were assessed by calibrated examiners regarding gingivitis, oral hygiene, and DMFT (decayed, missing, and filled teeth), completed the Center for Epidemiologic Studies-Depression Scale (CES-D) and provided demographics. Participants were categorized based on clinically significant depressive symptoms (CES-D ≥ 16) and rural/urban domicile. Women with depression and those living in rural areas had worse oral health on all three indices than their non-depressed and urban counterparts. Depression, particularly among women in rural areas, affects certain oral health indices and represents a modifiable target for intervention. Moreover, treatments designed specifically for rural populations may be of particular utility. Women who are pregnant or planning to become pregnant may benefit from regular depression screenings from their dental and medical health care providers. © The Author(s) 2015.
Rural American women number well over 25 million and represent all socio-economic and ethnic classifications, yet they share a conservative orientation towards sex roles and appropriate life styles, characteristic social and geographic isolation, and the dilemma of how to manage the traditional demands of rural culture and the contemporary…
Kwapong, Olivia Adwoa Tiwaah Frimpong
Using rural household survey data collected from 1000 female household heads selected from all the ten administrative regions in Ghana, this paper explored the policy implications for using ICTs for empowerment of rural women. A contingent valuation (CV) method was used to quantitatively estimate the influence of selected socio-economic factors on…
LeMasters, Katherine; Baber Wallis, Anne; Chereches, Razvan; Gichane, Margaret; Tehei, Ciprian; Varga, Andreea; Tumlinson, Katherine
Women in rural Romania face significant health disadvantages. This qualitative pilot study describes the structural disadvantage experienced during pregnancy by women in rural Romania, focusing on the lived experiences of Roma women. We explore how women in rural communities experience pregnancy, their interactions with the healthcare system, and the role that ethnic and social factors play in pregnancy and childbearing. We conducted 42 semi-structured interviews with health and other professionals, seven narrative interviews with Roma and non-Roma women and a focus group with Roma women. Data were analysed using thematic analysis. We identified intersectional factors associated with women's pregnancy experiences: women perceiving pregnancy as both unplanned and wanted, joyful, and normal; women's and professionals' differing prenatal care perceptions; transport and cost related barriers to care; socioeconomic and ethnic discrimination; and facilitators to care such as social support, having a health mediator and having a doctor. Talking directly with professionals and Roma and non-Roma women helped us understand these many factors, how they are interconnected, and how we can work towards improving the pregnancy experiences of Roma women in rural Romania.
Rodríguez-Salés, Vanesa; Roura, Esther; Ibañez, Raquel; Peris, Mercè; Bosch, F. Xavier; de Sanjosé, Sílvia
Background: Female immigration in Catalonia, Spain, increased dramatically in the last 10 years. The Public Health system in the Region, provides a free of charge opportunistic cervical cancer screening. Aim: This study examines cervical cancer screening coverage and prevalence of cytology abnormalities in Catalonia by immigration status. Methods: The study analyzes the cytologies registered among women aged 25–65 that have been attended at the Primary Health Centers (PHC) for any reason (n = 1,242,230) during 2008–2011. Coverage was estimated from Governmental data base Information System Primary Care (SISAP) that includes 77% of PHC. The database is anonymous, and includes information on age, country of birth, diagnostic center, and cytology results. Results: During the period 2008–2011, 642,643 smears were performed in a total of 506,189 women over 14 years, of whom 18.3% were immigrants. Cytology coverage was higher among immigrant women compared to Spanish born (51.2 and 39% respectively). Immigrant women also had a higher prevalence of abnormal Paps compared to the Spanish population, 4.5 and 2.9% respectively (p < 0.001). Conclusion: Immigrant women in Catalonia had a high access to the Public Health Services and to cervical cancer screening facilities. The higher prevalence of abnormal cytologies in immigrant women compared to native women indicates the relevance to prioritize cervical cancer screening activities on a regular base in new comers. PMID:24392348
Valvi, Damaskini; Monfort, Nuria; Ventura, Rosa; Casas, Maribel; Casas, Lidia; Sunyer, Jordi; Vrijheid, Martine
Developmental exposure to phthalates may be associated with adverse health outcomes but information on the variability and predictors of urinary phthalate metabolite concentrations during pregnancy is limited. We evaluated in Spanish pregnant women (n=391) the reproducibility of urinary phthalate metabolite concentrations and predictors of exposure. We measured mono-(4-methyl-7-hydroxyoctyl) phthalate (7-OHMMeOP), mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono-(2-carboxyhexyl) phthalate (MCMHP), mono-benzyl phthalate (MBzP), mono-ethyl phthalate (MEP), mono-iso-butyl phthalate (MiBP) and mono-n-butyl phthalate (MnBP) in two spot urine samples collected in the first and third pregnancy trimesters. Questionnaires on predictors and food-frequency questionnaires were administered in the first and/or third pregnancy trimesters. Using creatinine-adjusted phthalate metabolite concentrations (log10-trasformed) we calculated intraclass correlation coefficients (ICCs). Linear mixed and regression models assessed the associations between predictors and phthalate metabolites. The ICCs ranged from 0.24 to 0.07 and were higher for MBzP, MEP, MiBP, and lower for MEOHP and MEHHP. Overweight, lower education and social class, and less frequent consumption of organic food were associated with higher levels of some phthalate metabolites. The use of household cleaning products (bleach, ammonia, glass cleaners, oven cleaning sprays and degreasing products) at least once per week during pregnancy was associated with 10-44% higher urinary phthalate metabolites. Bottled-water consumption, consumption of food groups usually stored in plastic containers or cans, use of plastic containers for heating food and cosmetic use were not associated with increased concentrations of phthalate metabolites. This large study with repeated phthalate measurements
Canto-de Cetina, T; Polanco-Reyes, L; Vera-Gamboa, L
Influence of environment and lactation patterns on amenorrhea duration and frequency of ovulation before the first menstrual bleeding postpartum are studied on a group of 100 women (half rural, half from urban areas). All subjects studied were highly motivated to breastfeed for prolonged periods. Results show a more prolonged amenorrhea, although not statistically significant, in those women from the rural zone. Ovulation frequency before the first vaginal bleeding was 14% none ovulated before six months.
Olmedo-Requena, Rocío; Fernández, Julia Gómez; Prieto, Carmen Amezcua; Moreno, Juan Mozas; Bueno-Cavanillas, Aurora; Jiménez-Moleón, José J
To analyse the factors associated with the level of adherence to a Mediterranean dietary pattern in healthy Spanish women before pregnancy. A prospective series of 1175 women. An FFQ validated in Spanish populations served to collect dietary data. The Mediterranean Diet Adherence Index was used to assess the level of adherence to a Mediterranean diet pattern. Polytomic regression was performed to identify the associated factors. Catchment area of Virgen de las Nieves University Hospital, Andalusia, Spain. The women were invited to participate in the study at the 20th-22nd gestational week. The selection criteria were: Spanish nationality, 18 years of age or older, singleton pregnancy and absence of health problems that required modifying the diet or physical activity. An inverse relationship was found between women's age and level of adherence to a Mediterranean diet pattern, with a clear dose-response association: a younger age entailed worse adherence (P < 0·001). The habit of smoking and sedentary lifestyle had a positive relationship with low adherence, giving OR = 5·36 (95 % 1·91, 15·07) for women who smoked >20 cigarettes/d and OR = 2·07 (95 % CI 1·34, 3·17) for sedentary women. Higher age, higher educational level, and higher social class of the women were associated with a higher level of adherence to the Mediterranean diet (P < 0·001). In our sample population, younger age, lower social class, primary educational level and elements of an unhealthy lifestyle such as smoking and lack of exercise were associated with low adherence to a Mediterranean diet.
Uthman, O A; Aremu, O
Malnutrition is a serious public health problem, particularly in developing countries, linked to a substantial increase in the risk of mortality and morbidity. Women and young children are most often affected. Rural disadvantage is a known factor, but little attention has been paid to rural-urban disparity among women. To provide a reliable source of information for policy-makers, the current study used nationally representative data from 26 countries in sub-Saharan Africa to update knowledge about the prevalence malnutrition and its rural-urban disparities among women. The data sources were the demographic and health surveys of 26 countries conducted between 1995 and 2006. The methods included meta-analysis, meta-regression, sub-group and sensitivity. Overall, rural women were 68% more likely to be malnourished compared with their urban counterparts. In the meta-regression analysis, sub-region, sample size, and the year the study was conducted explained the observed heterogeneity. This meta-analysis provided usable data for women in sub-Saharan Africa. The magnitude of rural-urban malnutrition disparity revealed provides a baseline that will be of assistance to clinicians, researchers, and policy-makers in the detection, prevention and treatment of malnutrition among rural women.
Hypertension is an important public health problem and the major causes of cardiovascular morbidity and mortality among aged and elderly population in India. The present study is an attempt to assess age related trends of blood pressure and prevalence of hypertension in rural and urban women as well as correlation of blood pressure with obesity indicators (WC, BMI, and WHR). Data for present cross-sectional study were collected by purposive sampling method from six hundred Jat women (300 rural and 300 urban), aged 40 to 70 years. Karl Pearson's correlation coefficient (r) was employed to find the relationship between blood pressure and obesity indicators. The results revealed an age associated increase in mean values of systolic and diastolic blood pressure in rural and urban women. Urban women showed significantly higher overall mean value of systolic (mm of Hg) (133.93 vs. 130.79, p < 0.001), diastolic blood pressure (mm of Hg) (84.34 vs. 82.81, p < 0.01) and pulse rate (81.72 +/- 6.27 vs. 80.94 +/- 9.06, p > 0.05) as compared to rural women. The overall prevalence of hypertension was found to be 9% in rural and 26.66% in urban women as per JNC VII criteria. Increased prominence of hypertension among urban Jat women may be attributed to their modern lifestyle having more stress, less manual work and faulty dietary habits. There was a very low awareness of hypertension in the rural subjects (37%) than their urban (72%) counterparts. Rural and urban women revealed a positive and significant association of systolic blood pressure with body mass index, whereas only urban women displayed positive correlation of waist circumference with systolic (r = 0.183**) and diastolic (r = 0.151**) blood pressure.
Leach, Corinne R.; Schoenberg, Nancy E; Hatcher, Jennifer
Rural Appalachian women bear a disproportionate burden from many types of cancer yet often are underrepresented in cancer research. This paper uses two case studies to illustrate barriers faced and strategies used when recruiting hard-to-reach rural participants. Recruitment barriers include the population’s competing demands and lack of trust of outsiders. Strategies employed include involving insider advocates, highlighting the positive experiences of early participants, spending extensive time in the community, and emphasizing potential community benefits of the study. We suggest recruitment strategies to better involve rural women and others who, by virtue of being “hard-to reach,” often are overlooked. PMID:21378508
Barreiro, Rocío; Regal, Patricia; López-Racamonde, Olga; Cepeda, Alberto; Fente, Cristina A
The importance of dietary lipids during childhood is evident, as they are necessary for correct growth and development of the newborn. When breastfeeding is not possible, infant formulas are designed to mimic human milk as much as possible to fulfill infant's requirements. However, the composition of these dairy products is relatively constant, while human milk is not a uniform bio-fluid and changes according to the requirements of the baby. In this study, breast milk samples were donated by 24 Spanish mothers in different lactation stages and different infant formulas were purchased in supermarkets and pharmacies. Gas chromatography coupled to flame ionization detection was used for the fatty acid determination. Compared to breast milk, first-stage formulas are apparently very similar in composition; however, no major differences were observed in the fatty acid profiles between formulas of different lactation stages. The Galician women breast milk has a fatty acid profile rich in oleic acid, linoleic acid, arachidonic acid, and docosahexaenoic acid. When comparing human milk with formulas, it becomes evident that the manufacturers tend to enrich the formulas with essential fatty acids (especially with α-linolenic acid), but arachidonic and docosahexaenoic acid levels are lower than in breast milk. Additionally, the obtained results demonstrated that after 1 year of lactation, human milk is still a good source of energy, essential fatty acids, and long-chain polyunsaturated fatty acids for the baby.
Valls, Rosa; Puigvert, Lídia; Melgar, Patricia; Garcia-Yeste, Carme
The first research conducted on violence against women in the university context in Spain reveals that 62% of the students know of or have experienced situations of this kind within the university institutions, but only 13% identify these situations in the first place. Two main interrelated aspects arise from the data analysis: not identifying and acknowledging violent situations, and the lack of reporting them. Policies and actions developed by Spanish universities need to be grounded in two goals: intransigence toward any kind of violence against women, and bystander intervention, support, and solidarity with the victims and with the people supporting the victims. © The Author(s) 2016.
Desai, Sapna; Sinha, Tara; Mahal, Ajay
This paper presents findings on hysterectomy prevalence from a 2010 cross-sectional household survey of 2,214 rural and 1,641 urban, insured and uninsured women in low-income households in Ahmedabad city and district in Gujarat, India. The study investigated why hysterectomy was a leading reason for use of health insurance by women insured by SEWA, a women's organisation that operates a community-based health insurance scheme. Of insured women, 9.8% of rural women and 5.3% of urban women had had a hysterectomy, compared to 7.2% and 4.0%, respectively, of uninsured women. Approximately one-third of all hysterectomies were in women younger than 35 years of age. Rural women used the private sector more often for hysterectomy, while urban use was almost evenly split between the public and private sectors. SEWA's community health workers suggested that such young women underwent hysterectomies due to difficulties with menstruation and a range of gynaecological morbidities. The extent of these and of unnecessary hysterectomy, as well as providers' attitudes, require further investigation. We recommend the provision of information on hysterectomy as part of community health education for women, and better provision of basic gynaecological care as areas for advocacy and action by SEWA and the public health community in India. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
Isla, Dolores; Felip, Enriqueta; Viñolas, Nuria; Provencio, Mariano; Majem, Margarita; Artal, Angel; Bover, Isabel; Lianes, Pilar; DE Las Peñas, Ramón; Catot, Silvia; DE Castro, Javier; Blasco, Ana; Terrasa, Josefa; Gonzalez-Larriba, José Luis; Juan, Oscar; Dómine, Manuel; Bernabe, Reyes; Garrido, Pilar
The WORLD07 project is a female-specific database to prospectively analyze the characteristics of Spanish women with lung cancer. We analyzed and compared lung cancer features in women with and without a family history of cancer/lung cancer. Two thousand and sixty women were included: 876 had a family history of cancer (lung cancer, 34%) and 886 did not, with no significant differences between groups, except for smoking status (p=0.036). We found statistically significant correlations between epidermal growth factor receptor (EGFR) mutation and smoking status in patients with a family history of cancer (r=-0.211; p<0.001) and lung cancer (r=-0.176; p<0.001). Longer median overall survival was observed in women with a family history of cancer and lung cancer. Among Spanish women with lung cancer, a greater proportion were current smokers in those with a family history of cancer/lung cancer. There was a significant correlation between the presence of EGFR mutation and smoking. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
Simon, Melissa A.; Ragas, Daiva M.; Nonzee, Narissa J.; Phisuthikul, Ava M.; Luu, Thanh Ha; Dong, XinQi
To explore patient perceptions of patient-provider communication in breast and cervical cancer-related care among low-income English- and Spanish- speaking women, we examined communication barriers and facilitators reported by patients receiving care at safety net clinics. Participants were interviewed in English or Spanish after receiving an abnormal breast or cervical cancer screening test or cancer diagnosis. Following an inductive approach, interviews were coded and analyzed by the language spoken with providers and patient-provider language concordance status. Of 78 participants, 53% (n = 41) were English-speakers and 47% (n = 37) were Spanish-speakers. All English-speakers were language-concordant with providers. Of Spanish-speakers, 27% (n = 10) were Spanish-concordant; 38% (n = 14) were Spanish-discordant, requiring an interpreter; and 35% (n = 13) were Spanish mixed-concordant, experiencing both types of communication throughout the care continuum. English-speakers focused on communication barriers, and difficulty understanding jargon arose as a theme. Spanish-speakers emphasized communication facilitators related to Spanish language use. Themes among all Spanish-speaking sub-groups included appreciation for language support resources and preference for Spanish-speaking providers. Mixed-concordant participants accounted for the majority of Spanish-speakers who reported communication barriers. Our data suggest that, although perception of patient-provider communication may depend on the language spoken throughout the care continuum, jargon is lost when health information is communicated in Spanish. Further, the respective consistency of language concordance or interpretation may play a role in patient perception of patient-provider communication. PMID:23553683
Nagaoka, Chizuko; Karki, Manohar
This paper examines the literacy and post-literacy needs of rural women in Nepal, describes a pilot study in using community radio to supplement a classroom-based post-literacy programme for these women, analyses the findings of this intervention and considers the implications for similar programmes in other settings.
Bhandari, Shreya; Bullock, Linda F. C.; Sharps, Phyllis W.
This study explored strategies from the Intimate Partner Violence Strategy Index (IPVSI) that a sub-set of 20 rural, low-income, abused women of a larger, multi-site, mixed-method study employed to deal with Intimate Partner Violence (IPV) during the perinatal period. We conducted 32 in-depth interviews with women who were pregnant (N = 12) and/or…
Khan, Seemin Anwar
Conducted in the Punjab in Jhok Sayal, a predominantly Muslim village, this narrative study described: the environment and living conditions of women in this rural village (comprised mainly of tenants and landless labourers); the attitudes of the women toward education, marriage, family planning, and skills; and the woman's daily and annual…
Rural Japanese women have been overlooked or misrepresented in the academic and nationalist discourses on Japanese women. Using an anti-colonial feminist framework, I advocate that centering discussions on Indigenous knowledges will help fill this gap based on the belief that Indigenous-knowledge framework is a tool to show the agency of the…
Ghose, Malini; Mullick, Disha
This paper is based on the findings of a research study which traced 56 rural women learners 15 years after they had participated in an empowerment and education programme in North India. It attempts to understand, from the perspectives of women from marginalised communities, the ways in which participating in the programme had been empowering for…
Karau, Paul Bundi; Winnie, Mueni Saumu; Geoffrey, Muriira; Mwenda, Mukuthuria
Uptake of VCT and other HIV prevention strategies among rural African women is affected by various socio-cultural and economic factors which need elucidation. Our aim was to establish the responsiveness to HIV education among rural women attending three dispensaries in Kenya. This study was designed to assess gender and psycho-social factors that influence HIV dynamics in rural Kenya. This was a cross-sectional questionnaire based study of 1347 women, conducted in October 2009. Socio-economic status as well as knowledge on methods of HIV transmission was assessed. Testing status, knowledge on existing VCT services and willingness to share HIV information with their children was assessed. Majority of the women have heard about VCT services, but significantly few of them have been tested. Those with secondary school education and above are more knowledgeable on methods of HIV transmission, while those with inadequate education are more likely to cite shaking hands, sharing utensils, mosquito bites and hugging as means of transmission (p = 0.001). 90% of educated women are willing to share HIV information with their children, compared to 40% of uneducated women. Marital status is seen to positively influence testing status, but has no significant effect on dissemination of information to children. We conclude that despite the aggressive HIV education and proliferation of VCT services in Kenya, women are not heeding the call to get tested. Education has a positive impact on dissemination of HIV information. Focus needs to shift into increasing acceptability of testing by women in rural Kenya.
Balasubramanian, K.; Thamizoli, P.; Umar, Abdurrahman; Kanwar, Asha
This article is an attempt to study the role of mobile phones in the non-formal and informal context among rural women from resource poor communities. In particular, it focuses on the women's control over the mobile phone as a learning tool through the domestication of technologies. The distance learning, gender dimensions, and use of technologies…
Shan, Hongxia; Liu, Zhiwen; Li, Ling
As industrialisation and urbanisation aggressively take hold in China, all possible labour pools are being tapped to meet the market demands. Liushou women, or women who stay behind in rural areas as their spouses join the massive migrant workforce, are one such labour pool. Vocational training has been adopted by the Chinese state as a…
Lee, Jessica; Macdonald, Doune
This paper makes use of critical discourse analysis and Bourdieu's theoretical framework to explore rural young women's meanings of health and fitness and how the healthism discourse is perpetuated through their experiences in school physical education (PE). The young women's own meanings are explored alongside interview data from their school PE…
Pearson, Veronica; Phillips, Michael R.; He, Fengsheng; Ji, Huiyu
Reports on a sample of 147 young women living in rural areas in China who had attempted suicide. The women's suicidal behavior was characterized by high levels of impulsivity and low rates of mental illness, including depression. Detailed suggestions are made about ways to implement suicide prevention strategies within the particular social and…
Taub, Diane E.; McLorg, Penelope A.; Bartnick, April K.
Through exploring the lived experiences of disabled women, this study investigates how physical and social barriers affect their social relationships. In-depth tape-recorded interviews investigating a variety of social and interpersonal issues were conducted with 24 women with physical or visual impairments who lived in a rural region of the…
Peterson, Jane Anthony; Cheng, An-Lin
To identify key behavioral factors that contribute to physical activity and weight management in overweight, rural women and determine the degree to which social support, stage of behavior change, and self-efficacy for physical activity and depressive symptoms are linked to physical activity, body weight, and body mass index (BMI). Twenty-five overweight or obese rural women completed self-report scales and height and weight measurements; BMI was calculated. Self-report scales included the International Physical Activity Questionnaire (physical activity level), Social Support for Exercise and Social Support Questionnaire (social support), Stage of Exercise Adoption (stage of behavior change), Self-efficacy for Exercise (self-efficacy), and the Patient Health Questionnaire (depressive symptoms). Higher levels of physical activity were associated with greater self-efficacy and the self-esteem domain of social support. Rural women reported more depressive symptoms over the year. Women did not significantly increase physical activity and gained weight during the 1-year study. Rural women have limited resources available to increase physical activity to facilitate weight loss. Routine screening and treatment for depression in rural women may need to be initiated concurrently with interventions to promote health behavior changes. ©2012 The Author(s) ©2012 American Association of Nurse Practitioners.
Fonkem, R N
This is a discussion of the work of the Rural Women Development Council for poor rural women in Cameroon. The concept of absolute poverty involves the measurement of the quantity and quality of necessities required to maintain the average well-being of an individual or group of individuals. The standards are considered to be relative to a particular time and place. Subjective poverty is a state of acceptance by the person who is poor that he or she is poor; it is independent of the perspective of onlookers. Income levels vary resulting, and as a result, poverty exists. Under those premises, the Rural Women Development Council (RWDC) is helping to alleviate poverty in rural women through microcredit schemes. Over 200 women have engaged in farming and small trades. Increased equity, enhanced opportunity, peace and security, participation and sustainable future, in addition to increased income, help to defeat poverty. Strategies for eradicating poverty include enhancing the ability of local communities to adapt to stress, overcome emergencies and improve long-term productivity. The RWDC have observed that loanees are today economically above other rural women.
Kornelsen, Jude; Grzybowski, Stefan
To investigate rural parturient women's experiences of obstetric care in the context of the social and economic realities of life in rural, remote, and small urban communities. Data collection for this exploratory qualitative study was carried out in 7 rural communities chosen to represent diversity of size, distance to hospital with Caesarean section capability and distance to secondary hospital, usual conditions for transport and access, and cultural and ethnic subpopulations. We interviewed 44 women who had given birth up to 24 months before the study began. When asked about their experiences of giving birth in rural communities, many participants spoke of unmet needs and their associated anxieties. Self-identified needs were largely congruent with the deficit categories of Maslow's hierarchy of needs, which recognizes the contingency and interdependence of physiological needs, the need for safety and security, the need for community and belonging, self-esteem needs, and the need for self-actualization. For many women, community was critical to meeting psychosocial needs, and women from communities that currently have (or have recently had) access to local maternity care said that being able to give birth in their own community or in a nearby community was necessary if their obstetric needs were to be met. Removing maternity care from a community creates significant psychosocial consequences that are imperfectly understood but that probably have physiological implications for women, babies, and families. Further research into rural women's maternity care that considers the loss of local maternity care from multiple perspectives is needed.
Gómez-de-Tejada Romero, María-Jesús; Navarro Rodríguez, María-del-Carmen; Saavedra Santana, Pedro; Quesada Gómez, José-Manuel; Jódar Gimeno, Esteban; Sosa Henríquez, Manuel
First, to study the difference between two groups of postmenopausal women living in different population centres (rural vs urban) in the prevalence of osteoporosis, fragility fractures and factors which may influence them: hypovitaminosis D, bone mineral density, coexistence of other diseases which predispose to their appearance; secondly, to observe the influence of low socioeconomic status, categorised as poverty. 1229 postmenopausal women were studied, of whom 390 (31.7%), were living in rural areas and 839 (68.3%), in urban areas. Data regarding risk factors related to osteoporosis were obtained, and, among other biochemical measures, 25 hydroxyvitamin D and parathyroid hormone were determined. Bone densitometry was carried out in the lumbar spine and proximal femur, as well as lateral X-rays of the dorsal and lumbar spine. The women who lived in rural areas were older, shorter, heavier and had a higher body mass index than those from urban areas. Among the women from rural areas there was a higher prevalence of poverty, and higher levels of obesity, arterial hypertension and diabetes mellitus were observed, as well as a higher prevalence of densitometric osteoporosis. The rural women had lower values of bone mineral density in the lumbar spine and a higher prevalence of vertebral fractures and hypovitaminosis D. The variables which were associated independently with living in rural areas were poverty, obesity, vertebral fractures, BMD in the lumbar spine and levels of 25 hydroxyvitamin D. In our study, postmenopausal women who live in rural populations have more poverty, lower values of vitamin D, lower BMD in the lumbar spine and a higher prevalence of vertebral fractures and of osteoporosis. The higher prevalence of obesity, arterial hypertension and diabetes mellitus observed in these women may be adjuvant factors, all fostered by their socioeconomic state of poverty. Copyright © 2014. Published by Elsevier Ireland Ltd.
Cordasco, Kristina M; Mengeling, Michelle A; Yano, Elizabeth M; Washington, Donna L
Disparities in health and health care access between rural and urban Americans are well documented. There is evidence that these disparities are mirrored within the US veteran population. However, there are few studies assessing this issue among women veterans (WVs). Using the 2008-2009 National Survey of Women Veterans, a population-based cross-sectional national telephone survey, we examined rural WVs' health and health care access compared to urban WVs. We measured health using the Medical Outcomes Study Short-Form (SF-12); access using measures of regular source of care (RSOC), health care utilization, and unmet needs; and barriers to getting needed care. Rural WVs have significantly worse physical health functioning compared to urban WVs (mean physical component score of 43.6 for rural WVs versus 47.2 for urban WVs; P = .007). Rural WVs were more likely to have a VA RSOC (16.4% versus 10.6%; P = .009) and use VA health care (21.7% versus 12.9%; P < .001), and had fewer non-VA health care visits compared with urban WVs (mean 4.2 versus 5.9; P = .021). They had similar overall numbers of health care visits (mean 5.8 versus 7.1; P = .11 ). Access barriers were affordability for rural WVs and work release time for urban WVs. Rural WVs additionally reported that transportation was a major factor affecting health care decisions. Our findings demonstrate VA's crucial role in addressing disparities in health and health care access for rural WVs. As VA continues to strive to optimally meet the needs of all WVs, innovative care models need to account for their high health care needs and persistent barriers to care. © 2016 National Rural Health Association.
García-Martín, Antonia; Quesada Charneco, Miguel; Alvárez Guisado, Alejandro; Jiménez Moleón, José Juan; Fonollá Joya, Juristo; Muñoz-Torres, Manuel
To analyze the effects of nutritional intervention with a milk product enriched with soy isoflavones on quality of life and bone metabolism in postmenopausal Spanish women. We performed a double-blind controlled randomized trial in ninety-nine postmenopausal women. Group S women (n=48) were randomized to consume milk product enriched with soy isoflavone (50 mg/day) while group C (n=51) consumed product control for 12 months. Parameters of quality of life (Cervantes scale), markers of bone metabolism and bone mass estimated by ultrasound of the calcaneus (QUS) were evaluated. Overall, there was an improvement in the domains menopause (P=.015) and vasomotor symptoms (P<.001). S group emphasized the assessment of vasomotor symptoms (P=.001) and differed positively from group C in health (P=.019), sex (P=.021) and partner (P=.002). Serum levels TRAP (P<.001) and OPG (P=.007) decreased and concentrations of 25-OH-vitamin D increased (P<.001) without differences between groups. In the assessment of QUS, there was an increase in estimated bone mineral density in group S (P=.040), whereas in group C there were no significant differences. Daily consumption of these milk products increases levels of 25-OH-vitamin D and decreases bone metabolism markers. Additional supplementation with soy isoflavones seems to improve quality of life and bone mass in Spanish postmenopausal women. Copyright © 2010 Elsevier España, S.L. All rights reserved.
Cotelo, María del Carmen Suárez; Pita-García, Paula
The Iowa Infant Feeding Attitude Scale (IIFAS) has been shown to have good psychometric properties for English-speaking populations, but it has not been validated among low-risk pregnant women in Spain. The aim of this study was to assess the reliability and validity of the translated version of the IIFAS in order to examine infant feeding attitudes in Spanish women with an uncomplicated pregnancy. Low-risk expectant women (n = 297) were recruited from eight primary public health care centres in Galicia (Spain). Questionnaires including both socio-demographic and breastfeeding characteristics and items about infant feeding were administered during the third trimester. Participants were contacted by telephone during the postpartum period to obtain information regarding their infant feeding status. Prediction validity and internal consistency were assessed. The translated IIFAS (69.76 ± 7.75), which had good psychometric properties (Cronbach’s alpha = 0.785; area under the curve (AUC) of the receiver operating characteristic (ROC) curve = 0.841, CI95% = 0.735–0.948), showed more positive attitudes towards breastfeeding than towards formula feeding, especially among mothers who intended to exclusively breastfeed. This scale was also useful for inferring the intent to breastfeed and duration of breastfeeding. This study provides evidence that the IIFAS is a reliable and valid tool for assessing infant feeding attitudes in Spanish women with an uncomplicated pregnancy. PMID:29690542
Cotelo, María Del Carmen Suárez; Movilla-Fernández, María Jesús; Pita-García, Paula; Novío, Silvia
The Iowa Infant Feeding Attitude Scale (IIFAS) has been shown to have good psychometric properties for English-speaking populations, but it has not been validated among low-risk pregnant women in Spain. The aim of this study was to assess the reliability and validity of the translated version of the IIFAS in order to examine infant feeding attitudes in Spanish women with an uncomplicated pregnancy. Low-risk expectant women ( n = 297) were recruited from eight primary public health care centres in Galicia (Spain). Questionnaires including both socio-demographic and breastfeeding characteristics and items about infant feeding were administered during the third trimester. Participants were contacted by telephone during the postpartum period to obtain information regarding their infant feeding status. Prediction validity and internal consistency were assessed. The translated IIFAS (69.76 ± 7.75), which had good psychometric properties (Cronbach's alpha = 0.785; area under the curve (AUC) of the receiver operating characteristic (ROC) curve = 0.841, CI 95% = 0.735⁻0.948), showed more positive attitudes towards breastfeeding than towards formula feeding, especially among mothers who intended to exclusively breastfeed. This scale was also useful for inferring the intent to breastfeed and duration of breastfeeding. This study provides evidence that the IIFAS is a reliable and valid tool for assessing infant feeding attitudes in Spanish women with an uncomplicated pregnancy.
Phillips, Julie; Hustedde, Carol; Bjorkman, Sarah; Prasad, Rupa; Sola, Orlando; Wendling, Andrea; Bjorkman, Kurt; Paladine, Heather
PURPOSE Women family physicians experience challenges in maintaining work-life balance while practicing in rural communities. We sought to better understand the personal and professional strategies that enable women in rural family medicine to balance work and personal demands and achieve long-term career satisfaction. METHODS Women family physicians practicing in rural communities in the United States were interviewed using a semistructured format. Interviews were recorded, professionally transcribed, and analyzed using an immersion and crystallization approach, followed by detailed coding of emergent themes. RESULTS The 25 participants described a set of strategies that facilitated successful work-life balance. First, they used reduced or flexible work hours to help achieve balance with personal roles. Second, many had supportive relationships with spouses and partners, parents, or other members of the community, which facilitated their ability to be readily available to their patients. Third, participants maintained clear boundaries around their work lives, which helped them to have adequate time for parenting, recreation, and rest. CONCLUSIONS Women family physicians can build successful careers in rural communities, but supportive employers, relationships, and patient approaches provide a foundation for this success. Educators, employers, communities, and policymakers can adapt their practices to help women family physicians thrive in rural communities. PMID:27184995
Phillips, Julie; Hustedde, Carol; Bjorkman, Sarah; Prasad, Rupa; Sola, Orlando; Wendling, Andrea; Bjorkman, Kurt; Paladine, Heather
Women family physicians experience challenges in maintaining work-life balance while practicing in rural communities. We sought to better understand the personal and professional strategies that enable women in rural family medicine to balance work and personal demands and achieve long-term career satisfaction. Women family physicians practicing in rural communities in the United States were interviewed using a semistructured format. Interviews were recorded, professionally transcribed, and analyzed using an immersion and crystallization approach, followed by detailed coding of emergent themes. The 25 participants described a set of strategies that facilitated successful work-life balance. First, they used reduced or flexible work hours to help achieve balance with personal roles. Second, many had supportive relationships with spouses and partners, parents, or other members of the community, which facilitated their ability to be readily available to their patients. Third, participants maintained clear boundaries around their work lives, which helped them to have adequate time for parenting, recreation, and rest. Women family physicians can build successful careers in rural communities, but supportive employers, relationships, and patient approaches provide a foundation for this success. Educators, employers, communities, and policymakers can adapt their practices to help women family physicians thrive in rural communities. © 2016 Annals of Family Medicine, Inc.
Dickson, Kwamena Sekyi; Adde, Kenneth Setorwu; Amu, Hubert
Background . There is a paucity of empirical literature in Ghana on rural areas and their utilisation of health facilities. The study examined the effects of the sociodemographics of rural women on place of delivery in the country. Methods . The paper made use of data from the 2014 Ghana Demographic and Health Survey. Women from rural areas who had given birth within five years prior to the survey were included in the analysis. Descriptive analyses and binary logistic regression were used to analyse the data. Results . Wealth, maternal education, ecological zone, getting money for treatment, ethnicity, partner's education, parity, and distance to a health facility were found as the determinants of place of delivery among women in rural Ghana. Women in the richest wealth quintile were three times (OR = 3.04, 95% CI = 0.35-26.4) more likely to deliver at a health facility than the poorest women. Conclusions . It behoves the relevant stakeholders including the Ghana Health Service and the Ministry of Health to pay attention to the wealth status, maternal education, ecological zone, ethnicity, partner's education, parity, and distance in their planning regarding delivery care in rural Ghana.
Cudney, Shirley; Sullivan, Therese; Winters, Charlene A; Paul, Lynn; Oriet, Pat
To add to the knowledge base of illness management of chronically ill, rural women by describing the self-identified problems and solutions reported by women participants in the online health-education segment of the Women to Women (WTW) computer outreach project. WTW is a research-based computer intervention providing health education and online peer support for rural women with chronic diseases. Messages posted to the online chat room were examined to determine the women's self-management problems and solutions. The self-identified problems were: (1) difficulties in carrying through on self-management programmes; (2) negative fears and feelings; (3) poor communication with care providers; and (4) disturbed relationships with family and friends. The self-identified solutions to these problems included problem-solving techniques that were tailored to the rural lifestyle. Although not all problems were 'solvable', they could be 'lived with' if the women's prescriptions for self-management were used. Glimpses into the women's day-to-day experiences of living with chronic illness gleaned from the interactive health-education discussions will give health professionals insights into the women's efforts to manage their illnesses. The data provide health professionals with information to heighten their sensitivity to their clients' day-to-day care and educational needs.
Izugbara, C Otutubikey; Afangideh, A Isong
This study addresses the quest for rural-based health care services among women in urban Nigeria relying on a large qualitative database obtained from 63 Igbo women living in Aba, Nigeria. Results indicate that urban Igbo women of different socioeconomic and demographic characteristics utilize the services of different rural-based health care providers-indigenous healers, traditional birth attendants (TBAs), faith/spiritual, western-trained doctors and nurses as well as chemist shopkeepers-for conditions ranging from infertility, through child birthing and abortions, to swollen body, epilepsy, bone setting, and stubborn skin diseases. Major attractions to rural-based therapists were the failure of urban-based health services to provide cure, perceived mystical nature of conditions, need to conceal information on therapeutic progress and/or the nature of specific disease conditions, belief in rural-based therapists' ability to cure condition, and affordability of the services of rural-based health care providers. Findings underscore the critical implications of service characteristics, cultural beliefs, and the symbolic content of place(s) for care seekers' patterns of resort. We suggest that need exists for policies and programs aimed at making health care services in urban Nigeria more responsive to care seekers' socioeconomic and cultural sensitivities, integrating informal health care providers into Nigeria's health care system, and strengthening public health education in Nigeria.
Through organizing informal self-help groups (SHGs), rural women in India are provided credit and extension support for various production-oriented income-generating activities. These activities usually include garment-making, embroidery, food processing, bee-keeping, basketry, gem cutting, weaving, and knitting. SHGs are self-governed, with decisions about production and marketing taken collectively, although the group leader is responsible for identifying potential marketing centers and consumers. These groups represent a new culture in rural development, breaking with traditional bureaucracy and top-down management. Informal groups empower rural women to manage rural industries and make decisions collectively for their common economic interests. Experience with SHGs in Orissa, lessons from nongovernmental organization intervention, and a model for empowering poor people in a small town in Kerala are discussed.
Black, Angela R; Cook, Jennifer L; Murry, Velma McBride; Cutrona, Carolyn E
Ecological theory was used to explore the pathways through which intimate relationship quality influenced health functioning among rural, partnered African American women. Structural equation modeling was used to analyze data from 349 women in Georgia and Iowa. Women's intimate relationship quality was positively associated with their psychological and physical health functioning. Support from community residents moderated this link, which was strongest for women who felt most connected with their neighbors and for women who believed their neighborhood to have a sense of communal responsibility. Future research should identify other factors salient to health functioning among members of this population.
Liu, Tongtong; Li, Shunping; Ratcliffe, Julie; Chen, Gang
There is a heavy burden of cervical cancer in China. Although the Chinese government provides free cervical cancer screening for rural women aged 35 to 59 years, the screening rate remains low even in the more developed regions of eastern China. This study aimed to assess knowledge and attitudes about cervical cancer and its screening among rural women aged 30 to 65 years in eastern China. A cross-sectional study was conducted in four counties of Jining Prefecture in Shandong Province during August 2015. In total, 420 rural women were randomly recruited. Each woman participated in a face-to-face interview in which a questionnaire was administered by a trained interviewer. A total of 405 rural women (mean age 49 years old) were included in the final study. Among them, 210 (51.9%) participants had high knowledge levels. An overwhelming majority, 389 (96.0%) expressed positive attitudes, whilst only 258 (63.7%) had undergone screening for cervical cancer. Related knowledge was higher amongst the screened group relative to the unscreened group. Age, education and income were significantly associated with a higher knowledge level. Education was the only significant factor associated with a positive attitude. In addition, women who were older, or who had received a formal education were more likely to participate in cervical cancer screening. The knowledge of cervical cancer among rural women in eastern China was found to be poor, and the screening uptake was not high albeit a free cervical cancer screening program was provided. Government led initiatives to improve public awareness, knowledge, and participation in cervical cancer screening programs would likely be highly beneficial in reducing cervical cancer incidence and mortality for rural women.
Peñacoba-Puente, Cecilia; Marín-Morales, Dolores; Carmona-Monge, Francisco Javier; Velasco Furlong, Lilian
In this study, our purpose was to examine whether personality and cognitive factors could be related to post-partum depression (PPD), mediated by anxiety, in Spanish women. Women were evaluated for personality and cognitive factors after the first trimester, for anxiety in the third trimester, and for PPD 4 months after childbirth. A structural equation model revealed that personality and cognitive factors were associated with anxiety and PPD as predictors. Neuroticism and extroversion proved to be the most relevant factors. Conscientiousness was associated with pregnancy anxiety. Pregnancy anxiety appeared as an independent predictor of PPD. The model presented here includes personality and cognitive and emotional factors as predictors of PPD. Comprehensive care for pregnant women should contemplate assessment and intervention on all these aspects. Special focus should be on cognitive factors and emotional regulation strategies, so as to minimize the risk of later development of emotional disorders during puerperal phases.
