Public Health and Occupational Safety Journal

Compliance with family planning and its association with quality of life among Meranaw women in rural Philippines

Maslainie Aliola — 2026-05-24

Background: The COVID-19 pandemic disrupted access to essential health services, including family planning (FP), particularly in rural and underserved communities. These disruptions may influence women’s reproductive practices and overall quality of life (QoL).

Objectives: This study aimed to determine the level of family planning compliance and examine its influence on the quality of life among Meranaw women during the COVID-19 pandemic.

Methods: A descriptive cross-sectional design was employed among 378 Meranaw women who were family planning users in selected municipalities of Lanao del Sur, Philippines. Data were collected from January to October 2022. A stratified random sampling technique was used based on municipal distribution to ensure proportional representation of respondents. A validated researcher-developed questionnaire assessed attitude- and practice-related compliance (CVI = 0.81–0.92; α = 0.79), while QoL was measured using the WHOQOL-BREF. Data were analyzed using descriptive statistics and multiple linear regression.

Results: Respondents demonstrated high compliance in both attitude (mean = 3.61) and practice (mean = 3.41) domains. Overall QoL was rated very satisfactory (mean = 5.72), with the highest scores in the psychological (mean = 5.89) and relational (mean = 5.85) domains. Multiple regression analysis revealed that age (β = .319, p < .001), monthly income (β = –.097, p = .008), number of children (β = .395, p < .001), duration of FP use (β = .092, p = .034), and type of FP method (β = .129, p < .001) significantly predicted QoL. The model explained a substantial proportion of variance (R² = 0.974), indicating strong predictive capacity.

Conclusions: Meranaw women demonstrated high compliance with family planning practices despite pandemic-related constraints, thereby significantly improving the quality of life. Sustaining family planning services during public health crises is essential to maintaining women’s well-being, particularly in rural and culturally distinct populations.

Better BMI but higher anemia risk? Evidence from lacto-vegetarian women

Hamid Nurrohman — 2026-05-24

Background: The increasing adoption of plant-based diets in the United States, particularly lacto-vegetarian patterns, has been driven by their perceived metabolic benefits. However, middle-aged women represent a nutritionally vulnerable group due to menopausal transitions and a high risk of anemia. In this context, the potential trade-off between improved body weight and micronutrient deficiencies remains insufficiently explored.

Objectives: This study examined the nutritional trade-offs between lacto-vegetarian and non-vegetarian diets, focusing on body mass index (BMI), anemia status, and lifestyle behaviors among middle-aged women in California, USA.

Methods: A cross-sectional study was conducted between June and September 2025 in California, USA, involving 40 women aged 40–65 years (20 lacto-vegetarians and 20 non-vegetarians), selected purposively. Socio-demographic characteristics and lifestyle behaviors were collected using a validated structured questionnaire. BMI, blood pressure, and hemoglobin levels were measured using standardized procedures. Data were analyzed using the Mann–Whitney U test and Spearman rank correlation, with results summarized using median and interquartile range (IQR) where appropriate. Statistical significance was set at p < 0.05.

Results: Lacto-vegetarian women showed a higher proportion of normal BMI compared to non-vegetarians (50% vs 30%, p=0.04). However, anemia prevalence was markedly higher among lacto-vegetarians (70% vs 10%, p=0.001). No significant differences were observed in physical activity, smoking, or blood pressure (p>0.05). These findings indicate a clear nutritional trade-off: improved weight status is associated with increased anemia risk.

Conclusions: Lacto-vegetarian diets were associated with more favorable BMI profiles but a significantly higher risk of anemia. These findings highlight the need for targeted nutritional strategies and public health interventions in the United States, particularly emphasizing iron and vitamin B12 adequacy among middle-aged women adopting plant-based diets.

Climate change and public health in Africa: A narrative review of resilience strategies for health systems

Kabiru Gulma — 2026-05-24

Background: Climate change poses an escalating threat to public health in Africa, a continent responsible for less than 10% of global greenhouse gas emissions yet disproportionately bearing the burden of its consequences. Existing health systems remain fragile, under-resourced, and ill-equipped to absorb climate-related shocks.

Objectives: To synthesize evidence on the health impacts of climate change in Africa and identify strategies for building climate-resilient health systems.

