Perspectives of Kurdish Postnatal Women on Respectful Maternity Care: A Qualitative Study Khalat Karwan Fares, Hamdia Mirkhan Ahmed, Kochr Ali Mahmood, Sirwan Khalid Ahmed, Hiwa Abdulrahman Ahmad, et al. Health Science Reports, 2026 Background and Aims Respectful maternity care (RMC) is an essential component of high‐quality maternal healthcare and a fundamental human right, ensuring that women experience childbirth with dignity, privacy, and autonomy. Despite global efforts to promote RMC, many women, particularly in low‐ and middle‐income countries, continue to experience mistreatment and disrespect during childbirth. This study aims to elucidate Kurdish postnatal women's preferences regarding respectful behaviors and interactions during labor and delivery, while also exploring their lived experiences, expectations, and the challenges they encounter within the healthcare system. Methods A qualitative descriptive study design was employed, from September 18, 2023 to December 26, 2023, utilizing semi‐structured in‐depth interviews with 20 postnatal women in a public hospital setting in the Kurdistan Region of Iraq. Participants were selected through purposive sampling to capture diverse socio‐economic and cultural backgrounds. Thematic analysis was used to identify key themes related to RMC, guided by the WHO framework on respectful maternity care. Results Thematic analysis revealed six major themes: respect and dignity, gentleness and supportive care, clear communication, privacy, family presence, and cultural and religious sensitivity. Women emphasized the importance of non‐discriminatory treatment, kind and patient midwives, clear and respectful communication, and privacy during medical procedures. Family presence during labor and culturally sensitive practices were also highly valued. Additionally, some women reported concerns regarding verbal abuse, neglect, and socioeconomic discrimination, indicating gaps in the provision of RMC. Conclusions The findings highlight the urgent need for healthcare systems in the Kurdistan region to align maternity care practices with the cultural, emotional, and physical needs of women. Recommendations include enhanced training for maternity care providers on respectful, patient‐centered care, ensuring privacy, accommodating cultural and religious preferences, and supporting the involvement of family members during labor. Addressing these areas can strengthen trust in maternity services, improve maternal experiences, and contribute to broader global goals in maternal health and human rights.
Association between body weight perception and actual body mass index among adult women in Erbil city, Iraq Sherzad A. Shabu, Mariwan H. Saka, Manhal N. Boya, Hamdia M. Ahmed, Sahar M. Zaki, et al. Journal of Health Population and Nutrition, 2024 Background The misperception of body weight can significantly affect individuals' health behaviors, such as physical activity, diet, and weight management. This study aimed to examine the association between body weight perception and actual body mass index (BMI) among adult women and explore the factors influencing this relationship. Methods Five hundred forty female individuals aged 18–65 participated in this cross-sectional study. The validated Global Physical Activity Questionnaire was used for data collection. The BMI of the participants was calculated from measured body weight and height. Body weight perception was assessed using a single questionnaire item. The association of BMI and body weight perception was assessed, and the result was categorized as underestimation, consistency, and overestimation. The Chi-square test was used to assess the association between the consistency of BMI and body weight perception by different sociodemographic factors. The kappa test was used to analyze the consistency of BMI and body weight perception. Results Of the 540 participants, 13.3% underestimated their body weight status, 79.1% accurately perceived their body weight status, and 7.6% overestimated their body weight status. Unmarried women (11.7%) were more likely than ever married (4.3%) to overestimate their body weight (p = 0.005). On multiple logistic regression, being unmarried (OR = 1.68 (95%CI 1.01–2.80)) was significantly associated with body weight misperception. Body weight perception and BMI categories showed a significantly good consistency (kappa = 0.612, p < 0.001). Correct perception of body weight was highest among the overweight, followed by normal weight and underweight individuals (82.1%, 75.8%, and 72.2%, respectively). Conclusion Body weight perception was well associated with actual body weight status. Unmarried women are more likely to misperceive body weight, particularly overestimating it. Underestimation of body weight was relatively high and much higher than the overestimation, which might keep obese individuals from weight loss activities. Preventing obesity should include awareness about body weight misperceptions.
