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Papers by Kristien Roelens

BMC Pregnancy and Childbirth

Background Increasing male involvement during pregnancy is considered an important, but often ove... more Background Increasing male involvement during pregnancy is considered an important, but often overlooked intervention for improving maternal health in sub-Saharan Africa. Intervention studies aimed at improving maternal health mostly target mothers hereby ignoring the crucial role their partners play in their ability to access antenatal care (ANC) and to prevent and treat infectious diseases like HIV and malaria. Very little is known about the current level of male involvement and barriers at different levels. This study explores the attitudes and beliefs of health policymakers, health care providers and local communities regarding men’s involvement in maternal health in southern Mozambique. Methods Ten key informant interviews with stakeholders were carried out to assess their attitudes and perspectives regarding male involvement in programmes addressing maternal health, followed by 11 days of semi structured observations in health care centers. Subsequently 16 focus group discussi...

Artificial Intelligence in Medicine

BMC Pregnancy and Childbirth

Background The role of the male partner and wider family in maternal health, especially in case o... more Background The role of the male partner and wider family in maternal health, especially in case of emergencies, has been receiving increasing attention over the last decade. Qualitative research has highlighted that women depend on others to access high quality maternity care. Currently little is known about these factors in relation to maternal health in Mozambique. Methods A cross sectional household survey was conducted with men and women in southern Mozambique about decision making, financial support and knowledge of danger signs. A multivariable logistic model was used to identify factors associated with knowledge of danger signs and Cohen’s kappa for agreement among couples. Results A total of 775 men and women from Marracuene and Manhica districts were interviewed. Maternal health care decisions were frequently made jointly by the couple (32–49%) and financial support was mainly provided by the man (46–80%). Parental and parent-in-law involvement in decision making and financ...

BMJ Open

ObjectivesTo assess the prevalence of major obstetric haemorrhage managed with peripartum hystere... more ObjectivesTo assess the prevalence of major obstetric haemorrhage managed with peripartum hysterectomy and/or interventional radiology (IR) in Belgium. To describe women characteristics, the circumstances in which the interventions took place, the management of the obstetric haemorrhage, the outcome and additional morbidity of these women.DesignNationwide population-based prospective cohort study.SettingEmergency obstetric care. Participation of 97% of maternities covering 98.6% of deliveries in Belgium.ParticipantsAll women who underwent peripartum hysterectomy and/or IR procedures in Belgium between January 2012 and December 2013.ResultsWe obtained data on 166 women who underwent peripartum hysterectomy (n=84) and/or IR procedures (n=102), corresponding to 1 in 3030 women undergoing a peripartum hysterectomy and another 1 in 3030 women being managed by IR, thereby preserving the uterus. Seventeen women underwent hysterectomy following IR and three women needed further IR despite h...

Acta Med Port, 2020

Introduction: The aim of the study described in this paper is to screen medical curricula in rela... more Introduction: The aim of the study described in this paper is to screen medical curricula in relation to the attention paid to intimate partner violence, by applying a framework derived from the international literature. Material and Methods: We screened curricula of five Mozambican medical schools based on a state-of-the-art intimate partner violence curriculum framework. The latter framework was based on a review of the literature. Results: Few medical schools of Mozambique could be identified addressing intimate partner violence in their curriculum. When tackled, intimate partner violence content is mostly dealt within the context of Obstetrics and Gynaecology, Community Health and Forensic Medicine rotations. Intimate partner violence contents are integrated as stand-alone modules in some specific subjects. In none of the schools, specific teachers teaching intimate partner violence could be identified. No time allocation was specified to address the topic; no teaching and learn...

BACKGROUND Midwifery care plays a vital role in the reduction of preventable maternal and newborn... more BACKGROUND Midwifery care plays a vital role in the reduction of preventable maternal and newborn mortality and morbidity. There is a growing concern about the quality of care during facility based childbirth and the occurrence of disrespect and abuse (D&A) worldwide. While several studies have reported a high prevalence of D&A, evidence about the drivers of D&A is scarce. AIM This study aims to explore midwives’ professional identity and perspectives on the occurrence of D&A in urban Mozambique. METHODS A qualitative study took place in the central hospital of Maputo, Mozambique. Nine focus group discussions with midwives were conducted, interviewing 56 midwives. RQDA software was used for analyzing the data by open coding and thematic analysis. RESULTS Midwives felt proud of their profession but felt they were disrespected by the institution and wider society because of their inferior status compared to doctors. Furthermore, they felt being blamed for poor health outcomes. The occ...

