United Nations Population Fund

Abstract Background Evidence suggests that Intimate Partner Violence (IPV) is associated with reduced use of maternal health services (MHS), including ANC, institutional deliveries, and use of modern contraception. The effects of IPV on MHS work through mechanisms such as psychological barriers, alongside restricted decision-making and movement related to financial dependence, and fear of further abuse. We assessed trends in IPV and its effects on accessing healthcare, and two maternal health services (ANC and institutional delivery) among women of reproductive age (15–49 years) in four nationally representative surveys in Uganda. Methods In this study, we conducted a cross-sectional analysis of secondary data, utilizing information from four Uganda Demographic and Health Surveys (UDHS) that were carried out in 2006, 2011, 2016, and 2022. The UDHS uses a multistage stratified sampling methodology to select households from both urban and rural areas across regions in Uganda. Women between the ages of 15 and 49 years who were either residents or visitors in these households were eligible for interviews. Data for this analysis are drawn from the domestic violence module that generates information on spousal/intimate partners violence among ever-married women. Both exploratory and inferential data analyses were conducted to generate descriptive statistics for key variables, and a modified Poisson regression model to provide evidence for the association between maternal health services and IPV using prevalence ratios (PRs) with 95% confidence intervals as measures of association. Analyses were weighted and accounted for a multi-stage cluster design, conducted using svyset command in STATA version 18. Results Trends in the women experiencing intimate partner violence (IPV) in the 12 months prior to the survey, and women reporting serious problems accessing healthcare (SPAHC) varied over the four UDHS. Overall, SPAHC dropped from 83.1% in 2006 to 60% in 2022, p-for-trend < 0.000. Similarly, IPV declined in the same period, dropping from 52.6% in 2006 to 39.2% in 2016, but increased to 45% in 2022. The overall pooled effect of IPV on SPAHC across the four DHS was about 8% higher among the ever-married women reporting IPV. The effects of IPV the two maternal health service; women’s place of delivery of the last birth in the past 5 years, comparing delivery at a public/ private health facility versus delivery at home, and timely (0–3 months) first ANC visit for the last birth tended to lower when women experienced IPV. Conclusion The study emphasizes the links between social determinants of health, serious problems in accessing healthcare and maternal services, and IPV as a major risk factor. Policymakers should enhance strategies to prevent IPV, which negatively impacts women's health and pregnancies, focusing on disadvantaged women, especially those in rural, low-education, and poorer communities.

Contraceptive stockouts are a major barrier to effective family planning (FP) service delivery in Nigeria, limiting access to modern methods and contributing to adverse reproductive health outcomes. Despite ongoing efforts to strengthen the supply chain, many health facilities continue to experience stockouts. A cross‐sectional study was conducted in September 2024 across 1,050 service delivery points (SDPs) in Nigeria. Descriptive statistics and univariate mixed‐effects logistic regression were used to explore associations between stockouts and facility characteristics, including location, supervision frequency, resupply methods, and logistics practices. Overall, 41.7 percent of SDPs reported at least one contraceptive stockout in the three months preceding the survey. Stockouts were slightly more common in rural facilities (56.8 percent) compared to urban facilities (43.2 percent), though this difference was not statistically significant (p = 0.53). Monthly supervisory visits were associated with significantly lower stockout rates (p = 0.014). Facilities relying on external agencies for resupply had 1.55 times higher odds of stockouts than those calculating needs internally (p = 0.058). Delays exceeding two weeks between ordering and delivery were the strongest predictor of stockouts (odds ratio: 1.76, 95 percent confidence interval: 1.257–2.474, p < 0.001). Improving supply chain efficiency, supervision frequency, and resupply models is critical to reducing contraceptive stockouts and enhancing FP service delivery in Nigeria.

Although global maternal and neonatal mortality have declined over recent decades, progress has stalled in contexts affected by conflict, fragility and displacement.(1–3) The 29 countries with United Nations humanitarian responseplans or flash appeals at the start of 2025 accounted for slightly less than one third of global births but contributed an estimated 58% of maternal deaths, 41% of stillbirths and 39% of newborn deaths. (2–4) These figures likely underestimate the burden in acute crises, where data are usually scarce.