Rennison, Callie Marie; DeKeseredy, Walter S; Dragiewicz, Molly
Woman abuse varies across intimate relationship categories (e.g., marriage, divorce, separation). However, it is unclear whether relationship status variations in violence against women differ across urban, suburban, and rural areas. We test the hypothesis that rural females, regardless of their intimate partner relationship status, are at higher risk of intimate violence than their urban and suburban counterparts. Results indicate that marital status is an important aspect of the relationship between intimate victimization and geographic area and that rural divorced and separated females are victimized at rates exceeding their urban counterparts.
Jackson, Afton; Shannon, Lisa
Research presenting outcomes for women who enter substance abuse treatment during pregnancy consistently shows benefits. While treatment has nearly universal benefits, there are many barriers to seeking substance abuse treatment for pregnant women. The purpose of this study is to explore barriers for rural pregnant women seeking substance abuse treatment. There were three eligibility criteria for study participation: (1) aged 18 and older, (2) pregnant, and (3) undergoing short-term inpatient detoxification at the University of Kentucky Chandler Medical Center. Eighty-five rural women (N = 85) were included in the analysis. Substance use history and previous treatment were assessed with measures adapted from the Addiction Severity Index. Treatment barriers were measured with three qualitative questions and were coded into four overarching categories: availability, accessibility, affordability, and acceptability barriers. This sample had an extensive substance use history. Almost all participants had used alcohol (98%), marijuana (98%), illicit opiates (99%), and cigarettes (97%). On average, participants reported about two barriers to receiving treatment (Mean = 1.8; SD = 1.3), with over 80% of the sample reporting having experienced any barrier to treatment. The majority experienced acceptability (51%) and accessibility (49%) barriers. Twenty-six percent (26%) of the sample reported availability barriers. A smaller percentage of participants reported affordability barriers (13%). Rural pregnant women seeking substance abuse treatment face many obstacles to receiving needed treatment. More studies on barriers to substance abuse treatment among rural pregnant women are needed. Identifying these barriers can help in improving treatment access and services.
This article describes approach papers, proposed strategies, and closing agreements among those attending the May 1998 Asian Pacific Forum on Women, Law, and Development (APWLD) among rural, indigenous women (IW). IW spoke of their experiences with globalization. The aim was to examine the effects of deregulation and privatization, liberalization, and global market and foreign monopoly capital on rural, IW in Asia. The expected outcome was an advocacy directive for APWLD in the forthcoming APEC and People's Summit in November 1998. Approach papers included F. N. Burnad's paper on the "Impact of Globalization on Rural Women" and V. Tauli-Corpuz's paper on "Globalization and its Impacts on Indigenous Women: The Philippine Experience." These papers emphasized the multiple roles of women, their increasing resourcefulness which leads to their enslavement, links between globalization and continuing colonization by transnationals and international institutions, access to ancestral resources, and promotion of export led production that threatens food security. Suggested strategies were to mobilize opposition to globalization and greater control over traditional resources and knowledge by IW. Several important questions were raised about nation states, dominant cultures, human rights violations, technology, and the close link between militarization and globalization. Participants agreed to mobilize for effectively resisting and eliminating unjust and unequal systems that exploit and oppress rural, poor, and indigenous people, especially women.
Hirt, Maiara Carmosina; Costa, Marta Cocco da; Arboit, Jaqueline; Leite, Marinês Tambara; Hesler, Lilian Zielke; Silva, Ethel Bastos da
Understand the social representations of violence against rural women, from the perspective of the elderly, considering how the generation and gender influence this aggravation. Qualitative study, based on the Theory of Social Representations.It was carried out with 12 elderly rural women from a city of Rio Grande do Sul, in July and August of 2013. The data obtained through a projective technique and semi-structured interviews has been analyzed through the reference of the Social Representations and content analysis. On one hand, the elderly represent violence as distant distress, anchored in extreme acts of aggression. On the other hand, they represent it as present in their relationships, showing themselves vulnerable to the domination of men in the context of life and work. It was revealed the invisibility of violence against elderly women in the rural context, where the male figure overlaps with the female.
Coulibaly, Sheick Oumar; Gies, Sabine; D'Alessandro, Umberto
In two cross-sectional surveys carried out in the rural health district of Boromo, Burkina Faso, malaria infection was evaluated in 295 pregnant women in May 2003 and 288 pregnant women in December 2003. Malaria prevalence, all P. falciparum infection, was higher in December (32.2%) than in May (11.9%) (P < 0.0001). In both surveys primigravidae had a significantly higher risk of infection than multigravidae (P < 0.0001). Such risk decreased significantly and progressively with gestational age, the highest risk being during the first trimester. Women who had not attended the antenatal clinic had also a significantly higher risk of malaria infection. Despite the high antenatal clinic attendance and the use (or misuse) of chloroquine chemoprophylaxis, malaria remains an important problem for pregnant women living in the rural district of Boromo. This requires a major effort by the health authorities to guarantee all pregnant women have access to and use preventive measures.
Costa, Marta Cocco da; Silva, Ethel Bastos da; Soares, Joannie Dos Santos Fachinelli; Borth, Luana Cristina; Honnef, Fernanda
To analyze the access and accessibility to the healthcare network of women dwelling in rural contexts undergoing violence situation, as seen from the professionals' speeches. A qualitative, exploratory, descriptive study with professionals from the healthcare network services about coping with violence in four municipalities in the northern region of Rio Grande do Sul. The information derived from interviews, which have been analyzed by thematic modality. (Lack of) information of women, distance, restricted access to transportation, dependence on the partner and (lack of) attention by professionals to welcome women undergoing violence situation and (non)-articulation of the network are factors that limit the access and, as a consequence, they result in the lack of confrontation of this problem. To bring closer the services which integrate the confrontation network of violence against women and to qualify professionals to welcome these situations are factors that can facilitate the access and adhesion of rural women to the services.
Lete, Iñaki; Dueñas, José Luis; Serrano, Isabel; Doval, José Luis; Martínez-Salmeán, Javier; Coll, Carme; Pérez-Campos, Ezequiel; Arbat, Agnès
To assess the attitudes of women with premenstrual symptoms in relation to their perception of complaints and request for medical advice. Cross-sectional study of a representative cohort of 2018 Spanish women aged 15-49 years. Participants were personally interviewed at home and completed the premenstrual symptoms screening tool. A total of 1554 women (73.7%) complained of some of the premenstrual symptoms during the last 12 menstrual cycles. The prevalence of moderate or severe premenstrual syndrome (PMS) was 8.9% and the prevalence of premenstrual dysphoric disorder (PMDD) 1.1%. Only 291 (18.7%) women had sought medical advice. The main reason given by 90.6% of symptomatic women for not seeking medical consultation was to consider that symptoms were normal. A total of 175 (60.1%) women received pharmacological treatment (hormonal contraceptives in 95% followed by analgesics in 50% and anti-inflammatory agents in 44%), 20% were not treated because physicians considered that symptoms were not important and would disappear spontaneously, and 12% received only advice to change life style. Women suffering from PMS or PMDD do not usually seek medical advice and among those seeking medical care, in many cases, an adequate response to their demands is not obtained. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Mistry, Ritesh; Galal, Osman; Lu, Michael
Studies in low-income countries have shown that women's autonomy (i.e. the freedom of women to exercise their judgment in order to act for their own interests) influences a number of reproductive and child health outcomes, including the use of pregnancy care services. However, studies have not examined the full spectrum of pregnancy care services needed for safe motherhood and have not accounted for community context. This study analyzed data on women and their villages from the cross-sectional population-based National Family Health Survey-2 (1998-1999) of rural India to investigate whether women's autonomy (measured in the 3 dimensions of decision-making autonomy, permission to go out, and financial autonomy) was associated with the use of adequate prenatal, delivery and postnatal care. The findings indicate women's autonomy was associated with greater use of pregnancy care services, particularly prenatal and postnatal care. The effect of women's autonomy on pregnancy care use varied according to the region of India examined (North, East and South) such that it was most consistently associated with pregnancy care use in south India, which also had the highest level of self-reported women's autonomy. The results regarding village level factors suggest that public investment in rural economic development, primary health care access, social cohesion and basic infrastructure such as electrification and paved roads were associated with pregnancy care use. Improvements in women's autonomy and these village factors may improve healthier child bearing in rural India.
Wang, Lei; Cui, Ying; Zhang, Li; Wang, Chao; Jiang, Yan; Shi, Wei
To investigate the impact of married women's gender equity awareness on use of reproductive healthcare services in rural China. The questionnaire-based study recruited 1500 married women who were aged 15-49years, had at least 1 pregnancy, and were living in rural Gansu, Qinghai, Shanxi, or Xinjiang, China, between October and December 2010. "Gender equity awareness" was quantified by responses to 7 statements, graded in accordance with a system scoring the strength of overall belief (≥19, strong; 15-18, moderate; and ≤14, weak). Only 383 women (26.3%) demonstrated high gender equity awareness. The percentage of women who received consistent prenatal care was highest in the group scoring 15 points or more (P<0.001); the percentage of women with hospital delivery and gynecologic examination (P<0.001) was highest in the group scoring 19 points or more; and the percentage of women with reproductive tract infections was highest in the group with the lowest scores (P<0.001). Women's gender equity awareness is not strong in rural midwest China. There was a positive correlation between gender equity awareness and use of reproductive healthcare services. There should be an emphasis on various activities to educate women so that they can fully access reproductive healthcare. © 2013.
Alvarado-Esquivel, C; Torres-Castorena, A; Liesenfeld, O; García-López, C R; Estrada-Martínez, S; Sifuentes-Alvarez, A; Marsal-Hernández, J F; Esquivel-Cruz, R; Sandoval-Herrera, F; Castañeda, J A; Dubey, J P
The epidemiology of Toxoplasma gondii infection in pregnant women in rural Mexico is largely unknown. The seroepidemiology of T. gondii infection in 439 pregnant women from 9 communities in rural Durango State, Mexico was investigated. Using commercial enzyme-linked immunoassays, sera were tested for T. gondii IgG, IgM, and avidity antibodies. Prevalences of T. gondii IgG antibodies in the communities varied from 0% to 20%. Overall, 36 (8.2%) of the 439 women had IgG T. gondii antibodies. Ten (2.3%) women had also T. gondii IgM antibodies; IgG avidity was high in all IgM-positive women, suggesting chronic infection. None of the women, however, had delivered a known T. gondii-infected child. The seroprevalence was significantly higher (P < 0.05) in women from low socio-economic conditions (14%) than in those with higher socio-economic status (6.6%). Multivariate analysis showed that T. gondii infection was associated with soil floors at home (adjusted OR = 2.89; 95% CI: 1.12-7.49). This is the first epidemiological study of T. gondii infection in pregnant women in rural Mexico.
Adeodu, O O; Alimi, T; Adekile, A D
Environmental factors may influence perception of or attitude to chronic disorders. The perception of sickle cell anaemia (SCA by 165 married Nigerian rural and 507 urban women was studied to determine how living in an urban or rural environment may influence perception. None of the subjects had children with SCA. The instrument used for data collection was a structured questionnaire designed to enquire into their knowledge about the cause, precipitating factors for crises, clinical features of SCA and their opinions regarding traditional and modern treatment options for the disorder. As a group, urban women had better knowledge about SCA than rural women probably because their social environment afforded a wider scope for interaction with and information exchange among people. For most respondents, the educational institutions attended the health institutions in the locality and the electronic media were poor sources of information on SCA. The study showed a serious lack of information about important aspects of SCA among rural women. We think the training of primary health care providers as counsellors on SCA, the inclusion of instruction about SCA in the curriculum of schools and sustained outreach programmes on SCA on the electronic media would ensure early education of people in both rural and urban communities and help to improve perception of the disorder.
Wan, Xia; Shin, Sanghyuk S.; Wang, Qian; Raymond, H. Fisher; Liu, Huilin; Ding, Ding; Yang, Gonghuan; Novotny, Thomas E.
Background Rural-to-urban migrant women may be vulnerable to smoking initiation as they are newly exposed to risk factors in the urban environment. We sought to identify correlates of smoking among rural-to-urban migrant women in China. Methods/Principal Findings A cross-sectional survey of rural-to-urban migrant women working in restaurants and hotels (RHW) and those working as commercial sex workers (CSW) was conducted in ten provincial capital cities in China. Multiple logistic regression was conducted to identify correlates of smoking. We enrolled 2229 rural-to-urban migrant women (1697 RHWs aged 18–24 years and 532 CSWs aged 18–30 years). Of these, 18.4% RHWs and 58.3% CSWs reported ever tried smoking and 3.2% RHWs and 41.9% CSWs reported current smoking. Participants who first tried smoking after moving to the city were more likely to be current smokers compared to participants who first tried smoking before moving to the city (25.3% vs. 13.8% among RHWs, p = 0.02; 83.6% vs. 58.6% among CSWs, p = <0.01). Adjusting for other factors, “tried female cigarette brands” had the strongest association with current smoking (OR 5.69, 95%CI 3.44 to 9.41) among participants who had ever tried smoking. Conclusions/Significance Exposure to female cigarette brands may increase the susceptibility to smoking among rural-to-urban migrant women. Smoke-free policies and increased taxes may be effective in preventing rural-to-urban migrant women from smoking initiation. PMID:21829683
This paper focuses on rural living as a dimension of women's experiences of living through breast cancer. The findings presented emanate from a feminist narrative research project that examined the experiences of rural women from south-west Queensland who were long-term survivors of breast cancer. This project aimed to listen, report and interpret rural women's stories of resilience in surviving breast cancer and moving on with their lives. The participants reported that there were both positive and negative aspects of living in a rural setting, especially when ill. Eight of the nine participants, however, felt strongly that the positive aspects of rural living outweighed the difficulties. This suggests that rurality in the context of health and illness must be considered as a multifaceted dimension, with resources to support cancer survivors building on the existing strengths in rural communities.
Alas, Alexandriah N.; Dunivan, Gena C.; Wieslander, Cecelia K.; Sevilla, Claudia; Barrera, Biatris; Rashid, Rezoana; Maliski, Sally; Eilber, Karen; Rogers, Rebecca G.; Anger, Jennifer Tash
Objectives The objective of this study was to compare perceptions and barriers between Spanish-speaking and English-speaking women in public and private hospitals being treated for pelvic organ prolapse (POP). Methods Eight focus groups, 4 in English and 4 in Spanish, were conducted at 3 institutions with care in female pelvic medicine and reconstructive surgery. Standardized questions were asked regarding patients' emotions to when they initially noticed the POP, if they sought family support, and their response to the diagnosis and treatment. Transcripts were analyzed using grounded theory qualitative methods. Results Thirty-three women were Spanish-speaking and 25 were English-speaking. Spanish speakers were younger (P = 0.0469) and less likely to have a high school diploma (P < 0.0001) than English speakers. Spanish-speaking women had more concerns that the bulge or treatments could lead to cancer, were more resistant to treatment options, and were less likely to be offered surgery. Women in the private hospital desired more information, were less embarrassed, and were more likely to be offered surgery as first-line treatment. The concept emerged that patient care for POP varied based on socioeconomic status and language and suggested the presence of disparities in care for underserved women with POP. Conclusions The discrepancies in care for Spanish-speaking women and women being treated at public hospitals suggest that there are disparities in care for POP treatment for underserved women. These differences may be secondary to profit-driven pressures from private hospitals or language barriers, low socioeconomic status, low health literacy, and barriers to health care. PMID:27636216
Alas, Alexandriah N; Dunivan, Gena C; Wieslander, Cecelia K; Sevilla, Claudia; Barrera, Biatris; Rashid, Rezoana; Maliski, Sally; Eilber, Karen; Rogers, Rebecca G; Anger, Jennifer Tash
The objective of this study was to compare perceptions and barriers between Spanish-speaking and English-speaking women in public and private hospitals being treated for pelvic organ prolapse (POP). Eight focus groups, 4 in English and 4 in Spanish, were conducted at 3 institutions with care in female pelvic medicine and reconstructive surgery. Standardized questions were asked regarding patients' emotions to when they initially noticed the POP, if they sought family support, and their response to the diagnosis and treatment. Transcripts were analyzed using grounded theory qualitative methods. Thirty-three women were Spanish-speaking and 25 were English-speaking. Spanish speakers were younger (P = 0.0469) and less likely to have a high school diploma (P < 0.0001) than English speakers. Spanish-speaking women had more concerns that the bulge or treatments could lead to cancer, were more resistant to treatment options, and were less likely to be offered surgery. Women in the private hospital desired more information, were less embarrassed, and were more likely to be offered surgery as first-line treatment. The concept emerged that patient care for POP varied based on socioeconomic status and language and suggested the presence of disparities in care for underserved women with POP. The discrepancies in care for Spanish-speaking women and women being treated at public hospitals suggest that there are disparities in care for POP treatment for underserved women. These differences may be secondary to profit-driven pressures from private hospitals or language barriers, low socioeconomic status, low health literacy, and barriers to health care.
Giner, Elisenda; Ruiz, Laura; Serrano, Mª Ángeles; Valls, Rosa
Background/Context: Women's sexuality, and the ways they experience it, has been a major topic in feminist theories and movements throughout history. For the more than 20,000 working-class women who participated in the Free Women movement in Spain (the libertarian women's movement, which started in 1936), women's sexuality was also a key topic in…
Chen, Likwang; Chen, Chi-Liang; Yang, Wei-Chih
Background Taiwan's National Health Insurance (NHI), implemented in 1995, substantially increased the number of health care facilities that can deliver free prenatal care. Because of the increase in such facilities, it is usually assumed that women would have more choices regarding prenatal care facilities and thus experience reduction in travel cost. Nevertheless, there has been no research exploring these issues in the literature. This study compares how Taiwan's NHI program may have influenced choice of prenatal care facility and perception regarding convenience in transportation for obtaining such care for women in rural and non-rural areas in Taiwan. Methods Based on data collected by a national survey conducted by Taiwan's National Health Research Institutes (NHRI) in 2000, we tried to compare how women chose prenatal care facility before and after Taiwan's National Health Insurance program was implemented. Basing our analysis on how women answered questionnaire items regarding "the type of major health care facility used and convenience of transportation to and from prenatal care facility," we investigated whether there were disparities in how women in rural and non-rural areas chose prenatal care facilities and felt about the transportation, and whether the NHI had different influences for the two groups of women. Results After NHI, women in rural areas were more likely than before to choose large hospitals for prenatal care services. For women in rural areas, the relative probability of choosing large hospitals to choosing non-hospital settings in 1998–1999 was about 6.54 times of that in 1990–1992. In contrast, no such change was found in women in non-rural areas. For a woman in a non-rural area, she was significantly more likely to perceive the transportation to and from prenatal care facilities to be very convenient between 1998 and 1999 than in the period between 1990 and 1992. No such improvement was found for women in rural areas. Conclusion We
Chen, Likwang; Chen, Chi-Liang; Yang, Wei-Chih
Taiwan's National Health Insurance (NHI), implemented in 1995, substantially increased the number of health care facilities that can deliver free prenatal care. Because of the increase in such facilities, it is usually assumed that women would have more choices regarding prenatal care facilities and thus experience reduction in travel cost. Nevertheless, there has been no research exploring these issues in the literature. This study compares how Taiwan's NHI program may have influenced choice of prenatal care facility and perception regarding convenience in transportation for obtaining such care for women in rural and non-rural areas in Taiwan. Based on data collected by a national survey conducted by Taiwan's National Health Research Institutes (NHRI) in 2000, we tried to compare how women chose prenatal care facility before and after Taiwan's National Health Insurance program was implemented. Basing our analysis on how women answered questionnaire items regarding "the type of major health care facility used and convenience of transportation to and from prenatal care facility," we investigated whether there were disparities in how women in rural and non-rural areas chose prenatal care facilities and felt about the transportation, and whether the NHI had different influences for the two groups of women. After NHI, women in rural areas were more likely than before to choose large hospitals for prenatal care services. For women in rural areas, the relative probability of choosing large hospitals to choosing non-hospital settings in 1998-1999 was about 6.54 times of that in 1990-1992. In contrast, no such change was found in women in non-rural areas. For a woman in a non-rural area, she was significantly more likely to perceive the transportation to and from prenatal care facilities to be very convenient between 1998 and 1999 than in the period between 1990 and 1992. No such improvement was found for women in rural areas. We concluded that women in rural areas were
Liu, Zhaoping; Li, Wenxian; Sun, Jing; Liu, Chenghong; Zeng, Qiang; Huang, Jian; Yu, Bo; Huo, Junsheng
This study evaluated the intake of soy foods and soy isoflavones by rural adult women and potential determinant factors. Soy food consumption and information on age, education and medical history were collected on 1,188 subjects in Gansu Province and Hebei Province, China using a food frequency questionnaire to gather data on food intake over the past year. Weight and height were simultaneously measured. The results showed that 1139 (95.9%) rural women consumed soy foods in the past year. The average intake of soy foods and isoflavones was 38.7 +/- 58.2 (median = 23.5) g/d and 17.7 +/- 26.6 (median= 8.9) mg/d, respectively. Tofu accounted for the most contribution to their intake. The soy isoflavone intake ranged between 0-35 mg/day in 89.2% of subjects. Gansu women had higher intakes of soy foods and isoflavones than Henbei women (P< 0.05). Women aged 41-50 years consumed less soy foods and isoflavones than the 20-30-year olds and 31-40 year olds(P < 0.05). The intake of soy foods (P< 0.01) and isoflavones (P< 0.01) by women who experienced secondary education or above was significantly higher than illiterate women. Women without a medical history had a higher soy isoflavone intake than women with a medical history, but the difference was not statistically significant. These results suggest that the intake of soy isoflavones by Chinese rural adult women was much higher than women in Western countries. The distribution of intake was skewed to the right and varied among women in regard to region, age group and education level.
Helps, Catherine; Barclay, Lesley
Aboriginal women in rural areas have lower rates of breastfeeding than Australian averages. The reasons for this are poorly understood. Aboriginal people experience higher morbidity and increased rates of chronic disease throughout the life cycle. The protective effects of sustained breastfeeding could benefit rural Aboriginal communities. To explore the factors impacting upon infant feeding choices in a rural Aboriginal Community. Semi-structured interviews were conducted with eight Aboriginal rural dwelling first time mothers. These women received a continuity of midwife and Aboriginal Health Worker model of care. Interviews were also undertaken with five Aboriginal Health Workers and two Aboriginal community breastfeeding champions. The analysis was integrated with a conventional literature review and was further developed and illustrated with historical literature. Indigenist methodology guided the study design, analysis and the dissemination of results. Three key themes were identified. These were "I'm doing the best thing for..." which encompasses the motivations underpinning infant feeding decisions; "this is what I know..." which explores individual and community knowledge regarding infant feeding; and "a safe place to feed" identifying the barriers that negative societal messages pose for women as they make infant feeding decisions. It appears loss of family and community breastfeeding knowledge resulting from colonisation still influences the Aboriginal women of today. Aboriginal women value and trust knowledge which is passed to them from extended family members and women within their Community. Cultural, historical and socioeconomic factors all strongly influence the infant feeding decisions of individuals in this study. Efforts to normalise breastfeeding in the culture of rural dwelling Aboriginal women and their supporting community appear to be necessary and may promote breastfeeding more effectively than optimal professional care of individuals can
Mehta, Naaman V; Trivedi, Mayur; Maldonado, Luis E; Saxena, Deepak; Humphries, Debbie L
Type II diabetes has risen dramatically among rural women in India, specifically in the states of Gujarat, Karnataka, Tamil Nadu and Uttar Pradesh. Recent studies suggest that rural Indian women's low level of self-efficacy, or confidence in their ability to carry out tasks, such as managing diabetes, is a key reason for this increase. Therefore, this study utilizes the Health Belief Model to analyze whether increased awareness of diabetes leads to a positive increase in levels of self-efficacy among diabetic women in two rural villages of Gujarat. A cross-sectional study of 126 known cases of women with diabetes was carried out in the villages of Rajpur and Valam in the Mehsana District in the state of Gujarat, India, to assess the relationship between diabetes knowledge and self-efficacy. The instrument was adapted from the Michigan Diabetes Research and Training Center's Diabetes Empowerment Scale-Short Form and Knowledge, Attitudes and Practices Assessment of the Indian Institute of Public Health Gandhinagar. Participants' mean knowledge score was 10.77±2.86 out of a possible 24 points, for a mean percentage of 45%. The median self-efficacy score for the women was 7 with an interquartile range of 3. The age-adjusted multiple regression analysis demonstrated a significant positive correlation between knowledge and self-efficacy (p<0.001). The observations of this study suggest a positive correlation between diabetes knowledge and self-efficacy. Future diabetes educational interventions in India should place a greater emphasis on increasing knowledge among rural women. Specifically, these interventions should emphasize the major gaps in knowledge regarding causes of diabetes, complications and treatment procedures. Educational interventions that are catered more towards rural women will be critical for improving their self-efficacy.
Kiggundu, Edith; Castle, Jane
There is an urgent need for fresh approaches to HIV & AIDS education for adults and youth in South Africa, particularly for those marginalised by society, such as rural black women. In this article we explore the factors which affect awareness, condom use and HIV & AIDS risk among a group of women who attend classes in a rural Adult…
Empowering women to control and change their lives continues to be an important goal for many nations. This article examines the empowering effects of being selected and trained to lead rural schools in Bangladesh, using survey and interview data from 152 village women working with the Bangladesh Rural Advancement Committee education programme.…
West, Delia Smith; Greene, Paul; Pulley, LeaVonne; Kratt, Polly; Gore, Stacy; Weiss, Heidi; Siegfried, Nicole
Few studies have investigated community clinic-based interventions to promote mammography screening among rural African American women. This study randomized older low-income rural African American women who had not participated in screening in the previous 2 years to a theory-based, personalized letter or usual care; no group differences in…
Coughlin, Steven S.; Thompson, Trevor D.
Previous studies have suggested that men and women in rural areas are less likely than those in urban areas to receive routine cancer screening. Methods: We examined the colorectal cancer screening practices of men (n = 23,565) and women (n = 37,847) aged >50 years living in rural areas and other areas of the United States using data from the…
Ames, Barbara D.; Brosi, Whitney A.; Damiano-Teixeira, Karla M.
The purpose of this qualitative study was to better understand the experience of wage-earning women in the context of rural economic restructuring. An ecological and life course theoretical framework was used. Nine community leaders and 17 wage-earning women residing in a rural northern Michigan county participated in semistructured interviews,…
Aghi, M B; Grupta, P; Mehta, F
This report of the Smoking Intervention Project pertains to women in Kerala and Andhra, India. The typical woman in Kerala is a fulltime housewife who also works in the fields, growing, tending, and harvesting a paddy. The rural woman is somewhat literate, and she is alert, independent, and individualistic. She chews tobacco with betel leaf and areca nut, has her own private supply of chewing material, and uses it whenever she wants. Her counterpart in Andhra is less literate, probably has more children, seems poorer, and may chew tobacco but smokes a locally made cigar/cheroot called a chutta. She lights it and when well lit puts the glowing end inside her mouth. The Kerala woman typically suffers from precancerous lesions in right or left buccal mucosa, buccal groove, on or under the tongue. The Andhra woman also has lesions on the palate. Both are totally unaware of the ill effects of tobacco. Oral cancer may be called the national cancer of India. More suffer from it than from any other cancer. The Smoking Intervention Project is divided into 3 phases: phase 1 -- a cross sectional field survey, determined the prevalence rates of oral precancerous lesions and their association with tobacco habits in a population of 50,915; phase 2 -- a 10 year follow-up study of 3/5 of the original study population, which indicated that oral cancer and precancerous lesions occurred almost solely among those who smoked or chewed tobacco and oral cancer was almost always preceded by some type of precancerous lesions; and phase 3 -- the intervention part of the project is to make people give up tobacco and to investigate any effect this might have on incidence and regression rate of precancerous lesions. The intervention program outlined a timetable for employing different communication media and regulating the information flow so as not to overwhelm the target population and to make the message more easily understandable, if necessary. Intervention strategies have been continually
Kozica, Samantha L; Harrison, Cheryce L; Teede, Helena J; Ng, Sze; Moran, Lisa J; Lombard, Catherine B
The obesity epidemic is well established, particularly in rural settings. Programs promoting healthy lifestyles for rural women are urgently needed; however, participant engagement is challenging. In the context of a large randomized controlled trial targeting the prevention of weight gain in rural women, we explored successful recruitment strategies and aimed to understand participants' barriers, enablers and reasons for program participation. We recruited women (aged 18-55 years) from the general rural Australian population. A mixed-methods approach was applied to explore factors that influenced program participation, including quantitative questionnaires for all participants (n = 649) and qualitative semi-structured interviews conducted for a subgroup of participants (n = 45). Data were collected at three time points: baseline, 6 and 12 months post program commencement. We recruited 649 rural women through a community communication and partnering strategy, a program marketing campaign and mobilization of social networks. Program participants were diverse across education and income levels and were representative of the wider Australian regional population. Factors that influenced program engagement were divided into personal (perceived program benefits and program accessibility) and social (peer persuasion and support). Identified enablers included convenience of the program location, perceived program utility, such as weight management and optimization of lifestyle choices, as well as attending the program with peer support. Barriers to engagement, which are likely exacerbated in rural communities included lack of anonymity, self-consciousness and segregated social networks in rural settings. Participants reported that eliciting local support and maximizing publicity is fundamental to improving future program engagement. Multiple program promotion strategies including communication, marketing and partnering, as well as mobilization of social networks and peer
Carnahan, Leslie R.; Peacock, Nadine R.
Introduction Women living in rural areas in the United States experience disproportionately high rates of diseases such as obesity and heart disease and are less likely than women living in urban areas to meet daily physical activity (PA) recommendations. The purpose of our research was to understand age-specific perceptions of barriers and facilitators to rural women engaging in PA and to identify strategies to promote PA among these women. Methods As part of a community health assessment to learn about women’s health issues, 110 adult women participated in 14 focus groups. The women were divided into 4 age groups, and focus groups were held in various community settings. We used qualitative analysis methods to explore themes in the women’s narratives, including themes related to PA knowledge, PA behavior, and access to PA facilities. Results Participants described multiple and often conflicting individual, social, and environmental barriers and facilitators to PA. Several barriers and facilitators were shared across age groups (eg, competing priorities and inadequate knowledge about PA’s role in disease prevention and disease management). Other barriers (eg, illness and injury) and facilitators (eg, PA as a social opportunity) differed by age group. Conclusion Rural women in southernmost Illinois have often contradictory barriers and facilitators to PA, and those barriers and facilitators are different at different points in a woman’s life. Our findings suggest the need for multilevel, multisector approaches to promote PA. Additionally, this research supports the need for tailored PA promotion programs for rural women to address the barriers these women face across their lifespan. PMID:27685431
Shannon, Lisa; Nash, Shondrah; Jackson, Afton
Among pregnant women, intimate partner violence (IPV) is recognized as a critical risk factor in adverse health outcomes for the mother and newborn alike. This pilot study examined IPV and health for rural Appalachian pregnant women, a particularly vulnerable high-risk and high-needs group. Participants were 77 rural, Appalachian pregnant women entering a hospital-based inpatient detoxification unit primarily for Opiate Dependence. Study participants gave informed consent to a face-to-face interview and secondary data abstraction from hospital medical records. IPV was measured via questions from the National Violence Against Women Survey, the Revised Conflict Tactics Scale (CTS2), and the Psychological Maltreatment of Women Inventory (PMWI). The majority of the sample reported lifetime psychological (89.6%) and physical (64.9%) violence. A little over three fourths (75.3%) experienced IPV in the past year. Furthermore, over one third (39.0%) experienced stalking, physical, or sexual violence in the past year. Most participants (71.4%) experienced psychological abuse in the past year. IPV experiences, in conjunction with pervasive substance use, mental and physical health problems, and poverty present in rural Appalachia, culminate in a particularly high-risk and high-needs group of pregnant women. These women present unique opportunities and challenges for prevention, intervention, and treatment. © The Author(s) 2015.
Mutombo, Namuunda; Bakibinga, Pauline; Mukiira, Carol; Kamande, Eva
The last two decades have seen an increase in literature reporting an increase in knowledge and use of contraceptives among individuals and couples in Kenya, as in the rest of Africa, but there is a dearth of information regarding knowledge about benefits of family planning (FP) in Kenya. To assess the factors associated with knowledge about the benefits of FP for women and children, among women in rural Western Kenya. Data are drawn from the Packard Western Kenya Project Baseline Survey, which collected data from rural women (aged 15-49 years). Ordinal regression was used on 923 women to determine levels of knowledge and associated factors regarding benefits of FP. Women in rural Western Kenya have low levels of knowledge about benefits of FP and are more knowledgeable about benefits for the mother rather than for the child. Only age, spousal communication and type of contraceptive method used are significant. Women's level of knowledge about benefits of FP is quite low and may be one of the reasons why fertility is still high in Western Kenya. Therefore, FP programmes need to focus on increasing women's knowledge about the benefits of FP in this region.
Balwicki, Lukasz; Smith, Danielle M; Pierucka, Magdalena; Goniewicz, Maciej L; Zarzeczna-Baran, Marzena; Jedrzejczyk, Tadeusz; Strahl, Marzena; Zdrojewski, Tomasz
Smoking rates among women in Poland are high, and access to specialized smoking cessation services in rural areas are limited. The aim of this study was to assess factors related to quitting among pregnant women who smoke in rural areas of Poland. Data were collected during interviews conducted by midwives among 4512 women at various stages of their pregnancy. The interviews took place in small towns with populations having less than 8000 residents, located within 12 out of 16 voivodships (provinces). We used exhaled carbon monoxide to verify self-reported smoking status. Overall, 38% of women interviewed (n = 1578) smoked before they found out they were pregnant. Among these women, 33% quit just after they had become aware of their pregnancy. The main predictors of early quitting were: higher educational attainment among pregnant women (adjusted odds ratio [AOR] 3.21; 95% confidence interval [CI] = 1.81-5.68), secondary educational attainment among their partners (AOR 1.63; 95% CI = 1.06-2.48), and not having children (AOR 1.71; 95% CI = 1.31-2.24). The main barriers to early quitting were: living with at least one current smoker (AOR 0.55, 95% CI = 0.39-0.76), being single (AOR 0.45; 95% CI = 0.29-0.71), and having both parents smoke cigarettes (AOR 0.67; 95% CI = 0.46-0.97). A modest proportion of women included in this study quit after they became aware of their pregnancy. However, women faced multiple barriers to quitting, including the smoking status of their family members. The factors identified in the study can inform the design of tailored interventions for pregnant women in rural areas. Smoking rates among women in Poland are high, and access to specialized smoking cessation services in rural areas are limited. This study found that women were motivated to quit smoking, and many quit after they had become aware of their pregnancy. However, women faced multiple barriers to quitting, including the smoking status of their family members. The factors
Reed, Elizabeth; Donta, Balaiah; Dasgupta, Anindita; Ghule, Mohan; Battala, Madhusudana; Nair, Saritha; Silverman, Jay; Jadhav, Arun; Palaye, Prajakta; Saggurti, Niranjan; Raj, Anita
Objectives The social positioning (i.e. social status and autonomy) of women in the household facilitates women's access to and decision-making power related to family planning (FP). Women's access to spending money, which may be an indicator of greater social positioning in the household, may also be greater among women who engage in income generating activities for their families, regardless of women's status in the household. However, in both scenarios, access to money may independently afford greater opportunity to obtain family planning services among women. This study seeks to assess whether access to money is associated with FP outcomes independently of women's social positioning in their households. Methods Using survey data from married couples in rural Maharashtra, India (n = 855), crude and adjusted regression was used to assess women's access to their own spending money in relation to past 3 month use of condoms and other forms of contraceptives (pills, injectables, intrauterine device). Results Access to money (59 %) was associated with condom and other contraceptive use (AORs ranged 1.5-1.8). These findings remained significant after adjusting for women's FP decision-making power in the household and mobility to seek FP services. Conclusion While preliminary, findings suggest that access to money may increase women's ability to obtain FP methods, even in contexts where social norms to support women's power in FP decision-making may not be readily adopted.
Hysterectomy appears to be on the rise amongst low-income, rural women in India as routine treatment for gynaecological ailments. This paper explores the individual, household, socio-economic and health system factors that influenced women's decisions to undergo hysterectomy in rural Gujarat, with a focus on women's perspectives. Interviews were conducted with 35 rural, low-income women who had undergone hysterectomy, local gynaecologists and other key informants, alongside observation of daily life and health-related activities. Inductive, open coding was conducted within a framework analysis to identify thematic influences on the decision to undergo hysterectomy. Women underwent hysterectomy at an average age of 36, as treatment for typically severe gynaecological ailments. I argue that women, faced with embedded social inequality in the form of gender biases, lack of labour security and a maternal-centric health system, demonstrated pragmatic agency in their decision to remove the uterus. When they experienced gynaecological ailments, most sought two to three opinions and negotiated financial and logistical concerns. The health system offered few non-invasive services for non-maternal health issues. Moreover, women and health care providers believed there is limited utility of the uterus beyond childbearing. Women's responsibilities as caretakers, workers and producers drove them to seek permanent solutions that would secure their long-term work and health security. Thus, hysterectomy emerged as a normalised treatment for gynaecological ailments, particularly for low-income women with limited resources or awareness of potential side effects. In this setting, hysterectomy reflects the power structures and social inequalities in which women negotiated medical treatment--and the need to reverse a culture of permanent solutions for low-income women. Copyright © 2016 Elsevier Ltd. All rights reserved.
Kako, Peninnah M.; Stevens, Patricia E.; Karani, Anna K; Mkandawire-Valhmu, Lucy; Banda, Anne
As people live longer and more productively with HIV infection, issues of agency in reducing HIV risk are particularly important for HIV-infected women living in high prevalence, under-resourced countries such as Kenya. Because of their gendered lives, in that being masculine is associated with dominance, while being feminine is associated with passiveness, women in rural Kenya must cope with continued HIV transmission risk even after knowing they are infected with HIV. In this narrative interview study, informed by theories of gender and post-colonial feminism, we examined personal accounts of HIV risk and risk reduction of 20 rural women in eastern Kenya who were living with HIV. From our analysis of the women's narratives, two major themes emerged: gender-based obstacles even in the context of a known HIV diagnosis, and struggles with economic pressures amid HIV risks. Implications for policy, programs, and research are discussed. PMID:22137546
Molina, Yamile; Zimmermann, Kristine; Carnahan, Leslie R; Paulsey, Ellen; Bigman, Cabral A; Khare, Manorama M; Zahnd, Whitney; Jenkins, Wiley D
Rural cancer disparities are increasingly documented in the USA. Research has identified and begun to address rural residents' cancer knowledge and behaviors, especially among women. Little, however, is known about rural female residents' awareness of cancer inequities and perceived contributing factors affecting them and their families. The purpose of this study was to address these gaps in the literature via a secondary analysis of qualitative needs assessment in Illinois' rural southernmost seven counties, a geographic region with relatively high rates of cancer incidence, morbidity, and mortality. A convenience sample of 202 rural adult female residents was recruited and participated in 26 focus groups, with 3-13 women per group. Inductive content analysis, guided by the principle of constant comparison, was used to analyze the qualitative data. Most respondents indicated their awareness of disproportionate cancer burden in their communities. Individual-level behaviors and environmental toxins were identified as contributing factors. Interestingly, however, environmental toxins were more often discussed as factors contributing to geographic differences, whereas individual-level behaviors were noted as important for overall cancer prevention and control. This study provides important insight into female rural residents' perspectives and offers novel venues for educational programs and research in the context of communication to eliminate disparities.
