Implanon has a low first-year discontinuation rate as compared with other contraceptive methods. FP clients should be given sufficient pre-insertion counselling about side effects of Implanon and duration of protection. Physicians should offer Implanon mainly to clients seeking long-term contraception in order to decrease its discontinuation rate and increase its cost effectiveness.

Background Female genital mutilation/cutting (FGM/C) is a traditional harmful practice that has been prevalent in Egypt for many years. The medicalization of FGM/C has been increasing significantly in Egypt making it the country with the highest rate of medicalization. In this qualitative study, we explored the drivers and motives behind why healthcare professionals perform FGM/C and why mothers rely on them to perform the practice on their daughters. Methods The study drew on a “mystery client” approach, coupled with in-depth interviews (IDIs) and focus group discussions (FGDs) with health care providers (i.e. physicians and nurses) and mothers. It was conducted in three geographic areas in Egypt: Cairo, Assiut and Al Gharbeya. Results Study findings suggest that parents who seek medicalized cutting often do so to minimize health risks while conforming to social expectations. Thus, the factors that support FGM/C overlap with the factors that support medicalization. For many mothers and healthcare providers, adherence to community customs and traditions was the most important motive to practice FGM/C. Also, the social construction of girls’ well-being and bodily beauty makes FGM/C a perceived necessity which lays the ground for stigmatization against uncut girls. Finally, the language around FGM/C is being reframed by many healthcare providers as a cosmetic surgery. Such reframing may be one way for providers to overcome the law against FGM/C and market the operation to the clients. Conclusion These contradictions and contestations highlighted in this study among mothers and healthcare providers suggest that legal, moral and social norms that underpin FGM/C practice are not harmonized and would thus lead to a further rise in the medicalization of FGM/C. This also highlights the critical role that health providers can play in efforts to drive the abandonment of FGM/C in Egypt. Electronic supplementary material The online version of this article (10.1186/s12914-019-0202-x) contains supplementary material, which is available to authorized users.

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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease which affects all aspects of quality of life (QoL) of the patients. Comprehensive patient assessment should include QoL measures in addition to the objective clinical measures of the disease. There is no specific Arabic instrument for assessment of QoL of SLE patients. The objective of this study was to translate and cross culturally adapt the SLEQOL questionnaire into Arabic and test its reliability and validity. The SLEQOL questionnaire was translated into Arabic based on the Guidelines for Translation and Cross-cultural Adaptation into other languages. Reliability was assessed by interviewing patients three times: two interviews on the same day by different interviewers and the third interview 14 days later by one of the first interviewers. Validity was assessed by correlating SLEQOL scores of 91 patients with 36-item Short Form Health Survey (SF-36) scores and clinical parameters of the patients. We found that the Arabic version of SLEQOL has a Cronbach's alpha of 0.936, interobserver and intraobserver correlation coefficients of 0.809 and 0.886 respectively. Strong correlations were also found between SLEQOL scores and SF-36 Physical and Mental Component summaries. In conclusion, the Arabic version of SLEQOL is a reliable and valid instrument for measuring QoL of Egyptian SLE patients.

Background: Domestic violence against women (DVAW) is widely recognized as a public health problem. In India, health sector response to DVAW is suboptimal. Present study aimed to assess the knowledge, attitude, practice and learning needs of nursing personnel regarding women’s health issues related to domestic violence.Methods: This facility based cross sectional study was carried out among 100 nursing personnel from Public sector in Delhi, selected using stratified random sampling. Data were collected using a validated, pretested, structured self reported questionnaire with a few open ended questions. It included knowledge, attitude, practice and learning needs of nursing personnel relevant to DV. Descriptive statistics were used for data analysis using Stata 11.0 (College Station, Texas, USA).Results: Two third of nursing personnel (67%) had moderate knowledge scores and 27% had poor knowledge scores; 19% had favourable attitude scores towards DV; 57% had good practice scores; 44% reported moderate to high need for learning and majority lacked preparedness to manage DV victims. The knowledge was significantly associated with younger age, single, graduate/ Post graduates, B.Sc. Nursing degree holders, working in tertiary hospital, as staff nurse/public health nurse/sister in charge and those with lesser experience, (p<0.05). The attitude was significantly associated with younger age, single, graduate/post graduates, and those with lesser experience, (p<0.05).Conclusions: Nursing personnel had substantial gap in their knowledge, attitude and practice related to DV and a large unmet learning need highlighting the need for relevant pre service and continuing education.

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