Document Type : Original Article

Authors

1 Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department Of Midwifery and Reproductive Health, Reproductive Sciences and Sexual Health Research Center. Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

BACKGROUND: Women’s health is supposed to be one of the indicators of development.
Reproductive health is an important part of women’s health. Vulnerable women are a group of women
whose reproductive health needs to be given special attention. The purpose of this study was to
compare the reproductive health of vulnerable and nonvulnerable women.
MATERIALS AND METHODS: This cross‑sectional study was conducted on vulnerable
women (n = 250) and nonvulnerable women (n = 250). The samples were selected from vulnerable
women’s centers and comprehensive health centers in Isfahan by quota and using simple random
sampling method in 2017. The research tool was a researcher‑made questionnaire completed by the
researcher using interview method. Internal reliability of the questionnaire was confirmed to be 0.89
using Cronbach’s alpha. A P < 0.05 was considered to be statistically significant. Data analysis was
performed using SPSS 18 software and independent t‑test, Mann–Whitney, Pearson, Spearman,
and Chi‑square tests.
RESULTS: The results showed that the mean total score of reproductive health in the nonvulnerable
group (81.41) was significantly higher than that of the vulnerable group (68.6). The mean total score
and the score of reproductive health components, except some of them, were significantly different
between the two groups (P < 0.05). Having an addicted spouse and unsafe sex were the most
prevalent features associated with high‑risk behaviors.
CONCLUSIONS: According to the results, reproductive health status of vulnerable women
is inappropriate in all dimensions. Given the importance of this issue, the development and
implementation of special health programs for this group seem to be necessary.

