Hamdia Mirkhan Ahmed

@hmu.edu.krd

College of Health Sciences
Hawler Medical University



                    

https://researchid.co/hamdia76

RESEARCH INTERESTS

Nursing, Midwifery, Women's health, Health System, Nursing Philosophy, Ethics

27

Scopus Publications

693

Scholar Citations

13

Scholar h-index

17

Scholar i10-index

Scopus Publications

  • 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, Florentina Hettinga, and Nazar P. Shabila

    Springer Science and Business Media LLC
    Abstract 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, and Amir Abdulrahman Ahmad

    Public Library of Science (PLoS)
    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.

  • Breast Cancer Stigma in Iraq
    Hamdia Mirkhan Ahmed and Kaveh Khoshnood

    Springer Science and Business Media LLC

  • 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, and Nazar P. Shabila

    Springer Science and Business Media LLC
    Abstract 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 and Hamdia Mirkhan Ahmed

    Cambridge University Press (CUP)
    Abstract 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, Barzhang Q. Mzori, and Nazar P. Shabila

    Public Library of Science (PLoS)
    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.

  • Rate and Types of Childbirth Mistreatment and Abuse and Its Association with Satisfaction with Birth Care: A Cross-Sectional Study of 1196 Kurdish Women
    Hamdia Mirkhan Ahmed

    Springer Science and Business Media LLC
    Background and Objectives Concern about mistreatment and abuse during childbirth care is growing, and evidence suggests that many women worldwide experience mistreatment during childbirth. The study aimed to assess the prevalence of abused women during labor, types of abuse, rate of satisfaction with birth care among abused women, and associated sociodemographic and obstetric factors with mistreatment and abuse in the delivery room. Methods A cross-sectional study was conducted with data from 1196 women who experienced a vaginal delivery at least once within the past year in a public health setting in Erbil city, Kurdistan Region, Iraq. The author developed a questionnaire after a comprehensive review of the literature. Data were collected through direct interviews with the sample. Frequency, percentage, and chi-square tests were used for data analysis. Results About half of the study sample (49.9%) mentioned that they experienced mistreatment and/or abuse during labor and delivery. The most experienced type of mistreatment and abuse were as follows: lack of privacy (84.6%), patient-blaming (58.5), purposeful neglect (51.6%), abandonment of care, and detention in facilities (43.9%), Non-consented care (42.9%). The rate of physical and verbal abuse was 24.3% and 29.8%, respectively. There was a highly significant association between parity and general satisfaction with birth care with experiencing abuse (P = 0.006, P ≤ 0.001). Conclusions Mistreatment and abuse of women during childbirth are present among Kurdish women, leading to generally non-satisfaction with birth care, and exploring the reasons behind why health care providers mistreatment and abuse women during childbirth is critical.

  • Factors associated with experiencing lifetime intimate partner violence among pregnant displaced women living in refugee camps in Erbil, Iraq
    Kathryn E. Mishkin, Hamdia Mirkhan Ahmed, and Shaymaa Samir Maqsood

    Informa UK Limited
    According to the World Health Organization, intimate partner violence (IPV) affects 35% of women worldwide and 40% of pregnant women, often resulting in maternal and infant death and harm. Displaced persons are at higher risk of abuse compared to the general population. While few studies have explored IPV in Iraq, research from Erbil, Iraq showed nearly 60% of women reported experiencing IPV in their lifetime. No publications examining IPV among displaced women in Iraq exist. Considering the severe impacts of IPV in pregnancy and the associated risks for IPV among women in refugee camps, this paper presents the first analysis of prevalence and factors associated with lifetime IPV among displaced pregnant women in two Iraqi refugee camps. Thirteen percent of women reported experiencing any abuse and experiencing IPV was associated with receiving fewer years of schooling (p = 0.04), not having a private doctor (p = 0.002), attending the first prenatal visit during the third trimester (p = 0.03), feeling pressure to have a child (p = 0.003), knowing someone who was physically injured by their husband (p = 0.05), experiencing suicidal ideation (p = 0.02), and being worried about harming one's baby (p = 0.02). Policy and programme recommendations for screening and prevention of IPV in resource-limited settings are provided.