Ghosh, Bhola Nath; De, Utpal Kumar
Women living in rural areas are closely associated with the natural environment. Poor families are mostly dependent on natural resources for their survival activities viz. grazing of cattle, collection of water for drinking and cooking purposes and collection of fuel wood. In the poor families due to the compulsion of earning, adult males mostly go for outside activities and sometimes female members of the family also join them. The aforementioned natural resource collection activities are considered to be inferior, less remunerative and hence suitable for the women or young kids to perform. Thus, they are found to be more close to the nature than men and this very close relationship makes them perfect managers of the eco-system in their vicinity. The life of rural women is so much intertwined with the environment that they can't even think of her survival without it. However, there might be significant inter-household differences in the distribution of such activities between male and female members of the families, depending upon their socio-economic characteristics, cultural and religious beliefs and attitude towards women and children. The involvement of women in such activities is also found to be more in the tribal dominated societies. This paper tried to examine the extent to which women in rural Jharkhand are involved in such natural resource collection and management activities. Also, we tried to unearth various economic and cultural reasons and their impact on the involvement of women in such activities across various social and economic groups. The analysis of primary data collected from the rural areas of tribal dominated Jharkhand reveals that income, occupation and status of the families have significant inverse link with the involvement of women and also of girl children at the cost of their educational prospects. Religious and cultural beliefs also enter in the determination of extent of involvement of women and children in the rural society. It is
Befort, Christie A; Donnelly, Joseph E; Sullivan, Debra K; Ellerbeck, Edward F; Perri, Michael G
Rural women have among the highest rates of obesity and sedentary lifestyle, yet few studies have examined strategies for delivering state-of-the-art obesity treatment to hard-to-reach rural areas. The purpose of this pilot trial was to examine the impact and cost-effectiveness of a 6-month behavioral weight loss program delivered to rural women by phone either one-on-one with a counselor or to a group via conference call. Thirty-four rural women (mean BMI=34.4, SD=4.6) were randomized to group phone-based treatment or individual phone-based treatment. Completers analysis showed that weight loss was greater in the group condition (mean=14.9 kg=, SD=4.4) compared to the individual condition (mean=9.5 kg, SD=5.2; p=.03). Among the total sample, 62% of participants in the group condition achieved the 10% weight loss goal compared to 50% in the individual condition, and group treatment was found to be more cost-effective. Future research is warranted to examine the benefits of group phone-based treatment for long-term management of obesity among rural populations.
Haines, Helen M; Baker, Janet; Marshall, Diana
To describe the clinical outcomes and sustainability factors of a long-standing midwifery led caseload model of rural maternity care. Retrospective clinical audit from 1998 to 2011 and autoethnographic narrative of the midwifery program told by the longest serving midwives under three key themes relating to sustainable practice. Regional Health Service with annual birth rate of 500. Maternity care is provided by either public antenatal clinic/GP shared care or midwife-led care. Women attending a rural caseload midwifery group practice between the period 1998-2011 and midwives working in the same group practice during that period. Antenatal attendance, maternal mortality, infant morbidity and mortality, mode of birth, known midwife at birth, initiation of breastfeeding. There were 1674 births between 1998 and 2011. Clinical outcomes for women and infants closely reflected national maternity indicator data. The group practice midwives attribute sustainability of the program to the enjoyment of flexibility in their working environment, to establishing trust amongst themselves, the women they care for, and with the obstetricians, GPs and health service executives. The rigorous application of midwifery principles including robust clinical governance have been hallmarks of success. This caseload midwifery group practice is a safe, satisfying and sustainable model of maternity care in a rural setting. Clinical outcomes are similar to standard care. Success can be attributed to strong leadership across all levels of policy, health service management and, most importantly, the rural midwives providing the service. © 2015 National Rural Health Alliance Inc.
Fahey, Nisha; Soni, Apurv; Allison, Jeroan; Vankar, Jagdish; Prabhakaran, Anusha; Moore Simas, Tiffany A; Byatt, Nancy; Phatak, Ajay; O'Keefe, Eileen; Nimbalkar, Somashekhar
Common mental disorders (CMD) are a constellation of mental health conditions that include depression, anxiety, and other related nonpsychotic affective disorders. Qualitative explanatory models of mental health among reproductive-aged women in India reveal that distress is strongly associated with CMD. The relationship of perceived stress and CMD might be attenuated or exacerbated based on an individual's sociodemographic characteristics. To screen for Common Mental Disorders (CMD) among reproductive-aged women from rural western India and explore how the relationship between perceived stress and CMD screening status varies by sociodemographic characteristics. Cross-sectional survey of 700 women from rural Gujarat, India. CMD screening status was assessed using Self-Reported Questionnaire 20 (SRQ-20). Factors associated with CMD screening status were evaluated using multivariable logistic regression. Effect modification for the relationship of perceived stress and CMD screening status was assessed using interaction terms and interpreted in terms of predicted probabilities. The analytic cohort included 663 women, with roughly 1 in 4 screening positive for CMD (157, 23.7%). Poor income, low education, food insecurity, and recurrent thoughts after traumatic events were associated with increased risk of positive CMD screen. Perceived stress was closely associated with CMD screening status. Higher education attenuated the relationship between high levels of stress and CMD screening status (82.3%, 88.8%, 32.9%; P value for trend: 0.03). Increasing income and age attenuated the link between moderate stress and CMD. Our findings suggest a high burden of possible CMD among reproductive-aged women from rural western India. Higher education might mitigate the association between elevated stress and CMD. Future efforts to improve mental health in rural India should focus on preventing CMD by enhancing rural women's self-efficacy and problem-solving capabilities to overcome
Hubbard, Gill; Venning, Christine; Walker, Alison; Scanlon, Karen; Kyle, Richard G
The aim of this study was to identify the supportive care needs and unmet needs of women with breast cancer (BC) in rural Scotland. In 2013, a survey of supportive care needs of rural women with BC was conducted using the short-form Supportive Care Needs Survey (SCNS-SF34). Semi-structured interviews were subsequently conducted with a purpose sample of questionnaire respondents. Forty-four women with BC completed the survey and ten were interviewed. Over half of participants reported at least one moderate to high unmet need (56.8 %, n = 25), a tenth reported low needs (11.4 %, n = 5), and around a third reported no unmet needs for all 34 items (31.8 %, n = 14). The most prevalent moderate to high needs were 'being informed about cancer in remission' (31.8 %, n = 14), 'fears about the cancer spreading' (27.3 %, n = 12), 'being adequately informed about the benefits and side-effects of treatment' and 'concerns about the worries of those close to you' (both 25.0 %, n = 11). Interviews highlighted the following unmet needs: information about treatment and side effects, overview of care, fear of recurrence, impact on family and distance from support. Rural women with BC report similar unmet needs to their urban counterparts. Fear of recurrence is a key unmet need that should be addressed for all women with BC. However, they also report unique unmet needs because of rural location. Thus, it is critical that cancer services address the additional unmet needs of rural women with BC and, in particular, needs relating to distance from services.
Background: A review of the literature produced no rigorously tested and validated Spanish-language physical activity survey or evaluation tools for use by USDA’s food assistance and education programs. The purpose of the current study was to develop and evaluate the face validity of a visually enha...
Tearne, Elizabeth; Cox, Kylee; Giglia, Roslyn
Objectives Monitoring surveys and research outline a paucity of alcohol consumption data for women in the period of lactation, particularly in rural areas of developed countries. Identifying the drinking profile of ante- and postnatal women in this population will aid in the effective dissemination of public health interventions. This paper will present the first alcohol consumption data of pregnant and breastfeeding women living in rural Western Australia (WA). Methods A prospective cohort of 489 mothers and their infants were recruited between April 2010 and November 2011. All women regardless of their infant feeding method were followed up at 4, 10, 16, 26, 32, 40 and 52 weeks postpartum. Data were analysed to ascertain the prevalence and patterns of alcohol consumption during pregnancy and lactation. Results Approximately 20% of women consumed alcohol during pregnancy, with a predominance of women from older age groups and smokers. At 4, 6 and 12 months postpartum; 45.9%, 47.0% and 51.9% of breastfeeding mothers were consuming alcohol respectively. Conclusions for Practice There remains a considerable proportion of women who continue to drink during pregnancy. Although proven successful, public health campaigns now need to target women who are older and who smoke. Women are continuing to consume alcohol during the period of lactation, with the majority doing so at low levels.
Luz, Luciana; Agadjanian, Victor
Women's decision-making autonomy in developing settings has been shown to improve child survival and health outcomes. However, little research has addressed possible connections between women's autonomy and children's schooling. To examine the relationship between rural women's decision-making autonomy and enrollment status of primary school-age children living in their households and how this relationship differs by child's gender. The analysis uses data from a 2009 survey of rural households in four districts of Gaza province in southern Mozambique. Multilevel logistic models predict the probability of being in school for children between 6 and 14 years old. The results show a positive association of women's decision-making autonomy with the probability of being enrolled in primary school for daughters, but not for sons. The effect of women's autonomy is net of other women's characteristics typically associated with enrollment and does not mediate the effects of those characteristics. Based on the results, we argue that women with higher levels of decision-making autonomy may have a stronger preference for daughters' schooling and may have a greater say in making and implementing decisions regarding daughters' education, compared to women with lower autonomy levels. Results also illustrate a need for considering a broader set of autonomy-related characteristics when examining the effects of women's status on children's educational outcomes.
Gómez, María L.; Ashford, Kristin; Linares, Ana M.; Hall, Lynne A.
Background and Purpose Prenatal and postpartum psychosocial stress are associated with adverse pregnancy outcomes. Hispanic women experience higher levels of stress during pregnancy. This pilot study assessed the psychometric characteristics of the Everyday Stressors Index-Spanish (ESI-S) version. Methods Secondary analysis in a convenience sample, n = 51 women. Results The ESI-S showed adequate internal consistency (Cronbach’s alpha = .86). Two factors accounted for 40% of the item variance. The greatest sources of stress were “having too many responsibilities” and “not enough money for basics”. Higher levels of stressors were associated with older age, living without a partner, and working part or full time. The ESI-S was positively correlated with measures of perinatal depression. Conclusions Findings support the reliability and validity of the newly translated ESI-S. PMID:26673774
Gómez, María L; Ashford, Kristin; Linares, Ana M; Hall, Lynne A
Prenatal and postpartum psychosocial stress are associated with adverse pregnancy outcomes. Hispanic women experience higher levels of stress during pregnancy. This pilot study assessed the psychometric characteristics of the Everyday Stressors Index-Spanish (ESI-S) version. Secondary analysis in a convenience sample, n = 51 women. The ESI-S showed adequate internal consistency (Cronbach's alpha = .86). Two factors accounted for 40% of the item variance. The greatest sources of stress were "having too many responsibilities" and "not enough money for basics". Higher levels of stressors were associated with older age, living without a partner, and working part or full time. The ESI-S was positively correlated with measures of perinatal depression. Findings support the reliability and validity of the newly translated ESI-S.
Pedraza-Flechas, Ana María; Lope, Virginia; Moreo, Pilar; Ascunce, Nieves; Miranda-García, Josefa; Vidal, Carmen; Sánchez-Contador, Carmen; Santamariña, Carmen; Pedraz-Pingarrón, Carmen; Llobet, Rafael; Aragonés, Nuria; Salas-Trejo, Dolores; Pollán, Marina; Pérez-Gómez, Beatriz
We explored the relationship between sleep patterns and sleep disorders and mammographic density (MD), a marker of breast cancer risk. Participants in the DDM-Spain/var-DDM study, which included 2878 middle-aged Spanish women, were interviewed via telephone and asked questions on sleep characteristics. Two radiologists assessed MD in their left craneo-caudal mammogram, assisted by a validated semiautomatic-computer tool (DM-scan). We used log-transformed percentage MD as the dependent variable and fitted mixed linear regression models, including known confounding variables. Our results showed that neither sleeping patterns nor sleep disorders were associated with MD. However, women with frequent changes in their bedtime due to anxiety or depression had higher MD (e β :1.53;95%CI:1.04-2.26). Copyright © 2017 Elsevier B.V. All rights reserved.
Dworkin, Emily R.; Zambrano-Vazquez, Laura; Cunningham, Sarah R.; Pittenger, Samantha L.; Schumacher, Julie A.; Stasiewicz, Paul R.; Coffey, Scott F.
The co-occurrence of posttraumatic stress disorder and substance use disorder (PTSD-SUD) can pose significant problems for rural pregnant and postpartum women (PPW) and the well-being of their children. Although effective treatments exist, PPW experience limitations in their ability to access and engage in treatment that may be compounded by various aspects of rural settings, so providers must be attentive to these barriers in order to address this pressing public health need. In addition, as part of increasing rural access to care, it is important to consider the costs and benefits to PPW of selecting exposure-based techniques (e.g., prolonged exposure) to disseminate. The current article discusses the treatment of PTSD-SUD in rural PPW in the context of the authors’ experiences providing an exposure-based cognitive behavioral treatment for PTSD in this population. Barriers to treatment access and engagement are discussed and recommendations are provided. PMID:28983389
O'Leary, Jeanne M.
Labor force participation of nonmetropolitan women rose in the 1970's but not in a consistent pattern. Their labor force participation rose 4.5% between 1973 and 1978, when they comprised 41% of the total nonmetropolitan labor force. Although women accounted for 89% of nonmetropolitan employment growth in the 1960's and 58% in the 1970's, their…
Hazard Community Coll., KY.
A project was created to provide individualized and technical training specially designed for women who desired to become small business owners. Recruitment of eastern Kentucky women in the Hazard Community College five-county service area was done through direct mailing; posting of flyers; and newspaper, radio, and television publicity. In…
Zhang, X-J; Wang, G-Y; Shen, Q; Yu, Y-L; Sun, Y-H; Yu, G-B; Zhao, D; Ye, D-Q
This study aims to explore the current status of married women in regard of their use of contraceptive methods (permanent methods versus non-permanent methods) and to find out factors that affect the use of contraceptive methods in rural areas of Anhui Province of China. Survey. Anhui, China. A total of 53,652 married women aged 18-49 years. A multistage probability sampling method was used to identify a representative sample of 53,652 married women aged 18-49 years. All women were asked to provide detailed information by completing detailed questionnaires. Contraceptive prevalence and influence factors. The total birth control rate of the sample was 95.2%. Samples choosing the permanent and nonpermanent contraceptive methods have taken up 46.7 and 48.5% respectively. Female sterilisation was the first choice with a usage rate of 43.6%, followed by intrauterine device (IUD), which was used by 41.1% of samples. Single-variable analysis showed that the choice of contraceptive methods was associated with age, education level, parity, frequency of sex intercourses in a month, contraceptive knowledge, RTI symptom and the gender of the last child of rural married women. A significant increase in contraceptive use of rural married women in Anhui Province of China. Female sterilisation and IUD still play the dominant role. Effective family planning methods should be advocated through adequate counselling on the correct use and proper management, with consideration of the background of custom and belief.
Kim, Younglee; Dee, Vivien
To determine factors that affect self-care of rural Hispanic women at risk for postpartum depression (PPD). This study was a descriptive cross-sectional design based on the key concepts of Orem's Self-care Deficit Nursing theory. Data were collected from 223 Hispanic postpartum women residing in Mecca, North Shore, and Thermal in California by an interviewer-administered survey. Four instruments were utilized: Edinburgh Postnatal Depression Scale (EPDS) for PPD, Multidimensional Scale of Perceived Social Support for social support, Duke University Religion Index (DUREL) for spirituality, and Self Rated Abilities for Health Practices for self-care. The prevalence of women at risk for PPD was about 43 %. Social support, spirituality, and self-care ability were significantly correlated in women with PPD. Social support was a strong factor in predicting self-care ability for 'Nutrition', 'Psychological well-being', 'Exercise', and 'Responsible Health Practices' in the rural Hispanic women at risk for PPD. The study findings can enable nurses and healthcare professionals to develop effective tailored interventions to assist rural Hispanic women's abilities to perform self-care for health, and in particular, during the postpartum period.
Anwar, S; Iqbal, M P; Azam, I; Habib, A; Bhutta, S; Soofi, S B; Bhutta, Z A
We undertook a cross-sectional study in rural Jehlum and urban Karachi to evaluate the prevalence of vitamin D deficiency in Pakistani pregnant women and neonates and to assess any association of serum 25(OH) vitamin D [25(OH)D] concentration with vitamin D binding protein (Gc) genotypes. Altogether, 390 women and 266 neonates were recruited from urban and rural sites, respectively. Serum 25(OH)D was measured by an immunoassay, while Gc genotypes were identified using polymerase chain reaction followed by restriction fragment length polymorphism or PCR-RFLP. One-way analysis of variance or ANOVA and linear regression were used for statistical analysis. In urban Karachi, 99.5% of women and 97.3% of neonates were vitamin D deficient (< 50 nmol/L), while 89% of women and 82% of neonates were deficient in rural Jehlum. Gc genotypes were not associated with serum 25(OH)D concentrations in both women and their neonates. We conclude that vitamin D deficiency is highly prevalent in Pakistani women and their neonates, and Gc genotypes are not associated with serum 25(OH)D concentrations.
Jacobson, Lisette T; Dong, Frank; Scheuermann, Taneisha S; Redmond, Michelle L; Collins, Tracie C
Smoking during pregnancy is associated with poor birth outcomes. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a public nutritional assistance program for low-income pregnant women and their children up to age five. This study examined differences in smoking behavior among women enrolled in the Kansas WIC program. A secondary analysis was conducted using the Pregnancy Nutrition Surveillance System dataset of enrolled women between 2005 and 2011. Geographic residency status was obtained through application of the Census tract-based rural-urban commuting area codes. Chi square tests of association were used to assess differences. Multi-variable binary logistic regression was used to assess maternal characteristics and smoking 3 months prior to pregnancy. Total sample size averaged 21,650 women for years 2005 through 2011. Low-income, rural pregnant women smoked at significantly higher rates before, during, and after pregnancy. High smoking rates have remained unchanged since 2008. The following characteristics were associated with reduced odds of smoking 3 months prior to pregnancy: being 17 years old or younger, Hispanic, a high school graduate, urban location, normal body mass index, no live births prior to current pregnancy, and using multi-vitamins. Results from this study indicate that the WIC population in rural areas may have different needs regarding smoking cessation programming than the urban WIC population. Findings help inform WIC program administrators and assist in enhancing current smoking cessation services to the Kansas WIC population.
Harding, Catherine; Ritchie, Jan
This study aimed to explore the contraceptive practices of women in methadone treatment for opiate use in rural New South Wales and the reasons for those practices. Demographic characteristics, including age, marital status, sexual activity and contraceptive use, of all 23 women on a rural methadone program were documented. A smaller subgroup of seven women was interviewed using a semi-structured qualitative technique and issues around contraception explored in more depth. The study found that women who did not use contraception often had a low perceived risk of pregnancy for a variety of reasons including past infertility, menstrual irregularities and effect of drugs. The women had concerns about, and often felt guilty about, the effect of drug use on their children. They also had concerns about the side-effects of contraception. The study has implications for education and counselling of women when they enter drug treatment programs. Problems associated with opiate use are not just restricted to metropolitan areas but are part of rural health.
Rahman, Atif; Ahmed, Mansoor; Sikander, Siham; Malik, Abid; Tomenson, Barbara; Creed, Francis
The prevalence of depression is very high among adult women in Pakistan but it is not known whether such a high prevalence occurs in younger women. We aimed to assess the prevalence and correlates of depression in 16 to 18-year old unmarried women in Pakistan. Population-based survey of all 16 to 18-year old unmarried women in one rural community in Rawalpindi District, Punjab, Pakistan. Depressive disorder and psychological distress were assessed using the Structured Clinical Interview for DSM-IV Disorders (SCID) and Self-Reporting Questionnaire (SRQ) respectively. 337 eligible women were identified of whom 321 (95%) were interviewed. Fourteen (4.4%) had depressive disorder; one third scored 9 or more on SRQ. On multivariate analysis a high SRQ score was associated with childhood experience of poverty, father's education, stressful life events, disturbed family relationships and mother's depression. The sample was derived from one rural community only and the results should be generalised with caution. Depressive disorder is not common in young women in rural Pakistan though distress appears common and is associated with early and recent adversity and family difficulties. These results suggest future work might aim to understand onset and prevent chronic depression.
Dickson, Megan F; Staton-Tindall, Michele; Smith, Kirsten E; Leukefeld, Carl; Webster, J Matthew; Oser, Carrie B
Facebook (FB) use has grown exponentially over the past decade, including in rural areas. Despite its popularity, FB has been underutilized as a research follow-up approach to maintain contact with research participants and may have advantages in less densely populated areas and among more hard-to-reach, at-risk groups. The overall goal of this study was to examine FB as a supplemental follow-up approach to other follow-up strategies with rural drug-using women. Face-to-face interviews were conducted with randomly selected women who completed baseline interviews in 3 rural jails in 1 state. Analyses focus on participants who were released from jail and were eligible for 3-month follow-up (n = 284). Bivariate analyses were used to examine differences between FB users and nonusers, and multivariate logistic regression models examined predictors of 3-month follow-up participation and being located for follow-up using FB. About two-thirds (64.4%) of participants were regular FB users. Bivariate analyses indicated that FB users were younger, more educated, and more likely to have used alcohol in the 30 days before incarceration but less likely to have a chronic health problem. Regression analyses indicated that rural FB users had more than 5 times the odds of being located for the 3-month follow-up interview, even after controlling for other variables. There were no significant predictors of being followed up using FB. Findings suggest that FB is widely used and well accepted among rural drug-using women. Among hard-to-reach populations, including those in rural, geographically isolated regions, FB serves as a method to improve participant follow-up. © 2016 National Rural Health Association.
Gervasoni, Ann; Smith, Jeremy; Howard, Peter
This paper provides insight into the experience of Clemente humanities education for six regional and rural Australian women living around Ballarat. Each took part in an audio-taped semi-structured interview which explored the impact that university study had on their lives. Their responses suggest that Clemente Ballarat was life-giving. The…
Simpson, Lyn; Daws, Leonie; Wood, Leanne
To overcome barriers to participation in small business training faced by rural Australian women, training needs and delivery issues were identified and a good practice matrix was developed with the following components: marketing, content, delivery, support, impact, and innovation. Underlying principles included unique needs, diversity, use of…
Brandt, Heather M.; Sharpe, Patricia A.; McCree, Donna H.; Wright, Marcie S.; Davis, Jennifer; Hutto, Brent E.
Background: Human papillomavirus (HPV) is a very common sexually transmitted infection linked to cervical disease. Vaccines for some types of HPV were in development at the time of the study. Purpose: The study examined HPV vaccine acceptability among underserved women in a rural region of the southeastern U.S. with high rates of cervical cancer…
Usman, Lantana M.
Recently, politics of education in Nigeria have shifted from urban to rural literacy, which led to the development of programmes such as the nomadic women's adult education programme. The primary objective of this study was to evaluate the efficacy of the programme's implementation strategies, and the extent to which the health educational…
Jones, Shelley K.
This paper presents findings from the third stage of a longitudinal, qualitative study involving nine female participants from a class cohort in a secondary school in rural Uganda. Since 2004-05, this study has tracked the progress of these young women's lives, and the present aspect of the study explores the ways in which they have found that…
Agho, Augustine O; Mosley, Barbara W; Rivers, Patrick A; Parker, Shandowyn
Purpose: This study was a two-year educational intervention and research project aimed at increasing the awareness of breast cancer and the utilization of Clinical Breast Examination (CBE) services and Self-Breast Examination (SBE) among elderly rural and urban African American women who are Medicare beneficiaries. Design: The study was…
Zhao, Xu; Haste, Helen
A Beijing-based non-governmental organization (NGO) strives to empower rural Chinese women and migrant girls by increasing their awareness of constitutional rights and promoting their capacities to exercise their civil and political rights. This article reports the NGO leaders' perceptions of the goals, strategies, and challenges in their…
As a third age PhD candidate with a passion for learning, I wanted to explore the learning of other rural third age women who live on the Lower Eyre Peninsula (LEP) of South Australia. This reflects the methodological stance of heuristic inquiry, which requires the researcher to have a passionate interest in the phenomena under investigation, and…
McAtee, Atticia B.; Benshoff, James M.
Job loss researchers have focused on the physical and mental well being of White working and middle class men, their families, friends, and coworkers to with immediate reemployment as the outcome. This study focused on low-income rural women dislocated workers and their decision to enroll in community college for retraining or seek immediate…
Russell, Scott C.; McDonald, Mark B.
Examines and enumerates economic changes that have occurred in the traditional rural Navajo community of Shonto. While women's net income contributions to Shonto's economy has declined, their position has seen only a slight erosion; their activities (sheep and goat husbandry, agriculture, arts and crafts) are still considered necessary and…
Han, Keonghee Tao; Leonard, Jacqueline
Using critical race theory as an analytical framework to examine White privilege and institutional racism, two teacher educators, in a rural predominantly White university tell counterstories about teaching for social justice in literacy and mathematics education courses. In sharing our counterstories in this paper, we, women faculty of color,…
Dubbink, Jan Henk; van der Eem, Lisette; McIntyre, James A; Mbambazela, Nontembeko; Jobson, Geoffrey A; Ouburg, Sander; Morre, Servaas A; Struthers, Helen E; Peters, Remco P H
Sexual behaviour is a core determinant of the HIV and sexually transmitted infection (STI) epidemics in women living in rural South Africa. Knowledge of sexual behaviour in these areas is limited, but constitutes essential information for a combination prevention approach of behavioural change and biomedical interventions. This descriptive study was conducted in rural Mopani District, South Africa, as part of a larger study on STI. Women of reproductive age (18-49 years) who reported sexual activity were included regardless of the reason for visiting the facility. Questionnaires were administered to 570 women. We report sexual behaviour by age group, ethnic group and self-reported HIV status. Young women (<25 years) were more likely to visit bars, practice fellatio, have concurrent sexual partners and report a circumcised partner than older women (>34 years); there was no difference for condom use during last sex act (36 % overall). Sotho women were more likely to report concurrent sexual partners whereas Shangaan women reported more frequent intravaginal cleansing and vaginal scarring practice in our analysis. HIV-infected women were older, had a higher number of lifetime sexual partners, reported more frequent condom use during the last sex act and were more likely to have a known HIV-infected partner than women without HIV infection; hormonal contraceptive use, fellatio, and a circumcised partner were less often reported. This study provides insight into women's sexual behaviour in a rural South African region. There are important differences in sexual behaviour by age group and ethnicity and HIV status; these should be taken into account when designing tailor-made prevention packages.
Martius Von Harder, G
Rural extension services are designed to provide rural dwellers with information needed to further technical or social development and to solve problems. Extension agents should be fully aware of their responsibility for the advice they provide. The number of rural and agricultural development and extension agencies has multiplied greatly in the past 2 decades. Agricultural extension is the principal component of most rural development strategies. Training given to men is usually economic, while that for women is devoted to household and social functioning. Programs for women usually lag general development programs. Training of women is usually not included in agricultural extension programs, especially in countries practicing segregation of the sexes. Agricultural extension programs are generally limited to cultivation techniques and neglect transformation and storage of crops and seed preparation for increased production. Measures that could improve productivity of women's agriculture-related work are expected to be delivered through the intermediacy of their husbands, but the husbands may not appreciate the import of such messages if they are not familiar with their wives' work. Agricultural training should consider all stages of production, should be delivered to the individuals actually performing the tasks, and should be ecologically appropriate. The overall objective of agricultural extension is to increase production, but most programs do not specify who is to use the surplus or to benefit from it. The rural population or the urban population may be the prime beneficiary, or cash crops may be produced for export. Although increased production should benefit the rural population through a better food supply, in reality most extension programs are devoted to cash crops for export and are less than fully successful because of problems of crop distribution and marketing and other shortcomings. Where men and women perform the same agricultural work, it should
Nielsen, Anna; Lan, Pham Thi; Marrone, Gaetano; Phuc, Ho Dang; Chuc, Nguyen Thi Kim; Stålsby Lundborg, Cecilia
We interviewed 1,805 women in a rural setting in Vietnam with the aim of investigating women's knowledge regarding reproductive tract infections (RTIs) and their health-seeking behavior. We found that women's overall knowledge was poor. Furthermore, only one-third of the symptomatic women sought health care. RTIs affect millions of women globally each year. Most vulnerable are women in low- and middle-income countries where poverty and gender inequities affect their access to health care services. Findings from our study can be used in similar rural settings worldwide to understand and manage the widespread problem of RTIs.
Mbule, Marjorie A; Byaruhanga, Yusuf B; Kabahenda, Magaret; Lubowa, Abdulrahman
In spite of intervention efforts, in Uganda, as in other developing countries, high levels of anaemia among pregnant women continue. Anaemia among women of reproductive age (15-49 years) is a matter of national concern. This study was carried out to assess determinants of anaemia in Kiboga district. This was a single cross-sectional, descriptive survey. The anaemia status of the pregnant women was determined by measuring their haemoglobin levels. Possible determinant factors including socio-economic characteristics, knowledge, attitudes, practices and food intake were assessed using a structured questionnaire. Results showed that the prevalence of anaemia among pregnant women in Kiboga district was high enough (63.1%) to be described as a severe public health problem. The uptake and utilisation of the public-health intervention package to combat anaemia in pregnancy was low, with iron/folic acid supplementation at 13.2%, use of intermittent preventive treatment of malaria 45.4%, and use of de-worming medicines 14.5%. Women from households without a functional radio were 2.07 times more likely be anaemic (95%CI, 1.08-3.00) compared with women from households where there was a functional radio. There was little awareness and functional knowledge about anaemia among pregnant women. The high prevalence of anaemia observed in Kiboga district can be attributed to poverty and limited access to nutrition and health education information which lead to low uptake and utilization of the public-health intervention package to combat anaemia in pregnancy.
Ahmed, S M; Adams, A; Chowdhury, A M; Bhuiya, A
This paper explores a number of socioeconomic factors thought to explain the wide prevalence of undernutrition among rural Bangladeshi women. The 1992 baseline survey data of the BRAC-ICDDR,B Joint Research Project at Matlab were used. Anthropometry was performed on a random sub-sample of 1462 currently married, non-pregnant women between 15 and 49 years of age. Women's nutritional status was defined in terms of Body Mass Index (BMI = wt in kg/ht in m2). Compared with women from better-off households, the mean weight (41.2 vs 43.0 kg; p < 0.0001), mid-upper arm circumference (MUAC) (22.1 vs 22.7; p < 0.0001), and BMI (18.5 vs 19.1; p < 0.0001) of poor women were consistently lower. However, no significant difference in mean height was found between the two groups. The results showed that women aged more than 35 years are twice as likely to have a BMI < 18.5 compared with younger women. Both years of schooling received and socioeconomic status are found to be important predictors of women's BMI. Women who have received one or more years of formal education are nearly half as likely to suffer chronic energy deficiency (BMI < 18.5) than women with no schooling. Again, better-off women are found to be 0.77 times less likely to have chronic energy deficiency than women from poor households. The implications of these findings in improving the nutritional status of rural Bangladeshi women are discussed.
Jackson, M N G; McCulloch, B J
Women are just as vulnerable to 'heart attacks' (used throughout this study to mean 'myocardial infarction') as men and are often unaware of many associated symptoms. Researchers have illustrated that women have difficulty identifying the symptoms of cardiovascular disease, with patients often delaying treatment after the onset of symptoms. Some individuals wait hours or even days before seeking medical care. This is particularly concerning for older rural women because the rates of death from cardiovascular disease and cancer are higher in some rural areas. Despite idealistic views of country life as being active, less stressful, and possessing strong social and community support, rural Americans are more likely than their urban counterparts to face challenges to maintaining health.
The purpose of this paper is to utilize information gathered from a qualitative study exploring older rural women's identification of symptoms and health decision-making specific to heart attack vignettes. Snowball sampling was the main approach utilized to access participants; after an initial contact was successful, participants contacted additional older rural women to see if they might be willing to participate in an interview. This resulted in a final sample of 33 women who resided in rural Midwestern areas of the USA, were 65 years or older, lived in a county defined as rural by the US Census, and were willing to participate in a face-to-face interview. Each interview included a demographic questionnaire, a health questionnaire, and three health vignettes with follow-up questions. Vignettes provided a way of initiating discussions about health decisions without invading the privacy known to be important to rural residents. The term 'heart attack' was used in the interviews because it was thought to be better recognised than the medical term 'myocardial infarction'. All data were audio taped, transcribed, and coded using line-by-line coding. Data were analyzed using content
Kreft Pearce, Jennifer; McCaslin, Sara; Morgan, Leann
This study investigates the attitudes women and girls from the East Texas region have towards engineering and physics. We use an online survey and interviews to determine what influences women to choose their career paths. Surprisingly, we find that women have more positive attitudes about physics and engineering than their male counterparts. For the group of students interviewed, self assessment of ability, lack of role models, and confusion about work/life balance issues were some of the determining factors in their choice not to pursue a career in a STEM field.
Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis F; Hernández-Tinoco, Jesús
Hepatitis E virus (HEV) infection represents a risk for mortality in pregnant women. The seroepidemiology of HEV infection in rural pregnant women in the Americas is largely unknown. The aim of the study was to determine the seroepidemiology of anti-HEV IgG antibodies in rural pregnant women in Durango, Mexico. The presence of anti-HEV IgG antibodies was determined in 439 pregnant women in rural Durango, Mexico using an enzyme-linked immunoassay. Seroprevalence association with socio-demographic, clinical and behavioral characteristics of the women was also investigated. Twenty five (5.7%; 95% CI: 3.88-8.27) of the 439 women (mean age: 24.53 ± 6.1 years) had anti-HEV antibodies. Multivariate analysis showed that HEV seropositivity was associated with increasing age (OR = 1.11; 95% CI: 1.03-1.20; P = 0.004), consumption of unpasteurized cow milk (OR = 5.37; 95% CI: 1.17-24.63; P = 0.03), and overcrowding at home (OR = 2.36; 95% CI: 1.13-4.92; P = 0.02). In contrast, the variables educational level, occupation, socio-economic status, foreign travel, consumption of untreated water and raw or undercooked meat, and raising animals did not show associations with HEV seropositivity. Exposure to HEV was associated with the number of deliveries but not with the number of cesarean sections or miscarriages. This is the first report of seroprevalence and contributing factors for HEV infection in rural pregnant women in the Americas, and of an association of the consumption of unpasteurized cow milk with HEV exposure. Results of this study should be useful for designing optimal preventive measures against HEV infection. vg
Harrison, Cheryce L; Teede, Helena J; Kozica, Samantha; Zoungas, Sophia; Lombard, Catherine B
Obesity is a major public health concern and women living in rural settings present a high-risk group. With contributing factors poorly explored, we evaluated their association with weight in rural Australian women. Women aged 18-50 years of any body mass index (BMI) were recruited between October 2012 and April 2013 as part of a larger, randomised controlled trial within 42 rural towns. Measured weight and height as well as self-reported measures of individual health, physical activity, dietary intake, self-management, social support and environmental perception were collected. Statistical analysis included linear regression for continuous variables as well as chi-squared and logistic regression for categorical variables with all results adjusted for clustering. 649 women with a mean baseline age and BMI of 39.6±6.7 years and 28.8±6.9 kg/m 2 respectively, were studied. Overall, 65% were overweight or obese and 60% overall reported recent weight gain. There was a high intention to self-manage weight, with 68% attempting to lose weight recently, compared to 20% of women reporting health professional engagement for weight management. Obese women reported increased weight gain, energy intake, sitting time and prevalence of pre-existing health conditions. There was an inverse relationship between increased weight and scores for self-management, social support and health environment perception. Many women in rural communities reported recent weight gain and were attempting to self-manage their weight with little external support. Implications for Public Health: Initiatives to prevent weight gain require a multifaceted approach, with self-management strategies and social support in tandem with building a positive local environmental perception. © 2016 Public Health Association of Australia.
Hayati, Elli Nur; Eriksson, Malin; Hakimi, Mohammad; Högberg, Ulf; Emmelin, Maria
Background Experiencing domestic violence is considered a chronic and stressful life event. A theoretical framework of coping strategies can be used to understand how women deal with domestic violence. Traditional values strongly influenced by religious teachings that interpret men as the leaders of women play an important role in the lives of Javanese women, where women are obliged to obey their husbands. Little is known about how sociocultural and psychosocial contexts influence the ways in which women cope with domestic violence. Objective Our study aimed to deepen our understanding of how rural Javanese women cope with domestic violence. Our objective was to explore how the sociocultural context influences coping dynamics of women survivors of domestic violence in rural Purworejo. Design A phenomenological approach was used to transform lived experiences into textual expressions of the coping dynamics of women survivors of domestic violence. Results Experiencing chronic violence ruined the women's personal lives because of the associated physical, mental, psychosocial, and financial impairments. These chronic stressors led women to access external and internal resources to form coping strategies. Both external and internal factors prompted conflicting impulses to seek support, that is, to escape versus remain in the relationship. This strong tension led to a coping strategy that implied a long-term process of moving between actively opposing the violence and surrendering or tolerating the situation, resembling an elastic band that stretches in and out. Conclusions Women survivors in Purworejo face a lack of institutional support and tend to have traditional beliefs that hamper their potential to stop the abuse. Although the women in this study were educated and economically independent, they still had difficulty mobilizing internal and external support to end the abuse, partly due to internalized gender norms. PMID:23336615
He, Dian; Zhang, Ying; Ji, Ning; Zhou, You; Mao, Qunxia; Cheng, Yimin
To examine the prevalence of contraceptive use in rural China and to determine factors that influence choice of contraceptive method. A cross-sectional study was conducted using multistage cluster sampling to identify married women aged 20-49 years residing in Shaanxi Province, China. Data on demographics and contraceptive use were collected via detailed questionnaire. The prevalence of contraceptive use in the study population was 93.9% (19 599/20 878 eligible women). Among the women using contraceptives, 10 408 (53.1%) used sterilization (female and male) and 6947 (35.4%) chose an intrauterine device. In total, 2244 (11.4%) women used short-acting contraceptive (SAC) methods: condoms and pills accounted for 8.7% (n=1712) and 1.0% (n=216), respectively. Young age; high level of education; low parity; increased number of abortions; low frequency of sexual intercourse; long duration between marriage and delivery; and marriage after 1994 were all associated with SAC usage. Although contraceptive use was high in rural China, the participants' awareness of free selection of contraceptive method and the rate of SAC use were both low. Appropriate and diverse family-planning services should be provided to meet the needs of women living in rural areas. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Reviews have assessed studies of breast and cervical cancer screening access and utilization for rural women, but none analyze interventions to increase screening rates. A mixed methods literature search identified studies of breast and/or cervical cancer prevention education and patient navigation interventions for rural women. Rural areas need greater implementation and evaluation of screening interventions as these services address the challenges of delivering patient-centered cancer care to un-/underserved communities. The lack of intervention studies on breast and cervical cancer education and patient navigation programs compared to urban studies highlights the need for validation of these programs among diverse, rural populations.
Liu, Fangchao; Zhang, Shikun; Liu, Jue; Wang, Qiaomei; Shen, Haiping; Zhang, Yiping; Liu, Min
Infection with rubella virus during pregnancy can result in congenital defects and adverse pregnancy outcomes. The risk of rubella infection is greatly determined by the level of rubella antibodies in the serum. A survey of rubella antibody seronegativity rates was conducted in 780 000 women in rural China who were planning a pregnancy, in order to evaluate the herd susceptibility in different age groups and by high, middle, and low GDP per capita regions. In order to evaluate the herd susceptibility to rubella, a nationwide population-based study of rural Chinese women who were planning to have a baby and who were aged 21-49 years was instigated. As a part of the National Free Pre-conception Health Examination Project covering 29 provinces in 2012, a physical check-up program was provided to women who planned to become pregnant within the next 6 months. All medical data were from serological samples tested by ELISA, and the participants' immunity status was categorized based on levels of rubella antibodies. Economic data were also collected to explore the association between herd susceptibility and socioeconomic characteristics in the women of childbearing age. A total 264 306 of 782 293 recruited women preparing for pregnancy tested susceptible to rubella (33.79%). The seronegativity rate in women with a history of vaccination was significantly lower than that in women who had not received the vaccination or did not know their vaccination history (23.76%, 33.70%, and 35.68%, respectively). The seronegativity rates were 26.89%, 37.86%, and 32.61% in high, middle, and low GDP per capita areas, respectively. After stratified analysis and adjusting for other factors by multiple logistic regression, the lower seronegativity rates in women in high GDP per capita regions compared to women in middle and low GDP per capita regions remained in the different age groups and subgroups of immunization history. There is a clear difference in rubella-specific susceptibility
Rural women in Southern Mexico link their diabetes to distressful life experiences rooted in ordinary violence. While much has been written on the use that diabetes sufferers make of their morbid condition as an idiom of distress, I investigate the personal and social effects that such an idiom has on women. As I illustrate, diabetes reflects an ambivalence that helps women to speak about the unspeakable and, at the same time, reinforces their ideas of culpability, namely that they are to blame for both the gendered violence that they endure and the diabetes from which they suffer.