Oral Presentations - Proffered Abstracts

BMC Pregnancy and Childbirth

Journal of Psychosomatic Research

BMC Health Services Research

The Journal of nutrition, 2018

The breast-milk composition in the first 6 wk postpartum of women who have undergone bariatric su... more The breast-milk composition in the first 6 wk postpartum of women who have undergone bariatric surgery (BS) is unknown. The aim of this study was to examine 1) the breast-milk macronutrient and vitamin A composition in women who had and who had not undergone BS and 2) the impact of maternal diet on the breast-milk composition. We hypothesized that the milk of women who had undergone BS would be less energy dense and have a lower vitamin A concentration than that of other women. A multicenter prospective substudy was conducted at 2 university hospitals. Breast-milk samples were collected from 24 normal-weight [NW; mean ± SD body mass index (BMI; kg/m2): 21.5 ± 1.7; mean ± SD age: 29 ± 6 y], 39 overweight (OW; BMI: 26.9 ± 1.5; aged 29 ± 5 y), and 12 obese women (BMI: 35.0 ± 5.7; aged 29 ± 5 y) as well as from 11 women who had undergone BS (BMI: 28.0 ± 4.4; aged 30 ± 4 y) from day 3 until week 6 of lactation. Milk energy and macronutrients (Human Milk Analyzer; Miris) and vitamin A con...

BMC pregnancy and childbirth, Jan 6, 2017

We aimed to investigate the impact of a referral-based intervention in a prospective cohort of wo... more We aimed to investigate the impact of a referral-based intervention in a prospective cohort of women disclosing intimate partner violence (IPV) on the prevalence of violence, and associated outcomes psychosocial health, help-seeking and safety behaviour during and after pregnancy. Women seeking antenatal care in eleven Belgian hospitals were consecutively invited from June 2010 to October 2012, to participate in a single-blind randomized controlled trial (RCT) and handed a questionnaire. Participants willing to be interviewed and reporting IPV victimisation were randomised. In the Intervention Group (IG) participants received a referral card with contact details of services providing assistance and tips to increase safety behaviour. Participants in the Control Group (CG) received a "thank you" card. Follow-up data were obtained through telephone interview at an average of 10 months after receipt of the card. At follow-up (n = 189), 66.7% (n = 126) of the participants repor...

Physis: Revista de Saúde Coletiva, 2016

Resumo O estudo explora as percepções e experiências dos homens sobre o planejamento familiar (PF... more Resumo O estudo explora as percepções e experiências dos homens sobre o planejamento familiar (PF) em dois contextos do sul de Moçambique: na localidade de Macarretane (província de Gaza) e no bairro da Mafalala (cidade capital, de Maputo). Combinando métodos qualitativos, exploram-se os conhecimentos e práticas dos homens sobre o PF, bem como percebem seu papel (e envolvimento) na saúde sexual reprodutiva e as formas de diálogo e negociação com suas parceiras sobre o PF. O PF foi definido apenas como barreira às gravidezes indesejadas. Os conhecimentos dos homens sobre o PF do ponto de vista biomédico são fracos. Existe a percepção de que os contraceptivos modernos criam efeitos secundários no corpo da mulher, colocando em risco sua capacidade reprodutiva e o prazer sexual. A capacidade ou incapacidade de negociar o uso do PF pelas mulheres é influenciada pelas normas de gênero e pelas masculinidades vigentes. Os homens consideram que o seu papel no PF é de consentir que as parceir...

