---

Background: Preconception care is an opportunity to change unhealthy behaviors which in turn reduces unplanned pregnancy and plays an important role in reducing maternal and infant mortality. The aim of this study was to determine the level of preconception care and its related factors in pregnant women.
 
Methods: This cross-sectional study was conducted on 394 pregnant women referred to Gorgan health centers in 2017. Samples were selected by multi-stage stratified sampling method from Gorgan health centers in Golestan province. Data was gathered using self-report questionnaire. Data analysis was performed using chi-square test, Fisher's exact, and Kruskal-Wallis tests in SPSS-16. The P-value less than 0.05 were considered significant.
 
Results: 32.7%  of women were received complete preconception care and 17.8%  had no pre-pregnancy care. Only 44.2% of women used folic acid daily since the first trimester of pregnancy. Most of pregnant women (63.7%) performed triple screening laboratory test (FBS, CBC, TSH). Preconception care was more successful in mothers with higher level of education (p<0.001), having health insurance (p<0.001), history of disease (p=0.027), higher family income (p=0.044), and nulliparity (p= 0.049).
 
Conclusions: Preconception care coverage and acid folic consumption is not optimal. It seems necessary to plan more precisely on how such services need to be provided. The identification of factors associated with this care showed that far less attention was paid among low-income, without assurance coverage and low-educated people. Since these people do not have enough money to take care of mother and infant during pregnancy, health policymakers should provide the related services for free.
 

---

Background: Infants are regarded as the most vulnerable group with special needs in natural disasters. Since midwives are responsible for providing reproductive health services for infants in natural disasters, this study was performed to assess their professional competencies. Methods: This cross-sectional study was conducted in Tehran, Iran. A total of 361 midwives were selected by cluster sampling method. After giving them informed consents, they participated in the study and completed the researcher-made questionnaire on providing health services for infants in natural disasters. Their professional competence was investigated through self-assessment in terms of their perceived importance, knowledge, and skill. Midwives inclusion criteria were as follows: having a degree in midwifery, having at least 6 months of experience in one of the public hospitals in the city, and a desire to participate in the study. Those who did not complete about 15% of the questionnaire items were decided to be excluded from the study.The Questionnaire included 10 items about infant care designed based on literature review of the resources and associated with the goals of MISP (Minimum package of the reproductive health services in natural disasters). To evaluate the instruments` validity, the questionnaire was given to 15 faculty members of the Nursing and Midwifery School of Tehran University of Medical Sciences. Five midwives were members of Tehran Red Crescent. After receiving comments from midwives and faculty members, the questionnaire items were reviewed. For analyzing the questionnaire reliability, the Cronbach coefficient α was calculated with 0.8. The data were analyzed by using SPSS, version 17. The analyses included descriptive and analytical statistics such as ANOVA, t-test at a significance level P<0.05. Results: Mean (SD) total score of professional competency of midwives in providing services for infants in natural disasters was 91.95(20.2) obtained from 3 subcategories: perceived importance, 39.83(9.55); knowledge, 22.5(5.06); and skill 30.16(6.86). There were significant relationships between the scores of professional competency of midwives with age (P=0.053), degree of education (P=0.028), workplace (P=0.053), and experience in natural disaster (P=0.047). About 49.86% of midwives demonstrated middle level of professional competency. The lowest knowledge and skill score were reported in managing common neonatal problems e.g. asphyxia, sepsis, physical trauma, which require referral and stability. Conclusions: The average scores of professional competencies of midwives to deliver Reproductive health service to infants in natural disasters show the necessity of related and integrated education. It is recommended that by holding emergency maneuvers and natural disaster simulations, midwives be educated with regard to natural disasters in order to know how to respond in these challenging situations. 

---

Background: reproductive health is having physical, mental and social health not being sick or disable, in all related systems of reproduction, function and its process. This study aims to investigate the effective factors on using reproductive health services and their outcomes.
Methods: this was a narrative review and the keywords, including reproductive health, family health, services, health promotion, barriers and effective factors outcome, were determined basing on Mesh and searching the papers in Google, PubMed, Science Direct, SID and Scholar, published since 1990 to 2019. The criteria to participate in this study included the papers examined the effective barriers on using  reproductive health services and their outcomes; the criteria of putting unrelated papers aside were basing on the subject. Finally 39 papers were chosen from 85 ones (26 English and 13 Persian papers) to write the review.
Results: our findings in this paper were related to the effective barriers on using reproductive health services and their outcomes and divided into four groups. the effective barriers on using reproductive health services included poverty, violence, migration, injustice , inequality and their outcomes as the outcomes of poverty (access to modern family planning services, difference between fertility in urban and rural population due to in equality in access to contraception methods , differences in level of women’s knowledge about reproduction issues in poor and rich communities , increasing infertility, unsafe abortion and increasing  sexually transmitted diseases ), violence including some scopes like mental health (depression, sleep disorder, Posttraumatic Stress Disorder and suicide), reproductive health (unintended pregnancy, unsafe abortion, Complications of pregnancy, sexual disorders and   sexually transmitted diseases like HIV), risky behaviors (unprotected sex, multiple sex partners and sexual violence ), tragic outcomes (death caused by pregnancy complications, rape, unsafe apportion, killing newborn infant and suicide) and social outcomes (unintended pregnancy, leaving school, losing relationships and rejection by family and friends ), migration (increasing undesirable outcomes of pregnancy like low birth weight, sexually transmitted diseases, induced abortion and decreasing access to health services ) , injustice and inequality (reduced access to family planning services by poor communities comparing to rich ones and increasing fertility, increasing unintended pregnancy, short intervals between pregnancies and increasing family members ).
 Conclusions: according to the important role of reproductive health in human and communities, training people is necessary, not only for medical reasons but also as a basis in strength of marital life. Lack of information or incorrect data can increase family and marital problems so the effective factors and barriers should be determined and met.