Terrill, Lauren; Gullifer, Judith
This study explored experiences of eight rural, Anglo-Australian women aged between 65 and 75 using semi-structured interviews. Thematic analysis revealed three prominent themes: (a) the free and busy me highlights the increased freedom in later life enabling choices regarding activities the women would like to engage in; (b) the secret is being positive and pragmatic emphasizes the importance of adopting a pragmatic acceptance of growing older; and (c) narratives of growth and stagnation highlights the pursuit of growth among older women in order to enhance the current self. Findings emphasize the construction of later life as one of liberation, resilience and growth.
Kamal, S M Mostafa; Hassan, Che Hashim; Kabir, M A
This study examines the inequality of the use of skilled delivery assistance by the rural women of Bangladesh using the 2007 Bangladesh Demographic and Health Survey data. Simple cross-tabulation and univariate and multivariate statistical analyses were employed in the study. Overall, 56.1% of the women received at least one antenatal care visit, whereas only 13.2% births were assisted by skilled personnel. Findings revealed apparent inequality in using skilled delivery assistance by socioeconomic strata. Birth order, women's education, religion, wealth index, region and antenatal care are important determinants of seeking skilled assistance. To ensure safe motherhood initiative, government should pay special attention to reduce inequality in seeking skilled delivery assistance. A strong focus on community-based and regional interventions is important in order to increase the utilization of safe maternal health care services in rural Bangladesh. © 2013 APJPH.
Perry, Cynthia K; McCalmont, Jean C; Ward, Judy P; Menelas, Hannah-Dulya K; Jackson, Christie; De Witz, Jazmyne R; Solanki, Emma; Seguin, Rebecca A
To describe our use of intervention mapping as a systematic method to adapt an evidence-based physical activity and nutrition program to reflect the needs of rural Latinas. An intervention mapping process involving six steps guided the adaptation of an evidence based physical activity and nutrition program, using a community-based participatory research approach. We partnered with a community advisory board of rural Latinas throughout the adaptation process. A needs assessment and logic models were used to ascertain which program was the best fit for adaptation. Once identified, we collaborated with one of the developers of the original program (StrongWomen - Healthy Hearts) during the adaptation process. First, essential theoretical methods and program elements were identified, and additional elements were added or adapted. Next, we reviewed and made changes to reflect the community and cultural context of the practical applications, intervention strategies, program curriculum, materials, and participant information. Finally, we planned for the implementation and evaluation of the adapted program, Mujeres Fuertes y Corazones Saludables, within the context of the rural community. A pilot study will be conducted with overweight, sedentary, middle-aged, Spanish-speaking Latinas. Outcome measures will assess change in weight, physical fitness, physical activity, and nutrition behavior. The intervention mapping process was feasible and provided a systematic approach to balance fit and fidelity in the adaptation of an evidence-based program. Collaboration with community members ensured that the components of the curriculum that were adapted were culturally appropriate and relevant within the local community context.
Redondo, Iratxe; Herrero-Fernández, David
The aim of this study was to build a Spanish version of the Reading the Mind in the Eyes Test (RMET) including limited time of response and an integrated glossary, and to test its validity. A total of 433 university students (121 men and 350 women) and 38 anorexic women completed the RMET and other related measures of empathy and alexithymia. The results of the Parallel Analysis suggested a unidimensional structure for 19 items, which was verified through a Confirmatory Factor Analysis. Similarly to other research, this factor had a low reliability (α = .56, ρ = .59); however, regarding validity, the total score of the instrument showed positive correlations with empathy and negatives with alexithymia. Furthermore, healthy females were superior to males in RMET, and to anorexic women; but no significant differences appeared between healthy men and the anorexic group. This study confirms the validity of the test and permits a relatively short and inexpensive means of administration in large samples of adults. Besides, it suggests the necessity of assessing and treating the theory of mind in anorexic women.
Keding, Gudrun B; Msuya, John M; Maass, Brigitte L; Krawinkel, Michael B
ABSTRACT Background: For many developing countries, obesity and its sequelae have become a challenge of a magnitude similar to hunger and undernutrition. The main objective of this study was, therefore, to investigate the weight status of women in rural Tanzania with reference to season as well as the link between women's weight, food consumption, and attitudes toward obesity. Methods: Three cross-sectional surveys in 3 different seasons within 1 year interviewed the same 210 women, ages 17–45 years, from 3 rural districts of northeastern and central Tanzania. These surveys assessed body mass index (BMI), food intake, and dietary diversity through 24-hour recalls, women's attitudes toward obesity, vegetable production, and socioeconomic status. Results: Although 71% of the women had a normal BMI, 7% were underweight, 16% overweight, and 6% obese. The BMI was correlated with the Dietary Diversity Score (DDS), the Food Variety Score (FVS), with the consumption of foods from the food groups “bread/cakes,” “sugar,” and “tea,” and with the production of exotic vegetables. In a multiple regression model, FVS was directly associated with BMI. When asked to describe the typical characteristics of an obese person, women mentioned more negative than positive characteristics. Conclusion: The prevalence of overweight and obesity was 3 times higher than that of underweight. Apparently, even in rural areas of Tanzania, a nutrition transition is underway. No direct association was identified between vegetable consumption and BMI. Although this study did not assess behavioral factors, such behavioral factors as activity levels as well as attitudes need to be considered, even in rural settings, to address all facets of malnutrition. PMID:25276549
Minnesota State Dept. of Energy and Economic Development, St. Paul.
The texts of four speeches and seven workshop presentations comprise this report intended to be a resource for rural women seeking careers in business ownership and to assist Minnesota's legislature and others interested in helping them. Presentations provide practical, technical, and inspirational information by 18 women with experience and…
Castelló, Adela; Lope, Virginia; Vioque, Jesús; Santamariña, Carmen; Pedraz-Pingarrón, Carmen; Abad, Soledad; Ederra, Maria; Salas-Trejo, Dolores; Vidal, Carmen; Sánchez-Contador, Carmen; Aragonés, Nuria; Pérez-Gómez, Beatriz; Pollán, Marina
The objective of the present study was to assess the reproducibility of data-driven dietary patterns in different samples extracted from similar populations. Dietary patterns were extracted by applying principal component analyses to the dietary information collected from a sample of 3550 women recruited from seven screening centres belonging to the Spanish breast cancer (BC) screening network (Determinants of Mammographic Density in Spain (DDM-Spain) study). The resulting patterns were compared with three dietary patterns obtained from a previous Spanish case-control study on female BC (Epidemiological study of the Spanish group for breast cancer research (GEICAM: grupo Español de investigación en cáncer de mama)) using the dietary intake data of 973 healthy participants. The level of agreement between patterns was determined using both the congruence coefficient (CC) between the pattern loadings (considering patterns with a CC≥0·85 as fairly similar) and the linear correlation between patterns scores (considering as fairly similar those patterns with a statistically significant correlation). The conclusions reached with both methods were compared. This is the first study exploring the reproducibility of data-driven patterns from two studies and the first using the CC to determine pattern similarity. We were able to reproduce the EpiGEICAM Western pattern in the DDM-Spain sample (CC=0·90). However, the reproducibility of the Prudent (CC=0·76) and Mediterranean (CC=0·77) patterns was not as good. The linear correlation between pattern scores was statistically significant in all cases, highlighting its arbitrariness for determining pattern similarity. We conclude that the reproducibility of widely prevalent dietary patterns is better than the reproducibility of more population-specific patterns. More methodological studies are needed to establish an objective measurement and threshold to determine pattern similarity.
Bopp, Melissa; Wilcox, Sara; Oberrecht, Larissa; Kammermann, Sandra; McElmurray, Charles T
This study examined factors influencing strength training (ST) in two convenience samples of older rural women. Focus group (FG) participants were 23 Caucasian and 16 African American women aged 67.5 +/- 9.2 years. Survey participants were 60 Caucasian and 42 African American women, aged 70.59 +/- 9.21 years. FG participants answered questions about the risks, benefits, and barriers to ST. Survey participants completed measures of demographics, physical activity (including ST), depression and stress, decisional balance for exercise (DBE), barriers to PA, and social support (SS). Regression modeling examined correlates of ST. FG participants identified physical health gains and improved appearance as ST benefits. African American women also included mental health benefits and "feeling good". Both Caucasian and African American groups named physical health problems as risks of ST. Caucasian women identified time constraints, lack of ST knowledge, physical health problems, lack of exercise facilities, and the cost of ST as barriers. African American women cited being "too tired", physical health problems, lack of support, and other family and work responsibilities. The linear regression model explained 23.2% of the variance in hours per week of ST; DBE and family SS were independent positive correlates. This study identified correlates to participation in ST in older rural women and provides a basis for developing ST interventions in this population.
Mary, Bright; D'Sa, Juliana Linnette
Cervical cancer is one of the leading causes of cancer in women worldwide. One way by which the incidence of this malignant disease can be minimized is by imparting knowledge through health education. This study aimed at developing an educational package on cervical cancer (EPCC) and determining its effectiveness in terms of significant increase in knowledge of rural women regarding cervical cancer. A one group pre-test, post-test design was adopted. Thirty rural women were selected using a convenient sampling method. Data were collected using a demographic questionnaire and a structured knowledge questionnaire developed by the researchers. The EPCC was designed for a duration of one hour and 10 minutes. The structured knowledge questionnaire was first administered as the pre-test, following which knowledge on cervical cancer was imparted using the EPCC. On the 8th day, the post-test was administered. Data were analyzed using descriptive and inferential statistics. The mean post-test knowledge score of the women regarding cervical cancer was significantly higher than that of their mean pre-test score, indicating that the EPCC was effective in improving the knowledge of rural women on cervical cancer. The association between pre-test knowledge scores and selected demo-graphic variables were computed using chi-square test showed that pre-test knowledge score of the women regarding cervical cancer was independent of all the socio-demographic variables. It was concluded that the EPCC is effective in improving the knowledge of women, regarding cervical cancer. Since the prevalence of cervical cancer is high, there is an immediate need to educate women on prevention of cervical cancer.
Sun, Xiaoming; Sun, Yu; Zong, Zhanhong; Shu, Xingyu; Mao, Jingshu; Hearst, Norman
China's national family planning system is mainly directed toward women of early reproductive ages. Most studies of service provision focused on younger women, who almost all receive regular examinations. Little is known about service-seeking behavior among women of late reproductive ages. This cross-sectional household survey interviewed 1,811 rural women aged 40 to 49 in seven provinces. We examined sexual and reproductive health, utilization of sexual and reproductive health services, and predictors of receiving a free gynecological examination in the past 2 years. Educational levels were not high, and most women were rural farmers or housewives. More than one-fourth had migrated for work to big cities when they were younger. The mean frequency of sex in the last month was 3.6 times. Approximately 22.7% of women had not received a gynecological examination and 31.2% had not received any health education during the past 2 years. The first choice for where to seek services was township medical facilities (58.4%). On multivariate regression, age, education, migrant working experience, awareness of the need for intrauterine device removal after menopause, health education received, and attitude toward health examinations were significantly associated with receiving a gynecological examination in the past 2 years. Women of late reproductive age in rural China are not receiving as regular care as younger women. This study identifies sociodemographic and health service correlates for service-seeking behavior, many of which are modifiable. Health services should pay greater attention to this group, including community-based efforts to encourage routine examinations and appropriate use of health services.
This study compares fertility control among women participating in income-generation programs and among a socioeconomically similar comparison group in Bangladesh. Interviews were conducted among a sample of about 100 currently married women from each of four income-generation programs in Bangladesh: the government's Women's Program of the Bangladesh Rural Development Board (BRDB), the Women's Entrepreneurship Development Program of Bangladesh's Small and Cottage Industries Corporation (BSCIC), the Grameen Bank, and the Bangladesh Rural Advancement Committee (BRAC) Women's Program. There were 417 women in the sample and 389 women in the comparison group. These programs provided credit to women for activities, such as paddy husking and poultry keeping. The BSCIC did not provide any direct or indirect family planning input. The BRDB encouraged women to use modern contraceptives. The Grameen and BRAC educated participants about the benefits of small families. Three groups, with the exception of BRAC, used women's groups. The sample group had almost eight times the average household income of the comparison group. About 20% of the sample group were engaged in nontraditional activities. Almost 20% worked outside the home. 18% were engaged in wage work. Over 40% worked more than 5 hours per day. 75% were members of informal groups. The sample and comparison groups differed in the context of productive work and contraceptive use. Multivariate findings show strong support for the direct and significant effect of employment programs on fertility-regulating behavior of poor respondents. Nongovernmental groups with a women's group approach were more effective in raising income levels and physical mobility. The BSCIC had much lower contraceptive prevalence. Program participants had higher sterilization rates, but actual fertility was also higher.
Karunachandra, Nilanthi N; Perera, Irosha R; Fernando, Gihan
Sri Lanka is a middle income country and 80% of its population lives in rural areas. There is a well organized maternal and child health program and oral health care has recently been incorporated. The aim of this study was to report the oral disease burden of rural and urban antenatal women in the Western Province of Sri Lanka, thus highlighting the need to provide oral health care to this group. The sample consisted of 459 rural pregnant women in their second trimester and 348 urban pregnant women in their third trimester. Data were collected using interviewer administered questionnaires and a clinical oral examination conducted by calibrated examiners. The mean Decayed Missing and Filled Teeth (DMFT) among rural antenatal women were 5.4 ± 3, with 2.27 (± 2.31) decayed teeth, 1.25 (± 1.97) missing teeth, and 1.90 (± 1.89) filled teeth. Among urban antenatal women, the mean DMFT was 3.69 (± 3.62) with 1.04 (± 2.15) decayed teeth, 1.07 (± 1.59) missing teeth and 1.59 (± 2.06) filled teeth. Rural antenatal women had a significantly higher experience of decayed teeth (p=0.001) and filled teeth (p=0.026), and twice as many untreated dental caries, compared with urban women. Moreover, almost 60% of rural women presented with bleeding gums. Similarly, the prevalence of calculus was 30.3% for rural women and 13.5% for urban women. The most significant finding was 3.5% prevalence of shallow periodontal pockets (4-5 mm) for rural women but 73.0% for urban women (p=0.0001). In the final model of multiple logistic regression analysis, significant predictors for dental caries experience were age (adjusted OR [95% CI]: 2.51 [1.55-4.06], p=0.0001) and location (urban vs rural adjusted OR [95% CI)]: 0.25 [0.11-0.55], p=0.001). However for periodontal status the only significant association was between age and Community Periodontal Index of Treatment Needs (CPITN): CPITN=0 versus CPITN>0 in bivariate analysis for the overall sample (p=0.001). Antenatal women in Sri Lanka
Velasco, Casilda; Luna, Juan D; Martin, Aurelia; Caño, Africa; Martin-de-Las-Heras, Stella
To investigate the prevalence of intimate partner violence in Spanish women during the 12 months prior to delivery and to identify associated risk factors using two screening instruments. A population-based study. Fifteen public hospitals in southern Spain. A total of 779 women admitted to the hospital obstetrics department. Intimate partner violence was diagnosed with the Abuse Assessment Screen and Index of Spouse Abuse screening instruments. Prevalence and associated risk factors of intimate partner violence during pregnancy. According to the Abuse Assessment Screen, intimate partner violence during the pre-delivery year was experienced by 7.7% of the women, emotional abuse by 4.8%, and physical abuse by 1.7%. According to the Index of Spouse Abuse, non-physical intimate partner violence during this period was reported by 21.0% of the women and physical intimate partner violence by 3.6%. After adjusting for socio-demographic characteristics, multivariate regression models showed that an uncommitted relationship and absence of kin support were significantly associated with an increased intimate partner violence risk during the pre-delivery year. Employment was a significant protective factor against any of the three forms of intimate partner violence (Abuse Assessment Screen) and physical intimate partner violence (Index of Spouse Abuse) during this period. A high proportion of women in Spain experience intimate partner violence during or just before pregnancy. Pregnant women in an uncommitted relationship or without kin support were at greater risk of intimate partner violence. Screening instruments for intimate partner violence during pregnancy should be evaluated in different cultural contexts. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.
Kanade, A N; Rao, S; Kelkar, R S; Gupte, S
Varying results of worldwide intervention programs to pregnant mothers necessitate the need to understand the relationship between maternal nutrition and birth size among well nourished and undernourished mothers. To examine this relationship among urban affluent mothers and to compare the findings with those on rural Indian mothers. Data collected on urban affluent mothers (n = 236) was compared with rural mothers (n = 633). Mothers were contacted at 18 +/- 2 and 28 +/- 2 wk of gestation for anthropometry, dietary intakes [24-hr recall, Food Frequency Questionnaire (FFQ)] and after delivery for neonatal anthropometry. Despite large differences in nutritional status of urban and rural mothers ( pre-pregnant weight 55.9 +/- 9.2 Vs 41.5 +/- 5.2 kg, respectively) maternal fat intakes at 18 wk were associated with birth weight (p < 0.05), length (p < 0.01) and triceps skin fold thickness (p < 0.05) of the newborn in urban and rural mothers. Consumption of fruits was associated with birth length (p < 0.05) in urban (18wk) and with birth weight (p < 0.01) and length (p < 0.01) in rural (28wk) mothers, when their energy intakes were low. Maternal consumption of milk too, was associated with newborn's triceps (p < 0.01) in urban (28wk) while with birth weight (p < 0.05) and length (p < 0.05) in rural (18wk) mothers. The findings mainly underscore the importance of consumption of micronutrient rich foods, when energy intakes are limiting during pregnancy, for improving birth size. Creating nutritional awareness and motivating rural mothers for consuming micronutrient rich foods like green leafy vegetables and seasonal fruits that are easily available in rural areas, will be a much affordable solution for combating the problem of low birth weight rather than waiting for improvement in the existing nationwide programs for pregnant women.
This article focuses on rural indigenous Mexican women's experiences with uterine prolapse, particularly the illness's expression of social suffering. Drawing on ethnographic research conducted during 2004-2005 and 2007 in a Nahua village in the state of Veracruz, the article analyzes the multifactorial nature of women's social suffering. Results show that the roots of uterine displacement for the women lie in lack of social relations and in perceptions of bodily vigor. Additionally, inequality present in the women's interactions with mainstream Mexico brings into focus the larger structural factors that shape their reproductive health. The implications of research on the effect of social support on women's embodiment of social suffering can extend beyond one illness, linking it to broader issues shaping the health of marginalized populations. © 2014 by the American Anthropological Association.
Hossen, Abul; Westhues, Anne
This study was an exploration of the experiences of 17 women, age 60 or more years, from Bangladesh. The women were asked about decision-making processes with respect to their access to health care and whether they perceived that there were differences based on age and sex in the way a household responds to an illness episode. The overall theme that characterized their experiences was "being in a socially excluded space." The themes that explained this perception of social exclusion included gender- and age-based social practices, gender- and class-based economic practices, religious beliefs that restricted the mobility of women, and social constructions of health and illness that led the women to avoid seeking health care. We conclude that the Bangladesh constitutional guarantee that disparities will be eliminated in access to health care between rich and poor, men and women, rural and urban residents, and younger and older citizens has not yet been realized.
OTIS, MELANIE D.; OSER, CARRIE B.; STATON-TINDALL, MICHELE
This exploratory study examines the relationship between sexual identity and violent victimization experiences as predictors of differences in illicit substance and alcohol use and substance use problems among a sample of incarcerated women in rural Appalachia (N = 400). Results indicated that, compared to heterosexual women, sexual minority women were more likely to have a lifetime history of weapon, physical, and sexual assault, and were younger at the time of their first violent victimization. Sexual minority women were younger than heterosexual women at the age of onset for intravenous drug use and at the time they first got drunk, and were more likely to report having overdosed. Multivariate analysis found violent victimization to be the strongest predictor of a history of overdose and substance use problems. PMID:27660590
Paul, Mandira; Essén, Birgitta; Sariola, Salla; Iyengar, Sharad; Soni, Sunita; Klingberg Allvin, Marie
The societal changes in India and the available variety of reproductive health services call for evidence to inform health systems how to satisfy young women's reproductive health needs. Inspired by Foucault's power idiom and Bandura's agency framework, we explore young women's opportunities to practice reproductive agency in the context of collective social expectations. We carried out in-depth interviews with 19 young women in rural Rajasthan. Our findings highlight how changes in notions of agency across generations enable young women's reproductive intentions and desires, and call for effective means of reproductive control. However, the taboo around sex without the intention to reproduce made contraceptive use unfeasible. Instead, abortions were the preferred method for reproductive control. In conclusion, safe abortion is key, along with the need to address the taboo around sex to enable use of "modern" contraception. This approach could prevent unintended pregnancies and expand young women's agency.
This article focuses on the impact of a telecenter program in Bamshela, South Africa, on women in the local community. The Government's telecenter initiative was conceived with an awareness of gender issues and the need to promote women's needs and rights in mind. However, as the center moves into its second year, many opportunities for the it to have a meaningful impact on the community from the start have already been lost. It has not generated enough income to keep prices at an affordable rate. Research has shown that many Bamshela women are using the telecenter as a phoneshop. Lack of knowledge, skills, and education among women is an obstacle to their use of computers at the center; however, center managers believe that rural women will become familiar with electronic methods of communication and may come to use these services. The telecenter has a long way to go before it can replace face-to-face communication and bring prestige to the community.
Gurmu, Eshetu; Endale, Senait
Wife beating is the most common and widespread form of intimate partner violence in Ethiopia. It results in countless severe health, socio-economic and psychological problems and has contributed to the violation of human rights including the liberty of women to enjoy conjugal life. The main purpose of this study is to assess the levels and patterns of wife beating refusal and its associated socio-cultural and demographic factors in rural and urban Ethiopia. The 2011 Ethiopian Demographic and Health Survey (EDHS) data based on 11,097 and 5287 women in the reproductive age group (i.e. 15-49 years) living in rural and urban areas, respectively,were used in this study. Cronbach's alpha was used to assess the internal consistency of the measure of women's attitudes towards wife beating. The Statistical Package for Social Sciences was applied to analyze the data. A binary logistic regression model was fitted to identify variables that significantly predict respondents' refusal of wife beating. Separate analysis by a place of residence was undertaken as attitude towards wife beating vary between rural and urban areas. The likelihood of refusing wife beating in Ethiopia was significantly higher among urban women (54.2%) than rural women (24.5%). Although there was a significant variations in attitude towards refusing wife beating among different regions in Ethiopia, increasing educational level, high access to media, age of respondents were associated with high level of refusal of wife beating. In contrast, rural residence, being in marital union, high number of living children, being followers of some religions (Muslim followers in urban and Protestants in rural) were associated with low level of refusal of wife beating. The findings of this study reveal that wife beating in Ethiopia is a function of demographic and socio-cultural factors among which age and educational attainment of respondents, number of living children, religious affiliation, marital commitment and
Manzano-Salgado, Cyntia B; Casas, Maribel; Lopez-Espinosa, Maria-Jose; Ballester, Ferran; Martinez, David; Ibarluzea, Jesus; Santa-Marina, Loreto; Schettgen, Thomas; Vioque, Jesus; Sunyer, Jordi; Vrijheid, Martine
Prenatal exposure to perfluoroalkyl substances (PFAS) might affect child health; but maternal determinants of PFAS exposure are unclear. We evaluated the socio-demographic and dietary factors of prenatal PFAS concentrations in a Spanish birth cohort. We analyzed perfluorohexanesulfonic acid (PFHxS), perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorononanoic acid (PFNA) in 1216 plasma samples collected during the 1(ST) trimester of pregnancy (2003-2008). We used multivariable linear regressions to assess the geometric mean (GM) ratios of PFAS concentrations by socio-demographic and dietary factors. We used analysis of variance (ANOVA) to assess the variability of PFAS concentrations by maternal factors. GM PFAS concentrations ranged from 0.55ng/mL for PFHxS to 5.77ng/mL for PFOS. Women born outside of Spain had lower PFAS concentrations (e.g. GM ratio for PFHxS 0.53[95%CI: 0.46, 0.60] than Spanish women. PFHxS and PFOA concentrations were higher in mothers from the regions of Sabadell (2.13[1.93, 2.35] and 1.73[1.60, 1.88], respectively) and Valencia (1.40[1.28, 1.54] and 1.42[1.31, 1.53], respectively) than Gipuzkoa. PFOA and PFNA concentrations decreased with parity (≥2 children: 0.79[0.67, 0.94] and 0.82[0.68, 0.99], respectively). Younger women (i.e. <25years) had lower PFHxS (0.73[0.62, 0.86]) and PFOS (0.85[0.75, 0.96]) concentrations than older women. PFHxS and PFOA concentrations were lower in women who previously breastfed for >6months compared to those who never breastfed (0.79[0.67, 0.94] and 0.82[0.71, 0.95], respectively). High intake of fish and shellfish during pregnancy (i.e. ≥5.6 servings/week) was associated with 11% (1.11[1.04, 1.18]) higher PFOS concentrations than the lowest intake group. Our ANOVA models explained 26% to 40% of PFAS concentrations variability. Prenatal PFAS concentrations were mainly determined by maternal country of birth, region of residence, previous breastfeeding and age. Fish and
Lan, Pham Thi; Lundborg, Cecilia Stålsby; Mogren, Ingrid; Phuc, Ho Dang; Chuc, Nguyen Thi Kim
The serious long-term complications of sexually transmitted infections (STI) in women and newborns are well-documented. Particularly, STI imply considerable social consequences for women. Low STI knowledge has been shown to be associated with unsafe sex. In Vietnam, misconceptions regarding STI exist, and rural women delay seeking care for STI. The aim of the study was to investigate knowledge of STI among women aged 15 to 49 years in a rural district of Vietnam and to evaluate possible associations between socioeconomic factors and STI knowledge. A cross-sectional population-based study using face-to-face interviews was carried out between March and May 2006 in a demographic surveillance site in rural Vietnam. In total, 1805 women aged 15-49 years were randomly selected to participate in the study. The interviews were based on a structured questionnaire including questions on sociodemographic characteristics of the women and their knowledge about STI. Each correct answer was scored 1, incorrect or do not know answer was scored 0. Multivariate analyses were applied to examine associations between socio-economic conditions and STI knowledge. Intra-cluster correlation was calculated to examine similarities of STI knowledge within clusters. Of the 1,805 respondents, 78% (73% married vs. 93% unmarried, p < 0.001) did not know any symptoms of STI, 50% could not identify any cause of STI, 59% (54% married vs. 76% unmarried, p < 0.001) did not know that STI can be prevented. Only 31% of the respondents (36% married vs. 14% unmarried, p < 0.001) answered that condom use could protect against STI, and 56% considered partner treatment necessary. Of 40 possible correct answers, the mean knowledge score was 6.5 (range 0-26, median 6). Young, unmarried women and women who lived in the highlands or mountainous areas demonstrated very low levels of STI knowledge (regression coefficients -1.3 and -2.5, respectively, p < 0.001). Experience of an induced abortion was significantly
Chang, Ann Lee; Pacheco, Misty; Yoshino, Kurt; Miyamura, Jill; Maddock, Jay
Objective The purpose of this study was to examine primary cesarean delivery rates among women with low risk pregnancies in urban and rural hospitals in Hawaii. Methods This is a retrospective study of all low-risk women (term, vertex, singleton) who had a primary cesarean delivery in any Hawaii hospital from 2010 to 2011 using a statewide health information database. Hospitals were divided into two categories: rural and urban. Results Of the 27,096 women who met criteria for this study, 7105 (26.2 %) delivered in a rural hospital. Low-risk women who delivered in a rural hospital had a primary cesarean delivery rate of 18.5 % compared to 11.8 % in the urban hospitals, p < .0001. Low-risk women who delivered at rural hospitals had significantly higher unadjusted and adjusted odds ratios for cesarean delivery. The association with rural hospital was stronger after adjusting for confounders, aOR 2.47 (95 % CI 2.23-2.73) compared to unadjusted OR 1.70 (95 % CI 1.58-1.83) for primary cesarean delivery. Conclusions on practice In a geographically isolated population, rates of primary cesarean delivery among low-risk women are significantly higher in rural hospitals. This disparity should be investigated further.
Saroha, Ekta; Altarac, Maja; Sibley, Lynn M
Low contraceptive utilisation and high fertility in rural Uttar Pradesh (UP), India, is a major concern for the world's second most populous country. The association between reasons for low contraceptive utilisation and maternal factors has been inadequately researched. Data from the 'morbidity and performance assessment' study were analysed to explore reasons for low contraceptive utilisation and their association with maternal factors among 308 women in Maitha, rural UP, India. Chi-square, t-test, ANOVA, and logistic regression analyses were conducted. Majority (84.2%) of the rural women in Maitha, UP, India were not using any contraceptives. Upper caste, literate wives, and wives whose husbands were literate were more likely to use contraceptives. About one-third of the women did not want to use a contraceptive because they wanted another child. Large numbers (65.3%) of women wanted to use contraceptives but were unable to do so due to lack of knowledge (38.9%), fear of side-effects (15.5%), husband/family disapproval (15.5%), inconvenience (10.7%), and other reasons (19.1%). Maternal parity, wives' and husband's literacy were significantly associated with the reasons for low contraceptive utilisation (p < 0.05). Contraceptive utilisation can be Improved by taking into consideration such maternal characteristics. All state subsidised contraceptives should be more widely known, understood and made available.
Fattah, Kazi Nazrul; Camellia, Suborna
Prevention of violence against women requires understanding men's controlling attitudes and behaviors toward women. In Bangladesh, while the incidence of men's violence against women is alarmingly increasing, existing research to understand the determinants of men's violent behavior resulted in contradictory findings. The current study explores rural Bangladeshi men's support for gender norms, beliefs, and attitudes concerning violence against women, and looks at how these are influenced by men's age, marital status, education, and affiliation with organizations that promote gender equality. The study also attempts to understand men's bystander attitudes and responses to incidents of violence against women. Using the theoretical framework of hegemonic masculinity, the study was conducted among a sample of 1,200 men and women. Results indicate that in the study areas, young, unmarried men are less supportive to gender norms, beliefs, and attitudes that promote violence against women. Positive association was observed with men's educational attainment and affiliation with nongovernmental organization (NGO) interventions. Regardless of age, marital status, or education, men's bystander response toward intervening to prevent violence against women was found to be low. Women showed similar level of support for inequitable gender norms, beliefs, and attitudes. Analysis of the findings using a hegemonic masculinity lens reveals more complicated dynamics of power and hegemonic control at work that perpetuate men's violence against women. Based on the findings, the study also identifies possible strategies for violence prevention interventions in Bangladesh.
Wingler, Sylvia Adams
This dissertation focuses on the narratives of four rural art educators of the Foothills of Western North Carolina. These women are the first art educators in this area in public education. They are often viewed as the invisible women in art who support community arts, much like the "invisible women in art history." From the view of the…
Chuks, Okeke Ben
Women play a very vital role in national development. The role relates to a complete range of socio-economic activities. Rural women are not only users of basic services, bearers and socialisers of children and keepers of the home, they also represent a product potential, which is not being fully tapped. Records have shown that women form more…
Crosby, Richard A.; Hagensee, Michael E.; Vanderpool, Robin; Nelson, Nia; Parrish, Adam; Collins, Tom; Jones, Nebraska
Objectives To describe women’s comfort levels and perceptions about their experience self-collecting cervico-vaginal swabs for HPV testing; to determine whether nurse-guided patient navigation increases the odds of women receiving a traditional Pap test after HPV screening; and to test the hypothesis that women testing positive for oncogenic HPV would be more likely to have a subsequent Pap test than those testing negative. Methods 400 women were recruited from eight rural Appalachian counties, in 2013 and 2014. After completing a survey, women were provided instructions for self-collecting a cervico-vaginal swab. Specimens were tested for 13 oncogenic HPV types. Simultaneously, women were notified of their test results and offered initial navigation for Pap testing. Chart-verified Pap testing within the next six months served as the endpoint. Results Comfort levels with self-collection were high: 89.2% indicated they would be more likely to self-collect a specimen for testing, on a regular basis, compared to Pap testing. Thirty women (7.5%) had a follow-up Pap test. Women receiving added nurse-guided navigation efforts were significantly less likely to have a subsequent test (P = .01). Women testing positive for oncogenic HPV were no more likely than those testing negative to have a subsequent Pap test (P = .27). Data were analyzed in 2014. Conclusions Rural Appalachian women are comfortable self-collecting cervico-vaginal swabs for HPV testing. Further, efforts to re-contact women who have received an oncogenic HPV test result and an initial navigation contact may not be useful. Finally, testing positive for oncogenic HPV may not be a motivational factor for subsequent Pap testing. PMID:26462184
In a particular way, the HIV pandemic exposes the prevailing gender relations and the definitions of male and female gender roles, both in intimate relationships and in the wider society. The HIV pandemic reveals the contradictions between women's legal rights and the persistence of women's cultural and sexual subordination. It reflects the impact of poverty, gender roles, culture and religion. Although HIV and AIDS cuts across class, South African rural black women's infection risk seems particularly high since they suffer notably from subordination and socio-economic hardships. Negotiating safer sex in marriage or intimate partnerships is very difficult for them in view of the traditional spaces in which they find themselves, where patriarchal structures are pervasive. Based on data obtained from a case study, this paper examines socio-cultural constraints to rural women's sexual agency in a patriarchal social order. These rules are based on a patriarchal code of respect, which is still pervasive in many aspects of the community under investigation. In terms of gender relations, the patriarchal code of respect is founded on an assumed 'naturalisation' of the two genders and the natural superiority of the male over the female. In terms of sexuality it is translated into male sex-right. The fear of HIV infection is omnipresent and results in unmarried women engaging in the negotiation of their wants and needs. Owing to the patriarchal code of respect, married women are perceived as having no choice in negotiating safer sex and are forced to put their lives at risk in contracting HIV. Unmarried women have greater although not endless choices in this regard. Although the study participants unexpectedly displayed a rather negative perception of other women, in order to strengthen women in their proximal environment the HIV epidemic may be seen as a vehicle for building solidarity among women in the community.
Li, Nan; Zhou, Ling-zhi; Dai, Li-na; Tian, Zhen; Lai, Jian-qiang; Zhao, Xian-feng; Yin, Shi-an
To study the relations between different feeding patterns and the body weight retention of the perinatal women living in rural areas of China. A cluster sampling method was used to investigate 409 women, who are currently living in rural areas of Tianjin, at pregnant and perinatal status. While, their body weights and heights before pregnancy, antepartum and postpartum were measured, respectively. Body weight retention was the difference of the measured data after postpartum minus pre-pregnant weight. Variance analysis was used for statistic comparison. The rate of exclusive breastfeeding was 70.9% (290/409) within four months. The net body weight retention of women (5.8 kg) using the exclusive breastfeeding was lower than that of the women (7.0 kg) using artificial feeding within 4 - 6 months, but there was no significantly statistic difference (F = 1.45, P = 0.236). However, there was the opposite result within 7 - 9 months, the data showed that the body weight retention in the women using the exclusive breastfeeding was 4.9 kg, which was significantly higher than that the women (2.9 kg) with artificial feeding (F = 3.17, P = 0.043). The food consumption of the women (901 g) using exclusive breastfeeding was the highest, followed by those (877 g) using mixed feeding and the women (750 g) using artificial feeding. The body weight retention after postpartum should be related to infant feeding patterns. After postpartum, the weight loss of women using the exclusive breastfeeding is relatively low. While, for the women using the exclusive breastfeeding, the net weight retention during pregnancy and after postpartum were lower than those with artificial feeding. Therefore, it is necessary to enhance health education and guidance on promoting exclusive breast-feeding as well as increasing awareness on pre-pregnant health.
Mittal, Srabani; Das, Samiran
Since the home is the primary source of exposure of children to second-hand smoke (SHS), measures to restrict smoking at home should be introduced to protect children from its adverse health consequences. Objectives of the study were to assess the level of awareness of rural Indian women on the health impacts of SHS on children and to look into the strategies they used to reduce children's exposure to SHS at home. A community-based cross-sectional study was conducted among 438 rural women using a survey questionnaire. Information on socio-demographic characteristics, knowledge on specific health effects of SHS on children, and attitude toward having a smoke-free home were collected. The perceived reasons that made it difficult to have smoke-free homes were also explored. A total of 75.8% of women agreed that SHS was a serious health risk for children. Knowledge on health impacts of SHS on children identified asthma as the most common problem. Smoking by husbands (89.7%) was the major source of exposure to SHS at home. While 67.6% of women reported having taken measures to limit SHS exposure in their homes, only 12.8% of them had tried to introduce a complete ban on smoking at home. On a five-point evaluation scale, 73.3% of the women indicated a failure of their initiatives to have smoke-free homes. Women's initiatives to introduce restrictions on smoking at home had very limited success and did not produce an appreciable change in smoking behavior at home. Lack of empowerment of women in rural India probably rendered the interventional measures ineffective.
Walcott, Melonie M; Hatcher, Abigail M; Kwena, Zachary; Turan, Janet M
Women's ability to safely disclose their HIV-positive status to male partners is essential for uptake and continued use of prevention of mother-to-child transmission (PMTCT) services. However, little is known about the acceptability of potential approaches for facilitating partner disclosure. To lay the groundwork for developing an intervention, we conducted formative qualitative research to elicit feedback on three approaches for safe HIV disclosure for pregnant women and male partners in rural Kenya. This qualitative acceptability research included in-depth interviews with HIV-infected pregnant women (n = 20) and male partners of HIV-infected women (n = 20) as well as two focus groups with service providers (n = 16). The participants were recruited at health care facilities in two communities in rural Nyanza Province, Kenya, during the period June to November 2011. Data were managed in NVivo 9 and analyzed using a framework approach, drawing on grounded theory. We found that facilitating HIV disclosure is acceptable in this context, but that individual participants have varying expectations depending on their personal situation. Many participants displayed a strong preference for couples HIV counseling and testing (CHCT) with mutual disclosure facilitated by a trained health worker. Home-based approaches and programs in which pregnant women are asked to bring their partners to the healthcare facility were equally favored. Participants felt that home-based CHCT would be acceptable for this rural setting, but special attention must be paid to how this service is introduced in the community, training of the health workers who will conduct the home visits, and confidentiality. Pregnant couples should be given different options for assistance with HIV disclosure. Home-based CHCT could serve as an acceptable method to assist women and men with safe disclosure of HIV status. These findings can inform the design and implementation of programs geared at promoting HIV
Guy, Meghan; Norman, Wendy V.; Malhotra, Unjali
Objective To design reliable survey instruments to evaluate needs and expectations for provision of women's health services in rural communities in British Columbia (BC). These tools will aim to plan programming for, and evaluate effectiveness of, a women's health enhanced skills residency program at the University of British Columbia. Design A qualitative design that included administration of written surveys and on-site interviews in several rural communities. Setting Three communities participated in initial questionnaire and interview administration. A fourth community participated in the second interview iteration. Participating communities did not have obstetrician-gynecologists but did have hospitals capable of supporting outpatient specialized women's health procedural care. Participants Community physicians, leaders of community groups serving women, and allied health providers, in Vancouver Island, Southeast Interior BC, and Northern BC. Methods Two preliminary questionnaires were developed to assess local specialized women's health services based on the curriculum of the enhanced skills training program; one was designed for physicians and the other for women's community group leaders and aboriginal health and community group leaders. Interview questions were designed to ensure the survey could be understood and to identify important areas of women's health not included on the initial questionnaires. Results were analyzed using quantitative and qualitative methods, and a second draft of the questionnaires was developed for a second iteration of interviews. Main findings Clarity and comprehension of questionnaires were good; however, nonphysician participants answered that they were unsure on many questions pertaining to specific services. Topics identified as important and missing from questionnaires included violence and mental health. A second version of the questionnaires was shown to have addressed these concerns. Conclusion Through iterations of
Background Despite declining smoking rates among the general Australian population, rates among Indigenous Australians remain high, with 47% of the Indigenous population reporting daily smoking - twice that of other Australians. Among women, smoking rates are highest in younger age groups, with more than half of Aboriginal women smoking during pregnancy. A lack of research focused on understanding the social context of smoking by Aboriginal women in rural Australia limits our ability to reduce these rates. This study aimed to explore the factors contributing to smoking initiation among rural Aboriginal women and girls and the social context within which smoking behaviour occurs. Methods We conducted three focus groups with 14 Aboriginal women and service providers and 22 individual interviews with Aboriginal women from four rural communities to explore their perceptions of the factors contributing to smoking initiation among Aboriginal girls. Results Four inter-related factors were considered important to understanding the social context in which girls start smoking: colonisation and the introduction of tobacco; normalization of smoking within separate Aboriginal social networks; disadvantage and stressful lives; and the importance of maintaining relationships within extended family and community networks. Within this context, young girls use smoking to attain status and as a way of asserting Aboriginal identity and group membership, a way of belonging, not of rebelling. Family and social structures were seen as providing strong support, but limited the capacity of parents to influence children not to smoke. Marginalization was perceived to contribute to limited aspirations and opportunities, leading to pleasure-seeking in the present rather than having goals for the future. Conclusions The results support the importance of addressing contextual factors in any strategies aimed at preventing smoking initiation or supporting cessation among Aboriginal girls and women
Passey, Megan E; Gale, Jennifer T; Sanson-Fisher, Robert W
Despite declining smoking rates among the general Australian population, rates among Indigenous Australians remain high, with 47% of the Indigenous population reporting daily smoking - twice that of other Australians. Among women, smoking rates are highest in younger age groups, with more than half of Aboriginal women smoking during pregnancy. A lack of research focused on understanding the social context of smoking by Aboriginal women in rural Australia limits our ability to reduce these rates. This study aimed to explore the factors contributing to smoking initiation among rural Aboriginal women and girls and the social context within which smoking behaviour occurs. We conducted three focus groups with 14 Aboriginal women and service providers and 22 individual interviews with Aboriginal women from four rural communities to explore their perceptions of the factors contributing to smoking initiation among Aboriginal girls. Four inter-related factors were considered important to understanding the social context in which girls start smoking: colonisation and the introduction of tobacco; normalization of smoking within separate Aboriginal social networks; disadvantage and stressful lives; and the importance of maintaining relationships within extended family and community networks. Within this context, young girls use smoking to attain status and as a way of asserting Aboriginal identity and group membership, a way of belonging, not of rebelling. Family and social structures were seen as providing strong support, but limited the capacity of parents to influence children not to smoke. Marginalization was perceived to contribute to limited aspirations and opportunities, leading to pleasure-seeking in the present rather than having goals for the future. The results support the importance of addressing contextual factors in any strategies aimed at preventing smoking initiation or supporting cessation among Aboriginal girls and women. It is critical to acknowledge
Anson, O; Haanappel, F W
Almost five decades ago, the Chinese Communist Party wished to abolish all "remnants of feudalism," including the patriarchal social order. Just one year after the revolution, the Marriage Law endorsed women's rights within the family, but no operative measures were taken to enforce it. Some of the economic reforms since independence even strengthened patrilocality and, possibly, patriarchal values. The purpose of this study was to explore the degree to which patrilocality served to maintain the traditional patriarchal stratification among women in the household by exploring women's health patterns and utilization of health services. Data were collected from 3859 women residing in rural Hebei, and variation in health and help seeking of six categories of relation to household head--mothers, wives, daughters, daughters-in-law, family heads, and other relatives--were explored. Utilization of health services is not dependent on women's position in the household, but primarily on per-capita income. Health patterns seem to indicate that mothers of the head of the household still have a considerable power to define their roles and share of household work. Women head of family, most of whom are married, appear to be under strain, which could be a result of their culturally "deviant" position. We conclude that old patriarchal values are intertwined with values of equality in current rural China.