BMC Pregnancy and Childbirth

Background Increasing male involvement during pregnancy is considered an important, but often ove... more Background Increasing male involvement during pregnancy is considered an important, but often overlooked intervention for improving maternal health in sub-Saharan Africa. Intervention studies aimed at improving maternal health mostly target mothers hereby ignoring the crucial role their partners play in their ability to access antenatal care (ANC) and to prevent and treat infectious diseases like HIV and malaria. Very little is known about the current level of male involvement and barriers at different levels. This study explores the attitudes and beliefs of health policymakers, health care providers and local communities regarding men’s involvement in maternal health in southern Mozambique. Methods Ten key informant interviews with stakeholders were carried out to assess their attitudes and perspectives regarding male involvement in programmes addressing maternal health, followed by 11 days of semi structured observations in health care centers. Subsequently 16 focus group discussi...

Artificial Intelligence in Medicine

BMC Pregnancy and Childbirth

Background The role of the male partner and wider family in maternal health, especially in case o... more Background The role of the male partner and wider family in maternal health, especially in case of emergencies, has been receiving increasing attention over the last decade. Qualitative research has highlighted that women depend on others to access high quality maternity care. Currently little is known about these factors in relation to maternal health in Mozambique. Methods A cross sectional household survey was conducted with men and women in southern Mozambique about decision making, financial support and knowledge of danger signs. A multivariable logistic model was used to identify factors associated with knowledge of danger signs and Cohen’s kappa for agreement among couples. Results A total of 775 men and women from Marracuene and Manhica districts were interviewed. Maternal health care decisions were frequently made jointly by the couple (32–49%) and financial support was mainly provided by the man (46–80%). Parental and parent-in-law involvement in decision making and financ...

BMJ Open

ObjectivesTo assess the prevalence of major obstetric haemorrhage managed with peripartum hystere... more ObjectivesTo assess the prevalence of major obstetric haemorrhage managed with peripartum hysterectomy and/or interventional radiology (IR) in Belgium. To describe women characteristics, the circumstances in which the interventions took place, the management of the obstetric haemorrhage, the outcome and additional morbidity of these women.DesignNationwide population-based prospective cohort study.SettingEmergency obstetric care. Participation of 97% of maternities covering 98.6% of deliveries in Belgium.ParticipantsAll women who underwent peripartum hysterectomy and/or IR procedures in Belgium between January 2012 and December 2013.ResultsWe obtained data on 166 women who underwent peripartum hysterectomy (n=84) and/or IR procedures (n=102), corresponding to 1 in 3030 women undergoing a peripartum hysterectomy and another 1 in 3030 women being managed by IR, thereby preserving the uterus. Seventeen women underwent hysterectomy following IR and three women needed further IR despite h...

Acta Med Port, 2020

Introduction: The aim of the study described in this paper is to screen medical curricula in rela... more Introduction: The aim of the study described in this paper is to screen medical curricula in relation to the attention paid to intimate partner violence, by applying a framework derived from the international literature. Material and Methods: We screened curricula of five Mozambican medical schools based on a state-of-the-art intimate partner violence curriculum framework. The latter framework was based on a review of the literature. Results: Few medical schools of Mozambique could be identified addressing intimate partner violence in their curriculum. When tackled, intimate partner violence content is mostly dealt within the context of Obstetrics and Gynaecology, Community Health and Forensic Medicine rotations. Intimate partner violence contents are integrated as stand-alone modules in some specific subjects. In none of the schools, specific teachers teaching intimate partner violence could be identified. No time allocation was specified to address the topic; no teaching and learn...

BACKGROUND Midwifery care plays a vital role in the reduction of preventable maternal and newborn... more BACKGROUND Midwifery care plays a vital role in the reduction of preventable maternal and newborn mortality and morbidity. There is a growing concern about the quality of care during facility based childbirth and the occurrence of disrespect and abuse (D&A) worldwide. While several studies have reported a high prevalence of D&A, evidence about the drivers of D&A is scarce. AIM This study aims to explore midwives’ professional identity and perspectives on the occurrence of D&A in urban Mozambique. METHODS A qualitative study took place in the central hospital of Maputo, Mozambique. Nine focus group discussions with midwives were conducted, interviewing 56 midwives. RQDA software was used for analyzing the data by open coding and thematic analysis. RESULTS Midwives felt proud of their profession but felt they were disrespected by the institution and wider society because of their inferior status compared to doctors. Furthermore, they felt being blamed for poor health outcomes. The occ...