  • Antenatal Depression Symptoms Among Pregnant Women Seeking Health Services in Erbil, Iraq
    Kathryn Mishkin, Shaymaa Samir Maqsood, and Hamdia Mirkhan Ahmed

    Springer Science and Business Media LLC
    Maternal depression, which includes depression in the prenatal and postpartum periods, is estimated to affect between 10 and 20% of women globally but the rate is higher in the Middle East. Research focused on maternal depression in Iraq is limited to one study focused on postpartum depression. This paper identifies the prevalence and factors associated with antenatal depression among pregnant Iraqi women. Women seeking maternal health services at primary health centers were invited to participate. Data were collected by trained midwifery students in Erbil, Iraq. Responses to the PHQ-2 PRIME-MD depression questions were used to identify depressive symptoms. Chi-square and logistic regression analyses were used to analyze findings. Of the 179 participants, 86 (48%) reported depressive symptoms. In bivariate analysis, antenatal depression was associated with gestational age (p = 0.03), first prenatal visit in the second trimester (p = 0.003), loss of appetite (p = 0.003), not having help at home (p = 0.03), and use of prenatal vitamins (p = 0.002). Gravida approached significance (p = 0.07). In adjusted analysis, women reporting loss of appetite were more likely to report depressive symptoms (OR = 3.09, 95% CI: 1.47–6.51). Consistent with other research from the region, nearly half the women reported depressive symptoms. Because lack of appetite is associated with depressive symptoms, women reporting loss of appetite should be prioritized for depression screening in time-constrained settings.

  • Association between women's level of education and family daily nutrient intake and obesity status in Iraq
    AmaniLayth Hameed and HamdiaMirkhan Ahmed

    Medknow
    Background: Mothers play an important role in controlling family eating habits as well as the type of food consumed. Obesity is one of the causing factors for many diseases. Objectives: This study was designed to determine whether a woman's level of education is associated with the family's daily dietary intake and mother weight status or not. Materials and Methods: A web survey study designed through Google Forms was sent online to the entire Iraqi population from August 26 to September 20, 2020. The survey was distributed through institutional and private social networks (University E-mail, Facebook, Instagram, Viber, and WhatsApp). This method was entirely effective for the research hypothesis. A face-to-face interview was also conducted with illiterate women in public hospitals and medical centers. Results: The study result by 376 participating women showed a significant relationship between the level of education and body mass index (BMI) (P = 0.001). No significant relationship was shown between the level of daily dietary intake and BMI. The results also showed a significant association between education and family level of dietary intake (P = 0.003). The study showed a better daily dietary intake with those who do not have a high education level. Conclusions: The study concluded that healthy dietary choices and daily food intake are not related to education level but the mother's nutritional knowledge level.


  • Quality of life of women from families of martyred individuals in the Kurdistan region of Iraq as a conflict area in the Middle East
    Hamdia Mirkhan Ahmed

    Springer Science and Business Media LLC
    Abstract Background Quality of life (QOL) research develops data and insight into issues that pertain not only to the individual, but that can also apply to the population as a whole. This study aimed to analyze the QOL of Kurdish women from families of martyred individuals in the Kurdistan region of Iraq. Methods A cross-sectional study of 380 women from families of martyred individuals was conducted. All women were patients at the Medical Center of Martyr Families in Erbil City from January 2018 to April 2019. Data were collected through interviews and the WHOQOL-BREF scale was used to measure QOL. The women’s QOL scores were divided into four categories (i.e., quartiles): 1st, 2nd, 3rd and 4th quartile. Kruskal-Wallis and Chi-Square tests were used for data Analysis. Results The women’s QOL scores fell into the following quartiles: Overall QOL and General Health (n = 66.6%) in the 1st quartile, Physical and Psychological Health (n = 56.9%) in the 2nd quartile, Social Relationships (n = 47.9%) in the 3rd quartile, Environmental health (n = 85.6%) in the 2nd and 3rd quartile. The total QOL of more than half (n = 52.1%) of the women studied were in 1st and 2nd quartiles. Conclusion Women from families of martyred individuals were not satisfied with their QOL, especially in terms of Physical and Psychological Domains. International political and humanitarian actions are needed to reduce the destructive consequences of war and conflict on these suffering women.