---

Background: Today, one of the key ways to promote Sexual and Reproductive Health of women is to attract men's participation in this field. Since there are challenges in our information about men's knowledge of their role in this field, the present study was designed to determine men's knowledge of their participation in women's sexual and reproductive health and its predictive factors in Iranian men.
Methods: The present study was designed and psychometrically analyzed the men's knowledge about their participation in sexual and reproductive health and then their knowledge was evaluated and described. In order to design the tool, the basics were prepared by interviewing and reviewing the texts.
 Then, face (qualitative and quantitative), content (qualitative and quantitative), structure (convergent and discriminant) validity, and reliability of the scale were assessed. Then, in a descriptive-analytic study, 449 men were selected by convenience method from health centers, Nowshahr and Chalus cities in Mazandaran province.
 Inclusion criteria included married men over 15 years of age with at least a fifth grade literacy in Farsi who came to health centers and who volunteered to participate in the study. Data were collected using a questionnaire (designed by the research team). The minimum knowledge score was 39 and the maximum was 195.
Results: Face (qualitative and quantitative (impact score>1.5)), content (qualitative and quantitative (CVR>0.62 and CVI>0.70)), structure (convergent and discriminant) validity, and reliability of the scale (Cronbach’s alpha > 0.7) were acceptable for all factors as well as internal consistency and structural reliability based on standard indices.
Confirmatory and exploratory factor analysis extracted six items of 28 items: "emotional and gender attention", "support for girls", "attention and supply of sexual and reproductive health needs", "violence avoidance", "responsibility" and "reproductive rights" with 28 items. The six-factor fitting of men's knowledge tool was confirmed by standard indices.
14.5% of the participants had a under school diploma. Most of them (76.4%) reported average household income. The maximum age of 72 was at least 23 and their mean age was 42.6. The results showed that the mean score of men's knowledge was 127.45 ± 8.33 and the maximum was 140, at least 86. Significant predictors in the regression analysis were forced marriage (B = -10.676), economic violence (B = -1.381), and having a history of abortion (B = -2.022).
Conclusions: The findings of the study showed that men's knowledge is inversely correlated with men's economic violence against women and forcing young people to choose a partner against their own inner desires and also with unwanted pregnancy and abortion. Therefore, policymakers and managers are recommended to pay close attention to increasing men's knowledge and it’s predictive to prevent these three inappropriate social phenomena.

---

---

Background: Preconception care is an opportunity to change unhealthy behaviors, and reduces unplanned pregnancies and plays important role in reducing maternal and infant mortality. Considering the importance of these care services, this study was conducted to determine preconception care and its related factors in Groan's pregnant women.
Methods: This cross-sectional descriptive study was conducted on 394 pregnant women referring to Gorgan health centers. Samples were selected by multi-stage Stratified sampling. Bayrami's researcher-made questionnaire, that validity and reliability Steps has been accomplished in Mashhad urban community, was used to collect information. Data analysis was performed by using SPSS16 software and chi-square test and KruskalWallis. P value less than 0.05 was considered significant.
Results: 32.7% (129) of women was received complete preconception care and 17.8% (70) had no pre-pregnancy care, only, 44.2% (174) of women used folic acid daily from the previous three months of pregnancy. Also, 251 (63.7%) of pregnant women performed triple screening laboratory test (FBS, CBC, TSH). Preconception care was done better in mother's with high education (P <0.001), health insurance (P <0.001), illness history (P <0.005), high family income (P <0.001) and nulliparity (P = 0.001).
Conclusions: Preconception care coverage and acid folic consumption is not optimal. It seems to be necessary to plan more precisely how such services are provided. The identification of factors associated with this care, showed that less attention was paid for low-income, without assurance coverage and low-educated people. Although these people will not have enough money to take care of their during pregnancy, health policymakers should take care of these services for free.