Research practice, satisfaction, motivation, and challenges among university academics in Kurdistan Region of Iraq Hamdia Mirkhan Ahmed, Nazdar Ezzaddin Alkhateeb, Nazar P. Shabila, Amir Abdulrahman Ahmad Plos One, 2024 Background Researchers in universities and academic institutions must be in a leading position in generating research evidence to inform and direct national policies and strategies, improve service delivery, and achieve the main objectives. This study aimed to determine the factors that promote or hinder research productivity and quality among university academics in Kurdistan Region of Iraq. Methods A cross-sectional study was conducted on 949 university academics from all public universities in the Kurdistan Region of Iraq. The authors developed a questionnaire that included sociodemographic data, challenges, satisfaction, and motivation for conducting research. Data were collected using a Google form. Frequencies, percentages, and the Chi-square test were used to analyze the data. Results Most university academics (94.6%) believed that research was part of their job, but only 51.6% were satisfied with their role as academic researchers. The lack of financial motivation was the main reason for dissatisfaction, while the main incentive to conduct research was the passion for science. Around 21% of the university academics had not published any research, while 53.1% published 1–5 articles. Half of the participants (49.7%) lacked training in writing research proposals, and the majority (86.1%) have not applied for international grants. Approximately half of university academics (46.9%) shared their research findings with stakeholders, and the primary method was by sharing their published papers (59.4%), followed by seminars (42.2%). One of the important challenges in conducting research was the lack of funding (62.8%). Conclusions The academics at universities in the Kurdistan Region of Iraq are passionate about their role as researchers, but face many challenges in conducting effective research. A strategic plan is needed to provide an encouraging environment for university academics regarding infrastructure, financial, and technical support. More studies are needed to identify the root factors of academic staff needs and challenges.
A cross-sectional study on the perceived barriers to physical exercise among women in Iraqi Kurdistan Region Sherzad A. Shabu, Mariwan H. Saka, Dara A. Al-Banna, Sahar M. Zaki, Hamdia M. Ahmed, et al. BMC Women S Health, 2023 Background Limited research has investigated the barriers to physical exercise among women in Iraqi Kurdistan Region and other similar Muslim and Middle Eastern societies. This study aimed to determine the prevalence of perceived barriers to physical exercise among women and examine the associations of these barriers with the participants’ sociodemographic characteristics. Methods A cross-sectional study was carried out in Erbil, Iraqi Kurdistan Region, from December 2022 to January 2023. A self-administered online survey was designed using Google Forms. A convenience sample of 500 women and girls aged 18–65 years was selected for the study. A questionnaire was designed for data collection, including a list of 21 potential barriers to physical exercise developed based on literature review and experts’ opinions. The barriers were divided into three categories: interpersonal (8 barriers), social environment (8 barriers), and built environment factors (5 barriers). The participants were asked to indicate for each potential barrier whether it was “not really a barrier, somewhat a barrier, or a very important barrier.“ The statistical package for social sciences was used to estimate the prevalence of different barriers and assess their association with sociodemographic characteristics using the Chi-square test. Results The prevalence of physical inactivity among the study participants was 68.2%. The most prevalent interpersonal barriers to physical exercise included lack of time (47.4%), followed by fatigue (24%), and cost (22.4%). Regarding social environment factors, work (30.6%), harassment outside (22.2%), not having a friend or family member accompanying (19%), and not being allowed by family (15.4%) were the most prevalent barriers to physical exercise. Lack of footpaths, cycle lanes, or parks (34.4%), limited accessibility of gyms or other exercise facilities (25.8%), and environmental pollution (21%) were the most prevalent built environment factors as barriers to physical exercise. Conclusion Women in Iraqi Kurdistan Region experience many barriers to physical exercise. Women require family and social support and awareness about exercise benefits to overcome interpersonal and social environment barriers to physical exercise. Built environment factors are very important barriers and can be reduced by taking appropriate action and adopting necessary policies to provide the required infrastructure and facilities for physical exercise.