  • Healthcare worker’s attitude toward spirituality and spiritual care in the intensive care unit with COVID-19


  • 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 City, Iraq
    Hamdia Mirkhan Ahmed

    Springer Science and Business Media LLC
    Background Effective communication by maternity care staff can help a woman during labor and birth have a positive birth experience. Due to limited knowledge regarding this topic in Iraqi Kurdistan, therefore, this study assessed: 1) The level of women’s satisfaction regarding verbal and non-verbal communication of midwives and physicians in the delivery room and 2) the association between this satisfaction level and socio-demographic and obstetric characteristics of the women and their general satisfaction with care during labor and delivery. Methods A cross-sectional study was conducted on a convenient sample of 1196 women recruited between January and March 2019 from Erbil city, Iraq, who gave birth in the year before that. Data were collected from women through direct interview. A questionnaire which included sociodemographic, obstetrical information and 28 items related to verbal and non-verbal communication of physicians and midwives in the delivery room was used. Chi-square tests were used to find the association between dependent and independent variables. Results Although 58.4% of the women were generally satisfied with communication of midwives and physicians in the delivery room, a large percentage (41.6%) were not satisfied. Only 14.6 and 27.3% of the women were completely satisfied with verbal and non-verbal communication of health care providers, respectively. There was a statistically significant association between women’s satisfaction with care during labor and their satisfaction with health care providers’ communication; 70.4% of women who were satisfied with care during birth were also satisfied with the communication of delivery room staff. There were statistically significant associations between the satisfaction of women with the communication of midwives and physicians and their level of education, parity, having stillbirth or neonatal death, and the setting of the last delivery. Conclusions Women’s satisfaction with verbal and nonverbal communication of health care providers in the delivery room is associated with their satisfaction with birth care. Improving communication skills of health care providers can be a considerable part of improving care in delivery room.

  • Impacts of antenatal nursing interventions on mothers' breastfeeding self-efficacy: An experimental study
    Safiya Sabri Piro and Hamdia Mirkhan Ahmed

    Springer Science and Business Media LLC
    Abstract Background A considerable amount of research demonstrates how breastfeeding self-efficacy significantly influences breastfeeding outcomes. The aim of this study was to evaluate the role of nursing intervention on mother’s breastfeeding self-efficacy. Methods In this experimental investigation, 130 pregnant women who attended a primary health care centre were randomly assigned to the experimental (n = 65) or control (n = 65) groups. The experimental group received two 60–90 min group breastfeeding educational sessions based on the breastfeeding self-efficacy theory along with routine care. Mothers’ knowledge, attitudes, prenatal and postnatal self-efficacy towards the breastfeeding were compared between both groups. The Iowa Infant Feeding Attitude Scale measured the attitudes. Prenatal Breastfeeding Self-Efficacy Scale measured the self-efficacy during pregnancy and Breastfeeding Self-Efficacy-Short Form measured the self-efficacy in postnatal period. Results Breastfeeding self-efficacy during pregnancy and following two months of delivery in the experimental group was significantly higher. The experimental group had a higher level of knowledge and attitude in comparison with subjects in the control group. In addition, the mothers who breastfed exclusively had higher levels of postnatal self-efficacy in both experimental and control groups compared to formula feeding women (52.00 vs. 39.45 in the control and 57.69 vs. 36.00 in the experimental subjects; P < 0.001). Conclusion The present investigation suggests that antenatal breastfeeding education is an effective way to increase the level of breastfeeding self-efficacy, which increases exclusive breastfeeding practice.


  • Religious leaders’ position toward female genital cutting and their perspectives on the relationship between the Islamic religion and this practice
    Hamdia M. Ahmed, Mosleh S. Kareem, Nazar P. Shabila, and Barzhang Q. Mzori

    Informa UK Limited
    ABSTRACT This study aimed to understand the position of religious leaders toward female genital cutting (FGC) and their perspectives on the relationship between the Islamic religion and FGC. In-depth interviews were conducted with 29 religious leaders in Erbil governorate, Iraqi Kurdistan region from June 2016 to May 2017 using a semi-structured interview guide. Most interviewees supported the continuation of FGC or thought that it should be at least permissible. Religious requirement and reducing the sexual activity of girls and women were the primary reasons for supporting FGC. The religious leaders disagreed about whether Islam requires, encourages, permits, or discourages the practice. The religious leaders generally agreed that most of the Islamic religious scripts about FGC are weak, and no clear and strong hadiths encourage FGC. However, they believed that some hadiths suggest that Islam requires FGC and that no hadiths prohibit FGC. The absence of open opposition to FGC in a context in which legislation has banned this practice was notable. The position of many religious leaders toward FGC is potentially shaped by the cultural interest in feminine chastity and virginity. Religious leaders need to explore different Islamic law schools and consider the religious disagreement and medical evidence about FGC.

