Reproductive Health Literacy Among Married Women of Reproductive Age: A Cross-Sectional Study in Rural White Nile State, Sudan

Authors

Keywords:

Reproductive health, Health Literacy, Women, rural populations, Sudan, Uterine Cervical Neoplasms

Abstract

Background: Reproductive health literacy is a crucial determinant of women’s ability to make informed decisions regarding reproductive health. In rural Sudan, limited access to reliable health information may contribute to low levels of reproductive health literacy, yet evidence from this context remains limited and insufficient. Therefore, this study aimed to assess reproductive health literacy among married women of reproductive age and to determine the factors associated with good level of reproductive health literacy.

Methods: An analytical cross-sectional study was conducted among married women in a rural area of White Nile State, Sudan, in March 2026. Participants were selected by convenience sampling from married women aged 15–49 years who were residents of the study area. Data were collected via a structured, pre-tested questionnaire covering three domains: menstrual health knowledge, reproductive health practices, and cervical cancer awareness. The primary outcome was the reproductive health literacy score (0–18), categorized using Bloom’s cut-off points as poor (<50%), moderate (50–70%), or good (>70%). Analysis was performed using Statistical Package for the Social Sciences version 21 , including descriptive statistics, bivariate analysis, and multivariable linear regression.

Results: Out of 313 women approached, 310 were included in the final analysis. The mean age of participants was 33.1 ± 8.1 years. More than half (56.1%) had university or higher education, and the majority (69.4%) were housewives. The mean reproductive health literacy score was 10.57 ± 4.31. Overall, 26.5% of participants had poor reproductive health literacy, 41.9% had moderate reproductive health literacy, and 31.6% had good reproductive health literacy. Bivariate analysis showed significant associations between reproductive health literacy and education level, monthly income, and employment status (p<0.001). A significant positive trend was confirmed using the Jonckheere–Terpstra test, with increasing reproductive health literacy across higher levels of education (Z=5.08, p<0.001) and income (Z=3.74, p<0.001). Knowledge scores were highest in menstrual health (median 4, range 0–4) and lowest in cervical cancer awareness (median 1, range 0–6). In multivariable linear regression analysis, age (β=0.067, 95% CI: 0.002–0.131, p=0.044), moderate income (β=2.522, 95% CI:1.211–3.834, p<0.001), high income (β=2.744, 95% CI: 1.037–4.452, p=0.002), employment status (β=2.478, 95% CI: 1.131–3.825, p<0.001), consulting doctors or nurses for health information (β=2.672, 95% CI: 1.452–3.892, p<0.001), and use of social media (β=1.579, 95% CI: 0.480–2.678, p=0.005) were significant positive predictors of reproductive health literacy. In contrast, reliance on midwives as a primary source of information was significantly associated with lower reproductive health literacy scores (β=−1.908, 95% CI: −3.452–−0.365, p=0.016).

Conclusion: Reproductive health literacy among married women in this rural setting was predominantly moderate, with notably low awareness of cervical cancer. Socioeconomic factors including age, income, and employment, along with sources of health information, were independent predictors of reproductive health literacy. Targeted interventions are recommended to improve access to qualified healthcare professionals and strengthen reliable health information channels, particularly for low-income and unemployed women.

 

References

1.Tseng KW, Mohabbat H, Adachi A, Calaguas A, Kaur A, Salem N, et al. Reproductive Health Literacy and Knowledge

Among Female Refugees: A Scoping Review of Measurement Methodologies and Effect on Health Behavior. International

Journal of Environmental Research and Public Health. 2025 Jul 16;22(7):1121

2.Chen M, Luo Y, Fu J, Wang T, Meng Y, Xu C, et al. Reproductive health status and related knowledge among women

aged 20–39 years in rural China: a cross-sectional study. Reproductive Health. 2020 Jun 10;17(1).

3.Varelis T, Vincent, Ngarmbatedjimal A, Alladoum Ndingayande, Diarra A, Katchebe Vourbane, et al. Sexual and

reproductive health knowledge, attitudes, and behaviors: A survey of 12–17 year old Sudanese refugees in Chad. PLOS

global public health. 2024 Jan 25;4(1):e0002597–7.

4.Rafat B, Dolatian M, Hajian S, Ali M, Hamid AM, Zare E. Women’s Reproductive Health Literacy: A Qualitative Study. International Journal of Women’s Health and Reproduction Sciences [Internet]. 2023 [cited 2026 May 8];11(1):16–24. Available from: https://sid.ir/paper/1137846

5.Kohan S, Mohammadi F, Yazdi M, Dadkhah A. Evaluation of relationship between reproductive health literacy and demographic factors in women. Journal of Health Literacy. 2018;3(1):20–29.

6.Maricic M, Stojanovic G, Pazun V, Stepović M, Djordjevic O, Macuzic IZ, et al. Relationship Between Socio-Demographic Characteristics, Reproductive Health Behaviors, and Health Literacy of Women in Serbia. Frontiers in Public Health. 2021 Apr 29;9.

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Published

2026-08-19

How to Cite

Ibrahim, N., El-Maki, H., Suliman, F. E., & Malik, E. (2026). Reproductive Health Literacy Among Married Women of Reproductive Age: A Cross-Sectional Study in Rural White Nile State, Sudan. International Journal of Medical Students. Retrieved from https://ijms.pitt.edu/IJMS/article/view/4747

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Copyright (c) 2026 Nermin Elbadri Ibrahim, Hibatallh Mubarak El-Maki, Fatima Elzhraa Ahmed Mohammed Suliman, Elfatih Mohammed Malik

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