Keywords

1. Ramezan Zadeh F, Shariat M. Reproductive Health. In: Hatami H,
editor. The Text Book of Public Health Book. Tehran: Ministry
of Health and Medical Education (Iran) School of Health, Shahid
Beheshti University of Medical Sciences; 2013. p. 2235‑40.
2. MohammadiG, Amir Aliakbari S, Ramezankhani A, Alavi MajdH.
The reproductive health status of women with experience of
violence in harm reduction centers in Tehran. J Pejouhandeh
2011;16:219‑25.
3. MsetfiR, Jay S, T O’Donnell A, Kearns M, Kinsella EL, McMahon J,
Muldoon OT, et.al. Restricted reproductive rights and risky sexual
behaviour: How political disenfranchisement relates to women’s
sense of control, well‑being and sexual health. J Health Psychol
2017;23:252‑62.
4. WHO, UNICEF, UNFPA, World Bank Group and the
United Nations Population Division. Maternal Mortality: Levels
and Trends 2000 to 2017. Geneva: WHO, UNICEF, UNFPA, World
Bank Group and the United Nations Population Division; 2019.
Available from: https://www.who.int/reproductivehealth/
publications/maternalmortality‑2000‑2017/en/. [Last accessed
on 2019 Oct 17].
5. Singh NS, Smith J, Aryasinghe S, Khosla R, Say L, Blanchet K.
Evaluating the effectiveness of sexual and reproductive health
services during humanitarian crises: A systematic review. PLoS
One 2018;13:e0199300.
6. Casey SE. Evaluations of reproductive health programs in
humanitarian settings: A systematic review. Confl Health
2015;9:S1.
7. Seydi M, Ghafouri A, Jalali M. The study of personality Traits and
Defense Mechanism among prostitutes, Addicted and Normal
Women. J Res Add 2014;8:89‑105.
8. Center for Disease Management, AIDS Control and Sexually
Transmitted Diseases. Protocol for Special Counseling Centers
for Vulnerable Women; 2013.
9. United Nations Office on Drugs and Crime. Islamic Republic of
Iran; 2018. Available from: https://www.unodc.org/wdr2018/
prelaunch/WDR18_Booklet_5_WOMEN.pdf. [Last accessed on
2019 Aug 20].
10. Farivar M, Mirhashemi M. Prediction of Likelihood of Returning
to Drug Abuse Based on Resiliency and Communication Patterns
in Addicts’ Spouses. 2018;12:87‑100.
11. Gupta S, Sarpal SS, Kumar D, Kaur T, Arora S. Prevalence, pattern
and familial effects of substance use among the male college
students – A north Indian study. J Clin Diagn Res 2013;7:1632‑6.
12. Mehrara A, Amidi Mazaheri M, Hasanzadeh A. The survey of
quality of life, perceived stress, and its relationship with marital
satisfaction in married women working at health centers. J Educ
Health Promot 2019;8:249.
13. Scorgie F, Chersich MF, Ntaganira I, Gerbase A, Lule F, Lo YR.
“Sociodemographic characteristics and behavioral risk factors of
female sex workers in sub‑saharan Africa: A systematic review”,
AIDS Behav 2012;16:920‑33.
14. Madani Ghahfarokhi S. Rapid Situational Assessment of
Prostitution in Tehran with Emphasis on High‑Risk Behaviors
Related to HIV. Tehran, Iran: Center for Disease Control, Iran
Ministry of Health, United Nations Population Fund, Iranian
National Center for Addiction Studies; 2008.
15. Damirchi F, Khodabakhshi Koolaee A. Differences between
health‑promoting lifestyle among sex worker with substance
use and non‑substance use women (Case study in Tehran).
Community Health 2016;3:239‑47.
16. World Prison Brief Data, Asia, Iran, Further Information.
Available from: https://www.prisonstudies.Org. [Last accessed
on 2017 Oct 17].
17. Ayres JR, France Junior I, Calazans G, Saletti Filho H. The concept
of vulnerability and health practices: New perspectives and
challenges and health promotion: Concepts, reflections, trends.
Rio de Janeiro Fiocruz 2003;5:117‑39.
18. Iuana M, Ventura M, Simas L, Larouze B, Correa M. Reproductive
rights of women in the penitentiary system: tensions and
challenges in the transformation of reality. Cien Saude Colet
2016;8:45‑50.
19. Kolahi AA, Sayyarifard A, Rastegarpour A, Sohrabi MR,
Abadi AR, Nabavi M. The Function of Vulnerable and at‑risk
Women in Prevention of HIV/AIDS. J Qom Univ Med Sci
2012;6:58‑64.
20. Kashanian M, Baradaran HR, Hatami H, Ghasemi A. The effect on
pregnancy outcome of drug (Substance) abuse during pregnancy.
J Urmia Univ Med Sci 2013;23:752‑60.
21. Afkar A, Mehrabian F, Omidi‑Khalky S, Mahboubi M. Drug
abuse pattern and frequency of high risk behaviors the clients
to outpatient addiction treatment centers. Biol Todey’s World
2014;3:94‑9.
22. Weldegebreal R, Melaku YA, Alemayehu M, Gebrehiwot TG.
Unintended pregnancy among female sex workers in Mekelle city,
northern Ethiopia: A cross‑sectional study. BMC Public Health
2015;15:40.
23. Leal M, Silva Ayres B, Esteves‑Pereira A, Roma Sánchez A,
Larouzé B. Born in prison: Gestation and delivery behind bars
in Brazil. Ciênc Collective Health 2015;21:22‑7.
24. Ghorashi Z, Merghati‑Khoei E, Yousefy A. Measuring
Iranian women’s sexual behaviors: Expert opinion. J Edu Health Promot 2014;3:80
25. Roe‑sepowitz E. Juvenile entry into prostitution: The role of
emotional abuse. J Violence Against Women 2012;18:562‑79.
26. Khani S, Khezri F, Yari K. A study of Social vulnerability among
female‑headed households and headed women in Soltan
Abad District, Tehran. women in development and politics
2018;15:597‑620.
27. Ding Y, Li XT, Xie F, Yang YL. Survey on the implementation of
preconception care in Shanghai, China. Paediatr Perinat Epidemiol
2015;29:492‑500.
28. Yam EA, Kidanu A, Burnett‑Zieman B, Pilgrim N, Okal J,
Bekele A, et al. Pregnancy experiences of female sex workers in
Adama City, Ethiopia: Complexity of partner relationships and
pregnancy intentions. Stud Fam Plann 2017;48:107‑19.
29. Yazici AB, Uslu Yuvaci H, Yazici E, Halimoglu Caliskan E,
Cevrioglu AS, Erol A. Smoking, alcohol, and substance use and
rates of quitting during pregnancy: Is it hard to quit? Int J Womens
Health 2016;8:549‑56.
30. Xiao G, Xiaofeng L, Li L. Prevalence and Associated Factors of
Secondhand Smoke Exposure among Internal Chinese Migrant
Women of Reproductive Age: Evidence from China’s Labor‑Force
Dynamic Survey. Int J Environ Res Public Health. 2016;13:371.
31. Afzali M, Shahhosseini Z, Hamzeghardeshi Z. Social capital
role in managing high risk behavior: A narrative review. Mater
Sociomed 2015;27:280‑5.
32. Behboodi‑Moghadam Z, Mahmoodi Z, Ataee M, Esmaelzadeh
Saeieh S. Assessment of Reproductive Health in HIV Positive
Women That Referred to High Risk Behavioe Consultation Center.
Aumj 2018;7 Supple 3:1‑10.
33. Casey SE, Chynoweth SK, Cornier N, Gallagher MC, Wheeler EE.
Progress and gaps in reproductive health services in three
humanitarian settings: Mixed‑methods case studies. Confl Health
2015;9:S3.
34. Scorgie F, Nakato D, Harper E, Richter M, Maseko S, Nare P,
et al. ‘We are despised in the hospitals’: Sex workers’ experiences
of accessing health care in four African countries. Cult Health
Se×2013;15:450‑65.
35. Nik Mazlina M, Ruziaton H, Nuraini DB, Izan Hairani I,
Norizzati B, Isa MR, et al. Risk factors for women attending
pre‑pregnancy screening in selected clinics in Selangor. Malays
Fam Physician 2014;9:20‑6.
36. Hakari D, Mohamadzadeh R, Velayati A, Bolourian M. Barriers of
prenatal care and its relationship with pregnancy outcome among
women visited to Tabriz hospitals in 2009. Med Sci 2011;21:206‑21.