  • A qualitative assessment of women's perspectives and experience of female genital mutilation in Iraqi Kurdistan Region
    Hamdia M. Ahmed, Sherzad A. Shabu, and Nazar P. Shabila

    Springer Science and Business Media LLC
    BackgroundFemale genital mutilation (FGM) is prevalent in Iraqi Kurdistan Region, but there is a lack of adequate knowledge about how the practice is perceived by the women population who are the direct victims of the practice. This study aimed to assess the knowledge, beliefs, and attitude of a sample of Kurdish women of FGM and identify the main enabling factors for performing this practice and the barriers to ending it.MethodsThis qualitative study was based on six focus groups involving a sample of 51 women. We used a topic guide to lead discussions, which included questions on women’s perspectives of different aspects of FGM such as the reasons for practicing it, the positive and negative consequences, the continuation of the practice and tackling this problem in the community. Content analysis was used for the qualitative analysis of the data.ResultsThe women had poor knowledge about different aspects of FGM particularly concerning the procedure and the consequences. The mutilated participants revealed the devastating experience of the pain and the psychological effects they have experienced. Reducing sexual desire, having halal (permissible by Allah) hands, and religious requirement were the main reasons for practicing FGM. Reduction in women’s sexual desire and the related social problems with the husband were the main problems identified to be associated with FGM. Most women did not support the continuation of FGM practice, but some women still think that FGM should be left to the people’s preference. The participants identified raising people’s awareness, active involvement of religious leaders in prevention efforts and the issuance and enforcement of legislation against FGM as the primary measures to reduce FGM practice.ConclusionPassing through FGM at childhood is an overwhelming experience with long-term effects for women. There is still a significant segment among the women population that do not oppose the continuations of FGM and need religious and scientific evidence against FGM. Some reasons for practicing FGM are deeply embedded in the culture and traditions, and there is a need for extensive efforts to raise the awareness of the population and change their thoughts and behavior about FGM.

  • Effect of Change in Position and Back Massage on Pain Perception during First Stage of Labor
    Suad Abdul-Sattar Khudhur Ali and Hamdia Mirkhan Ahmed

    Elsevier BV
    Background: Labor is one of the most painful events in a women's life. Frequent change in positions and back massage may be effective in reducing pain during the first stage of labor. Aim: The focus of this study was to identify the impact of either change in position or back massage on pain perception during first stage of labor. Design: A quasi‐experimental study. Setting: Teaching hospital, Kurdistan Region, Iraq, November 2014 to October 2015. Subjects: Eighty women were interviewed as a study sample when admitted to the labor and delivery area and divided into three groups: 20 women received frequent changes in position (group A), 20 women received back massage (Group B), and 40 women constituted the control group (group C). Methods: A structured interview questionnaire to collect background data was completed by the researcher in personal interviews with the mothers. The intervention was performed at three points in each group, and pain perception was measured after each intervention using the Face Pain Scale. Results: The mean rank of the difference in pain scores among the study groups was as follows after the first, second, and third interventions, respectively: group A—52.33, 47.00, 49.2; group B—32.8, 30.28, 30.38; group C—38.44, 42.36, 41.21. There were significant differences between groups A, B, and C after the first, second, and third interventions (p1 = .011, p2 = .042, p3 = .024). Conclusions: Back massage may be a more effective pain management approach than change in position during the first stage of labor.

  • Knowledge and perspectives of female genital cutting among the local religious leaders in Erbil governorate, Iraqi Kurdistan region
    Hamdia M. Ahmed, Mosleh S. Kareem, Nazar P. Shabila, and Barzhang Q. Mzori

    Springer Science and Business Media LLC
    BackgroundReligious leaders are one of the key actors in the issue of female genital cutting (FGC) due to the influential position they have in the community and the frequent association of FGC with the religion. This study aimed to assess the knowledge and perspectives of the local religious leaders in Erbil governorate, Iraqi Kurdistan Region about different aspects of FGC.MethodsIn-depth interviews were conducted with a sample of 29 local religious leaders. A semi-structured questionnaire was used that included questions about their knowledge, understanding, and perspectives on different aspects of FGC such as the reasons for practicing it, their contact and communication with the community regarding the practice and perspectives about banning the practice by law.ResultsParticipants believed that FGC is useful for reducing or regulating the sexual desire of women to prevent adultery and engagement in pre and extramarital sexual relations and to enhance hygiene of women. They indicated that there is no any risk in doing FGC if there is no excessive cut. Most participants indicated that FGC is attributed to the religion and some considered it a tradition mixed with the religion. People rarely ask the advice of the religious leaders regarding FGC, but they frequently complain about the effects of the practice. Participants did not support having a law to ban FGC either because they thought it would be against the religion’s advice on FGC or it will not work.ConclusionsThe local religious leaders lack adequate knowledge about different aspects of FGC particularly the health consequences. There are different and disputing viewpoints about the reasons for practicing FGC, and there is poor support for having a law banning the practice. There is an essential need for enhancing the knowledge of the local religious leaders regarding FGC and its adverse effects on the women’s health.