O eixo da rodovia BR-316 sempre desempenhou um importante papel na dinâmica daocupação territorial em direção a leste da cidade de Belém, desde a Estrada de Ferrode Bragança, passando pela consolidação da rodovia Belém–Brasília posteriormentedenominada rodovia BR-316. Essa dinâmica, no entanto, nunca foi planejada ouregulada, o que gerou uma ocupação desordenada, com severos impactos à circulaçãoe ao desenvolvimento urbano. Nos últimos seis anos, o Governo do Estado iniciou aimplantação do Sistema Integrado de Transporte (SIT) nos onze quilômetros iniciaisda rodovia, projeto que provocará profundas alterações físicas e funcionais no citadotrecho, com significativa repercussão no uso do solo na Área de Entorno da Rodovia(AER). Este trabalho visa examinar como o padrão de uso e ocupação do solo atualpoderá impactar o SIT. Para a compreensão desse processo apresenta-se a retrospectiva histórica da ocupação da AER a partir de seu eixo e analisa-se o padrão atual com base em pesquisa de campo e em dados secundários do Censo Instituto Brasileiro de Geografia e Estatística. Por meio desta análise identificam-se quatro segmentos distintos quanto ao padrão de uso e ocupação do solo apontando seus impactos para o SIT.

A common misconception that prevails within some research communities postulates that research results 'speak for themselves' and are thus sufficient to influence policy. Yet, high-fidelity uptake of research is rarely a passive process; more often, researchers need to actively engage with policymakers. This process of policy engagement strives towards producing robust science that contributes to the betterment of our societies-but it is a process for which many researchers are not adequately trained. If publicly funded research fails to influence policy, many would regard it as falling short of fulfilling its potential value to society. Herein, we provide a framework for research-policymaker engagement, framed around the questions of why, on what, with whom, when, where and how clinical and public-health researchers can and should undertake engagement with policymakers. The views presented in this Perspective are a synthesis of the diverse, collective experience of the authors across global health contexts, supported by real-world illustrative case studies. We provide tangible recommendations for researchers, funders and policymakers to facilitate bridging the gap between evidence and policy.

Maternity care satisfaction for pregnant women and recently delivered mothers is linked to both short- and long-term complications. For health care providers, dissatisfaction can lead to high turnover, reduced efficiency, and decreased service quality. Increased midwifery care coverage enhances satisfaction; however, the Government of Bangladesh-sanctioned midwife positions are limited to the primary health care level only, not extending to secondary or tertiary health tiers. We aimed to evaluate the impact of introducing midwifery care at secondary-level health care facilities in Bangladesh by comparing the satisfaction levels of both providers and patients with those receiving regular care. We conducted a quasi-experimental study from September 2021 to December 2023 at two secondary-level health facilities - Sunamganj District Hospital (DH) (intervention) and Khagrachari DH (control). The primary outcome was the mean (x̄) percentage score of maternal satisfaction with antenatal care (ANC), delivery, and postnatal care (PNC) services, along with providers' satisfaction regarding their working environment, training, logistical support, and overall patient and service satisfaction at both facilities. We screened for eligibility a total of 200 pregnant women or recently delivered mothers who visited the facility for ANC, delivery, or PNC services. The satisfaction scores were significantly higher among women who received midwifery care compared to those who received regular care. The scores were for ANC x̄ = 97.8 (95% confidence interval (CI) = 96.6-99.0) vs. x̄ = 71.0 (95% CI = 68.7-73.4), for delivery x̄ = 97.9 (95% CI = 97.4-98.3) vs. x̄ = 83.3 (95% CI = 80.2-86.3), and for PNC x̄ = 97.5 (95% CI = 96.5-98.4) vs. x̄ = 77.7 (95% CI = 73.8-81.6). Similarly, the satisfaction score among midwives was significantly higher than among providers in regular care facilities (x̄ = 88.7; 95% CI = 82.9-94.5 vs. x̄ = 77.7; 95% CI = 73.0-82.3). Our study highlights that midwifery care significantly enhances patient and provider satisfaction compared to regular care across antenatal, delivery, and postnatal services.

This article presents the insights and experience from a four-year journey of implementing a cutting-edge Digital Identity Solution for Proof-of-Life in the United Nations Joint Staff Pension Fund (UNJSPF). The solution, which leveraged blockchain, biometrics, artificial intelligence (AI), and geo-localisation technologies, has revolutionised the process of verifying pension beneficiaries’ existence. The article delves into the challenges faced and addressed during deployment, highlighting how the system has enhanced accountability, security, and efficiency in beneficiary verification. Emphasis is placed on the solution’s success in streamlining what was previously a lengthy, error-prone manual process and the critical aspects of trust and assurance, discussing how UNJSPF has worked to ensure the reliability and security of the solution through external audits and certifications, including ISO standards.