Nyamathi, Adeline; Ekstrand, Maria; Zolt-Gilburne, Jessica; Ganguly, Kalyan; Sinha, Sanjeev; Ramakrishnan, Padma; Suresh, P.; Marfisee, Mary; Leake, Barbara
AIDS-related stigma has received increasing attention in the literature; however, little is known about the devastating impact it has on rural women living with AIDS (WLA) in India. This cross-sectional study (N = 68), analyzed from complete baseline data, identified a number of correlates of stigma among rural WLA in South India. Structured instruments were used to capture sociodemographic history, stigma, knowledge of HIV, depressive symptoms along with the recording of CD4 data. A higher level of felt stigma and more AIDS symptoms were related to avoidant coping, while fewer adherence strategies and lower support for ART adherence were also associated with avoidant coping. These findings promote the need for support and resources for rural India WLA. PMID:21915715
Nyamathi, Adeline; Salem, Benissa; Ernst, E J; Keenan, Colleen; Suresh, P; Sinha, Sanjeev; Ganguly, Kalyan; Ramakrishnan, Padma; Liu, Yihang
In this prospective, randomized clinical trial, correlates of adherence to antiretroviral therapy (ART) were assessed using a baseline questionnaire among 68 rural women living with AIDS (WLA) in India. Unadjusted analyses revealed positive relationships of ART adherence with Hindu religion, and support from spouses and parents, whereas negative associations were found with depression, poor quality of life, and having ten or more HIV symptoms. Multiple linear regression analysis also revealed that WLA who were Hindu, not depressed, had ART support from spouses and parents, and perceived some benefit from ART were more adherent to ART than their respective counterparts. This study reveals the unique challenges which rural WLA experience and the need to mitigate these challenges early in ART treatment. Further, the findings enable the refinement of an intervention program which will focus on strengthening ART adherence among rural WLA.
Gao, Ying; Huang, Yubei; Song, Fengju; Dai, Hongji; Wang, Peishan; Li, Haixin; Zheng, Hong; Dong, Henglei; Han, Jiali; Wang, Yaogang; Chen, Kexin
Objective To evaluate the urban-rural disparity of overweight/obesity and explore its potential trend with breast cancer among Chinese women. Results The prevalence of overweight/obesity for Chinese rural women (35.2%, 29.2% for overweight and 6.0% for obesity) was significantly higher than that for Chinese urban women (33.4%, 27.7% for overweight and 5.7% for obesity) (P < 0.001). For either rural or urban women, the prevalence of overweight/obesity was highest in north region, followed by east region for rural women and north-east region for urban women. For rural women, higher prevalence of overweight/obesity was significantly positively associated with elder age, Han nationality, low level of education, no occupation, high family income, less number of family residents, insurance, and elder age at marriage. Similar positive associations were also found for urban women, except negative associations for high family income, less number of family residents, and elder age at marriage. A non-significant positive trend between overweight/obesity and breast cancer was found for rural women [odds ratio (OR): 1.06; 95% confidence interval (CI): 0.87–1.29], but a significant positive trend for urban women (OR: 1.55; 95% CI: 1.19–2.02). Materials and Methods A total of 1 210 762 participants were recruited from the Chinese National Breast Cancer Screening Program. Overweight and obesity were defined as body mass index (BMI) ranged 24.0–27.9 kg/m2 and BMI ≥ 28.0kg/m2, respectively. Conclusions There was an obvious urban-rural disparity of overweight/obesity distribution among Chinese women, which could also lead to an obvious disparity of breast cancer distribution. PMID:27489359
Gao, Ying; Huang, Yubei; Song, Fengju; Dai, Hongji; Wang, Peishan; Li, Haixin; Zheng, Hong; Dong, Henglei; Han, Jiali; Wang, Yaogang; Chen, Kexin
To evaluate the urban-rural disparity of overweight/obesity and explore its potential trend with breast cancer among Chinese women. The prevalence of overweight/obesity for Chinese rural women (35.2%, 29.2% for overweight and 6.0% for obesity) was significantly higher than that for Chinese urban women (33.4%, 27.7% for overweight and 5.7% for obesity) (P < 0.001). For either rural or urban women, the prevalence of overweight/obesity was highest in north region, followed by east region for rural women and north-east region for urban women. For rural women, higher prevalence of overweight/obesity was significantly positively associated with elder age, Han nationality, low level of education, no occupation, high family income, less number of family residents, insurance, and elder age at marriage. Similar positive associations were also found for urban women, except negative associations for high family income, less number of family residents, and elder age at marriage. A non-significant positive trend between overweight/obesity and breast cancer was found for rural women [odds ratio (OR): 1.06; 95% confidence interval (CI): 0.87-1.29], but a significant positive trend for urban women (OR: 1.55; 95% CI: 1.19-2.02). A total of 1 210 762 participants were recruited from the Chinese National Breast Cancer Screening Program. Overweight and obesity were defined as body mass index (BMI) ranged 24.0-27.9 kg/m2 and BMI ≥ 28.0kg/m2, respectively. There was an obvious urban-rural disparity of overweight/obesity distribution among Chinese women, which could also lead to an obvious disparity of breast cancer distribution.
Keshet-Sitton, Atalya; Or-Chen, Keren; Yitzhak, Sara; Tzabary, Ilana; Haim, Abraham
Women are exposed to indoor and outdoor artificial light at night (ALAN) in urban and rural environments. Excessive exposure to hazardous ALAN containing short wavelength light may suppress pineal melatonin production and lead to an increased breast cancer (BC) risk. Our objective was to address the differences in BC risks related to light exposure in urban and rural communities. We examined indoor and outdoor light habits of BC patients and controls that had lived in urban and rural areas in a 5-year period, 10 to 15 years before the time of the study. Individual data, night time sleeping habits and individual exposure to ALAN habits were collected using a questionnaire. A total of 252 women (110 BC patients and 142 controls) participated in this study. The sample was divided to subgroups according to dwelling area and disease status. Age matching was completed between all subgroups. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated for urban and rural women separately, using binary logistic regression. OR results of urban population (92 BC patients and 72 control) revealed that BC risk increases with daily use of cellphone (OR = 2.13, 95% CI = 1.01-4.49, P < .05) and residence near strong ALAN sources (OR = 1.51, 95% CI = 0.99-2.30, P < .06). Nevertheless, BC risk decreases if a woman was born in Israel (OR = 0.44, 95% CI = 0.21-0.93, P < .03), longer sleep duration (OR = 0.75, 95% CI = 0.53-1.05, P < .1), and reading with bed light illumination before retiring to sleep (OR = 0.77, 95% CI = 0.61-0.96, P < .02). Furthermore, in the rural population (18 BC patients and 66 control) BC risk increases with the number of years past since the last menstruation (OR = 1.12, 95% CI = 1.03-1.22, P < .01). However, BC risk decreases with longer sleep duration (OR = 0.53, 95% CI = 0.24-1.14, P < .1), reading with room light illumination before retiring to sleep (OR = 0.55, 95% CI = 0.29-1.06, P < .07), and sleeping with closed shutters during the night (OR
Purpose. To test the impact of two home visiting curricula on postnatal physical activity in rural, Southern, African American mothers. Design. Randomized controlled trial. Setting. Three rural counties in Mississippi. Subjects. Between September 2013 and May 2016, 54 postpartum women randomized...
Abidoye, R. O.; Olukoya, A. A.
Compared blood screening data for 200 urban and rural pregnant women in Nigeria. Found that rural subjects had a greater incidence of moderate anemia than did urban subjects, and corpuscular hemoglobin concentrations fell with increased gestational age. No relationship was found between hemoglobin counts and nutrition habits. (HTH)
Meng, Qinqin; Zhang, Le; Liu, Jufen; Li, Zhiwen; Jin, Lei; Zhang, Yali; Wang, Linlin; Ren, Aiguo
The study aims to assess dietary folate levels and food sources in women immediately before pregnancy in a rural area of northern China associated with a high prevalence of neural tube defects. Information was collected by face-to-face interviews with women who sought premarital healthcare and planned to become pregnant within the next 12 months from November 2009 through December 2012. Information regarding food consumption was obtained by means of 24-hr dietary recall. Folate values were assigned to foods according to the China Food Composition 2004. Factors associated with dietary folate intake were analyzed by multiple linear regression. Mean (± standard deviation) and median (interquartile range) daily folate intake levels were 114.3 ± 59.7 and 102.8 (69.3-146.8) μg/day, respectively. Over 99% of the subjects had an intake level below 320 μg/day, the estimated average requirement for nonpregnant women. Only 1% and 7% of the women consumed 75% and 50%, respectively, of the recommended daily folate intake of 400 μg for nonpregnant women. Over 80% of total folate consumption came from cereals, vegetables, and tubers, whereas fruit consumption was severely lacking. Underweight women, farmers, women enrolled during the winter, and women with access to fewer food types or daily meals were more likely to exhibit low folate intake levels. Dietary folate intake among study participants was far below the recommended intake level. Folic acid fortification of cereals is advised to raise folate intake in rural Chinese women planning to become pregnant. © 2014 Wiley Periodicals, Inc.
Ghose, Malini; Mullick, Disha
This paper is based on the findings of a research study which traced 56 rural women learners 15 years after they had participated in an empowerment and education programme in North India. It attempts to understand, from the perspectives of women from marginalised communities, the ways in which participating in the programme had been empowering for them, or not. While most of the women were indeed able to transform several areas in their lives, this study illustrates that empowering outcomes cannot be assumed or articulated in categorical terms and that bringing about change requires the negotiation of power at various levels. The women's narratives stand in contrast to the prevalent discourses around women's literacy and empowerment, which highlight the importance of literacy only in terms of its positive impact on attaining development goals. Despite the vigorously discussed de-politicisation of the concept of empowerment, the authors show in this paper that empowerment, when informed by a critical feminist understanding, continues to provide a useful framework to analyse women's experiences related to education, as a process enabling women to understand and negotiate structures of power - which are neither static nor wholly dominating - and to find spaces to exercise agency. There are few longitudinal studies which trace the long-term impact of educational programmes on adult women, and most studies are in the nature of impact assessments of programmes. Through this paper the authors argue for the need to analyse the complexities around the relationship between women's education and empowerment.
Akhtar, Tasleem; Khan, Mir Hassan; Zahoorullah; Hussain, Hamid; Nazli, Rubina; Lutfullah, Ghosia
Zinc deficiency is a commonly reported health problem throughout the world. This cross sectional survey was conducted in rural Peshawar with an aim to estimate the prevalence of zinc deficiency in women of child bearing age and find its association with age, marital, pregnancy status and parity. Data was collected from 353 women age 15-45 years. EPI INFO version 6.04 was used for data analysis. Overall 98 (27.8 %) women were zinc deficient (<80 μg/dL) while 31 (8.8%) had severe zinc deficiency (<50μg/dL.). Mean zinc level was found to increase gradually with the increase in the age up to 40 years and then starts decreasing significantly beyond this age. A significant decrease (p<0.03) in zinc concentration was found in married as compared to unmarried women. Out of 31 female with severe zinc deficiency, 23 (74.2%) were pregnant. Pregnant women in second (OR (CI) 3.36 (1.52-7.44) p<0.0008) and third ((OR (CI) 3.73 (1.91-7.30) p<0.00002) trimester were 3.4 & 3.7 times, respectively more zinc deficient as compared to control women. Mean zinc levels were significantly lower in women having no children versus women with 1-5 numbers of children. This study concludes that severe zinc deficiency especially prevalent in pregnant women needs urgent correction through food supplementation.
Kaur, Ravneet; Garg, Suneela
Domestic violence is a major contributor to physical and mental ill health of women and is evident, to some degree, in every society in the world. The World Health Organization reports that globally 29% to 62% of women have experienced physical or sexual violence by an intimate partner. Ending gender discrimination and all forms of violence against women requires an understanding of the prevailing culture of bias and violence. The present study was conducted in a rural area in India. Focus group discussions (FGDs) were conducted among married women in the age group of 18 to 35 years. Physical violence was a major cause of concern among these women. Some women had to suffer even during pregnancy. An alcoholic husband emerged as the main cause for domestic violence. Husbands' relatives instigating wife beating was also common. Majority of the women preferred to remain silent despite being victimized. The women feared to resort to law because of implications such as social isolation. To address this, all sectors including education, health, legal, and judicial must work in liaison. Gender inequality must be eliminated and equal participation of women in the decision-making and development processes must be ensured.
Kulkarni, Bharati; Christian, Parul; LeClerq, Steven C; Khatry, Subarna K
We examined factors affecting compliance to antenatal micronutrient supplementation and women's perceptions of supplement use. Randomized controlled supplementation trial of four alternative combinations of micronutrients given during pregnancy through to 3 months postpartum. Women were visited twice weekly to monitor compliance and to replenish tablets by female study workers. At 6 weeks postpartum women with live births (n 4096) were interviewed regarding their perceptions of the supplement. Median compliance calculated as percentage of total eligible doses received by women was high (84 %). Rural southern Nepal. Pregnant women. Women with high compliance (above the median of 84 %) were likely to be older, less educated, poorer, undernourished, belong to lower caste and of Pahadi (hill) ethnicity compared with women with low compliance (at or below the median of 84 %). Smoking and drinking alcohol in the past week during pregnancy were strongly associated with low compliance. The major reason for irregular intake was forgetting to take supplements. A higher proportion of the high compliers liked taking the supplements but only half of them were willing to purchase them in the future. A large proportion of women (91 %) perceived a benefit from taking the supplement such as improved strength and health, whereas only about 10 % perceived any side-effects which were not a major barrier to compliance. The present analysis highlights that poor, undernourished, uneducated women can have high compliance to antenatal supplementation if they are supplied with the tablets and reminded to take them regularly, and counselled about side-effects.
Sánchez-Moreno, Marita; López-Yáñez, Julián; Altopiedi, Mariana
This article discusses the results obtained by two consecutive enquiries into the leadership styles and training needs of women and men leading higher education organisations. It compares the findings of the first stage of two studies, based on ad hoc questionnaires responded to by 136 women and 129 men. Results showed only subtle differences…
Mackert, Michael; Kahlor, Leeann; Silva, Kristi; Padilla, Yolanda
Hispanic women are 1.5-3 times as likely as non-Hispanic white women to have a child affected by neural tube defects. This disparity exists in spite of varied interventions designed to address the problem. The purpose of this research was to investigate Hispanic women's knowledge of folic acid, perceptions of existing education campaigns, and provide guidance for future promotion efforts. Three focus groups with Hispanic mothers (N = 18) were conducted to garner insights on these issues. Results suggested that these women understood the benefits of folic acid, did not see major cultural barriers to consuming folic acid-rich foods, and did not perceive insurmountable challenges to consuming a multivitamin with folic acid. For many women, an initial pregnancy served as their initial cue to action, suggesting a need for the continued development of education strategies that communicate the benefits of folic acid supplementation prior to pregnancy. Such strategies may necessitate targeting younger audiences, including teenagers.
Chang, Jen Jen; Salas, Joanne; Tabet, Maya; Kasper, Zachary; Elder, Keith; Staley, Holly; Brownson, Ross C
This study examined the association between body mass index (BMI) changes over time and the risk of elevated depressive symptoms in a cohort of Midwestern rural adults. The longitudinal study used data from a telephone survey in 2005 including 1,475 men and women enrolled in the Walk the Ozarks to Wellness Project from 12 rural communities in Missouri, Arkansas, and Tennessee. Multilevel random intercept mixed models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association between BMI calculated from self-reported height and body weight and elevated depressive symptoms, adjusting for sociodemographic, behavioral, and medical variables. Elevated depressive symptoms were common in this rural population (17%-19%) and the mean BMI was 28 kg/m 2 . For each unit increase in BMI over time, representing an average increase of about 5.8 pounds from baseline weight, there was a 6% increased odds of elevated depressive symptoms (aOR: 1.06, 95% CI: 1.02-1.12). Our findings hold important public health implications given the increasing rates of overweight and obesity over the past couple of decades, particularly among rural adults. © 2016 National Rural Health Association.
Cudney, Shirley; Weinert, Clarann; Kinion, Elizabeth
Successful adaptation to chronic illness is enhanced by active client-health care provider partnerships. The purposes of this article are to (a) examine the health care partnership needs of western rural women with chronic illness who participated in a computer-based support and education project, (b) describe how the role of the women in the partnership can be maximized by the use of a personal health record and improving health literacy, and (c) discuss ways health care providers can enhance their role in the partnership by careful listening and creating environments conducive to forging productive client-provider partnerships.
Weinert, Clarann; Cudney, Shirley; Hill, Wade G.
The study's purpose was to examine retention factors in a computer intervention with 158 chronically ill rural women. After a 22 week intervention, 18.9 percent of the women had dropped out. A Cox regression survival analysis was performed to assess the effects of selected covariates on retention. Reasons for dropping were tallied and categorized. Major reasons for dropping were: lack of time; decline in health status, and non-participation in study activities. Four covariates predicted survival time: level of computer skills, marital status, work outside of home, and impact of social events on participants' lives. Retention-enhancing strategies are suggested for implementation. PMID:18226760
Eyler, Amy A; Vest, Joshua R
Physical activity is an important aspect of health promotion and disease prevention. However, women often have lower rates of physical activity than men. The purpose of this study was to identify environmental and policy determinants to physical activity among rural white women. Six focus groups were conducted with women aged 20-50 years who were not currently regular exercisers. Women reported that the social environment had a strong impact on physical activity level. Factors of the social environment included guilt, family responsibility, and social support. Environmental and policy barriers such as lack of access to places to exercise and safety concerns were also discussed. Intervention suggestions included family exercise and work-site programs. Information gained from this study can be used to fuel further research and inform future physical activity interventions.
Tilak, Rina; Tilak, V W; Bhalwar, R
Use of insecticide treated bednets in prevention of malaria is a widely propagated global strategy, however, its use has been reported to be influenced and limited by many variables especially gender bias. A cross sectional field epidemiological study was conducted in a rural setting with two outcome variables, 'Bednet use'(primary outcome variable) and 'Women's Decision Making Power' which were studied in reference to various predictor variables. Analysis reveals a significant effect on the primary outcome variable 'Bednet use' of the predictor variables- age, occupation, bednet purchase decision, women's decision making power, husband's education and knowledge about malaria and its prevention. The study recommends IEC on treated bednets to be disseminated through TV targeting the elderly women who have better decision making power and mobilizing younger women who were found to prefer bednets for prevention of mosquito bites for optimizing the use of treated bednets in similar settings.
Stal, Karen Berit; Pallangyo, Pedro; van Elteren, Marianne; van den Akker, Thomas; van Roosmalen, Jos; Nyamtema, Angelo
To assess perceptions of the quality of obstetric care of women who delivered in a rural Tanzanian referral hospital. A descriptive-exploratory qualitative study, using semistructured in-depth interviews and participatory observation. Nineteen recently delivered women and 3 health workers were interviewed. Although most women held positive views about the care they received in hospital, several participants expressed major concerns about negative attitudes of healthcare workers. Lack of medical communication given by care providers constituted a major complaint. A more positive attitude by health workers and the provision of adequate medical information may promote a more positive hospital experience of women in need of obstetric care and enhance attendance. © 2015 John Wiley & Sons Ltd.
Neufeld, Lynnette M; Haas, Jere D; Grajéda, Ruben; Martorell, Reynaldo
The accurate estimation of gestational age in field studies in rural areas of developing countries continues to present difficulties for researchers. Our objective was to determine the best method for gestational age estimation in rural Guatemala. Women of childbearing age from four communities in rural Guatemala were invited to participate in a longitudinal study. Gestational age at birth was determined by an early second trimester measure of biparietal diameter, last menstrual period (LMP), the Capurro neonatal examination and symphysis-fundus height (SFH) for 171 women-infant pairs. Regression modelling was used to determine which method provided the best estimate of gestational age using ultrasound as the reference. Gestational age estimated by LMP was within +/-14 days of the ultrasound estimate for 94% of the sample. LMP-estimated gestational age explained 46% of the variance in gestational age estimated by ultrasound whereas the neonatal examination explained only 20%. The results of this study suggest that, when trained field personnel assist women to recall their date of LMP, this date provides the best estimate of gestational age. SFH measured during the second trimester may provide a reasonable alternative when LMP is unavailable.
Pérez-Fernández, M Reyes; Almazán Ortega, Raquel; Martínez Portela, José M; Alves Pérez, M Teresa; Segura-Iglesias, M Carmen; Pérez-Fernández, Román
The probability of developing osteoporosis decreases with an adequate supply of vitamin D, a balanced diet, and increased physical activity. In this study, we evaluated whether an educational intervention improves osteoporosis-related behavior in perimenopausal women from rural areas. A randomized experimental evaluation was performed of an educational intervention. The variables were physical activity, calcium intake and sun exposure in women from rural areas aged 45-54 years (n=216) at time 0 and 12 months after the educational intervention. In the control group (n=106), the information was sent by surface mail (month 0). In the intervention group (n=110), two interactive workshops were given (month 0). The topic of the workshops and the information sent by surface mail was healthy habits for osteoporosis prevention. After 12 months, the intervention group, but not the control group, had increased their physical activity (p=0.006), sun exposure (p=0.029), and calcium intake (53% to 64%). A simple educational intervention in perimenopausal women from rural areas improved healthy habits for osteoporosis prevention. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.
Borrull-Guardeño, Jessica; Domínguez, Alberto; Merizalde-Torres, Milton H; Sánchez-Martínez, Vanessa
The incidence of invasive cervical cancer and its mortality have been reduced through primary and secondary prevention. Screening rates tend to be lower in vulnerable groups, such as people with severe mental disorders, who have a later detection of cancer and a higher mortality. The access of these women to cervical cancer screening is uncertain in our context. The aim of this study was to determine the cervical cancer screening rates in women with severe mental disorders. This was a descriptive cross-sectional study. Women 25 to 65 years old who were admitted during 2016 to the psychiatric unit of a public hospital in Spain were included in the study, and it was determined if they had had cervical cancer screening. A total of 103 eligible women, with a mean age of 45.6 years, were enrolled. Only 28 of the participants (27.2%) had had a cervical cancer screening done in the last 5 years. By age groups, statistically significant differences were found, with women between 35 and 44 years of age having higher rates of cervical cancer screening (41.9%) and the oldest, between 55 and 65 years of age, having the lowest (5%). Women with severe mental health disorders who were admitted to acute psychiatric care units had much lower cervical cancer screening rates compared with the general population. Mental health nurses could be the optimum professionals to promote cancer primary and secondary prevention in women with mental disorders.
Rao, Kiran; Vanguri, Prameela; Premchander, Smita
Objective. To share experiences from a project that integrates a mental health intervention within a developmental framework of microcredit activity for economically underprivileged women in rural India. Method. The mental health intervention had two components: group counseling and stress management. The former comprised of ventilation and reassurance and the latter strengthening of coping skills and a relaxation technique. Focus group discussions were used to understand women's perception of how microcredit economic activity and the mental health intervention had affected their lives. Results. Women in the mental health intervention group reported reduction in psychological distress and bodily aches and pains. Majority (86%) reported that the quality of their sleep had improved with regular practice of relaxation and that sharing their problems in the group had helped them to unburden. The social support extended by the members to each other, made them feel that they were not alone and could face any life situation. Conclusion. The study provided qualitative evidence that adding the mental health intervention to the ongoing economic activity had made a positive difference in the lives of the women. Addressing mental health concerns along with livelihood initiatives can help to enhance both economic and social capital in rural poor women. PMID:22295190
Rao, Kiran; Vanguri, Prameela; Premchander, Smita
Objective. To share experiences from a project that integrates a mental health intervention within a developmental framework of microcredit activity for economically underprivileged women in rural India. Method. The mental health intervention had two components: group counseling and stress management. The former comprised of ventilation and reassurance and the latter strengthening of coping skills and a relaxation technique. Focus group discussions were used to understand women's perception of how microcredit economic activity and the mental health intervention had affected their lives. Results. Women in the mental health intervention group reported reduction in psychological distress and bodily aches and pains. Majority (86%) reported that the quality of their sleep had improved with regular practice of relaxation and that sharing their problems in the group had helped them to unburden. The social support extended by the members to each other, made them feel that they were not alone and could face any life situation. Conclusion. The study provided qualitative evidence that adding the mental health intervention to the ongoing economic activity had made a positive difference in the lives of the women. Addressing mental health concerns along with livelihood initiatives can help to enhance both economic and social capital in rural poor women.
Amin, R; Becker, S; Bayes, A
Nongovernmental organizations (NGOs) in rural Bangladesh are reaching out to poor women with collateral-free credit programs aimed at both alleviating poverty and increasing women's status. The present study investigated the hypothesis that participation in credit-related activities by NGO credit members leads to greater empowerment of credit members compared to nonmembers. The sample was comprised of 1164 loanees and 1200 nonloanees from the five NGO areas in Bangladesh and of 1200 nonloanees from non-program areas of rural Bangladesh with no significant NGO presence. NGO credit members had significantly higher scores on all three indices of female empowerment: inter-spouse consultation, autonomy, and authority. Moreover, nonmembers within NGO program areas had higher autonomy and authority scores than nonmembers within the comparison areas. Even after background variables were controlled in the multivariate analysis, NGO credit membership and residence in an NGO program area remained significantly and positively associated with both the autonomy and authority indices. Other variables that exerted a significant positive effect on women's empowerment were concrete or corrugated buildings, area of residence outside the southern or eastern regions, nonagricultural occupation, respondent's education, and age. In focus group discussions, NGO credit loanees reported that the program made them more confident, assertive, intelligent, self-reliant, and aware of their rights. NGO credit programs that target poor women are likely to produce substantial improvements in women's social and economic status, without the long delays associated with education or employment opportunities in the formal sector.
Bhandari, Shreya; Bullock, Linda F. C.; Richardson, Jeanita W.; Kimeto, Pamela; Campbell, Jacquelyn C.; Sharps, Phyllis W.
A subsample of 12 African American women (6 urban and 6 rural) were selected from a larger longitudinal, randomized control trial, Domestic Violence Enhanced Home Visitation (DOVE-R01 900903 National Institute of Nursing Research [NINR]/National Institutes of Health [NIH]). All African American women were chosen to control for any racial- and/or race-related cultural differences that may exist among women across geographical areas. The experiences of abuse during the perinatal period are drawn from in-depth interviews conducted at five points in time during pregnancy and the post-partum period. The analysis describes three major themes that highlight the similarities and differences among rural and urban women. The main themes found were (1) types of abuse, (2) location of abuse, and (3) response to abuse. In addition, two sub-themes (a) defiance and compliance and (b) role of children were also identified. Implications for universal screening for women of reproductive age, safer gun laws, and the need for further research are discussed. PMID:25315478
Kincaid, Shannon D.
Women have historically been underrepresented in the fields of science, technology, engineering, and math (STEM fields). The underrepresentation of women in STEM may be attributable to a variety of factors. These may include different choices men and women typically make in response to incentives in STEM education. For example, STEM career paths may be less accommodating to people who are less resilient. Another factor may be that there are relatively few female STEM role models. Perhaps strong gender stereotypes discourage women from pursuing STEM education and STEM jobs. The factors that contribute to success and the barriers that impeded success must be identified before any steps can be taken to improve the educational outcomes for women in STEM disciplines. Consequently, relatively little is known about the role of resilience in academically successful adult women in rural community colleges enrolled in STEM disciplines and the mechanisms that underlie the performance deficits that occur as a result of stereotype threat effect. This mixed method study addressed those knowledge gaps by determining: (1) if high resilience is positively correlated to high grade point average for women enrolled in STEM disciplines in rural community colleges in North Carolina, and (2) if stereotype threat effect is a risk factor for these women. Quantitative data were collected by using "The Resilience Scale" (Wagnild & Young, 1987) and through examination of grade point average of students from Datatel data management software. Qualitative data were collected through semi-structured focus group interviews. Findings from this study indicate high resilience is positively correlated to high grade point average for women enrolled in STEM disciplines in rural community colleges in North Carolina, and stereotype threat effect was a risk factor for low-scoring women (i.e. those women who reported resilience scores less than 121 and grade point averages lower than 2.70) and was not a
Routray, Parimita; Torondel, Belen; Clasen, Thomas; Schmidt, Wolf-Peter
While women and girls face special risks from lack of access to sanitation facilities, their ability to participate and influence household-level sanitation is not well understood. This paper examines the association between women's decision-making autonomy and latrine construction in rural areas of Odisha, India. We conducted a mixed-method study among rural households in Puri district. This included a cross sectional survey among 475 randomly selected households. These were classified as either having a functional latrine, a non-functional latrine or no latrine at all. We also conducted 17 in-depth interviews and 9 focus group discussions among household members of these three categories of households. Decisions on the construction of household level sanitation facilities were made exclusively by the male head in 80% of households; in 11% the decision was made by men who consulted or otherwise involved women. In only 9% of households the decision was made by women. Households where women were more involved in general decision making processes were no more likely to build a latrine, compared to households where they were excluded from decisions. Qualitative research revealed that women's non-involvement in sanitation decision making is attributed to their low socio-economic status and inability to influence the household's financial decisions. Female heads lacked confidence to take decisions independently, and were dependent on their spouse or other male family members for most decisions. The study revealed the existence of power hierarchies and dynamics within households, which constrained female's participation in decision-making processes regarding sanitation. Though governments and implementers emphasize women's involvement in sanitation programmes, socio-cultural factors and community and household level dynamics often prevent women from participating in sanitation-related decisions. Measures are needed for strengthening sanitation policies and effective
Searle, Jennifer; Goldberg, Lisa; Aston, Megan; Burrow, Sylvia
Participant narratives from a feminist and queer phenomenological study aim to broaden current understandings of trauma. Examining structural marginalisation within perinatal care relationships provides insights into the impact of dominant models of care on queer birthing women. More specifically, validation of queer experience as a key finding from the study offers trauma-informed strategies that reconstruct formerly disempowering perinatal relationships. Heteronormativity governs birthing spaces and presents considerable challenges for queer birthing women who may also have an increased risk of trauma due to structurally marginalising processes that create and maintain socially constructed differences. Analysis of the qualitative data was guided by feminist and queer phenomenology. This was well suited to understanding queer women's storied narratives of trauma, including disempowering processes of structural marginalisation. Semistructured and conversational interviews were conducted with a purposeful sample of thirteen queer-identified women who had experiences of birthing in rural Nova Scotia, Canada. Validation was identified as meaningful for queer women in the context of perinatal care in rural Nova Scotia. Offering new perspectives on traditional models of assessment provide strategies to create a context of care that reconstructs the birthing space insofar as women at risk do not have to come out as queer in opposition to the expectation of heterosexuality. Normative practices were found to further the effects of structural marginalisation suggesting that perinatal care providers, including nurses, can challenge dominant models of care and reconstruct the relationality between queer women and formerly disempowering expectations of heteronormativity that govern birthing spaces. New trauma-informed assessment strategies reconstruct the relationality within historically disempowering perinatal relationships through potentiating difference which avoids
Schuler, S R; Hashemi, S M; Riley, A P; Akhter, S
Although violence by men against women in Bangladesh occurs in most cases within the home, in a larger sense it does not originate in the home nor persist only within the home. It is simply one element in a system that subordinates women through social norms that define women's place and guide their conduct. This paper uses ethnographic and structured survey data from a study in rural Bangladesh to explore the relationship between domestic violence against women and their economic and social dependence. It describes some of the common situations in which violence against women occurs in Bangladeshi society, analyzes its larger context, and identifies factors that appear to lessen its incidence in this particular socio-economic setting. The study findings suggest that group-based credit programs can reduce men's violence against women by making women's lives more public. The problem of men's violence against women is deeply rooted, however, and the authors argue that much more extensive interventions will be needed to significantly undermine it.
Chanda, Sanjoy Kumar; Howlader, Hasan; Nahar, Nasrin
The key focus of this study is to explain the level of education of married women and their participation in decision making process at different arena of rural household. To find out the nature of the reality, survey research design was used for this study. The study was conducted at Maharajpur, one of the unions of Jhenidah district in Bangladesh in 2011. The respondents of the study consisted of 120 married women who were purposively selected from the study area. Data were collected through direct interview method using an interview schedule. Data were shown on univariate, as well as bivariate statistical tables and then analyzed. The study reveals that a significant percent (93.3) of higher level of education completed women had their consent of getting married whereas no consent was made by illiterate women. In the same way 46.7 percent higher level of education completed women had high level of purchasing power in compare to illiterate (.0%) and primary (14.6%) level completed women for the same level of purchasing. In the political decision making 86.7 percent higher level of education completed women had own consent to vote for election in contrast to 77.8 percent illiterate and 70.7 percent primary level completed women were influenced by their husband to decide voting.
Barrera, Alinne Z.; Wickham, Robert E.; Muñoz, Ricardo F.
Background Postpartum depression (PPD) is a maternal mental health problem that affects women from all regions of the world. Unfortunately, even in developed countries, half of the cases go undetected and, consequently, untreated. Individuals from low and middle income countries trend toward underutilization of mental health services, partly due to the limited number of available psychological resources. The primary aims of this pilot randomized controlled trial were to adapt to the Internet the Mothers and Babies Course/Curso Mamás y Bebés, a prevention of PPD intervention, to describe the characteristics of the pregnant women who engaged in the intervention site, and to obtain preliminary data on the efficacy of the Internet intervention to reduce the risk of PPD. Methods Pregnant women, 18 years or older who were interested in using the site for themselves were recruited and randomly assigned to a fully-automated self-help Internet intervention or to an information-only control condition. Randomized participants were invited to complete monthly depression assessments up to six months postpartum. To examine the prevention effects of the Internet intervention, pregnant women who did not meet current criteria for a major depressive episode, who engaged with the study website, and who provided depression data during the postpartum follow-up period were included in the study analyses. Results Participants were 111 predominantly Spanish-speaking (82.9%) and Latino/Hispanic (71.3%) pregnant women residing in 23 countries worldwide. The effect of the prevention intervention condition failed to reach significance at the a priori alpha-level. However, the observed coefficient trended in the hypothesized direction (b = −0.514, χ2 (1) = 3.43, p = .061; HR = 0.598). The benefits of receiving the e-MB Internet intervention was greater for pregnant women reporting high (vs. low) levels of prenatal depression symptoms (b = −0.605, χ2 (1) = 5.20, p =.023). Conclusions
Rodríguez-Muñoz, María de la Fe; Vallejo Slocker, Laura; Olivares Crespo, María Eugenia; Izquierdo Méndez, Nuria; Soto, Cristina; Le, Huynh-Nhu
Prenatal depression is a major public health problem, therefore predicting and preventing it is a relevant objective for public health agendas. Consequently, it is important to have adequate screening tools to detect risk factors associated with prenatal depression. The aim of this study was to evaluate the psychometric properties reliability and factor structure of the Spanish version of the Postpartum Depression Predictors Inventory- Revised- Prenatal Version (PDI-R) in pregnant women who attend prenatal care in an urban hospital in Spain. The sample was formed of 445 women receiving prenatal care in an obstetrics clinic in an urban public hospital in Madrid, Spain. The internal consistency of PDPI-R was assessed by measuring Cronbach's Alfa index, calculating the COR curve and percentiles for this sample. The PDPI-R showed good internal consistency in this sample (Cronbach's Alfa = 0,855). The area under the COR curve is 0,84 p≤0,001. Sensibility and specificity values were 62,3% and 69,5% respectively, and the cut-off point with greatest sensibility and specificity was 4. The PDPI-R is reliable and can be used to screen for risk factor for depression during pregnancy.
Walker, Susan Noble; Pullen, Carol H.; Boeckner, Linda; Hageman, Patricia A.; Hertzog, Melody; Oberdorfer, Maureen K.; Rutledge, Matthew J.