  • Knowledge, attitude, and experience of health professionals of female genital mutilation (FGM): A qualitative study in Iraqi Kurdistan Region
    Nazar P. Shabila, Hamdia M. Ahmed, and Kolsoom Safari

    Informa UK Limited
    ABSTRACT We aimed to assess the knowledge, attitude, and experience of health professionals of female genital mutilation (FGM). The study involved content analysis of semistructured interviews with 21 health professionals. The participants had poor knowledge regarding different aspects of FGM including its types, prevalence, and complications as well as the existing legislation that prohibits FGM. They believed that FGM is mainly practiced for religious reasons and to reduce sexual desire/arousal. Health professionals are apparently not involved in performing FGM, and they do not support its continuation. Health professionals can take a leading role in raising the awareness of women and combating FGM.

  • Assessment of women’s perspectives and experiences of childbirth and postnatal care using Q-methodology
    N.P. Shabila, H.M. Ahmed, and M.Y. Yasin

    World Health Organization Regional Office for the Eastern Mediterranean (WHO/EMRO)
    To complement standard measures of maternity care outcomes, an assessment of women's satisfaction with care is needed. The aim of this study was to elicit the perspectives and experiences of Iraqi women about childbirth and postnatal care services. The study participants were a sample of 37 women of different educational and socioeconomic status who had given birth during the previous 6 months. Q-methodology was used for data collection and analysis. Three distinct viewpoints and experiences of childbirth and postnatal care services were identified: a general perception of poor childbirth and postnatal care with lack of appropriate interpersonal care and support; a high satisfaction and positive experience with childbirth and postnatal care services among the confident and well-supported women; and poor satisfaction with the childbirth and postnatal care services in terms of meeting traditional cultural practices. Needs assessment around providers' skills and attitudes and the wider sociocultural environment of childbirth and postnatal care is necessary in Iraq.

  • Women's views and experiences of antenatal care in Iraq: A Q methodology study
    Nazar P Shabila, Hamdia M Ahmed, and Maryam Y Yasin

    Springer Science and Business Media LLC
    BackgroundUnderstanding women’s experiences and perspectives of antenatal care services is particularly critical for enhancing effectiveness of services delivery and addressing women’s needs and expectations. As part of a comprehensive assessment of the maternity care services in Iraq, this study aimed to explore the views and experiences of antenatal care in a sample of women.MethodsThis explorative study was conducted in Erbil governorate, Iraq. Data were collected using Q methodology, a technique for eliciting subjective views and identifying shared patterns among individuals. A sample of 38 women of different educational and socioeconomic statuses were invited to sort a set of 39 statements reflecting different aspects of the available antenatal care services and issues related to their last pregnancies into a distribution on a scale of nine from “disagree most” to “agree most”. By-person factor analysis was used to derive latent views through centroid factor extraction and varimax rotation of factors.ResultsAnalysis of the participants’ Q sorts resulted in identifying four distinct views and experiences of pregnancy and antenatal care services: (i) public maternity services second best: preference for, and ability to afford, private care, (ii) dissatisfaction with public maternity services: poor information sharing and lack of health promotion, (iii) satisfaction with public maternity service but information gaps perceived and (iv) public maternity services second best: preference for private care but unaffordable. The typical characterizations that were associated with each view were highlighted.ConclusionsThis study revealed different patterns of views and experiences of women of pregnancy and antenatal care services and recognized the particular issues related to each pattern. Different patterns and types of problems and concerns related mainly to inadequate provision of information and poor interpersonal communication, poor utilization of public services and a general preference to use private services were identified in the different groups of women.