Attitudes of Islamic Clerics to Receiving COVID-19 Vaccine in Iraqi Kurdistan: A Focus Group Study Deldar Morad Abdulah, Hamdia Mirkhan Ahmed Disaster Medicine and Public Health Preparedness, 2023 Objectives: Religious beliefs may play a role in the rejection and acceptance of coronavirus disease (COVID-19) vaccines. We aimed to explore attitudes of Islamic clerics toward receiving the COVID-19 vaccines in a semi-structured qualitative focus group study. Methods: The clerics of members of the Union of Muslim Scholars of the Erbil branch were included through their representative in Iraqi Kurdistan in 2021. Results: This study found that both acceptance and non-acceptance focus groups approved of the existence and importance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The acceptance group intended to receive COVID-19 to protect themselves and tried to convince people to receive the vaccine. However, the non-acceptance focus group did not believe in the COVID-19 vaccine due to different reasons: (1) COVID-19 vaccines have been commercialized and politicized by the governments; (2) the government makes limitations for the people due to COVID-19; (3) making fake vaccine cards; and (4) several serious side effects of COVID-19 (death, etc.) and not receiving by health care workers. The acceptance group reported that some rumors are spread in our community and impact the public to not receive COVID-19 vaccines. Conclusions: This study showed that some Islamic clerics have serious concerns about the side effects of COVID-19 vaccines.
Knowledge, attitudes, and positions of religious leaders towards female genital cutting: A cross-sectional study from the Kurdistan Region of Iraq Kazhan I. Mahmood, Sherzad A. Shabu, Karwan M-Amen, Abubakir M. Saleh, Hamdia Ahmed, et al. Plos One, 2022 Background Understanding the perspectives of the key players in the community regarding female genital cutting (FGC) is very important for directing preventive programs. Religious leaders help shape community behaviors, which is highly pertinent in the case of FGC as it is frequently perceived to be a religious requirement. This study assesses religious leaders’ knowledge, attitudes, and positions towards FGC in the Kurdistan Region of Iraq. Methods This cross-sectional study was conducted in the Kurdistan Region of Iraq. It included a purposive sample of 147 local religious leaders (khateebs) representing the three governorates of Erbil, Sulaimaniyah, and Duhok. A self-administered questionnaire was used to collect data about the religious leaders’ knowledge, attitude, and position towards FGC. Results The participants identified reduction of the sexual desire of women as the main benefit (37%) and risk (24%) of FGC. Cultural tradition and religious requirements were the main reported reasons for practicing FGC. About 59% of the religious leaders stated that people ask for their advice on FGC. Around 14% of the participants supported performing FGC, compared to 39.1% who opposed it. Religious (73.9%) and cultural (26.1%) rationales were the main reasons given for supporting FGC. Being a cultural practice with harmful effects (53.5%) and lack of clear religious evidence (46.6%) were the main reasons for being against FGC. Around 52% of the participants recommended banning FGC by law, while 43.5% did not support banning it. A statistically significant association (P = 0.015) was found between religious leaders’ residence and their position on performing FGC. More than 46% of those residing in Duhok were against performing FGC, compared to lower proportions in Erbil (38.8%) and Sulaimaniyah (30%). Conclusion Religious leaders believed that cultural tradition was the main reason behind practicing FGC and they believed that FGC is not common in KRI, and even that it is decreasing. The religious leaders in our study reported that they could have an influential role in the FGC issue due to their position in the community. There was no statistically significant association between religious leaders’ age, education level, or work experience and their position on performing FGC. However, a statistically significant association was found between religious leaders’ residence and their position on performing FGC. A conclusive decision concerning the prohibition of FGC needs to be made by religious authorities. Health awareness activities incorporating FGC risks should be carried out to inform religious leaders at different levels of religious positions. Further research exploring perspectives of religious authorities concerning religious leaders’ inconclusive judgment about FGC is deemed necessary.