Background Unhealthy diet and lack of physical activity increase rural midlife and older women’s risk for chronic diseases and premature death, and they are behind urban residents in meeting Healthy People 2010 objectives. Objectives To compare a tailored intervention based on the Health Promotion Model (HPM) and a generic intervention to increase physical activity and healthy eating among rural women. Methods In a randomized by site community-based controlled clinical trial, Wellness for Women, 225 women aged 50 to 69 years were recruited in two similar rural areas. Over 12 months, women received by mail either 18 generic newsletters or 18 newsletters computer-tailored on HPM behavior-specific cognitions (benefits, barriers, self-efficacy, and interpersonal support), activity, and eating. Outcomes at 6 and 12 months included behavioral markers and biomarkers of physical activity and eating. Data were analyzed by repeated measures ANOVA and χ2 tests (α < .05). Results Both groups significantly increased stretching and strengthening exercise and fruit and vegetable servings and decreased % calories from fat, while only the tailored group increased ≥ moderate intensity activity and decreased % calories from saturated fat from baseline to 6 months. Both groups increased stretching and strengthening exercise, while only the tailored group increased ≥ moderate activity and fruit and vegetable servings and decreased % calories from fat from baseline to 12 months. Both groups had several changes in biomarkers over the study. A higher proportion of women receiving tailored newsletters met Healthy People 2010 criteria for ≥ moderate activity, fruit and vegetable servings, and % calories from fat at 12 months. Discussion Mailed computer-tailored and generic print newsletters facilitated the adoption of change in both activity and eating over 6 months. Tailored newsletters were more efficacious in facilitating change over 12 months. PMID:19289928
Manyema, M; Norris, S A; Said-Mohamed, R; Tollman, S T; Twine, R; Kahn, K; Richter, L M
Approximately 25% of the world's population consists of young people. The experience of violence peaks during adolescence and the early adult years. A link between personal experience of violence and mental health among young people has been demonstrated but rural-urban differences in these associations are less well known in low to middle income countries. The aim of this study was to investigate the associations between interpersonal violence and psychological distress among rural and urban young women. Data on experiences of violence and psychological distress were collected from a total of 926 non-pregnant young women aged between 18 and 22 years of age in rural and urban sites in South Africa. The General Health Questionnaire-28 was used to assess psychological distress as an indicator of mental health. Generalised structural equation models were employed to assess potential pathways of association between interpersonal violence and psychological distress. Thirty-four percent of the urban young women (n = 161) reported psychological distress compared to 18% of rural young women (n = 81). In unadjusted analysis, exposure to interpersonal violence doubled the odds of psychological distress in the urban adolescents and increased the odds 1.6 times in the rural adolescents. In adjusted models, the relationship remained significant in the urban area only (OR 1.84, 95% CI 1.13-3.00). Rural residence seemed protective against psychological distress (OR 0.41, 95% CI 0.24-0.69). Structural equation modelling did not reveal any direct association between exposure to interpersonal violence and psychological distress among rural young women. Stressful household events were indirectly associated with psychological distress, mediated by violence among young women in the urban area. The relationship between violence and psychological distress differs between urban and rural-residing young women in South Africa, and is influenced by individual, household and community
Crosby, Richard A.; Yarber, William L.; DiClemente, Ralph J.; Wingood, Gina M.; Meyerson, Beth
Objectives. This study compared HIV-associated sexual health history, risk perceptions, and sexual risk behaviors of low-income rural and nonrural African American women. Methods. A cross-sectional statewide survey of African American women (n = 571) attending federally funded Special Supplemental Nutrition Program for Women, Infants, and Children clinics was conducted. Results. Adjusted analyses indicated that rural women were more likely to report not being counseled about HIV during pregnancy (P = .001), that a sex partner had not been tested for HIV (P = .005), no preferred method of prevention because they did not worry about sexually transmitted diseases (P = .02), not using condoms (P = .009), and a belief that their partner was HIV negative, despite lack of testing (P = .04). Conclusions. This study provided initial evidence that low-income rural African American women are an important population for HIV prevention programs. PMID:11919067
Staton-Tindall, Michele; Harp, Kathi L H; Minieri, Alexandra; Oser, Carrie; Webster, J Matthew; Havens, Jennifer; Leukefeld, Carl
Rural women, particularly those in the criminal justice system, are at risk for HIV related to the increasing prevalence of injection drug use as well as limited services. Research on HIV risk correlates, including drug use and mental health, has primarily focused on urban women incarcerated in prisons. The purpose of this exploratory study is to examine dual HIV risk by 3 different mental health problems (depression, anxiety, and posttraumatic stress disorder [PTSD]) among drug-using women in rural jails. This study involved random selection, screening, and face-to-face interviews with 136 women in 1 Appalachian state. Analyses focused on the relationship between mental health and HIV risk. Nearly 80% of women self-reported symptoms of depression, and more than 60% endorsed symptoms consistent with anxiety and PTSD symptoms. Mental health significantly correlated with severity of certain types of drug use, as well as risky sexual activity. In addition, for women experiencing anxiety and PTSD, injection drug use moderated the relationship between mental health and risky sexual activity. Based on these rates of drug use, mental health problems, and the emergence of injection drug use in rural Appalachia, the need to explore the relationships between these issues among vulnerable and understudied populations, such as rural women, is critical. Because of service limitations in rural communities, criminal justice venues such as jails provide opportune settings for screening, assessment, and intervention for drug use, mental health, and HIV education and prevention. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
Sinha, Gita; Dyalchand, Ashok; Khale, Manisha; Kulkarni, Gopal; Vasudevan, Shubha; Bollinger, Robert C
Sixty percent of India's HIV cases occur in rural residents. Despite government policy to expand antenatal HIV screening and prevention of maternal-to-child transmission (PMTCT), little is known about HIV testing among rural women during pregnancy. Between January and March 2006, a cross-sectional sample of 400 recently pregnant women from rural Maharashtra was administered a questionnaire regarding HIV awareness, risk, and history of antenatal HIV testing. Thirteen women (3.3%) reported receiving antenatal HIV testing. Neither antenatal care utilization nor history of sexually transmitted infection (STI) symptoms influenced odds of receiving HIV testing. Women who did not receive HIV testing, compared with women who did, were 95% less likely to have received antenatal HIV counseling (odds ratio = 0.05, 95% confidence interval: 0.02 to 0.17) and 80% less aware of an existing HIV testing facility (odds ratio = 0.19, 95% confidence interval: 0.04 to 0.75). Despite measurable HIV prevalence, high antenatal care utilization, and STI symptom history, recently pregnant rural Indian women report low HIV testing. Barriers to HIV testing during pregnancy include lack of discussion by antenatal care providers and lack of awareness of existing testing services. Provider-initiated HIV counseling and testing during pregnancy would optimize HIV prevention for women throughout rural India.
Barefoot, K Nikki; Warren, Jacob C; Smalley, K Bryant
Previous research has consistently demonstrated that, in comparison to their cisgender heterosexual counterparts, lesbians face a multitude of women's healthcare-related disparities. However, very little research has been conducted that takes an intersectionality approach to examining the potential influences of rural-urban location on the health-related needs and experiences of lesbians. The purpose of this study was to quantitatively compare rural and urban lesbians' access to women's health care, experiences with women's healthcare providers (WHCPs), and preventive behavior using a large, diverse sample of lesbians from across the USA. A total of 895 (31.1% rural and 68.9% urban) lesbian-identified cisgender women (ie not transgender) from the USA participated in the current online study. As part of a larger parent study, participants were recruited from across the USA through email communication to lesbian, gay, bisexual, and transgender (LGBT)-focused organizations and online advertisements. Participants were asked to complete a series of questions related to their women's healthcare-related experiences and behaviors (ie access to care, experiences with WHCPs, and preventive behavior). A series of χ2 analyses were utilized in order to examine rural-urban differences across dependent variables. An examination of sexual risks revealed that relatively more rural lesbians reported at least one previous male sexual partner in comparison to the urban sample of lesbians (78.1% vs 69.1%, χ2(1, N=890)=7.56, p=0.006). A similarly low percentage of rural (42.4%) and urban (42.9%) lesbians reported that they have a WHCP that they see on a regular basis for preventive care. In terms of experiences with WHCP providers, relatively fewer rural lesbians indicated that their current WHCP had discussed/recommended the human papillomavirus (HPV) vaccination in comparison to urban lesbians (27.5% vs. 37.2%; χ2 (1, N=796)=7.24, p=0.007). No other
Lai, Li-Jung; Chou, Chia-Lin; Su, H Irene; Chen, Tzeng-Ji; Chou, Li-Fang; Chou, Yueh-Ching; Hwang, Shinn-Jang; Yu, Hann-Chin
Background A shortage of gynecologists exists in many countries. Even within an affluent country, gynecological clinics might not be evenly distributed. The purpose of the study was to investigate the disparity in gynecological care between adult women living in towns with and without gynecologists in Taiwan. Methods Data sources were the cohort datasets of the National Health Insurance Research Database, with claims data of 1 million beneficiaries in 2010. A woman’s residency was operationally inferred from the locations where she had most frequently visited physicians’ clinics or local community hospitals within the year. Results In Taiwan, 145 (39.4%) of 368 towns had no practicing gynecologist. Of 382,167 women with health care use in the datasets, 21,794 (5.7%) lived in towns without a gynecologist. The overwhelming majority of these towns lay in sparsely populated, rural areas. During the year, 132,702 women (34.7%) had sought medical help for gynecological diseases and 113,698 (29.8%) had visited gynecologists for gynecological diseases. Women in towns without a gynecologist were less likely to consult for gynecological diseases (23.8% versus 35.4%; P<0.001) and visit gynecologists (18.7% versus 30.4%; P<0.001) than women in towns with a gynecologist. The disparity existed in each age group. Among 5,189 adult women living in towns without a gynecologist and having gynecological diseases, 78.5% (number [n]=4,074) visited gynecologists out of town, especially for infertility, benign disorders of the uterus and ovaries, gynecological examinations, and contraceptive problems, and by contrast 23.3% (n=1,209) visited nongynecologists in town, most commonly for menopausal disorders, endometriosis and pelvic pain, menstrual disorders and hormonal dysfunction, and genital dysplasia. Conclusion Gynecological care of rural women was adversely affected by the shortage of gynecologists. The consequences of accessibility in underserved areas deserve further
Ikwegbue, Joseph N; Ross, Andrew; Ogbonnaya, Harbor
Medical male circumcision (MMC) is a key strategy in the South African HIV infection prevention package. Women may have a potentially powerful role in supporting such a strategy. Circumcision is not a traditional part of Zulu society, and Zulu women may have limited knowledge and ambivalent or negative attitudes towards MMC. This study employs quantitative data to expand insight into rural Zulu women's knowledge of and attitudes towards MMC, and is important as women could potentially yield a powerful positive or negative influence over the decisions of their partners and sons. A hospital-based antenatal clinic in rural KwaZulu-Natal. Participants were 590 pregnant, mostly isiZulu-speaking women. Data on their knowledge of and attitude towards MMC were collected using a questionnaire and were analysed descriptively. The majority of the women supported MMC; however, knowledge of the potential benefits was generally poor. Most would encourage their partners and sons to undergo MMC. The preferred place for the procedure was a hospital. Zulu participants supported MMC and would support their partners and children being circumcised. Knowledge around potential benefits was worryingly poor, and further research into disseminating information is essential. The findings highlight the need for an expanded campaign of health education for women, and innovative means are suggested to enhance information accessibility. Reasons for preferring that MMC be carried out in hospital need to be explored further.
Peñacoba, Cecilia; Rodríguez, Laura; Carmona, Javier; Marín, Dolores
Agreeableness is associated with good mental health during pregnancy. Although different studies have indicated that agreeableness is related to adaptive coping, this relation has scarcely been studied in pregnant women. The aim of this study was to analyze the possible differences between high and low agreeableness in relation to coping strategies and psychiatric symptoms in pregnant women. We conducted a longitudinal prospective study between October 2009 and January 2013. Pregnant women (n = 285) were assessed in the first trimester of pregnancy, and 122 of them were assessed during the third. Data were collected using the Coping Strategies Questionnaire, the Symptom Check List 90-R, and the agreeableness subscale of the NEO-FFI. Using the SPSS 21 statistics package, binary logistic regression, two-way mixed analysis of variance, and multiple regression analyses and a Sobel test were conducted. Higher levels of agreeableness were associated with positive reappraisal and problem-solving, and lower levels of agreeableness were associated with overt emotional expression and negative self-focused coping. Women with low agreeableness had poorer mental health, especially in the first trimester. These findings should be taken into account to improve women's experiences during pregnancy. Nevertheless, given the scarcity of data, additional studies are needed.
Akter, Shamima; Jesmin, Subrina; Rahman, Md Mizanur; Islam, Md Majedul; Khatun, Most Tanzila; Yamaguchi, Naoto; Akashi, Hidechika; Mizutani, Taro
Parity increases the risk for coronary heart disease; however, its association with metabolic syndrome among women in low-income countries is still unknown. This study investigates the association between parity or gravidity and metabolic syndrome in rural Bangladeshi women. A cross-sectional study was conducted in 1,219 women aged 15-75 years from rural Bangladesh. Metabolic syndrome was defined according to the standard NCEP-ATP III criteria. Logistic regression was used to estimate the association between parity and gravidity and metabolic syndrome, with adjustment of potential confounding variables. Subjects with the highest gravidity (> = 4) had 1.66 times higher odds of having metabolic syndrome compared to those in the lowest gravidity (0-1) (P trend = 0.02). A similar association was found between parity and metabolic syndrome (P(trend) = 0.04), i.e., subjects in the highest parity (> = 4) had 1.65 times higher odds of having metabolic syndrome compared to those in the lowest parity (0-1). This positive association of parity and gravidity with metabolic syndrome was confined to pre-menopausal women (P(trend) <0.01). Among the components of metabolic syndrome only high blood pressure showed positive association with parity and gravidity (P(trend) = 0.01 and <0.001). Neither Parity nor gravidity was appreciably associated with other components of metabolic syndrome. Multi parity or gravidity may be a risk factor for metabolic syndrome.
Melton, Bridget; Marshall, Elaine; Bland, Helen; Schmidt, Michael; Guion, W Kent
Though the positive link between physical activity and maternal health is well documented, physical activity declines during pregnancy and, internationally, rural mothers are less likely than urban mothers to engage in physical activity. Some evidence suggests that self-efficacy is related to sustained engagement in physical activity. The purpose of this study was to examine self-efficacy, perceived benefits, and knowledge of safe exercise among 88 rural pregnant women in a southeastern region of the United States. Exercise self-efficacy was significantly related to maternal age and gestation. Women over age 26 years, and those in the second and third trimesters, scored significantly higher than younger women or those in the first trimester. Fifty-two percent (n = 46) of participants perceived that activity would decrease energy levels, 37.5% (n = 33) did not know that exercise can decrease the risk of gestational diabetes, and 47.6% (n = 41) were unaware that a mother who is overweight is more likely to have an overweight child. Results confirm a need for education to improve women's knowledge about health benefits and safety information related to physical activity during pregnancy. © 2013 Wiley Publishing Asia Pty Ltd.
Maternal mortality in Zimbabwe has unprecedentedly risen over the last two and half decades although a decline has been noted recently. Many reasons have been advanced for the rising trend, including deliveries without skilled care, in places without appropriate or adequate facilities to handle complications. The recent decline has been attributed to health systems strengthening through a multi-donor pooled funding mechanism. On the other hand, the proportion of community deliveries has also been growing steadily over the years and in this study we investigate why. We used twelve (12) focus group discussions with child-bearing women and eight (8) key informant interviews (KIIs). Four (4) were traditional birth attendants and four (4) were spiritual birth attendants. A thematic approach was used to analyse the data in Ethnography software. The study shows that women prefer community deliveries due to perceived low economic, social and opportunity costs involved; pliant and flexible services offered; and diminishing quality and appeal of institutional maternity services. We conclude that rural women are very economic, logical and rational in making choices on place of delivery. Delivering in the community offers financial, social and opportunity advantages to disenfranchised women, particularly in remote rural areas. We recommend for increased awareness of the dangers of community deliveries; establishment of basic obstetric care facilities in the community and more efficient emergency referral systems. In the long-term, there should be a sustainable improvement of the public health delivery system to make it accessible, affordable and usable by the public. PMID:28793315
Dodzo, Munyaradzi Kenneth; Mhloyi, Marvellous
Maternal mortality in Zimbabwe has unprecedentedly risen over the last two and half decades although a decline has been noted recently. Many reasons have been advanced for the rising trend, including deliveries without skilled care, in places without appropriate or adequate facilities to handle complications. The recent decline has been attributed to health systems strengthening through a multi-donor pooled funding mechanism. On the other hand, the proportion of community deliveries has also been growing steadily over the years and in this study we investigate why. We used twelve (12) focus group discussions with child-bearing women and eight (8) key informant interviews (KIIs). Four (4) were traditional birth attendants and four (4) were spiritual birth attendants. A thematic approach was used to analyse the data in Ethnography software. The study shows that women prefer community deliveries due to perceived low economic, social and opportunity costs involved; pliant and flexible services offered; and diminishing quality and appeal of institutional maternity services. We conclude that rural women are very economic, logical and rational in making choices on place of delivery. Delivering in the community offers financial, social and opportunity advantages to disenfranchised women, particularly in remote rural areas. We recommend for increased awareness of the dangers of community deliveries; establishment of basic obstetric care facilities in the community and more efficient emergency referral systems. In the long-term, there should be a sustainable improvement of the public health delivery system to make it accessible, affordable and usable by the public.
Hannah, Chona T; Lê, Quynh
Access to health care services is vital for every migrant's health and wellbeing. However, migrants' cultural health beliefs and views can hinder their ability to access available services. This study examined factors affecting access to healthcare services for intermarried Filipino women in rural Tasmania, Australia. A qualitative approach using semi-structured interviews was employed to investigate the factors affecting access to healthcare services for 30 intermarried Filipino women in rural Tasmania. The study used grounded theory and thematic analysis for its data analysis. Nvivo v8 (www.qsrinternational.com) was also used to assist the data coding process and analysis. Five influencing factors were identified: (1) language or communication barriers; (2) area of origin in the Philippines; (3) cultural barriers; (4) length of stay in Tasmania; and (5) expectations of healthcare services before and after migration. Factors affecting intermarried Filipino women in accessing healthcare services are shaped by their socio-demographic and cultural background. The insights gained from this study are useful to health policy-makers, healthcare professionals and to intermarried female migrants. The factors identified can serve as a guide to improve healthcare access for Filipino women and other migrants.
Akter, Shamima; Jesmin, Subrina; Rahman, Md. Mizanur; Islam, Md. Majedul; Khatun, Most. Tanzila; Yamaguchi, Naoto; Akashi, Hidechika; Mizutani, Taro
Background Parity increases the risk for coronary heart disease; however, its association with metabolic syndrome among women in low-income countries is still unknown. Objective This study investigates the association between parity or gravidity and metabolic syndrome in rural Bangladeshi women. Methods A cross-sectional study was conducted in 1,219 women aged 15–75 years from rural Bangladesh. Metabolic syndrome was defined according to the standard NCEP-ATP III criteria. Logistic regression was used to estimate the association between parity and gravidity and metabolic syndrome, with adjustment of potential confounding variables. Results Subjects with the highest gravidity (> = 4) had 1.66 times higher odds of having metabolic syndrome compared to those in the lowest gravidity (0-1) (P trend = 0.02). A similar association was found between parity and metabolic syndrome (P trend = 0.04), i.e., subjects in the highest parity (> = 4) had 1.65 times higher odds of having metabolic syndrome compared to those in the lowest parity (0-1). This positive association of parity and gravidity with metabolic syndrome was confined to pre-menopausal women (P trend <0.01). Among the components of metabolic syndrome only high blood pressure showed positive association with parity and gravidity (P trend = 0.01 and <0.001). Neither Parity nor gravidity was appreciably associated with other components of metabolic syndrome. Conclusions Multi parity or gravidity may be a risk factor for metabolic syndrome. PMID:23936302
Jirapongsuwan, Ann; Latt, Kyaw Thu; Siri, Sukhontha; Munsawaengsub, Chokchai
A cross-sectional study was undertaken to investigate family planning (FP) practices and associated factors among reproductive-age married women. Data were collected by interviewing the 300 married women living in a rural area of Myanmar. The questionnaire had reliability coefficients ranging from .8 to .9. Results indicated that 73.3% of women performed FP, and contraceptive injection was the most common method. Significant associations were found with age 21 to 35 years (adjusted odds ratio [adj OR] = 3.748, 95% CI = 2.179-6.445), adequacy of income (adj OR = 2.520, 95% CI = 1.477-4.290), good attitude toward FP (adj OR = 0.386, 95% CI = 0.228-0.656), good support from health care providers (adj OR = 0.129, 95% CI = 0.054-0.313), good support from family (adj OR = 0.304, 95% CI = 0.163-0.565), good support from friends (adj OR = 0.344, 95% CI = 0.193-0.613), and FP practice. It is recommended that designing FP programs with peers and family involvement could increase the practice of FP among rural Myanmar women. © 2016 APJPH.
Nie, Peng; Sousa-Poza, Alfonso; Xue, Jianhong
There is evidence that household air pollution is associated with poor health in China, and that this form of air pollution may even be more of a health concern in China than the much-publicized outdoor air pollution. However, there is little empirical evidence on the relationship between household air pollution and health in China based on nationally representative and longitudinal data. This study examines the association between the type of domestic cooking fuel and the health of women aged ≥16 in rural China. Using longitudinal and biomarker data from the China Family Panel Studies (n = 12,901) and the China Health and Nutrition Survey (n = 15,539), we investigate the impact of three major domestic cooking fuels (wood/straw, coal, liquefied petroleum gas (LPG)) on health status using both cross-sectional and panel approaches. Compared to women whose households cook with dirty fuels like wood/straw, women whose households cook with cleaner fuels like LPG have a significantly lower probability of chronic or acute diseases and are more likely to report better health. Cooking with domestic coal instead of wood or straw is also associated with elevated levels of having certain risks (such as systolic blood pressure) related to cardiovascular diseases. Our study provides evidence that using cleaner fuels like LPG is associated with better health among women in rural China, suggesting that the shift from dirty fuels to cleaner choices may be associated with improved health outcomes.
Wilkinson, D.; Abdool Karim, S. S.; Harrison, A.; Lurie, M.; Colvin, M.; Connolly, C.; Sturm, A. W.
Sexually transmitted infections (STIs) are of major public health concern in developing countries, not least because they facilitate transmission of human immunodeficiency virus (HIV). The present article presents estimates of the prevalence, on any given day, of STIs among women in rural South Africa and the proportion who are asymptomatic, symptomatic but not seeking care, and symptomatic and seeking care. The following data sources from Hlabisa district were used: clinical surveillance for STI syndromes treated in health facilities, microbiological studies among women attending antenatal and family planning clinics, and a community survey. Population census provided denominator data. Adequacy of drug treatment was determined through quality of care surveys. Of 55,974 women aged 15-49 years, a total of 13,943 (24.9%) were infected on any given day with at least one of Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, or Treponema pallidum. Of the women investigated, 6697 (48%) were asymptomatic, 6994 (50%) were symptomatic but not seeking care, 238 (1.7%) were symptomatic and would seek care, and 14 (0.3%) were seeking care on that day. Only 9 of the 14 women (65%) were adequately treated. STIs remained untreated because either women were asymptomatic or the symptoms were not recognized and acted upon. Improved case management alone is therefore unlikely to have a major public health impact. Improving partner treatment and women's awareness of symptoms is essential, while the potential of mass STI treatment needs to be explored. PMID:10063657
Karim, K M Rabiul; Emmelin, Maria; Lindberg, Lene; Wamala, Sarah
Women-focused development initiatives have become a controversial issue connected with women's health and welfare. Previous studies indicated that development initiatives might increase women's workload, family conflict, and marital violence. This study explored the gendered characteristics of a development initiative Rural Mother Center in Bangladesh. Data incorporated policy document and interviews of social workers working with the mother centers in two northwest subdistricts. The qualitative content analysis of data emerged a general theme of expanding women's responsibility while maintaining male privilege explaining gendered design and practice of the development initiative. The theme was supported by two gendered categories related to the design: (a) essentializing women's participation; (b) maintaining traditional gender, and four categories related to the practice; (c) inadequate gender knowledge and skills; (d) reinforcing traditional gender; (e) using women for improving office performance; and (f) upholding male privilege. The study suggests that though women-focused development initiatives need to be embraced with gender-redistributive policies, the social workers should be trained for attaining gender-transformative motivation and competencies.
Chorghade, GP; Barker, M; Kanade, S; Fall, CHD
Objective: To identify social, behavioural and cultural factors that explain the thinness of young women relative to their men in rural Maharashtra, India. Design: Twelve focus group discussions were conducted to explore the villagers' understanding of why women in their area might be thinner than men. Setting: Pabal village and surrounding hamlets, in the Pune district of Maharashtra, India. Subjects: Samples of young mothers and fathers, grandmothers and grandfathers were selected from families in the village with children below 10 years of age. Results: Four factors were identified that the villagers felt contributed to the disparity in thinness. First, marriage isolated girls from their own families and villages, and brought the expectation of early motherhood. Young brides were often unable to relax and eat adequately. Second, marriage increased the workload of young women. They were expected to do the heaviest household chores as well as farm work in this predominantly agricultural community. Third, women had no financial autonomy or freedom of movement, and were therefore denied access to supplementary food sources available to men. Fourth, young women felt responsible for their household's health and success. They were encouraged to fast regularly to ensure this. Despite feeling responsible, young women had no control over factors that might affect the household's well being. This made them anxious and worried a great deal of the time. Conclusions: Interventions to improve the nutritional status of young women in this region need to recognise the roles and responsibilities taken up by young brides. PMID:16480528
Ozumba, B C; Obi, S N; Ijioma, N N
The contraceptive information and services offered to single women in most developing countries is compromised by stigma attached to premarital sex. This study was to ascertain the knowledge, attitude and practice of contraception among single women in a rural and urban community in southeast Nigeria, using a cross-sectional survey of 279 and 295 single women in Ngwo (rural) and Enugu (urban) community. The mean age of the population was 21.3 years. Contraceptive awareness was more among the urban than rural respondents (90.2% vs 34.1%). The major sources of contraceptive knowledge were mass media (68%) and peer groups (86.3%) for the urban and rural respondents, respectively. Most respondents in both groups had positive attitude towards contraception. More urban than rural respondents (68.3% vs 12.5%) began sexual activity during adolescence and the level of contraceptive use during first coitus were 48.4% and 13.7%, respectively. Of the currently sexually active respondents, 32.5% (rural) and 59.7% (urban) were using a form of modern contraception. Condoms, followed by oral pills were the most popular contraceptive method because they can easily procure them over the counter. Poor contraceptive information, highly critical behavior of family planning providers towards unmarried women seeking contraception and attitude of male partners militate against contraceptive practice. There is need to promote information and education on contraception among single women, their male partners and family planning providers.
Zahangir, M S; Hasan, M M; Richardson, A; Tabassum, S
Background/Objectives: This study aims at examining the urban–rural differentials in the effects of socioeconomic predictors on underweight and obesity of ever-married women in Bangladesh. The effect of malnutrition and other risk factors on non-communicable diseases is also examined. Subjects/Methods: The information regarding nutritional status, socioeconomic and demographic background, and non-communicable diseases of ever-married women was extracted from the nationally representative, cross-sectional Bangladesh Demographic and Health Survey (BDHS 2011) data set. Both bivariate (χ2 test) and multivariate (multinomial logistic regression model) analyses were performed in determining the risk factors of malnutrition. The effect of malnutrition and associated risk factors on non-communicable diseases was determined using binary logistic regression models. Results: The overall prevalence as well as the effects of individual risk factors of malnutrition differ in urban and rural settings. Regional differentials in the prevalence of underweight were statistically significant only for rural areas. In rural and urban settings, women from households with poor economic status were 67% (odds ratio (OR) 0.33, 95% CI 0.26–0.43) and 81% (OR=0.19, 95% CI 0.13–0.29) less likely to be overweight, respectively, with respect to those from affluent households. Women from the Rangpur division were significantly more likely to suffer from anemia (OR=1.41, 95% CI 1.13–1.77) and hypertension (OR=1.67, 95% CI 1.19–2.34) than those from the Sylhet division (reference division). With respect to those considered as underweight, women who were categorized as overweight were 0.47 (OR=0.53, 95% CI 0.43–0.65) times less likely to suffer from anemia, and 1.83 (OR=2.83, 95% CI 1.99–4.02) and 1.70 (OR=2.70, 95% CI 2.09–3.50) times more likely to suffer from diabetes and hypertension, respectively. Conclusions: Rural–urban differentials in the effects of individual risk factors
Shaikh, Saijuddin; Schulze, Kerry J; Ali, Hasmot; Labrique, Alain B; Shamim, Abu Ahmed; Rashid, Mahbubur; Mehra, Sucheta; Christian, Parul; West, Keith P
Properties of bioelectrical impedance analysis (BIA) reflect body-composition and may serve as stand-alone indicators of maternal health. Despite these potential roles, BIA properties during pregnancy and lactation in rural South Asian women have not been described previously, although pregnancy and infant health outcomes are often compromised. This paper reports the BIA properties among a large sample of pregnant and postpartum women of rural Bangladesh, aged 12-46 years, participating in a substudy of a community-based, placebo-controlled trial of vitamin A or beta-carotene supplementation. Anthropometry and single frequency (50 kHz) BIA were assessed in 1,435 women during the first trimester (< or =12 weeks gestation), in 1237 women during the third trimester (32-36 weeks gestation), and in 1,141 women at 12-18 weeks postpartum. Resistance and reactance were recorded, and impedance and phase angle were calculated. Data were examined cross-sectionally to maximize sample-size at each timepoint, and the factors relating to BIA properties were explored. Women were typically young, primiparous and lacking formal education (22.2 +/- 6.3 years old, 42.2% primiparous, and 39.7% unschooled among the first trimester participants). Weight (kg), resistance (omega), and reactance (omega) were 42.1 +/- 5.7, 688 +/- 77, and 73 +/- 12 in the first trimester; 47.7 +/- 5.9, 646 +/- 77, and 64 +/- 12 in the third trimester; and 42.7 +/- 5.6, 699 +/- 79, and 72 +/- 12 postpartum respectively. Resistance declined with age and increased with body mass index. Resistance was higher than that observed in other, non-Asian pregnant populations, likely reflecting considerably smaller body-volume among Bangladeshi women. Resistance and reactance decreased in advanced stage of pregnancy as the rate of gain in weight increased, returning to the first trimester values by the three months postpartum. Normative distributions of BIA properties are presented for rural Bangladeshi women across a
Islam, Mohammad Touhidul; Igarashi, Isao; Kawabuchi, Koichi
Low utilization of antenatal care (ANC) by pregnant women, particularly in rural areas, is an obstacle to ensuring safe motherhood in Bangladesh. Currently, Micro Health Insurance (MHI) is being considered in many developing countries as a potential method for assuring greater access to health care, especially for the poor. So far, there is only limited evidence evaluating MHI schemes. This study assesses the impact of MHI administered by Gonoshasthaya Kendra (GK) on ANC utilization by poor women in rural Bangladesh. We conducted a questionnaire survey and collected 321 valid responses from women enrolled in GK's MHI scheme and 271 from women not enrolled in any health insurance plan. We used a two-part model in which dependent variables were whether or not women utilized ANC and the number of times ANC was used. The model consisted of logistic regression analysis and ordinary least squares regression analysis. The main independent variables were dummies for socioeconomic classes according to GK, each of which represented the premiums and co-payments charged by class. The results showed that destitute, ultra-poor, and poor women enrolled in MHI used ANC significantly more than women not enrolled in health insurance. Women enrolled in MHI, except for those who were destitute or ultra-poor, utilized ANC significantly more times than women not enrolled in health insurance. We assume that GK's sliding premium and co-payment scales are key to ANC utilization by women. Expanding the MHI scheme may enhance ANC utilization among poor women in rural Bangladesh.
Backstrand, Jeffrey R; Allen, Lindsay H; Black, Anne K; de Mata, Margarita; Pelto, Gretel H
Few studies have examined the relation of iron status to diet in populations from developing countries with high levels of iron deficiency and diets of poor quality. The objective was to identify nutrients, dietary constituents, and foods that are associated with better iron status in a rural Mexican population. A prospective cohort study was conducted in rural central Mexico. The subjects were 125 nonpregnant women aged 16-44 y. During the 12 mo before blood collection, food intakes were assessed repeatedly by a combination of dietary recalls, food weighing, and food diaries [mean (+/-SD) days of food intake data: 18.8 +/- 5.9 d]. Hemoglobin, hematocrit, and plasma ferritin were measured at the end of the study. Higher plasma ferritin concentrations were associated with greater intakes of nonheme iron and ascorbic acid after control for age, BMI, breast-feeding, season, and the time since the birth of the last child. Higher ascorbic acid intakes, but not higher intakes of heme and nonheme iron, predicted a lower risk of low hemoglobin and hematocrit values after control for the background variables. Consumption of the alcoholic beverage pulque predicted a lower risk of low ferritin and low hemoglobin values. Seasonal variation in ferritin, hemoglobin, and hematocrit values was observed. Better iron status was associated with greater intakes of foods containing nonheme iron and ascorbic acid. PULQUE:a beverage containing iron, ascorbic acid, and alcohol-may influence the iron status of women in rural central Mexico.
Wang, Yu; Liao, Su-Su; Weeks, Margaret R.; Jiang, Jing-Mei; Abbott, Maryann; Zhou, Yue-Jiao; He, Bin; Liu, Wei; Mosack, Katie E.
Objectives and Goal The objectives of this study were to measure the potential acceptability of a hypothetical microbicide among women in sex establishments in rural areas of Southern China, and demographic, behavioral and social context factors likely to affect microbicide acceptability. Study Design This was a cross-sectional survey, using a quota sampling, among 300 women from sex establishments in three rural towns. An interviewer-administered standardized questionnaire was used to measure the acceptability score of hypothetical microbicides’ characteristics, as well as sexual relationships and behaviors, and other contextual factors. Results Findings showed a generally positive response to microbicides, indicated by an acceptability index score of 2.89 (SD, 0.56, scale of 1–4) in the overall sample. Multivariate analysis shows the acceptability score varied significantly by study sites, type of sex-work establishments, marital status, sex partner type, vaginal product experience, locus of control by partners and locus of control by chance. Conclusions Microbicides may be acceptable among sex workers in rural settings in China; however, contextual factors should be carefully considered in education and promotion of microbicides in the future. PMID:17767093
Prieto, Jaime; Gómez, Miguel-Ángel; Pollard, Richard
The purpose of this study was to quantify the home advantage in both men's and women's First and Second Division water polo leagues, to compare the results obtained according to sex of participants and the level of competition, and to test for possible differences in home advantage when considering the interaction between these two factors. The sample comprised four seasons from 2007-2008 to 2010-2011 for a total of 1942 games analyzed. The results showed the existence of home advantage in both men's and women's First and Second Divisions. After controlling for the competitive balance of each league in each season, there was a significant difference between men's and women's leagues, with higher home advantage for men's leagues (58.60% compared with 53.70% for women's leagues). There was also a significant difference between the levels of competition, with greater home advantage for the Second Division (57.95% compared with 54.35% for First Division). No significant differences in home advantage were found when considering the interaction between sex of participants and the level of competition. The results in relation to sex of participants and the level of competition are consistent with previous studies in other sports such as football or handball.
von Gaudecker, Jane R; Taylor, Ann Gill; Keeling, Arlene W; Buelow, Janice M; Benjamin, Sailas
In India, women with epilepsy face unique challenges. A focused ethnography of six women within the epilepsy treatment gap was conducted in rural South India. Women were asked to describe their day-to-day lives. Data were collected through open-ended, semistructured interview questions, participant observation, and field notes. Thematic analysis was done. The disease-related stigma contributed to the women's physical, psychological, and emotional struggles; the women and their family members made every effort to conceal the disease. Educational interventions to create awareness could help women seek effective treatments for their seizures, thereby reducing the stigma and improving the quality of their lives.
Kogan, Steven M.; Simons, Leslie G.; Chen, Yifu; Burwell, Stephanie; Brody, Gene H.
Sexually transmitted infections disproportionately affect African Americans, particularly young women. The influence of a set of interrelated protective parenting processes—instrumental and emotional support, sexual risk communication, and encouragement of goals for employment or education—on emerging adult women was examined. Parenting was hypothesized to affect consistent condom use through its association with women’s reports of power equity in their intimate relationships. Hypotheses were tested with 135 sexually active women 18 to 21 years of age living in rural southern communities. Structural equation modeling indicated that (a) parenting processes predicted women’s self-reported relationship power equity and consistent condom use, and (b) relationship power equity predicted consistent condom use. Limited support emerged for a mediational role of relationship power equity in explaining the influence of parenting on consistent condom use. Parental involvement and young women’s establishment of personal control in their intimate relationships are important goals for sexual risk reduction programs. PMID:23729949
Sanderson, Bonnie; Littleton, MaryAnn; Pulley, LeaVonne
Sixty-one African American women (ages 20-50 years) from a rural community in Alabama participated in six focus groups. Barriers to and enablers of physical activity were identified and grouped into personal, environmental (social and physical), policy, and cultural themes for qualitative analyses. Personal factors included motivation, perceived health, feeling tired, and lack of time; social environmental factors included support from friends, family, and issues related to child care; physical environmental factors included weather, access to facilities, availability of sidewalks or other places to walk; policy factors included personal safety concerns (loose dogs, traffic, etc.) and inflexible work environments. Some, but not all, women perceived cultural differences as a factor affecting physical activity levels. Differences in socioeconomic levels and time demands among women of different cultures were identified as factors that may influence physical activity. Participants provided suggestions for community-based physical activity interventions using an environmental approach.
Kershaw, Trace S; Small, Maria; Joseph, Gabriel; Theodore, Melanie; Bateau, Reginald; Frederic, Rikerdy
Given that condom use is not directly under a woman's control, the sexual division of power may play an important role in sexual behavior among pregnant women. We assessed the influence of factors related to the theory of gender and power (e.g., relationship power, abuse history, and sexual communication) on sexual behavior (e.g., two or more partners in the year prior to pregnancy, condom use, condom-use intentions, and STI diagnosis) among 196 pregnant women recruited from five community dispensaries in rural Haiti. Results showed that gender and power factors significantly related to sexual behavior. Gender and power factors were most significant for condom use and intention to use condoms, accounting for 18 and 25% of the variance above and beyond HIV knowledge and demographic covariates, respectively. These results suggest the need to create prevention interventions that restore power imbalances, provide support for women suffering abuse, and strengthen communication skills.
Soriano-Vidal, F J; Vila-Candel, R; Soriano-Martín, P J; Tejedor-Tornero, A; Castro-Sánchez, E
Maternity care has focused on lowering maternal and neonatal morbidity, though women's beliefs and expectations of care have been set aside. Women face childbirth with preconceived expectations, some of which could be expressed on their birth plan. The latter could beinfluenced by health professionals through prenatal education classes, though this has not been measured before. Antenatal classes have been argued against,since no resulting improvement in childbirth experience has been demonstrated, though some advantages may be seen: they favour communication and give time for expressing maternal expectations and beliefs. The present study evaluates the influence of prenatal educational classes led by midwives upon women birth preferences. A multicentre, observational, prospective study was carried out, measuring variables in pregnant women attending prenatal educational classes in different health centres within the health districts in Valencia (Spain) over the period January-October 2012. Birth plan preferences were compared prior to and upon completion of the classes. A total of 212 eligible pregnant women (78.3% nulliparous) with an average age of 31.39±4.0 years consented to participate in the study. There were significant differences in birth plan preferences prior to and upon completion of the prenatal classes. Three items showed an increase between the initial session and the end of the intervention: the ability to push spontaneously, episiotomy avoidance, and early breastfeeding. An adjusted general linear model was used to compare pre-post results in relation to sociodemographic and obstetric variables. The changes in birth plans could suggest that prenatal educational classes exert an influence upon maternal birth preferences. Copyright © 2018 Elsevier Ltd. All rights reserved.
Lynch, Suzanne; Bethel, Jeffrey; Chowdhury, Najmul; Moore, Justin B
Breastfeeding has extensive health benefits for both infants and mothers. Despite these benefits, a significant number of women, disproportionately low-income women, do not initiate breastfeeding. Previous research has also demonstrated that breastfeeding prevalence varies by urbanicity level. The objective was to examine race/ethnicity and urbanicity trends in breastfeeding initiation among low-income women in North Carolina from 2003 to 2007. Breastfeeding initiation data from the North Carolina Pregnancy Nutrition Surveillance System were utilized, with responses from 240,054 women over the 5-year period. Overall, 65.4% of women in mixed-urban counties and 62.1% of women in urban counties initiated breastfeeding compared to only 49.8% of women in rural counties. The disparity between rural and urban counties widened over time, with urban and mixed-urban counties making significantly greater gains in breastfeeding initiation than rural counties. Hispanic and non-Hispanic white women had 6.17 (95% confidence interval [CI], 5.99-6.36) and 1.4 (95% CI, 1.46-1.53) times the odds of initiating breastfeeding as non-Hispanic blacks, respectively. Finally, stratified multivariate regression models identified that the association between race/ethnicity and breastfeeding varied by urbanicity level. The current study provides a clearer picture of rural and urban breastfeeding trends within North Carolina and has implications for states with similar racial/ethnic and urbanicity levels. The research determined that women in rural areas, particularly non-Hispanic blacks, are less likely to initiate breastfeeding. Increased emphasis should be placed on developing breastfeeding interventions for rural communities, particularly targeting the non-Hispanic black population.