RECENT SCHOLAR PUBLICATIONS

  • 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

  • Breast Cancer Stigma in Iraq
    HM Ahmed, K Khoshnood
    Current Breast Cancer Reports 15 (4), 345-349 2023

  • 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

  • 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

  • Effect of Respectful Maternity Care and Effective Communication during labor on childbirth satisfaction: an interventional study
    KK Fares, KKFKK Fares, HM Ahmed
    Mosul Journal of Nursing 11 (2), 396-405 2023

  • 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

  • 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

  • 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

  • Women's expectations of health care providers in the labor and delivery room in the Kurdistan Region of Iraq
    AF Hajimam, HM Ahmed, K Mishkin
    Zanco Journal of Medical Sciences (Zanco J Med Sci) 27 (1), 42-52 2023

  • Knowledge of Kurdish women about menopause and its related factors: A cross-sectional study in Iraq
    M Yaseen Yaseen, F Mohammed Azo, M Esmail Seniar, ...
    Journal of Research Development in Nursing and Midwifery 20 (1), 45-51 2023

  • Attitudes of Islamic Clerics to Receiving COVID-19 Vaccine in Iraqi Kurdistan: A Focus Group Study
    DM Abdulah, HM Ahmed
    Disaster Medicine and Public Health Preparedness 17, e415 2023

  • Women's expectations of health care providers in the labor and delivery room in the Kurdistan Region of Iraq
    K Mishkin, HM Ahmed, AF Hajimam
    Zanco Journal of Medical Sciences 27 (1) 2023

  • Body mechanics among pregnant women with lumbopelvic pain: A cross-sectional study
    BO Muhammad, HM Ahmed
    2022

  • Knowledge, attitudes, and positions of religious leaders towards female genital cutting: A cross-sectional study from the Kurdistan Region of Iraq
    KI Mahmood, SA Shabu, K M-Amen, AM Saleh, H Ahmed, BQ Mzori, ...
    Plos one 17 (11), e0265799 2022

  • Does perceived stigma or shame affect stage of presentation in Iraqi Kurdish women diagnosed with breast cancer?
    AB Chagpar, S Qader, M Baqri, K Khoshnood, H Ahmed
    Journal of Clinical Oncology 40 (16_suppl), e18680-e18680 2022

  • Rate and Types of Childbirth Mistreatment and Abuse and Its Association with Satisfaction with Birth Care: A Cross-Sectional Study of 1196 Kurdish Women
    HM Ahmed
    Maternal and child health journal 26 (6), 1322-1327 2022

  • In-silico approach to identify antiviral potent inhibitors against nsp4 of SARS-COV-2
    A Saeed, H Naseem, N Shafi, H Ahmed, T Faraz, R Fatimaand, A Khan
    Bioscience Research, 1321-1331 2022

  • 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

  • Perception, acceptance, and hesitancy of the public regarding Covid-19 vaccine and immunization: A literature review
    H Ahmed, K Aziz, A Ali
    1st International Ninevah Conference on Medical Sciences (INCMS 2021), 5-13 2021

  • Quality of Diet Pattern, Sun Exposure, and Vitamin D Statues Among Kurdish Children and Adolescent/Kurdistan Region/Iraq
    K Qadir, H Saadi, H Sedeeq, H Ahmad
    1st International Ninevah Conference on Medical Sciences (INCMS 2021), 109-116 2021

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, 1-12 2020
    Citations: 120

  • 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, 1249-1255 2012
    Citations: 60

  • 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
    Citations: 48

  • 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
    Citations: 48

  • 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, 1-11 2014
    Citations: 44

  • 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, 1-12 2019
    Citations: 42

  • 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
    Citations: 35

  • 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
    Citations: 35

  • 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
    Citations: 29

  • 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
    Citations: 23

  • 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
    Citations: 20

  • 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
    Citations: 20

  • 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
    Citations: 18

  • 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
    Citations: 13

  • 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
    Citations: 12

  • 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
    Citations: 12

  • Nurse/Midwives' practices during labor and delivery in Maternity Teaching Hospital in Erbil City
    LAHM Nuriy, HM Ahmed
    Erbil Journal of Nursing and Midwifery 1 (1), 23-32 2018
    Citations: 11

  • Prevalence and risk factors of episiotomy and perineal tear in the maternity teaching hospital of Erbil City, Iraq
    HM Ahmed, WH Abdollah, NG Al-Tawil
    Erbil Journal of Nursing and Midwifery 2 (1), 44-50 2019
    Citations: 8

  • Religious leaders’ position toward female genital cutting and their perspectives on the relationship between the Islamic religion and this practice
    NPSBQM Hamdia M. Ahmed , Mosleh S. Kareem
    Women & Health 2019
    Citations: 8

  • 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 2021
    Citations: 6