Methods: This study is a narrative literature review. A comprehensive search of peer-reviewed databases and gray literature was conducted. Sources were screened against predefined inclusion criteria and synthesized thematically across six domains: climate science, contextual vulnerabilities, health systems strengthening, governance, community engagement, and financing. A total of 22 studies and reports were included and analyzed using thematic synthesis following Thomas and Harden’s (2008) three-step approach.

Results: Climate change intensifies the burden of infectious and non-communicable diseases, disrupts health infrastructure, and deepens health inequities across African regions. Resilience-building requires strengthened governance, sustained domestic and international financing, multisectoral partnerships, community engagement, and climate-adaptive health information systems.

Conclusions: Concerted, context-sensitive action that integrates climate adaptation into health policy frameworks is urgently needed to protect the health and well-being of African populations from the accelerating impacts of climate change. Practical implications include strengthening health system governance, mobilizing climate finance, investing in climate-adaptive surveillance systems, and fostering community engagement and multisectoral collaboration to build durable climate resilience across African health systems.

Maternal education and child stunting in Kenya: The role of socio-economic confounding using DHS 2022 data

Anastacia Katungo Maluki — 2026-05-24

Background: Child stunting remains a major public health challenge in Kenya, reflecting long‑term nutritional deprivation and socioeconomic inequalities. Although maternal education is widely considered protective, its independent effect is often unclear due to confounding by structural factors.

Objectives: To examine the association between maternal education and child stunting among children under five in Kenya and to assess the extent of confounding and effect modification by key sociodemographic factors.

Methods: A cross‑sectional analytical study was conducted using data from the 2022 Kenya Demographic and Health Survey (KDHS). The sample included 19,530 children aged 0–59 months. Stunting was defined using height‑for‑age z-scores (<-2 SD). Descriptive, bivariate, stratified, and multivariable logistic regression analyses were performed, accounting for the complex survey design.

Results: Stunting prevalence was 18.2%. Stunting decreased with increasing maternal education, from 21.4–21.7% among children of mothers with no or primary education to 8.7% among those with higher education (χ² = 238, p < 0.001). However, the association was weak (Cramer’s V = 0.117) and attenuated after adjustment for socioeconomic factors. Household wealth was the strongest predictor, with children in the richest households having significantly lower odds of stunting than those in the poorest households (AOR = 0.268; 95% CI: 0.222–0.323; p < 0.001). Stunting risk increased with age, particularly among children aged 6–23 months, while females had lower odds than males (OR = 0.717; 95% CI: 0.662–0.776). Stratified analyses showed stronger protective effects of maternal education among older children. In contrast, variation across wealth groups should be interpreted cautiously, given inconsistent and non-significant findings in some strata. No meaningful effect modification by child sex was identified.

Conclusions: Child stunting in Kenya is primarily driven by structural socioeconomic factors. While maternal education is associated with reduced stunting, its effect is highly context dependent. Addressing poverty and inequality is essential for effective and equitable reductions in child stunting.

Factors associated with the use of the PUSTAKA online registration service at the Sekaran Community Health Center in Semarang City

Bunga Gustikasari Ismail — 2026-05-26

Background: Online registration services have been implemented in community health centers to facilitate patient access and reduce long queues by enabling appointment scheduling at specific times. However, the utilization of this service in several community health centers in Semarang City remains below the monthly target of 10%. At Sekaran Community Health Center, for example, the average utilization rate was only 1.03% between June and August 2023.

Objectives: This study analyzed the factors associated with the use of the PUSTAKA Online Registration Service at The Sekaran Community Health Center in Semarang City.

Methods: This study employed a quantitative research design with a cross-sectional approach. The population consisted of existing patients at Sekaran Community Health Center, with a sample of 97 respondents selected using accidental sampling. The variables examined included age, education, occupation, attitude, knowledge, perceived need, availability of facilities, and ease of obtaining information in relation to the decision to use PUSTAKA services. Data were collected using a closed-ended questionnaire that had previously undergone validity and reliability testing.

Results: The results of the research analysis using the chi square statistical test showed the conclusion that there was a significant relationship between the factors of age (p = 0.006), education (p = 0.007), occupation (p = 0.044), attitude (p = 0.017), perceived needs (p = 0.006), and ease of obtaining information (p = 0.021) with the decision to use PUSTAKA services at the Sekaran Health Center.

Conclusions: Meanwhile, there is no relationship between knowledge (p = 0.812) and the availability of facilities (p = 0.114) with the decision to use PUSTAKA.