Healthcare worker’s attitude toward spirituality and spiritual care in the intensive care unit with COVID-19 Pakistan Journal of Medical and Health Sciences, 2020
Prevalence and determinants of physical activity, leisure exercise, and sedentary behavior in women in Erbil: cross-sectional findings NP Shabila, SA Shabu, MN Boya, MH Saka, AM Saleh, HM Ahmed, ... Discover Public Health 23 (1), 682 , 2026 2026
Gestational weight gain status and body satisfaction among Kurdish women: A cohort study RG Abdulwahid, HM Ahmed 2026
Perspectives of Kurdish Postnatal Women on Respectful Maternity Care: A Qualitative Study KK Fares, HM Ahmed, KA Mahmood, SK Ahmed, HA Ahmad, MKK Rony Health Science Reports 9 (3), e72181 , 2026 2026
University of Kufa, Faculty of Nursing FM Azo, MY Yaseen, ME Seniar, SS Piro, TJ Piro, HM Ahmed Kufa Journal for Nursing Sciences 16, 1 , 2026 2026
Prevalence of stressful life events among women in Kurdistan Region: a Cross-Sectional Study FM Azo, SS Piro, MY Yaseen, ME Seniar, HM Ahmed Mosul Journal of Nursing 13 (2), 331-347 , 2025 2025
Medical Rights Violations and the Unethical Treatment of Kurdish Women: A Qualitative Study of Childbirth Experiences in Public Hospitals TJ Piro, KM Ahmad, AA Saeed, WH Abdullah, D Rasoal, HM Ahmed 2024
Maternal health experiences, depression, and anxiety among refugees and displaced persons in Iraq: a cross-sectional study HM Ahmed, SA Abdulla, N Al-Tawil, K Mishkin, N Al-Tawil Sr Cureus 16 (8) , 2024 2024 Citations: 5
Psychosocial and sexual aspects of female genital circumcision in a sample of Kurdish women in the Kurdistan Region of Iraq AH Hamad, HM Ahmed, AN Ali, AF Saber, AH Hamad, A Naif Cureus 16 (7) , 2024 2024 Citations: 14
Physical Factors of Spontaneous Abortion in Maternity Teaching Hospital in Erbil City JK Salh, HM Ahmed Erbil Journal of Nursing and Midwifery 7 (1), 01-09 , 2024 2024
Research practice, satisfaction, motivation, and challenges among university academics in Kurdistan Region of Iraq HM Ahmed, NE Alkhateeb, NP Shabila, AA Ahmad Plos one 19 (4), e0302540 , 2024 2024 Citations: 12
Prevalence, patterns, and determinants of physical activity and sedentary behavior in women in the Kurdistan Region of Iraq A Saleh Research Square (Research Square) , 2024 2024
Association between body weight perception and actual body mass index among adult women in Erbil city, Iraq SA Shabu, MH Saka, MN Boya, HM Ahmed, SM Zaki, F Hettinga, ... Journal of Health, Population and Nutrition 43 (1), 15 , 2024 2024 Citations: 9
Patient satisfaction with nursing care based on Newcastle Satisfaction with Nursing Scale in Erbil/Iraq MA Hajy, KM Ahmed, NS Ahmed, HM Ahmed continuity 13, 1320-1325 , 2024 2024 Citations: 3
Breast cancer stigma in iraq HM Ahmed, K Khoshnood Current Breast Cancer Reports 15 (4), 345-349 , 2023 2023 Citations: 2
A cross-sectional study on the perceived barriers to physical exercise among women in Iraqi Kurdistan Region SA Shabu, MH Saka, DA Al-Banna, SM Zaki, HM Ahmed, NP Shabila BMC Women's Health 23 (1), 543 , 2023 2023 Citations: 14
The Association of Knowledge and Practice of Body Mechanics and Lumbopelvic Pain among Pregnant Women: A Cross-sectional Study. BO Muhammad, HM Ahmed Journal of Midwifery & Reproductive Health 11 (4) , 2023 2023 Citations: 2
REPRODUCTIVE AND URINARY SYSTEM’S COMPLICATIONS AFTER CESAREAN SECTION VERSUS VAGINAL DELIVERY: A COMPARATIVE STUDY IN DUHOK CITY/IRAQ BH SADEQ, HM AHMED Journal of Duhok University 26 (1), 394-402 , 2023 2023
Effect of respectful maternity care and effective communication during labor on childbirth satisfaction: an interventional study KKFKK Fares, KK Fares, HM Ahmed 2023 Citations: 2
Prevalence and Associated Factors with Attending Antenatal Care in Akre City, Iraq BM Ahmed, HM Ahmed Erbil Journal of Nursing and Midwifery 6 (1), 84-93 , 2023 2023 Citations: 1
Maternal Satisfaction with Home Versus Health Facility Postnatal Nursing Intervention: A quasi Experimental Study R Mohamed, H Ahmed Kufa Journal for Nursing Sciences 13 (1) , 2023 2023
MOST CITED SCHOLAR PUBLICATIONS