Cunningham, Kenda; Ploubidis, George B; Menon, Purnima; Ruel, Marie; Kadiyala, Suneetha; Uauy, Ricardo; Ferguson, Elaine
To examine the association between women's empowerment in agriculture and nutritional status among children under 2 years of age in rural Nepal. Cross-sectional survey of 4080 households conducted in 2012. Data collected included: child and maternal anthropometric measurements; child age and sex; maternal age, education, occupation and empowerment in agriculture; and household size, number of children, religion, caste and agro-ecological zone. Associations between the Women's Empowerment in Agriculture Index (WEAI)'s Five Domains of Empowerment (5DE) sub-index and its ten component indicators and child length-for-age Z-scores (LAZ) and weight-for-length Z-scores (WLZ) were estimated, using ordinary least-squares regression models, with and without adjustments for key child, maternal and household level covariates. Two hundred and forty rural communities across sixteen districts of Nepal. Children under 24 months of age and their mothers (n 1787). The overall WEAI 5DE was positively associated with LAZ (β=0·20, P=0·04). Three component indicators were also positively associated with LAZ: satisfaction with leisure time (β=0·27, P<0·01), access to and decisions regarding credit (β=0·20, P=0·02) and autonomy in production (β=0·10, P=0·04). No indicator of women's empowerment in agriculture was associated with WLZ. Women's empowerment in agriculture, as measured by the WEAI 5DE and three of its ten component indicators, was significantly associated with LAZ, highlighting the potential role of women's empowerment in improving child nutrition in Nepal. Additional studies are needed to determine whether interventions to improve women's empowerment will improve child nutrition.
The seroepidemiology of Helicobacter pylori infection in pregnant women in Durango, Mexico is largely unknown. The prevalence of anti-H. pylori IgG antibodies was examined in 343 pregnant women living in rural areas in 7 municipalities in Durango State, Mexico, using enzyme-linked immunosorbent assays (ELISA). A correlation of H. pylori seropositivity with socio-demographic, obstetric and behavioral characteristics of pregnant women was also assessed. In total, 179 (52.2%) of the 343 pregnant women (mean age, 24.2 ± 5.9 years) had H. pylori IgG antibodies, 75 (41.9%) of whom had H. pylori IgG antibody levels higher than 100 U/mL. The seroprevalence of H. pylori infection varied from 33.3% to 65% among municipalities. In contrast, the seroprevalence was comparable among women regardless their age, educational level, occupation, socioeconomic status, animal contacts, foreign travel, eating habits, contact with soil, crowding, sanitary conditions at home and educational level of the head of their families. Multivariant analysis of socio-demographic and behavioral variables showed that H. pylori seropositivity was associated with municipality (OR=1.12; 95% CI: 1.01–1.24; P=0.02). Of the obstetric characteristics, the seroprevalence of H. pylori infection increased significantly with the number of pregnancies and deliveries but not with the number of cesarean sections or miscarriages. Rural pregnant women in Durango had a lower seroprevalence of H. pylori infection than those from populations in developing countries. Results support a variability of H. pylori seroprevalence within a region. Further research at a municipal level might help to understand the epidemiology of H. pylori infection. PMID:24711758
The seroepidemiology of Helicobacter pylori infection in pregnant women in Durango, Mexico is largely unknown. The prevalence of anti-H. pylori IgG antibodies was examined in 343 pregnant women living in rural areas in 7 municipalities in Durango State, Mexico, using enzyme-linked immunosorbent assays (ELISA). A correlation of H. pylori seropositivity with socio-demographic, obstetric and behavioral characteristics of pregnant women was also assessed. In total, 179 (52.2%) of the 343 pregnant women (mean age, 24.2 ± 5.9 years) had H. pylori IgG antibodies, 75 (41.9%) of whom had H. pylori IgG antibody levels higher than 100 U/mL. The seroprevalence of H. pylori infection varied from 33.3% to 65% among municipalities. In contrast, the seroprevalence was comparable among women regardless their age, educational level, occupation, socioeconomic status, animal contacts, foreign travel, eating habits, contact with soil, crowding, sanitary conditions at home and educational level of the head of their families. Multivariant analysis of socio-demographic and behavioral variables showed that H. pylori seropositivity was associated with municipality (OR=1.12; 95% CI: 1.01-1.24; P=0.02). Of the obstetric characteristics, the seroprevalence of H. pylori infection increased significantly with the number of pregnancies and deliveries but not with the number of cesarean sections or miscarriages. Rural pregnant women in Durango had a lower seroprevalence of H. pylori infection than those from populations in developing countries. Results support a variability of H. pylori seroprevalence within a region. Further research at a municipal level might help to understand the epidemiology of H. pylori infection.
Torondel, Belen; Clasen, Thomas; Schmidt, Wolf-Peter
Background While women and girls face special risks from lack of access to sanitation facilities, their ability to participate and influence household-level sanitation is not well understood. This paper examines the association between women's decision-making autonomy and latrine construction in rural areas of Odisha, India. Methods We conducted a mixed-method study among rural households in Puri district. This included a cross sectional survey among 475 randomly selected households. These were classified as either having a functional latrine, a non-functional latrine or no latrine at all. We also conducted 17 in-depth interviews and 9 focus group discussions among household members of these three categories of households. Results Decisions on the construction of household level sanitation facilities were made exclusively by the male head in 80% of households; in 11% the decision was made by men who consulted or otherwise involved women. In only 9% of households the decision was made by women. Households where women were more involved in general decision making processes were no more likely to build a latrine, compared to households where they were excluded from decisions. Qualitative research revealed that women’s non-involvement in sanitation decision making is attributed to their low socio-economic status and inability to influence the household’s financial decisions. Female heads lacked confidence to take decisions independently, and were dependent on their spouse or other male family members for most decisions. The study revealed the existence of power hierarchies and dynamics within households, which constrained female’s participation in decision-making processes regarding sanitation. Conclusions Though governments and implementers emphasize women’s involvement in sanitation programmes, socio-cultural factors and community and household level dynamics often prevent women from participating in sanitation-related decisions. Measures are needed for
Joyce, Lynda M.; Leadley, Samuel M.
Recently, there has been much discussion and media attention focusing on women in rural areas, especially on women in farming. It is timely to delve into the research which has been done in this area in the past, what research is presently being undertaken and what research concerns are emerging for the future. The chronological review presented…
A study was conducted at a rural community college to explore the process by which adult women who had returned to college decided whether to persist or drop out. In-depth interviews were conducted with 17 women who had been identified as exceptional in that they either persisted and graduated even though they had been initially identified as…
Abuya, Benta A.; Onsomu, Elijah O.; Moore, DaKysha; Piper, Crystal N.
The objective of this study was to examine the association between education and domestic violence among women being offered an HIV test in urban and rural areas in Kenya. A sample selection of women who experienced physical (n = 4,308), sexual (n = 4,309), and emotional violence (n = 4,312) aged 15 to 49 allowed for the estimation of the…
Using a critical theory framework, the article explores emancipatory narratives obtained through a case study of women in rural India. In-depth interviews, focus group conversations, observations, and document analysis highlight the complexity of the subsequent set of challenges facing women as it relates to both the education and empowerment for…
Urquieta-Salomon, Jose E.; Tepichin-Valle, Ana Maria; Tellez-Rojo, Martha Maria
The objective of this study is to evaluate the impact of a pilot study that promoted productive and capacity-building activities among deprived rural women of Mexico. The evaluation design is observational; 1,278 women are interviewed, and the comparison group is estimated by propensity score matching. The results show a positive impact on the…
Ahmed, Zebun N.
A study explored how rural women in the village of Srefultoli, Bangladesh describe, from their own point of view, their experiences with nonformal education (NFE). Feminist research has shown that existing NFE programs in developing countries give women traditional knowledge of family planning, nutrition, and health care, but they do not deal with…
Park, Rosemarie J.
A study to examine literacy programs for women in rural villages in India interviewed all program directors and staff and some women involved in nongovernmental (NGO) projects in the Pune area. NGO officials were universally disenchanted with government programs. NGOs' goals varied from preschool education in the villages to agricultural reform to…
Fan, Xiaojing; Wang, Weihua; Liu, Ruru; Dang, Shaonong; Kang, Yijun
To study the current status and risk factors of spontaneous abortion of women with Tibetan ethnicity at reproductive age in rural areas. Pregnant women who lived in Tibet were interviewed on their former reproductive history and being followed on the outcomes of pregnant from 2006 to 2012. Generalized Poisson regression model was used to explore the influencing factors of spontaneous abortion. OR value of the research factors was estimated and its 95% confidence interval counted. There were 1 557 pregnant women under this study, with a total number of 2 687 pregnancies and 2 382 productions. 171 women underwent spontaneous abortion, with a total number of 204 times, 93 women had histories of abortion, with a total number of 101 times. Among all the Tibetan pregnant women, the ratio between spontaneous abortion and pregnant women was 7.6% while the rate of spontaneous abortion was 7.9% . Ratio between the number of women who had experienced spontaneous abortion and the total number of women under survey was 11.0% . Pregnancy appeared the important reason on spontaneous abortion. The risk of having spontaneous abortion would increase among women who had more than 3 pregnancies. Results from Poisson regression analysis revealed that the odds ratio (OR) value before the adjustment was 3.921 (95% CI:2.553-6.021) but after the adjustment, it increased to 4.722 (95% CI:2.834-7.866). The increase of production time could reduce the risk of spontaneous abortion in women of childbearing age. Risks related to spontaneous abortion were associated with the number of pregnancies. Women seemed to have lower risk for spontaneous abortion after 2009, with OR value as 0.419 (95%CI:0.285-0.616) before, compared to aOR value as 0.580 (95%CI:0.380-0.885) after the adjustment Social-demographic characteristics was not found to be particularly associated with the occurrence of spontaneous abortion. Rate of spontaneous abortion among Tibetan women at childbearing age was not particularly
Weaver, Addie; Himle, Joseph A.; Taylor, Robert Joseph; Matusko, Niki N.; Abelson, Jamie M.
IMPORTANCE There is a paucity of research among African Americans and rural residents. Little is known about the association between urbanicity and depression or about the interaction of urbanicity, race/ethnicity, and sex on depression and mood disorder prevalence. OBJECTIVE To examine the interaction of urbanicity and race/ethnicity on lifetime and 12-month major depressive disorder (MDD) and mood disorder prevalence for African American women and non-Hispanic white women. DESIGN, SETTING, AND PARTICIPANTS The US National Survey of American Life data were used to examine the interaction of urbanicity and race/ethnicity on lifetime and 12-month diagnoses of DSM-IV MDD and mood disorder among female respondents, who included noninstitutionalized African American, Caribbean black, and non-Hispanic white women in the United States between February 2001 and June 2003. Participants included 1462 African American women and 341 non-Hispanic white women recruited from the South because all suburban and rural National Survey of American Life respondents resided in this region. Bivariate multiple logistic regression and adjusted prevalence analyses were performed. Urban, suburban, or rural location (assessed via Rural-Urban Continuum Codes), self-reported race/ethnicity, and sociodemographic factors (age, education, household income, and marital status) were included in the analysis. MAIN OUTCOMES AND MEASURES Lifetime and 12-month MDD and mood disorder assessed via the World Mental Health Composite International Diagnostic Interview. RESULTS Compared with urban African American women, rural African American women had a significantly lower odds of meeting criteria for lifetime (odds ratio [OR], 0.39; 95% CI, 0.23–0.65) and 12-month (OR, 0.29; 95% CI, 0.18–0.46) MDD and for lifetime (F = 0.46; 95% CI, 0.29–0.73) and 12-month (F = 0.42; 95% CI, 0.26–0.66) mood disorder. However, the interaction of urbanicity and race/ethnicity suggested that rural non-Hispanic white
This paper examines the influence of informal banking club participation on family planning practices in rural Ghana. Research from Asia suggests that family planning practices are improved by club participation. This study examines this thesis in an African context, using rural Ghana as a case study. A sample of 204 women (19 years and older) was drawn from Abokobi village, Ghana. Multivariate analyses of direct, mediating and moderating effects of women’s demographic background characteristics, membership status and length, and women’s empowerment status as predictors of family planning practices are assessed. Findings suggest that club membership and membership length is not associated with family planning practices; however, age, education level, number of children and empowerment status are.
Ranganathan, Meghna; Heise, Lori; Pettifor, Audrey; Silverwood, Richard J; Selin, Amanda; MacPhail, Catherine; Delany-Moretlwe, Sinead; Kahn, Kathleen; Gómez-Olivé, F Xavier; Hughes, James P; Piwowar-Manning, Estelle; Laeyendecker, Oliver; Watts, Charlotte
Introduction Young adolescent women in sub-Saharan Africa are three to four times more likely to be HIV-positive than boys or men. One of the relationship dynamics that is likely to be associated with young women's increased vulnerability to HIV is transactional sex. There are a range of HIV-related risk behaviours that may drive this vulnerability. However, to date, limited epidemiological data exist on the role of transactional sex in increasing HIV acquisition, especially among young women in sub-Saharan Africa. Our paper presents data on the prevalence of self-reported engagement in transactional sex and explores whether transactional sex is associated with increased risk of HIV infection among a cohort of young, rural, sexually active South African women. We also explore whether this relationship is mediated through certain HIV-related risk behaviours. Methods We analyzed baseline data from a phase III trial of conditional cash transfers for HIV prevention of 693 sexually active, school-going young women aged 13–20 years in rural South Africa. We examined the association between young women's engagement in transactional sex and HIV infection. Transactional sex is defined as a non-commercial, non-marital sexual relationship whereby sex is exchanged for money and/or gifts. We explored whether this relationship is mediated by certain HIV-related risk behaviours. We used logistic and multinomial regression and report unadjusted and adjusted odds ratios with 95% CI. Results Overall, 14% (n=97) of sexually active young women reported engaging in transactional sex. Engagement in transactional sex was associated with an increased risk of being HIV-positive (aOR: 2.5, CI: 95% 1.19–5.25, p=0.01). The effect size of this association remained nearly unchanged when adjusted for certain other dimensions of HIV risk that might help explain the underlying pathways for this relationship. Conclusions This study provides quantitative support demonstrating that transactional
Ranganathan, Meghna; Heise, Lori; Pettifor, Audrey; Silverwood, Richard J; Selin, Amanda; MacPhail, Catherine; Delany-Moretlwe, Sinead; Kahn, Kathleen; Gómez-Olivé, F Xavier; Hughes, James P; Piwowar-Manning, Estelle; Laeyendecker, Oliver; Watts, Charlotte
Young adolescent women in sub-Saharan Africa are three to four times more likely to be HIV-positive than boys or men. One of the relationship dynamics that is likely to be associated with young women's increased vulnerability to HIV is transactional sex. There are a range of HIV-related risk behaviours that may drive this vulnerability. However, to date, limited epidemiological data exist on the role of transactional sex in increasing HIV acquisition, especially among young women in sub-Saharan Africa. Our paper presents data on the prevalence of self-reported engagement in transactional sex and explores whether transactional sex is associated with increased risk of HIV infection among a cohort of young, rural, sexually active South African women. We also explore whether this relationship is mediated through certain HIV-related risk behaviours. We analyzed baseline data from a phase III trial of conditional cash transfers for HIV prevention of 693 sexually active, school-going young women aged 13-20 years in rural South Africa. We examined the association between young women's engagement in transactional sex and HIV infection. Transactional sex is defined as a non-commercial, non-marital sexual relationship whereby sex is exchanged for money and/or gifts. We explored whether this relationship is mediated by certain HIV-related risk behaviours. We used logistic and multinomial regression and report unadjusted and adjusted odds ratios with 95% CI. Overall, 14% (n=97) of sexually active young women reported engaging in transactional sex. Engagement in transactional sex was associated with an increased risk of being HIV-positive (aOR: 2.5, CI: 95% 1.19-5.25, p=0.01). The effect size of this association remained nearly unchanged when adjusted for certain other dimensions of HIV risk that might help explain the underlying pathways for this relationship. This study provides quantitative support demonstrating that transactional sex is associated with HIV infection in young
Pembe, Andrea B; Mbekenga, Columba K; Olsson, Pia; Darj, Elisabeth
In most low-income countries, many women with high-risk pregnancies and complications do not reach the referral hospitals despite the provision of referral advice. To explore how antenatal maternal referral advice is understood and handled in a rural Tanzanian community. Individual in-depth interviews were conducted with six women who did not go to hospital and 13 people who were involved in the referral advice. Narrative analysis was used to describe and create meanings out of the decision-making process. In all interviews, not following the referral advice was greatly influenced by close family members. Three main traits of how referral advice was understood emerged: convinced referral is not necessary, accepting referral advice but delayed by others, and passive and moving with the wind. The main reasons given for declining the referral advice included discrediting midwives' advice, citing previous successful deliveries despite referral advice; being afraid of undergoing surgery; lack of support for care of siblings at home; and high costs incurred during referral. Declining maternal referral advice centred around the pregnant women's position and their dependence on the family members around them, with a decreased ability to show autonomy. If they were socially and economically empowered, women could positively influence decision making during maternal referrals.
The global fight against HIV is progressing; however, women living in rural areas particularly in sub-Saharan Africa (SSA) continue to face the devastating consequences of HIV and AIDS. Lack of knowledge and geographical barriers to HIV services are compounded by gender norms often limiting the negotiation of safe sexual practices among women living in rural areas. This paper discusses findings from a qualitative study conducted in rural areas of Mozambique examining factors that influenced women to engage in HIV risk-reduction practices. The findings from this study led to the emergence of an HIV and AIDS risk assessment and reduction (HARAR) model, which is described in detail. The model helps in understanding gender-related factors influencing men and women to engage in risk-reduction practices, which can be used as a framework in other settings to design more nuanced and contextual policies and programs. PMID:25089093
Gipson, Jessica D; Gyaltsen, Kunchok; Gyal, Lhusham; Kyi, Tsering; Hicks, Andrew L; Pebley, Anne R
To identify sociodemographic characteristics and factors involved in Tibetan women's decisions to deliver at the Tibetan Birth and Training Center (TBTC) in rural western China. In the present mixed-methods study, a random sample of married women who delivered at the TBTC between June 2011 and June 2012 were surveyed. Additionally, four focus group discussions were conducted among married women living in the TBTC catchment area. Descriptive analyses were conducted, and dominant themes were identified. In focus group discussions, women (n=33) reported that improved roads and transportation meant that access to health facilities was easier than in the past. Although some of the 114 survey participants voiced negative perceptions of healthcare facilities and providers, 99 (86.8%) indicated that they chose to deliver at the TBTC because they preferred to have a doctor present. Most women (75 [65.8%]) said their mother/mother-in-law made the final decision about delivery location. Women valued logistic and cultural aspects of the TBTC, and 108 (94.7%) said that they would recommend the TBTC to a friend. Study participants preferred delivery care that combines safety and comfort. The findings highlight avenues for further promotion of facility delivery among populations with lower rates of skilled deliveries. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Karim, Rabiul; Lindberg, Lene; Wamala, Sarah; Emmelin, Maria
Without taking masculine issues into account, women's participation in development initiatives does not always guarantee their empowerment, health, and welfare in a male-dominated society. This study aimed to explore men's perceptions of women's participation in development (WPD) in rural Bangladesh. In adopting a qualitative approach, the study examined 48 purposively selected married and unmarried men aged 20-76 years in three northwest villages. Data collection was accomplished through four focus group discussions (FGDs) with 43 men clustered into four groups and through individual interviews with five other men. A qualitative content analysis of the data revealed an overall theme of "feeling challenged by fears and hopes," indicating variations in men's views on women's participation in development initiatives as represented by three main categories: (a) fearing the loss of male authority, (b) recognizing women's roles in enhancing family welfare, and (c) valuing women's independence. In the context of dominant patriarchal traditions in Bangladesh, these findings provide new insight into dynamics and variations of men's views, suggesting a need to better engage men during different stages of women-focused development initiatives.
Inasmuch as women's subordinate status is a product of the patriarchal structures of constraint that prevail in specific contexts, pathways of women's empowerment are likely to be "path dependent." They will be shaped by women's struggles to act on the constraints that prevail in their societies, as much by what they seek to defend as by what they seek to change. The universal value that many feminists claim for individual autonomy may not therefore have the same purchase in all contexts. This article examines processes of empowerment as they play out in the lives of women associated with social mobilization organizations in the specific context of rural Bangladesh. It draws on their narratives to explore the collective strategies through which these organizations sought to empower the women and how they in turn drew on their newly established "communities of practice" to navigate their own pathways to wider social change. It concludes that while the value attached to social affiliations by the women in the study is clearly a product of the societies in which they have grown up, it may be no more context-specific than the apparently universal value attached to individual autonomy by many feminists.
Paczkowski, Magdalena; Mbaruku, Godfrey; de Pinho, Helen; Galea, Sandro
Objectives. We fielded a population-based discrete choice experiment (DCE) in rural western Tanzania, where only one third of women deliver children in a health facility, to evaluate health-system factors that influence women's delivery decisions. Methods. Women were shown choice cards that described 2 hypothetical health centers by means of 6 attributes (distance, cost, type of provider, attitude of provider, drugs and equipment, free transport). The women were then asked to indicate which of the 2 facilities they would prefer to use for a future delivery. We used a hierarchical Bayes procedure to estimate individual and mean utility parameters. Results. A total of 1203 women completed the DCE. The model showed good predictive validity for actual facility choice. The most important facility attributes were a respectful provider attitude and availability of drugs and medical equipment. Policy simulations suggested that if these attributes were improved at existing facilities, the proportion of women preferring facility delivery would rise from 43% to 88%. Conclusions. In regions in which attended delivery rates are low despite availability of primary care facilities, policy experiments should test the effect of targeted quality improvements on facility use. PMID:19608959
Saroha, Ekta; Altarac, Maja; Sibley, Lynn M
The objective of this study was to examine the association between caste and maternal health care service use among rural Hindu women in India. We analyzed data from the Morbidity and Performance Assessment, a population-based cross-sectional study, for 482 Hindu women who were pregnant during January 1998 to January 1999 in Maitha, Uttar Pradesh, India. Maternal health care service use among both upper and lower caste women was very low. Upper caste women were almost three times more likely to use antenatal care (odds ratio [OR] = 2.72; 95% confidence interval [CI], 1.40-5.30), tetanus toxoid (OR = 2.50; 95% CI, 1.48-4.21), and contraceptives (OR = 2.66; 95% CI, 1.28-5.54) and almost five times (OR = 4.77; 95% CI, 1.81-12.54) more likely to have a trained birth attendant compared to the lower caste women. Caste was a significant determinant of tetanus toxoid use and trained birth attendant even after adjusting for sociodemographic factors. Besides caste, maternal literacy was the one sociodemographic factor that was significantly associated with the use of all maternal health care services. Information dissemination and awareness generation can improve the use of subsidized maternal health care services among women of all caste groups.
Kornelsen, Jude; McCartney, Kevin; Williams, Kim
This article was developed as part of a larger realist review investigating the viability and efficacy of decentralized models of perinatal surgical services for rural women in the context of recent and ongoing service centralization witnessed in many developed nations. The larger realist review was commissioned by the British Columbia Ministry of Health and Perinatal Services of British Columbia, Canada. Findings from that review are addressed in this article specific to the sustainability of rural perinatal surgical sites and the satisfaction of providers that underpins their recruitment to and retention at such sites. A realist method was used in the selection and analysis of literature with the intention to iteratively develop a sophisticated understanding of how perinatal surgical services can best meet the needs of women who live in rural and remote environments. The goal of a realist review is to examine what works for whom under what circumstances and why. The high sensitivity search used language (English) and year (since 1990) limiters in keeping with both a realist and rapid review tradition of using reasoned contextual boundaries. No exclusions were made based on methodology or methodological approach in keeping with a realist review. Databases searched included MEDLINE, PubMed, EBSCO, CINAHL, EBM Reviews, NHS Economic Evaluation Database and PAIS International for literature in December 2013. Database searching produced 103 included academic articles. A further 59 resources were added through pearling and 13 grey literature reports were added on recommendation from the commissioner. A total of 42 of these 175 articles were included in this article as specific to provider satisfaction and service sustainability. Operative perinatal practice was found to be a lynchpin of sustainable primary and surgical services in rural communities. Rural shortages of providers, including challenges with recruitment and retention, were found to be a complex issue, with
Gao, Guo-Peng; Zhang, Ren-Jie; Zhang, Xiu-Jun; Jia, Xiao-Min; Li, Xiu-De; Li, Xiang; Wang, Cheng-Cheng; Tong, Fei; Sun, Ye-Huan
This study aims to assess the prevalence of and factors associated with induced abortion among married women in rural areas of Anhui Province, China. A multistage probability sampling method was used to identify a representative sample of 53,652 married women aged 18-49 years in rural areas of Anhui Province, China. All women were interviewed in the form of a standardized questionnaire. We found that 32.0% (16,800) of these women had had at least one induced abortion: 21.1% (11,090) of women had had one; 7.6% (3976) of women had had two; and 4.1% (1734) of women had had at least three. The number of induced abortions per 100 pregnancies was found to be 22.0. Multivariate analysis showed that education, the age of a woman at her first marriage, number of total births, number of total pregnancies, and contraceptive methods were significant predictors for induced abortion after controlling for women's current age, employment and family yearly income. The study shows that the prevalence of induced abortion is still very high among married women in rural China, and highly effective methods of contraception (sterilization, intrauterine device) decrease women's recourse to induced abortion. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.
Staton-Tindall, Michele; Harp, Kathi LH; Minieri, Alexandra; Oser, Carrie; Webster, J. Matthew; Havens, Jennifer; Leukefeld, Carl
Objective Rural women, particularly those involved in the criminal justice system, are at risk for HIV due to the increasing prevalence of injection drug use, as well as limited services. Research on HIV risk correlates, including drug use and mental health, has primarily focused on urban women incarcerated in prisons. The purpose of this exploratory study is to examine dual HIV risk behavior by three different mental health problems (depression, anxiety, and PTSD) among drug-using women in rural jails. Methods This study involved random selection, screening, and face-to-face interviews with 136 women from rural jails in one Appalachian state. Analyses focused on the relationship between mental health and HIV risk among this sample of drug-using women. Findings Nearly 80% of women self-reported symptoms of depression, and more than 60% endorsed symptoms consistent with anxiety and PTSD symptoms. Mental health was significantly correlated with severity of certain types of drug use, as well as risky sexual activity. In addition, for women experiencing anxiety and PTSD, injection drug use moderated the relationship between mental health and risky sexual activity. Implications Based on these rates of drug use, mental health problems, and the emergence of injection drug use in rural Appalachia, the need to explore the relationships between these issues among vulnerable and understudied populations, such as rural women, is critical. Due to service limitations in rural communities, criminal justice venues such as jails provide opportune settings for screening, assessment, and intervention for drug use, mental health, and HIV education and prevention. PMID:25799305
Sileo, Katelyn M; Wanyenze, Rhoda K; Lule, Haruna; Kiene, Susan M
Uganda has one of the highest unmet needs for family planning globally, which is associated with negative health outcomes for women and population-level public health implications. The present cross-sectional study identified factors influencing family planning service uptake and contraceptive use among postpartum women in rural Uganda. Participants were 258 women who attended antenatal care at a rural Ugandan hospital. We used logistic regression models in SPSS to identify determinants of family planning service uptake and contraceptive use postpartum. Statistically significant predictors of uptake of family planning services included: education (AOR = 3.03, 95 % CI 1.57-5.83), prior use of contraceptives (AOR = 7.15, 95 % CI 1.58-32.37), partner communication about contraceptives (AOR = 1.80, 95 % CI 1.36-2.37), and perceived need of contraceptives (AOR = 2.57, 95 % CI 1.09-6.08). Statistically significant predictors of contraceptive use since delivery included: education (AOR = 2.04, 95 % CI 1.05-3.95), prior use of contraceptives (AOR = 10.79, 95 % CI 1.40-83.06), and partner communication about contraceptives (AOR = 1.81, 95 % CI 1.34-2.44). Education, partner communication, and perceived need of family planning are key determinants of postpartum family planning service uptake and contraceptive use, and should be considered in antenatal and postnatal family planning counseling.
Wylie, Blair J; Ae-Ngibise, Kenneth A; Boamah, Ellen A; Mujtaba, Mohammed; Messerlian, Carmen; Hauser, Russ; Coull, Brent; Calafat, Antonia M; Jack, Darby; Kinney, Patrick L; Whyatt, Robin; Owusu-Agyei, Seth; Asante, Kwaku P
Use of pesticides by households in rural Ghana is common for residential pest control, agricultural use, and for the reduction of vectors carrying disease. However, few data are available about exposure to pesticides among this population. Our objective was to quantify urinary concentrations of metabolites of organophosphate (OP), pyrethroid, and select herbicides during pregnancy, and to explore exposure determinants. In 2014, 17 pregnant women from rural Ghana were surveyed about household pesticide use and provided weekly first morning urine voids during three visits ( n = 51 samples). A total of 90.1% (46/51) of samples had detectable OP metabolites [geometric mean, GM (95% CI): 3,5,6-trichloro-2-pyridinol 0.54 µg/L (0.36-0.81), para-nitrophenol 0.71 µg/L (0.51-1.00)], 75.5% (37/49) had detectable pyrethroid metabolites [GM: 3-phenoxybenzoic acid 0.23 µg/L (0.17, 0.32)], and 70.5% (36/51) had detectable 2,4-dichlorophenoxyacetic acid levels, a herbicide [GM: 0.46 µg/L (0.29-0.73)]. Concentrations of para-nitrophenol and 2,4-dichlorophenoxyacetic acid in Ghanaian pregnant women appear higher when compared to nonpregnant reproductive-aged women in a reference U.S. Larger studies are necessary to more fully explore predictors of exposure in this population.
Langille, Donald B; Hughes, Jean; Murphy, Gail Tomblin; Rigby, Janet A
To examine contraceptive methods used by rural adolescent women and socio-demographic factors associated with not using effective contraception. Students in three Nova Scotia high schools participated in a survey concerning sexual activity, behaviours, and contraception used at last intercourse. Proportions using no effective contraception were examined with respect to socio-demographic variables. The overall response rate was 80%; 46% of 922 young women aged 15-19 had had intercourse in the previous year. Of these, 87% used effective contraception at last intercourse. Average school mark < 80%, and having a father with less than high school education were associated with not using effective contraception. Mother's education and employment, family structure, age of first intercourse and importance of religion were not associated with lack of contraception. Using no, or ineffective, contraception at last intercourse was seen in fewer young women than has been seen in other Canadian studies. In addition to examining use of contraception in rural Canadian adolescents, the study provides evidence concerning factors for consideration in targeted interventions.
Peppercorn, Jeffrey; Horick, Nora; Houck, Kevin; Rabin, Julia; Villagra, Victor; Lyman, Gary H; Wheeler, Stephanie B
Rural US women experience disparities in breast cancer screening and outcomes. In 2006, a national rural health insurance provider, the National Rural Electric Cooperative Association (NRECA), eliminated out-of-pocket costs for screening mammography. This study evaluated the elimination of cost sharing as a natural experiment: it compared trends in screening before and after the policy change. NRECA insurance claims data were used to identify all women aged 40 to 64 years who were eligible for breast cancer screening, and mammography utilization from 1998 through 2011 was evaluated. Repeated measures regression models were used to evaluate changes in utilization over time and the association between screening and sociodemographic factors. The analysis was based on 45,738 women enrolled in the NRECA membership database for an average of 6.1 years and included 279,940 person-years of enrollment. Between 1998 and 2011, the annual screening rate increased from 35% to a peak of 50% among women aged 40 to 49 years and from 49% to 58% among women aged 50 to 64 years. The biennial screening rate increased from 56% to 66% for women aged 40 to 49 years and from 68% to 73% for women aged 50 to 64 years. Screening rates increased significantly (P < .0001) after the elimination of cost sharing and then declined slightly after changes to government screening guidelines in 2009. Younger women experienced greater increases in both annual screening (6.2%) and biennial screening (5.6%) after the elimination of cost sharing in comparison with older women (3.0% and 2.6%, respectively). In a multivariate analysis, rural residence, lower population income, and lower population education were associated with modestly lower screening. In a national sample of predominantly rural working-age women, the elimination of cost sharing correlated with increased breast cancer screening. Cancer 2017;123:2506-15. © 2017 American Cancer Society. © 2017 American Cancer Society.
Kimoto, Riko; Ronquillo, Dolores; Caamaño, Maria C; Martinez, Guadalupe; Schubert, Lisa; Rosado, Jorge L; Garcia, Olga; Long, Kurt Z
Qualitative research using semi-structured interviews and key informant interviews were used to explore how women from low socioeconomic rural households in Queretaro State, Mexico perceived and reacted to their obesogenic environment. Reduced availability of healthy food options and household financial constraints along with reduced agency of women in this setting were factors that limited women's ability to access and consume diets consistent with the promotion of good health. The cultural values that emphasised obesity as a desirable state for women and the women's social networks that promoted these values were also identified as playing a role in reinforcing certain behaviours. Public health advocates wanting to design interventions in such settings need to be sensitive to the cultural as well as the environmental context described for rural Mexican women. © 2013 The Authors. Published by Elsevier Ltd All rights reserved.
Okonofua, Friday; Ntoimo, Lorretta; Ogungbangbe, Julius; Anjorin, Seun; Imongan, Wilson; Yaya, Sanni
Although Primary Health Care (PHC) was designed to provide universal access to skilled pregnancy care for the prevention of maternal deaths, very little is known of the factors that predict the use of PHC for skilled maternity care in rural parts of Nigeria - where its use is likely to have a greater positive impact on maternal health care. The objective of this study was to identify the factors that lead pregnant women to use or not use existing primary health care facilities for antenatal and delivery care. The study was a cross-sectional community-based study conducted in Esan South East and Etsako East LGAs of Edo State, Nigeria. A total of 1408 randomly selected women of reproductive age were interviewed in their households using a pre-tested structured questionnaire. The data were analyzed with descriptive and multivariate statistical methods. The results showed antenatal care attendance rate by currently pregnant women of 62.1%, and a skilled delivery of 46.6% by recently delivered women at PHCs, while 25% of women delivered at home or with traditional birth attendants. Reasons for use and non-use of PHCs for antenatal and delivery care given by women were related to perceptions about long distances to PHCs, high costs of services and poor quality of PHC service delivery. Chi-square test of association revealed that level of education and marital status were significantly related to use of PHCs for antenatal care. The results of logistic regression for delivery care showed that women with primary (OR 3.10, CI 1.16-8.28) and secondary (OR 2.37, CI 1.19-4.71) levels education were more likely to receive delivery care in PHCs than the highly educated. Being a Muslim (OR 1.56, CI 1.00-2.42), having a partner who is employed in Estako East (OR 2.78, CI 1.04-7.44) and having more than five children in Esan South East (OR 2.00, CI 1.19-3.35) significantly increased the odds of delivery in PHCs. The likelihood of using a PHC facility was less for women who had more
Estévez-López, Fernando; Camiletti-Moirón, Daniel; Aparicio, Virginia A; Segura-Jiménez, Víctor; Álvarez-Gallardo, Inmaculada C; Soriano-Maldonado, Alberto; Borges-Cosic, Milkana; Acosta-Manzano, Pedro; Geenen, Rinie; Delgado-Fernández, Manuel; Martínez-González, Luis J; Ruiz, Jonatan R; Álvarez-Cubero, María J
Candidate-gene studies on fibromyalgia susceptibility often include a small number of single nucleotide polymorphisms (SNPs), which is a limitation. Moreover, there is a paucity of evidence in Europe. Therefore, we compared genotype frequencies of candidate SNPs in a well-characterised sample of Spanish women with fibromyalgia and healthy non-fibromyalgia women. A total of 314 women with a diagnosis of fibromyalgia (cases) and 112 non-fibromyalgia healthy (controls) women participated in this candidate-gene study. Buccal swabs were collected for DNA extraction. Using TaqMan™ OpenArray™, we analysed 61 SNPs of 33 genes related to fibromyalgia susceptibility, symptoms, or potential mechanisms. We observed that the rs841 and rs1799971 GG genotype was more frequently observed in fibromyalgia than in controls (p = 0.04 and p = 0.02, respectively). The rs2097903 AT/TT genotypes were also more often present in the fibromyalgia participants than in their control peers (p = 0.04). There were no differences for the remaining SNPs. We identified, for the first time, associations of the rs841 (guanosine triphosphate cyclohydrolase 1 gene) and rs2097903 (catechol-O-methyltransferase gene) SNPs with higher risk of fibromyalgia susceptibility. We also confirmed that the rs1799971 SNP (opioid receptor μ1 gene) might confer genetic risk of fibromyalgia. We did not adjust for multiple comparisons, which would be too stringent and yield to non-significant differences in the genotype frequencies between cases and controls. Our findings may be biologically meaningful and informative, and should be further investigated in other populations. Of particular interest is to replicate the present study in a larger independent sample to confirm or refute our findings. On the other hand, by including 61 SNPs of 33 candidate-genes with a strong rationale (they were previously investigated in relation to fibromyalgia susceptibility, symptoms or potential mechanisms), the present
Greco, Giulia; Skordis-Worrall, Jolene; Mkandawire, Bryan; Mills, Anne
There is growing interest in using Sen's Capability Approach to assess quality of life and to evaluate social policies. This paper describes the formative stages of developing a quality of life measure: the selection of the relevant capabilities. This measure is intended to provide a more comprehensive outcome measure for the evaluation of complex interventions such as Maimwana womens' groups, a community based participatory intervention to improve maternal health in rural Malawi. Fifteen focus group discussions with 129 women were conducted to explore relevant concepts of quality of life in rural Malawi. Data collection started in October 2009. Findings were elicited based on framework analysis. The findings portray a complex and highly nuanced perception that women in rural Malawi have of their life and wellbeing. Quality of life was described using a variety of dimensions that are highly interconnected. Quality of life emerges to be not only shaped by the realisation of basic material needs such as being sufficiently nourished and adequately sheltered, but is also highly dependent on complex feelings, relations and social norms. The full exposition of wellbeing with its domains was organised into a framework constituting six different spheres of wellbeing: physical strength, inner wellbeing, household wellbeing, community relations, economic security and happiness. Despite the list being developed in a specific context and for a specific group of people, the similarities with lists developed in other contexts, with different methods and for different purposes, are considerable. This suggests that there are a number of core aspects of wellbeing considered a minimum requirement for a life of human dignity, that should be included in any attempt to assess quality of life and human development across populations. Copyright © 2015 Elsevier Ltd. All rights reserved.
Zimmermann, Kristine; Khare, Manorama M; Wright, Cherie; Hasler, Allison; Kerch, Sarah; Moehring, Patricia; Geller, Stacie
Rural populations in the United States experience unique challenges in health and health care. The health of rural women, in particular, is influenced by their knowledge, work and family commitments, as well as environmental barriers in their communities. In rural southern Illinois, the seven southernmost counties form a region that experiences high rates of cancer and other chronic diseases. To identify, understand, and prioritize the health needs of women living in these seven counties, a comprehensive gender-based community health assessment was conducted with the goal of developing a plan to improve women's health in the region. A gender-analysis framework was adapted, and key stakeholder interviews and focus groups with community women were conducted and analyzed to identify factors affecting ill health. The gender-based analysis revealed that women play a critical role in the health of their families and their communities, and these roles can influence their personal health. The gender-based analysis also identified several gender-specific barriers and facilitators that affect women's health and their ability to engage in healthy behaviors. These results have important implications for the development of programs and policies to improve health among rural women. Copyright © 2014 Elsevier Ltd. All rights reserved.
Khambalia, Amina; O'Connor, Deborah L; Zlotkin, Stanley
Recent evidence suggests that poor fetal growth is associated with preconception anemia and first trimester iron deficiency. Periconceptional iron and folate supplementation may improve the effectiveness of iron supplementation programs during pregnancy by treating preexisting anemia, building iron stores, and reducing risk of neural tube defects. Our objective in this study was to describe the iron and folate status of married, nulliparous women in rural Bangladesh from March to May 2007. Of 272 women, 37% were anemic (hemoglobin <120 g/L), 13% were folate deficient (plasma folate
Pentapati, Kalyana Chakravarthy; Acharya, Shashidhar; Bhat, Meghashyam; Rao, Sreevidya Krishna; Singh, Sweta
To assess the knowledge of dental decay among pregnant women and its relationship with sociodemographic characteristics and caries experience in rural India. A cross-sectional study was conducted among 381 pregnant women in southern India. Variables and knowledge of dental decay were recorded using a structured self-administered questionnaire. Dental caries was recorded by a calibrated examiner as per WHO guidelines. The majority of the respondents were under 30 years of age (91.6%), utilised a public health-care delivery system (57.2%), were primigravid (63%), had a pre-universtiy diploma (64.8%) and were in the 3rd trimester (63%). Overall, poor knowledge was expressed by 12% to 37% of the women. The mean (±SD) DT (decayed teeth), MT (missing teeth), FT (filled teeth) and DMFT (decayed, missing and filled teeth) were 3.08 (±2.6), 0.93 (±2.23), 0.39 (±1.14) and 4.4 (±3.56), respectively. There were no significant differences in the responses to the knowledge of caries with respect to age and trimester. Educational status, health-care delivery system and number of pregnancies had a significant association with knowledge of caries. This study highlighted the limited knowledge of dental decay among pregnant, rural, southern Indian women. Preventive programmes for pregnant women should be designed based upon a thorough interview including an informative session on the specific risks during this period, in order to motivate the patient towards oral health and implement the needed prophylactic measures.