Oral Presentations - Proffered Abstracts

BMC Pregnancy and Childbirth

Journal of Psychosomatic Research

BMC Health Services Research

The Journal of nutrition, 2018

The breast-milk composition in the first 6 wk postpartum of women who have undergone bariatric su... more The breast-milk composition in the first 6 wk postpartum of women who have undergone bariatric surgery (BS) is unknown. The aim of this study was to examine 1) the breast-milk macronutrient and vitamin A composition in women who had and who had not undergone BS and 2) the impact of maternal diet on the breast-milk composition. We hypothesized that the milk of women who had undergone BS would be less energy dense and have a lower vitamin A concentration than that of other women. A multicenter prospective substudy was conducted at 2 university hospitals. Breast-milk samples were collected from 24 normal-weight [NW; mean ± SD body mass index (BMI; kg/m2): 21.5 ± 1.7; mean ± SD age: 29 ± 6 y], 39 overweight (OW; BMI: 26.9 ± 1.5; aged 29 ± 5 y), and 12 obese women (BMI: 35.0 ± 5.7; aged 29 ± 5 y) as well as from 11 women who had undergone BS (BMI: 28.0 ± 4.4; aged 30 ± 4 y) from day 3 until week 6 of lactation. Milk energy and macronutrients (Human Milk Analyzer; Miris) and vitamin A con...

BMC pregnancy and childbirth, Jan 6, 2017

We aimed to investigate the impact of a referral-based intervention in a prospective cohort of wo... more We aimed to investigate the impact of a referral-based intervention in a prospective cohort of women disclosing intimate partner violence (IPV) on the prevalence of violence, and associated outcomes psychosocial health, help-seeking and safety behaviour during and after pregnancy. Women seeking antenatal care in eleven Belgian hospitals were consecutively invited from June 2010 to October 2012, to participate in a single-blind randomized controlled trial (RCT) and handed a questionnaire. Participants willing to be interviewed and reporting IPV victimisation were randomised. In the Intervention Group (IG) participants received a referral card with contact details of services providing assistance and tips to increase safety behaviour. Participants in the Control Group (CG) received a "thank you" card. Follow-up data were obtained through telephone interview at an average of 10 months after receipt of the card. At follow-up (n = 189), 66.7% (n = 126) of the participants repor...

Physis: Revista de Saúde Coletiva, 2016

Resumo O estudo explora as percepções e experiências dos homens sobre o planejamento familiar (PF... more Resumo O estudo explora as percepções e experiências dos homens sobre o planejamento familiar (PF) em dois contextos do sul de Moçambique: na localidade de Macarretane (província de Gaza) e no bairro da Mafalala (cidade capital, de Maputo). Combinando métodos qualitativos, exploram-se os conhecimentos e práticas dos homens sobre o PF, bem como percebem seu papel (e envolvimento) na saúde sexual reprodutiva e as formas de diálogo e negociação com suas parceiras sobre o PF. O PF foi definido apenas como barreira às gravidezes indesejadas. Os conhecimentos dos homens sobre o PF do ponto de vista biomédico são fracos. Existe a percepção de que os contraceptivos modernos criam efeitos secundários no corpo da mulher, colocando em risco sua capacidade reprodutiva e o prazer sexual. A capacidade ou incapacidade de negociar o uso do PF pelas mulheres é influenciada pelas normas de gênero e pelas masculinidades vigentes. Os homens consideram que o seu papel no PF é de consentir que as parceir...

Introduction There is growing evidence in the literature that the majority of medical doctors do... more Introduction

There is growing evidence in the literature that the majority of medical doctors do not recognize the signs and symptoms of Intimate Partner Violence (IPV) or its impact on women’s as well as men’s health. It is considered by many as a social or cultural issue. Regarding the perceptions of how medical doctors should address IPV, survivors agree that the first thing that physicians should bear in mind is that anyone can be a survivor of IPV and second that IPV is not only sexual assault. Lack of skills and resources to manage IPV, time constraints, discomfort with the subject, limited referral points, sharing the same cultural and gender norms of survivors, are some of the reasons why there is resistance among medical doctors to address IPV.

General objective
To identify ways to improve curricula on IPV mitigation-content in order to enhance prevention and medical care in Mozambique.