Impacts of antenatal nursing interventions on mothers’ breastfeeding self-efficacy: an experimental study SS Piro, HM Ahmed BMC pregnancy and childbirth 20 (1), 19 , 2020 2020 Citations: 223
Perspectives and pregnancy outcomes of maternal Ramadan fasting in the second trimester of pregnancy Kolsoom Safari, Tiran Jamil Piro, Hamdia Mirkhan Ahmad BMC Pregnancy and Childbirth 19 (128) , 2019 2019 Citations: 72
Role of verbal and non-verbal communication of health care providers in general satisfaction with birth care: a cross-sectional study in government health settings of Erbil … HM Ahmed Reproductive health 17 (1), 35 , 2020 2020 Citations: 70
Screening for postpartum depression using Kurdish version of Edinburgh postnatal depression scale HM Ahmed, SK Alalaf, NG Al-Tawil Archives of gynecology and obstetrics 285 (5), 1249-1255 , 2012 2012 Citations: 67
A qualitative assessment of women’s perspectives and experience of female genital mutilation in Iraqi Kurdistan Region HM Ahmed, SA Shabu, NP Shabila BMC women's health 19 (1), 66 , 2019 2019 Citations: 58
Women’s views and experiences of antenatal care in Iraq: a Q methodology study NP Shabila, HM Ahmed, MY Yasin BMC pregnancy and childbirth 14 (1), 43 , 2014 2014 Citations: 56
Knowledge and perspectives of female genital cutting among the local religious leaders in Erbil governorate, Iraqi Kurdistan region NPSBQM Hamdia M. Ahmed2 , Mosleh S. Kareem2 Reproductive Health 15 (44) , 2018 2018 Citations: 49
Effect of change in position and back massage on pain perception during first stage of labor SASK Ali, HM Ahmed Pain Management Nursing 19 (3), 288-294 , 2018 2018 Citations: 41
Prevalence of urinary incontinence and probable risk factors in a sample of kurdish women HM Ahmed, VA Osman, SK Al-Alaf, NG Al-Tawil Sultan Qaboos University Medical Journal 13 (2), 269 , 2013 2013 Citations: 35
knowledge, practice and attitude of married women about preconception care H Ahmed, P Tiran Journal of Client - centered Nursing care 3 (1), 37-44 , 2017 2017 Citations: 26
Rate and indications of cesarean section in Maternity Teaching Hospital In Erbil City/Kurdistan region/Iraq NGAT HM Ahmed Zanko Journal of Medical Sciences 22 (1) , 2017 2017 Citations: 25
Midwives’ clinical reasons for performing episiotomies in the Kurdistan Region: are they evidence-based? HM Ahmed Sultan Qaboos University Medical Journal 14 (3), e369 , 2014 2014 Citations: 25
Knowledge, attitude, and experience of health professionals of female genital mutilation (FGM): A qualitative study in Iraqi Kurdistan Region NP Shabila, HM Ahmed, K Safari Health care for women international 38 (11), 1202-1218 , 2017 2017 Citations: 23
Effect of respectful maternity care and effective communication during labor on postpartum depression: an interventional study KK Fares, HM Ahmed Pakistan Journal of Medical & Health Sciences 15 (9), 2692-8 , 2021 2021 Citations: 22
Psychosocial and sexual aspects of female genital circumcision in a sample of Kurdish women in the Kurdistan Region of Iraq AH Hamad, HM Ahmed, AN Ali, AF Saber, AH Hamad, A Naif Cureus 16 (7) , 2024 2024 Citations: 14
A cross-sectional study on the perceived barriers to physical exercise among women in Iraqi Kurdistan Region SA Shabu, MH Saka, DA Al-Banna, SM Zaki, HM Ahmed, NP Shabila BMC Women's Health 23 (1), 543 , 2023 2023 Citations: 14
Prevalence and severity of anemia among pregnant women in primary health centers/Erbil City RG Abdulwahid, HM Ahmed Kurdistan Journal of Applied Research 2 (2) , 2017 2017 Citations: 14
Assessment of women's perspectives and experiences of childbirth and postnatal care using Q-methodology NP Shabila, HM Ahmed, MY Yasin EMHJ-Eastern Mediterranean Health Journal 21 (9), 647-654 , 2015 2015 Citations: 14
Prevalence of abnormal vaginal signs and symptoms among attendees of Obstetrics and Gynecology Department of Shaqlawa Hospital HM Ahmed, VH Rasool, NG Al-Tawil Medical Journal of Babylon 11 (1), 120-9 , 2014 2014 Citations: 14
Factors associated with experiencing lifetime intimate partner violence among pregnant displaced women living in refugee camps in Erbil, Iraq HMASSM Kathryn E. Mishkin Global Public Health , 2022 2022 Citations: 13