August, Suzanne L.; De Rosa, Michael J.
Objective Urinary tract infection (UTI) is the most common non-intestinal infection worldwide. In the developed world, incidence and prevalence of UTI would be similar owing to the relatively short duration of illness experienced by women with ready access to healthcare services. We hypothesize that, in the developing world, factors limiting access to care and those which may increase the likelihood of developing UTI, result in increased morbidity. This difference is reflected in an increased prevalence of UTI in regions where women suffer the effects of UTI for extended periods of time. Methods This study represents a cross sectional analysis of UTI prevalence in rural western Panama conducted over the course of a 3-day medical mission. All women 18–45 years of age reporting to the medical brigade clinic were tested for UTI by dipstick urinalysis and a brief history regardless of whether they themselves were presenting with a complaint. Results UTI was diagnosed clinically by providers in 29.8% of the women tested although only 21.15% of these same women met the evidence-based study criteria. This prevalence of 21.15% is seven times greater than reported by the Panamanian Ministry of Health. When comparing the effectiveness of clinical diagnosis relative to urinalysis by dipstick, a Kappa coefficient revealed only low moderate agreement (0.42; SE 0.0955). Conclusions The prevalence of UTI in rural western Panama is greater than would be expected based on prevalence data from either the US or Panamanian Ministry of Health and may represent an opportunity for targeted interventions, including educational programming about UTI prevention. PMID:23094080
Sterling, Samara; Judd, Suzanne; Bertrand, Brenda; Carson, Tiffany L; Chandler-Laney, Paula; Baskin, Monica L
Obesity and chronic diseases disproportionately affect African-American women in the rural South (US) and may be influenced by adherence to a typical Southern-style diet. There is a need to examine dietary patterns of this population and to determine if consumption of nutritionally rich foods like nuts is associated with consumption of other nutritious foods. The objectives of this study were to identify (1) dietary patterns of overweight/obese African-American women in the rural South; (2) the role that nuts play in the diet; (3) and adherence to federal food group recommendations across dietary patterns. Secondary data analysis of two baseline 24-h dietary recalls was performed on 383 overweight/obese African-American women enrolled in a weight loss intervention in Alabama and Mississippi between 2011 and 2013. Cluster analysis identified dietary patterns. t tests and chi-square tests tested demographic and dietary differences across clusters. The proportion of women in each cluster who met federal recommendations for fruit, vegetable, nuts, added sugar, and sodium intake was calculated. Two dietary patterns were found. Nut intake frequency was higher in cluster 2 (P < .001), which was characterized by a higher intake frequency of fruits and vegetables, but high mean daily intake of added sugar (12.26 ± 7.67 tsp) and sodium (2800 ± 881 mg). Ninety-two percent of participants in this cluster consumed red/processed meats daily. Even among women in this population who consume a more plant-based dietary pattern containing nuts, there is still a need to decrease intake of added sugar, sodium, and red meat.
García, Patricia J.; Chavez, Susana; Feringa, Barbara; Chiappe, Marina; Li, Weili; Jansen, Kathrin U.; Cárcamo, César; Holmes, King K.
OBJECTIVE: To define the prevalences and manifestations of reproductive tract infections (RTIs) in rural Peruvian women. METHODS: During 1997-98, we visited 18 rural districts in coastal, highlands, and jungle regions of Peru. We administered standardized questionnaires and pelvic examinations to members of women's community-based organizations; and collected vaginal fluid for pH, amine odour, Gram stain, microscopy, and culture for Trichomonas vaginalis; cervical specimens for Chlamydia trachomatis, Neisseria gonorrhoeae; human papilloma virus (HPV) by polymerase chain reaction (PCR) assays, and blood for syphilis serology. FINDINGS: The 754 participants averaged 36.9 years of age and 1.7 sex partners ever; 77% reported symptoms indicative of RTIs; 51% and 26% reported their symptoms spontaneously or only with specific questioning, respectively. Symptoms reported spontaneously included abnormal vaginal discharge (29.3% and 22.9%, respectively). One or more RTIs, found in 70.4% of participants, included bacterial vaginosis (43.7%), trichomoniasis (16.5%), vulvovaginal candidiasis (4.5%), chlamydial infection (6.8%), gonorrhoea (1.2%), syphilis seropositivity (1.7%), cervical HPV infection (4.9%), and genital warts or ulcers (2.8%). Of 715 adequate Pap smears, 7 revealed cancer, 4 high-grade squamous intra-epithelial lesions (SIL) and 15 low-grade SIL. Clinical algorithms had very low sensitivity and predictive values for cervical infection, but over half the women with symptoms of malodorous vaginal discharge, signs of abnormal vaginal discharge, or both, had bacterial vaginosis or trichomoniasis. CONCLUSION: Overall, 77% of women had symptoms indicative of RTIs, and 70% had objective evidence of one or more RTIs. Women with selected symptoms and signs of vaginal infection could benefit from standard metronidazole therapy. PMID:15508193
Mediano, Pilar; Fernández, Leónides; Rodríguez, Juan M; Marín, María
The purpose of this study was to identify potential predisposing factors associated with human infectious mastitis. We conducted a case-control study among breastfeeding women, with 368 cases (women with mastitis) and 148 controls. Data were collected by a questionnaire designed to obtain retrospective information about several factors related to medical history of mother and infant, different aspects of pregnancy, delivery and postpartum, and breastfeeding practices that could be involved in mastitis. Bivariate analyses and multivariate logistic regression model were used to examine the relationship between mastitis and these factors. The variables significantly- and independently-associated with mastitis were cracked nipples (P < 0.0001), oral antibiotics during breastfeeding (P < 0.0001), breast pumps (P < 0.0001), topical antifungal medication during breastfeeding (P = 0.0009), mastitis in previous lactations (P = 0.0014), breast milk coming in later than 24 h postpartum (P = 0.0016), history of mastitis in the family (P = 0.0028), mother-infant separation longer than 24 h (P = 0.0027), cream on nipples (P = 0.0228) and throat infection (P = 0.0224). Valuable factors related to an increased risk of infectious mastitis have been identified. This knowledge will allow practitioners to provide appropriate management advice about modifiable risk factors, such as the use of pumps or inappropriate medication. They also could identify before delivery those women at an increased risk of developing mastitis, such as those having a familial history of mastitis, and thus develop strategies to prevent this condition.
Background The purpose of this study was to identify potential predisposing factors associated with human infectious mastitis. Methods We conducted a case–control study among breastfeeding women, with 368 cases (women with mastitis) and 148 controls. Data were collected by a questionnaire designed to obtain retrospective information about several factors related to medical history of mother and infant, different aspects of pregnancy, delivery and postpartum, and breastfeeding practices that could be involved in mastitis. Bivariate analyses and multivariate logistic regression model were used to examine the relationship between mastitis and these factors. Results The variables significantly- and independently-associated with mastitis were cracked nipples (P < 0.0001), oral antibiotics during breastfeeding (P < 0.0001), breast pumps (P < 0.0001), topical antifungal medication during breastfeeding (P = 0.0009), mastitis in previous lactations (P = 0.0014), breast milk coming in later than 24 h postpartum (P = 0.0016), history of mastitis in the family (P = 0.0028), mother-infant separation longer than 24 h (P = 0.0027), cream on nipples (P = 0.0228) and throat infection (P = 0.0224). Conclusions Valuable factors related to an increased risk of infectious mastitis have been identified. This knowledge will allow practitioners to provide appropriate management advice about modifiable risk factors, such as the use of pumps or inappropriate medication. They also could identify before delivery those women at an increased risk of developing mastitis, such as those having a familial history of mastitis, and thus develop strategies to prevent this condition. PMID:24902596
Background Women’s ability to safely disclose their HIV-positive status to male partners is essential for uptake and continued use of prevention of mother-to-child transmission (PMTCT) services. However, little is known about the acceptability of potential approaches for facilitating partner disclosure. To lay the groundwork for developing an intervention, we conducted formative qualitative research to elicit feedback on three approaches for safe HIV disclosure for pregnant women and male partners in rural Kenya. Methods This qualitative acceptability research included in-depth interviews with HIV-infected pregnant women (n = 20) and male partners of HIV-infected women (n = 20) as well as two focus groups with service providers (n = 16). The participants were recruited at health care facilities in two communities in rural Nyanza Province, Kenya, during the period June to November 2011. Data were managed in NVivo 9 and analyzed using a framework approach, drawing on grounded theory. Results We found that facilitating HIV disclosure is acceptable in this context, but that individual participants have varying expectations depending on their personal situation. Many participants displayed a strong preference for couples HIV counseling and testing (CHCT) with mutual disclosure facilitated by a trained health worker. Home-based approaches and programs in which pregnant women are asked to bring their partners to the healthcare facility were equally favored. Participants felt that home-based CHCT would be acceptable for this rural setting, but special attention must be paid to how this service is introduced in the community, training of the health workers who will conduct the home visits, and confidentiality. Conclusion Pregnant couples should be given different options for assistance with HIV disclosure. Home-based CHCT could serve as an acceptable method to assist women and men with safe disclosure of HIV status. These findings can inform the design and
Nyamathi, Adeline; Ekstrand, Maria; Srivastava, Neha; Carpenter, Catherine L; Salem, Benissa E; Al-Harrasi, Shawana; Ramakrishnan, Padma; Sinha, Sanjeev
In this focus group study, we explored the experiences of 16 rural women living with AIDS (WLA) who participated in the Asha-Life (AL) intervention to gain an understanding of the environmental, psychosocial, and cultural impact of the AL on their lives. Four themes emerged among AL participants: (a) the importance of tangible support, (b) need for social support, (c) ongoing challenges to accessing antiretroviral therapy (ART), and (d) perspectives on future programs. Our research findings support the development of future programs targeting mother-child dyads which emphasize nutritional knowledge, while reducing barriers to receiving ART, and physical, emotional, and financial support.
This study is a multiple logistic regression analysis of the relationship between dimensions of women's status and domestic abuse in rural Uttar Pradesh, India, using the 1998-1999 National Family Health Survey (NFHS-2). Findings indicate that the effects of a woman's status on her likelihood of experiencing abuse depend on the social realm within which status operates. Specifically, more "public" dimensions of status are associated with a greater probability of abuse, while "domestic" dimensions are protective. The findings are interpreted in terms of transitioning gender norms in Uttar Pradesh and provide clarity to the literature on the complex relationship between status and abuse.
Recent literature shows that ethics of care can be used as a theoretical basis to add a new, important dimension to social issues. This paper argues for a similar extension of the theoretical support from ethics of care to an area in bioethics. Specifically, it contends that a justification based ethics of care can be constructed to argue for a moral obligation to give some priority in the HIV-related initiatives to one of most vulnerable groups; namely, the rural women in India. In an epidemic situation this care-based approach has certain advantages as a moral justification over the usual traditional approaches.
Gust, Deborah A; Pan, Yi; Otieno, Fred; Hayes, Tameka; Omoro, Tereza; Phillips-Howard, Penelope A; Odongo, Fred; Otieno, George O
Intimate partner physical violence increases women's risk for negative health outcomes and is an important public health concern. The purpose of the present study was to determine 1) the proportion of girls (≤18 years) and women (>18 years) who experienced physical violence by a sexual partner, and 2) factors (including self-reported HIV infection) associated with girls and women who experienced physical violence by a sexual partner. Cross-sectional surveys conducted in the Gem Health and Demographic Surveillance System (HDSS) area in Siaya County, western Kenya in 2011-2012 (Round 1) and 2013-2014 (Round 2). Among 8003 unique participants (582 girls and 7421 women), 11.6% reported physical violence by a sexual partner in the last 12 months (girls: 8.4%, women: 11.8%). Three factors were associated with physical violence by a sexual partner among girls: being married or cohabiting (nearly 5-fold higher risk), low education, and reporting forced sex in the last 12 months (both with an approximate 2-fold higher risk). Predictive factors were similar for women, with the addition of partner alcohol/drug use and deliberately terminating a pregnancy. Self-reported HIV status was not associated with recent physical violence by a sexual partner among girls or women. Gender-based physical violence is prevalent in this rural setting and has a strong relationship with marital status, low education level, and forced sex among girls and women. Concerted efforts to prevent child marriage and retain girls in school as well as implementation of school and community-based anti-violence programs may help mitigate this risk.
Sinner, Penny J; Cerhan, James R; Folsom, Aaron R; Ross, Julie A
The etiology of acute myeloid leukemia (AML) is relatively unknown. Incidence rates are highest in the agricultural Midwest region compared with other regions of the United States. Many studies have examined the relationship between farming and leukemia, but most have mainly focused on men. We examined the potential association between farm or rural residence and AML in the Iowa Women's Health Study. In 1986, 37,693 women who were free of prior cancer completed a lifestyle and health questionnaire, which included a question on the place of residence. Women were subsequently followed until 2002 for cancer incidence; 79 women developed AML during the time period. Women who lived on a farm at baseline were more likely (relative risk, 1.91; 95% confidence interval, 1.19-3.05) to develop AML compared with women who did not live on a farm. Further, women who reported living on a farm or in a rural area were twice as likely (relative risk, 2.38; 95% confidence interval, 1.33-4.26) to develop AML compared with women who lived in a city with a population of >10,000 people. These results provide evidence that women who live on farms or rural areas are at an increased risk of AML.
Nurbazlin, Musa; Chee, Winnie Siew Swee; Rokiah, Pendek; Tan, Alexander Tong Boon; Chew, Yee Yean; Nusaibah, Abd Rahman Siti; Chan, Siew Pheng
Ultraviolet B sunlight exposure is a primary source of vitamin D. There have been reports of low vitamin D status amongst the Malaysian population despite it being a tropical country. This study was conducted to determine the influence of sun exposure on 25(OH)D concentrations in urban and rural women in Malaysia and factors predicting 25(OH)D concentrations. Women aged above 45 years were recruited from urban (n=107) and rural areas (n=293). Subjects were interviewed regarding their outdoor activities and usual outdoor attire over the previous week. 25(OH)D concentrations were analyzed using the vitamin D3 (25-OH) electrochemiluminescence immunoassay. Median (Q1-Q3) age of the participants was 57 (53-61) years old. Median (Q1-Q3) 25(OH)D concentration of rural women was significantly higher [69.5 (59.0-79.1) nmol/L] compared to urban women [31.9 (26.1- 45.5) nmol/L] (p<0.001). Rural women spent more time in the sun compared to urban women (7.83 (3.67-14.7) vs 2.92 (1.17-4.92) hours, p<0.001), although the fraction of body surface area (BSA) exposed to sunlight was significantly higher in the urban group [0.21 (0.21-0.43) vs 0.12 (0.07-0.17), p<0.001]. The calculated sun index (hours of sun exposure per week × fraction of BSA) was significantly higher in rural [0.89 (0.42-1.83)] compared to urban women [0.72 (0.26-1.28)], p=0.018. In the stepwise linear regression, rural dwelling increased the serum 25(OH)D by 31.74 nmol/L and 25(OH)D concentrations increased by 1.93 nmol/L for every unit increment in sun index. Urban women in Malaysia had significantly lower vitamin D status compared to rural women. Rural dwelling and sun index were key factors influencing vitamin D status in Malaysian women.
Conroy, Amy A; Tsai, Alexander C; Clark, Gina M; Boum, Yap; Hatcher, Abigail M; Kawuma, Annet; Hunt, Peter W; Martin, Jeffrey N; Bangsberg, David R; Weiser, Sheri D
Gender-based power imbalances place women at significant risk for sexual violence, however, little research has examined this association among women living with HIV/AIDS. We performed a cross-sectional analysis of relationship power and sexual violence among HIV-positive women on anti-retroviral therapy in rural Uganda. Relationship power was measured using the Sexual Relationship Power Scale (SRPS), a validated measure consisting of two subscales: relationship control (RC) and decision-making dominance. We used multivariable logistic regression to test for associations between the SRPS and two dependent variables: recent forced sex and transactional sex. Higher relationship power (full SRPS) was associated with reduced odds of forced sex (AOR = 0.24; 95 % CI 0.07-0.80; p = 0.020). The association between higher relationship power and transactional sex was strong and in the expected direction, but not statistically significant (AOR = 0.47; 95 % CI 0.18-1.22; p = 0.119). Higher RC was associated with reduced odds of both forced sex (AOR = 0.18; 95 % CI 0.06-0.59; p < 0.01) and transactional sex (AOR = 0.38; 95 % CI 0.15-0.99; p = 0.048). Violence prevention interventions with HIV-positive women should consider approaches that increase women's power in their relationships.
Schuler, S R; Hashemi, S M; Badal, S H
This ethnographic study examined the sociocultural context of domestic violence in 6 rural villages in Bangladesh, and the prevalence of wife-beating and its association with women's empowerment in income generation programs (IGPs). Data were obtained from interviews conducted during 1990-96. Four villages had IGPs, and 2 villages did not have credit programs. Over 66% of women reported having been beaten at one time or another. In one village 87% reported beatings. 38% reported beatings in the preceding year (a range of 14-60%). Men beat their wives over trivial matters or frustrations over problems for which wives were not responsible. Beatings were attributed to mens' desire to control behavior and reassert their authority when challenged or to exploit their wives for financial gain. Some of the most severe beatings were linked with dowry. Both husbands and wives considered the beatings legitimate. The highest level of violence was in villages that were experiencing the most changes in gender roles and that had the most women contributing to family support. The lowest levels of violence were in villages with the fewest contributing to family support. Interviews, case studies, and observations yielded ambivalent evidence about the influence of credit programs on domestic violence. Credit programs have the potential to increase women's status and to disseminate anti-violence messages among both men and women.
Juarez Bartola, M; Garcia Ventura, H; De Jesus Leon, M J
Mexico's peasant sector is undergoing great change as a result of the insertion of capitalist relations into areas that were previously remote. The traditional peasant subsistence economy has been displaced, and peasants have been forced to adopt a series of new strategies for survival, entailing proletarianization or selling of labor. Women in the community of San Nicolas Zoyapetlayoca, in the municipio of Tepeaca, have lived in a situation of poverty and precariousness for some time. Most of the population historically depended on the neighboring haciendas for their livelihood. Women and children also worked there, mistreated and without social protection. The lands that were distributed after the Revolution are insufficient to support the community, and most families must look elsewhere for employment. Incomes are insufficient to cover all the necessities of education, health, nutrition, and other aspects of life. Most women are educated no farther than the primary level. They spend most of their time preparing food, carrying water, washing clothes, caring for their children, and in other domestic chores. Some women work for wages as laborers, factory workers, or domestics. Rural women are disadvantaged by poor working conditions, insufficient education, low levels of health and nutrition, limited participation in social and political life, poor housing and lack of services, and frequently by their own attitudes of traditionalism or fatalism.
Finch, Karen; Ma, Shaojun; Qin, Dingxin; Xin, Guo; Xia, Wan; Novotny, Thomas E.
Background China has the largest population of cigarette smokers worldwide; surveys suggest rising prevalence among young women. Migratory lifestyles may confer increased susceptibility. Objectives we aimed to understand how migration relates to smoking among young women. Methods we implemented a cross-sectional behavioral survey of rural-to-urban Chinese women (n = 206) working in restaurants and commercial sex venues, assessing smoking attitudes, behaviors, and health-risk knowledge. Results rates of ever smoking and current smoking among restaurant workers were high compared with the rates in general population surveys (16.1% and 6.5%, respectively); rates were much higher among sex workers (54.9% and 33.3%, respectively). Multivariate analysis revealed education to be protective, whereas exposure to female-branded cigarettes was a risk for ever smoking. Conclusions Chinese migrant women appear to be smoking at higher rates than nonmigrant women. Priorities for future research include representative studies in multiple cities examining reasons for uptake and stimuli to quit. PMID:19443881
Commentary was provided on Dr. Ibraz's discussion of the traditional division of labor by gender in a Punjabi Pakistani village. The discussion was viewed as too general and superficial, and without reference to some of the vast amount of literature on women. The information provided on the invisibility of rural women and the lower contributions to household income is refuted by data from the Household Income and Expenditure Survey, which records a higher percentage of earners in rural areas than in urban areas. The survey data are recognized as possibly flawed, because only monetary employment is considered as income. Another criticism is leveled at the definition of productive activity which includes work which eliminates the need for expenditure. In a closed subsistence economy, this definition may work, but in a monetary market system in the larger society exchanging goods which are not produced is not technically income generation. A third concern was raised about the lack of any evidence in this village of women undertaking the work of men who migrated for cash income to other areas. Rauf's and Mumtaz's ethnographic studies have indicated that women become extensively involved in activities which were formerly shared with men, and rarely engage in activities in the exclusive domain of men. Beliefs in the reliability of findings were challenged also in the contention that women were unaware of the indirect income and savings of their work. Evidence was provided that women did sell their work in local markets and were involved in distribution and use of produce within the household. These activities would, for instance, expose women to the periodic seasonal expenses, such as meals served to communal helpers, or occasional expenses, such as ceremonial expenses. The arguments would have been strengthened with a more expanded discussion of the division of labor by age group. Women's role and status in society in relation to sociobiology has been challenged and
Nyamathi, Adeline; Ekstrand, Maria; Heylen, Elsa; Ramakrishna, Padma; Yadav, Kartik; Sinha, Sanjeev; Hudson, Angela; Carpenter, Catherine L; Arab, Lenore
We conducted a cross-sectional examination of the physical and psychological factors related to ART adherence among a sample of 400 women living with HIV/AIDS in rural India. Interviewer-administered measures assessed adherence, internalized stigma, depressive symptoms, quality of life, food insecurity, health history and sociodemographic information. CD4 counts were measured using blood collected at screening. Findings revealed that adherence to ART was generally low, with 94% of women taking 50% or less of prescribed medication in past month. Multivariate analyses showed a non-linear association between numbers of self-reported opportunistic infections (OIs) in past 6 months (p = 0.016) and adherence, with adherence decreasing with each additional OI for 0-5 OIs. For those reporting more than 5 OIs, the association reversed direction, with increasing OIs beyond 5 associated with greater adherence.
Maretzki, Audrey N
With funding provided by the Center for Higher Education of the United States Agency for International Development, The Pennsylvania State University and Tuskegee University collaborated with the University of Nairobi in establishing women's NutriBusiness Cooperatives in the Rift Valley and Central Provinces of Kenya. Between 1992 and 1999, the cooperatives were established, facilities and equipment were supplied and extensive participatory training was provided by university-affiliated investigators and project staff. This initiative enabled approximately 2500 rural Kenyan women farmers to add value to their crops by processing and locally marketing nutritious, convenient, culturally-appropriate weaning food mixes. Implementation of the NutriBusiness model is described and challenges of cultural engagement are highlighted.
Rahman, Mosiur; Islam, Mohammad Touhidul; Mostofa, Md Golam; Reza, Md Shahin
This study aimed to extend notions of men's role in women's antenatal care (ANC) status in rural Rajshahi, Bangladesh. The analyses were based on response of 480 men aged 15 to 54 years, living with at least 1 child younger than 3 years. Only 27% men accompanied their wives for ANC. Men's perception of actual roles for ANC services was low: 63% approved of women undergoing checkups; 33% discussed their wives' pregnancy with health professionals. Only 18% scored highly on the overall index of knowledge. From multivariate analysis, it was found that the number of men accompanying their wives for ANC was higher among those respondents who were married for the first time in the age-group 25 to 34 years and aged 35 years or more, had their last child at age-group 20 to 24 years or 25 to 34 years, had completed primary or secondary and higher education, and had mass media facilities. © 2012 APJPH.
Within the overall aim of poverty alleviation, development efforts have included credit and self-employment programmes. In Bangladesh, the major beneficiaries of such group-based credit programmes are rural women who use the loans to initiate small informal income-generating activities. This paper explores the benefits of women's participation in credit programmes on their own health seeking. Using data from a sample of 1798 households from rural Bangladesh, conducted in 1991-1992 through repeated random sampling of 87 districts covered by Grameen Bank, Bangladesh Rural Advancement Committee (BRAC) and Bangladesh Rural Development Board (BRDB), this paper addresses the question: does women's participation in credit programmes significantly affect their use of formal health care? A non-unitary household preference model is suggested to test the hypothesis that women's empowerment through participation in these programmes results in greater control of resources for their own demand for formal health care. The analysis controls for endogeneity due to self-selection and other unobserved village level factors through the use of a weighted two stage instrumental variable approach with village level fixed effects. The findings indicate a positive impact of women's participation in credit programmes on their demand for formal health care. The policy simulations on the results of this study highlight the importance of credit programmes as a health intervention in addition to being a mechanism for women's economic empowerment.
Carnahan, Leslie R; Zimmermann, Kristine; Peacock, Nadine R
Living in a rural food desert has been linked to poor dietary habits. Understanding community perspectives about available resources and feasible solutions may inform strategies to improve food access in rural food deserts. The objective of our study was to identify resources and solutions to the food access problems of women in rural, southernmost Illinois. Fourteen focus groups with women (n = 110 participants) in 4 age groups were conducted in a 7-county region as part of a community assessment focused on women's health. We used content analysis with inductive and deductive approaches to explore food access barriers and facilitators. Similar to participants in previous studies, participants in our study reported insufficient local food sources, which they believe contributed to poor dietary habits, high food prices, and the need to travel for healthful food. Participants identified existing local activities and resources that help to increase access, such as home and community gardens, food pantries, and public transportation, as well as local solutions, such as improving nutrition education and public transportation options. Multilevel and collaborative strategies and policies are needed to address food access barriers in rural communities. At the individual level, education may help residents navigate geographic and economic barriers. Community solutions include collaborative strategies to increase availability of healthful foods through traditional and nontraditional food sources. Policy change is needed to promote local agriculture and distribution of privately grown food. Understanding needs and strengths in rural communities will ensure responsive and effective strategies to improve the rural food environment.
Gao, Haoyue; Stiller, Caroline K.; Scherbaum, Veronika; Biesalski, Hans Konrad; Wang, Qi; Hormann, Elizabeth; Bellows, Anne C.
Micronutrient deficiencies and imbalanced dietary intake tend to occur during the reproductive period among women in China. In accordance with traditional Chinese culture, pregnant women are commonly advised to follow a specific set of dietary precautions. The purpose of this study was to assess dietary intake data and identify risk factors for nutritional inadequacy in pregnant women from urban and rural areas of Deyang region, Sichuan province of China. Cross-sectional sampling was applied in two urban hospitals and five rural clinics (randomly selected) in Deyang region. Between July and October 2010, a total of 203 pregnant women in the third trimester, aged 19–42 years, were recruited on the basis of informed consent during antenatal clinic sessions. Semi-structured interviews on background information and 24-h dietary recalls were conducted. On the basis of self-reported height and pre-pregnancy weight, 68.7% of the women had a pre-pregnancy body mass index (BMI) within the normal range (18.5 ≤ BMI < 25), 26.3% were found to be underweight with a BMI <18.5 (20.8% in urban vs. 35.6% in rural areas), while only 5.1% were overweight with a BMI ≥30. In view of acceptable macronutrient distribution ranges (AMDRs) the women’s overall dietary energy originated excessively from fat (39%), was low in carbohydrates (49.6%), and reached the lower limits for protein (12.1%). Compared to rural areas, women living in urban areas had significantly higher reference nutrient intake (RNI) fulfillment levels for energy (106.1% vs. 93.4%), fat (146.6% vs. 119.7%), protein (86.9% vs. 71.6%), vitamin A (94.3% vs. 65.2%), Zn (70.9% vs. 61.8%), Fe (56.3% vs. 48%), Ca (55.1% vs. 41%) and riboflavin (74.7% vs. 60%). The likelihood of pregnant women following traditional food recommendations, such as avoiding rabbit meat, beef and lamb, was higher in rural (80%) than in urban (65.1%) areas. In conclusion, culturally sensitive nutrition education sessions are necessary for both
Bai, Yang; Liu, Qing; Chen, Xinguang; Gao, Yanduo; Gong, Huiyun; Tan, Xiaodong; Zhang, Min; Tuo, Jiyu; Zhang, Yuling; Xiang, Qunying; Deng, Fenghua; Liu, Guiling
Despite the significance of cervical cancer screening, motivating more women to participate remains a challenge in resource-limited settings. In this study, we tested the protection motivation theory (PMT) in predicting screening intentions. Participants were women from Wufeng, a typical rural county in China. Participants (n = 3000) with no cervical cancer history were recruited from 10 randomly selected villages. As mediating variables, 6 PMT constructs (Perceived Risk, Fear Arousal, Perceived Severity, Response Efficacy, Response Cost, and Self-Efficacy) were measured using the standardized questionnaire. Structural equation modeling (SEM) method was employed to test PMT-based prediction models. Of the total sample, 57.77% believed that regular screening may reduce cervical cancer risk, and 45.26% agreed that women should be screened regularly. Our data fit the PMT model well (GFI = 0.95, AGFI = 0.93, CFI = 0.90, RMSEA = 0.06, SRMR = 0.04, Chi-square/df = 2.47). Knowledge of screening was directly and positively associated with screening intention. Age, annual income, and awareness of and prior experience with screening were significantly associated with screening intention by enhancing cervical cancer risk perception and by reducing response cost (P<0.05 for both). PMT can be used as guidance to investigate cervical cancer screening intentions among rural women in China with focus on cancer knowledge, some demographic factors, and awareness of and previous experience with screening. These findings, if verified with longitudinal data, can be used for intervention program development. Copyright © 2017 John Wiley & Sons, Ltd.
Singh, Abhishek; Pallikadavath, Saseendran; Ram, Faujdar; Ogollah, Reuben
Studies have widely documented the socioeconomic inequalities in maternal and child health related outcomes in developing countries including India. However, there is limited research on the inequalities in advice provided by public health workers on maternal and child health during antenatal visits. This paper investigates the inequalities in advice provided by public health workers to women during antenatal visits in rural India. The District Level Household Survey (2007-08) was used to compute rich-poor ratios and concentration indices. Binary logistic regressions were used to investigate inequalities in advice provided by public health workers. The dependent variables comprised the advice provided on seven essential components of maternal and child health care. A significant proportion of pregnant women who attended at least four ANC sessions were not advised on these components during their antenatal sessions. Only 51%-72% of the pregnant women were advised on at least one of the components. Moreover, socioeconomic inequalities in providing advice were significant and the provision of advice concentrated disproportionately among the rich. Inequalities were highest in the case of advice on family planning methods. Advice on breastfeeding was least unequal. Public health workers working in lower level health facilities were significantly less likely than their counterparts in the higher level health facilities to provide specific advice. A significant proportion of women were not advised on recommended components of maternal and child health in rural India. Moreover, there were enormous socioeconomic inequalities. The findings of this study raise questions about the capacity of the public health care system in providing equitable services in India. The Government of India must focus on training and capacity building of the public health workers in communication skills so that they can deliver appropriate and recommended advice to all clients, irrespective of
Johnson, Derek C; Lhaki, Pema; Bhatta, Madhav P; Kempf, Mirjam-Colette; Smith, Jennifer S; Bhattarai, Pankaj; Aryal, Shilu; Chamot, Eric; Regmi, Kiran; Vermund, Sten H; Shrestha, Sadeep
In April 2014 we investigated the association of migration of a woman's husband with her high-risk human papillomavirus (HR-HPV) infection status and her abnormal cervical cytology status in the Achham district of rural Far-Western Nepal. Women were surveyed and screened for HR-HPV during a health camp conducted by the Nepal Fertility Care Center. Univariate and multivariable statistical tests were performed to determine the association of a husband's migration status with HR-HPV infection and cervical cytology status. In 265 women, the prevalence of HR-HPV was 7.5% (20/265), while the prevalence of abnormal cervical cytology, defined using the Bethesda system as atypical glandular cells of undetermined significance or worse, was 7.6% (19/251). Half of the study participants (50.8%, 130/256) had husbands who had reported migrating for work at least once. Women aged ≤34 years were significantly less likely to test positive for HR-HPV than women aged >34 years (OR 0.22, 95% CI 0.07 to 0.71). HR-HPV infection and abnormal cervical cytology status were not directly associated with a husband's migration. Older women were found to have a higher prevalence of HPV than younger women. It is possible that a husband's migration for work could be delaying HR-HPV infections in married women until an older age. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Richardson, Robin A; Nandi, Arijit; Jaswal, Surinder; Harper, Sam
High work demands might be a determinant of poor mental health among women in low- and middle-income countries, especially in rural settings where women experience greater amounts of labor-intensive unpaid work. Research originating from such settings is lacking. We estimated the cross-sectional association between work demands and mental distress among 3177 women living in 160 predominantly tribal communities in southern Rajasthan, India. A structured questionnaire captured the number of minutes women spent on various activities in the last 24 h, and we used this information to measure women's work demands, including the total work amount, nature of work (e.g., housework), and type of work (e.g., cooking). Mental distress was measured with the Hindi version of the 12-item General Health Questionnaire. We used negative binomial regression models to estimate the association between work demands (amount, nature, and type) and mental distress. On average, women spent more than 9.5 h a day on work activities. The most time, intensive work activity was caring for children, the elderly, or disabled (149 min). In adjusted models, we found a U-shaped association between work amount and mental distress. High amounts of housework were associated with higher distress, whereas paid work and farmwork amount were not. Certain types of housework, including collecting water and cleaning, were associated with increased distress scores. We found an association between aspects of work demands and mental distress. Research in other contexts where women perform high amounts of unpaid work, particularly within the home or farm, is warranted.
Gust, Deborah A; Pan, Yi; Otieno, Fred; Hayes, Tameka; Omoro, Tereza; Phillips–Howard, Penelope A; Odongo, Fred; Otieno, George O
Background Intimate partner physical violence increases women’s risk for negative health outcomes and is an important public health concern. The purpose of the present study was to determine 1) the proportion of girls (≤18 years) and women (>18 years) who experienced physical violence by a sexual partner, and 2) factors (including self–reported HIV infection) associated with girls and women who experienced physical violence by a sexual partner. Methods Cross–sectional surveys conducted in the Gem Health and Demographic Surveillance System (HDSS) area in Siaya County, western Kenya in 2011–2012 (Round 1) and 2013–2014 (Round 2). Findings Among 8003 unique participants (582 girls and 7421 women), 11.6% reported physical violence by a sexual partner in the last 12 months (girls: 8.4%, women: 11.8%). Three factors were associated with physical violence by a sexual partner among girls: being married or cohabiting (nearly 5–fold higher risk), low education, and reporting forced sex in the last 12 months (both with an approximate 2–fold higher risk). Predictive factors were similar for women, with the addition of partner alcohol/drug use and deliberately terminating a pregnancy. Self–reported HIV status was not associated with recent physical violence by a sexual partner among girls or women. Conclusions Gender–based physical violence is prevalent in this rural setting and has a strong relationship with marital status, low education level, and forced sex among girls and women. Concerted efforts to prevent child marriage and retain girls in school as well as implementation of school and community–based anti–violence programs may help mitigate this risk. PMID:28959439
Hartley, Chelsey M; Barroso, Nicole; Rey, Yasmin; Pettit, Jeremy W; Bagner, Daniel M
Although a number of studies have examined the factor structure of the Edinburgh Postnatal Depression Scale (EPDS) in predominately White or African American samples, no published research has reported on the factor structure among Hispanic women who reside in the United States. The current study examined the factor structure of the EPDS among Hispanic mothers in the United States. Among 220 Hispanic women, drawn from a pediatric primary care setting, with an infant aged 0 to 10 months, 6 structural models guided by the empirical literature were evaluated using confirmatory factor analysis. Results supported a 2-factor model of depression and anxiety as the best fitting model. Multigroup models supported the factorial invariance across women who completed the EDPS in English and Spanish. These findings provide initial support for the 2-factor structure of the EPDS among Hispanic women in the United States. © 2014 Wiley Periodicals, Inc.
Hartley, Chelsey M.; Barroso, Nicole; Rey, Yasmin; Pettit, Jeremy W.; Bagner, Daniel M.
Background Although a number of studies have examined the factor structure of the Edinburgh Postnatal Depression Scale (EPDS) in predominately White or African American samples, no published research has reported on the factor structure among Hispanic women who reside in the United States. Objective The current study examined the factor structure of the EPDS among Hispanic mothers in the United States. Method Among 220 Hispanic women, drawn from a pediatric primary care setting, with an infant aged 0 to 10 months, 6 structural models guided by the empirical literature were evaluated using confirmatory factor analysis. Results Results supported a 2-factor model of depression and anxiety as the best fitting model. Multigroup models supported the factorial invariance across women who completed the EDPS in English and Spanish. Conclusion These findings provide initial support for the 2-factor structure of the EPDS among Hispanic women in the United States. PMID:24807217
Nanthamongkolchai, Sutham; Pitikultang, Supachai
Background: Sterilization is most widely used fertility regulation method in Nepal. However, prevalence of uptake of female sterilization in central hilly region is less than the national average. The objective of the study was to explore the number and factors related to intention of married women to undergo female sterilization in rural Kathmandu which lies within central hilly region. Materials and Methods: This is a community based cross-sectional survey research conducted in rural area of Kathmandu valley. Two hundred and forty currently married women with at least one child of any age were interviewed using a structured pre-tested questionnaire. Results: More than four-fifth of the respondents intended to undergo sterilization. Almost two-third of them wanted to limit their family size by taking this option. More than one-third of women not-intending to undergo sterilization feared weakness after sterilization. Age of the respondents, duration of marriage, and number of living children were significantly associated with intention to undergo sterilization. 15-24 years age group were six times more likely to have the intention for sterilization (OR 6.79, CI 2.28-20.19) compared to age 35 years and above group. Mothers with less than 3 living children are about three times more likely to have the intention to undergo sterilization (OR 2.87, CI 1.3-6.33) compared to women with more than 2 living children. Women married for 6 to 10 years were three times more likely to have the intention (OR 3.0, CI 1.09-8.27). However, gender of the living children was not associated with intention to undergo sterilization. Conclusion: There were significant numbers of women intending to undergo sterilization. Age of the mother, number of living children and the duration of marriage were found to be significantly influencing the intention to undergo sterilization. However, as intention refers to future plan, the respondents’ intention may change over time. The national family
Cornell, C. E.; Littleton, M. A.; Greene, P. G.; Pulley, L.; Brownstein, J. N.; Sanderson, B. K.; Stalker, V. G.; Matson-Koffman, D.; Struempler, B.; Raczynski, J. M.
The Uniontown, Alabama Community Health Project trained and facilitated Community Health Advisors (CHAs) in conducting a theory-based intervention designed to reduce the risk for cardiovascular disease (CVD) among rural African-American women. The multiphased project included formative evaluation and community organization, CHA recruitment and training, community intervention and maintenance. Formative data collected to develop the training, intervention and evaluation methods and materials indicated the need for programs to increase knowledge, skills and resources for changing behaviors that increase the risk of CVD. CHAs worked in partnership with staff to develop, implement, evaluate and maintain strategies to reduce risk for CVD in women and to influence city officials, business owners and community coalitions to facilitate project activities. Process data documented sustained increases in social capital and community capacity to address health-related issues, as well as improvements in the community’s physical infrastructure. This project is unique in that it documents that a comprehensive CHA-based intervention for CVD can facilitate wide-reaching changes in capacity to address health issues in a rural community that include improvements in community infrastructure and are sustained beyond the scope of the originally funded intervention. PMID:19047648
Shin, Sanghyuk S; Wan, Xia; Wang, Qian; Raymond, H Fisher; Liu, Huilin; Ding, Ding; Yang, Gonghuan; Novotny, Thomas E
Smoking may be a coping mechanism for psychosocial stress caused by discrimination. We conducted a cross-sectional survey of rural-to-urban migrant women wo