AUCTORES
Globalize your Research
Research article
*Corresponding Author: *Corresponding Author: Shiva
Citation: Shiva S. Halli and Rajeshwari A. Biradar (2022). Declining Son Preference among HIV Infected women in Northern Karnataka, India. J. Women Health Care and Issues. 5(2); DOI:10.31579/2642-9756/105
Copyright: © 2022 Shiva S Halli, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 20 December 2021 | Accepted: 06 January 2022 | Published: 10 January 2022
Keywords: women living with Hiv/Aids; son preference; karnataka; india
The study examined the sex preference among women living with HIV/AIDS (WLAHs) in Karnataka, India using a representative random sample of 633 women belonging to the age group 15-29 years since a large proportion of the women in India complete their family size before 30 years. The profile of the respondents indicates that the mean age was slightly over 25 years, was largely residing in rural areas and about a half of them were illiterate. There was a very high level of son preference prior to HIV infection. Though the percent of women desired to have a boy or daughter increased after being HIV positive, the results indicate a significant reduction in son preference after being tested positive compared prior to having any child and HIV negative. This could be due to a significant proportion of the WLHAs refine their desired family and sex preference possibly because of the fear of transmission of HIV virus to their child. The WLHAs desire could be healthy children irrespective of sex of the child so that the children do not have to suffer stigma and discrimination if they are HIV positive.
A large number of studies tried to understand the association between HIV status and fertility intentions and fertility outcomes. Lower fertility among HIV-infected women has been observed in women in Zaire, Uganda and Rwanda (Ryder et al., 1991; Allen et al, 1993; Sewankambo et al., 1994) although the studies have generally been too small to yield statistically significant results. Significantly reduced rates of pregnancy were however observed in HIV-infected women in a cross-sectional study carried out in Rakai district, Uganda (Serwadda et al., 1997). Whilst lower fertility rates have also been described in HIV infected women in developed countries (Selwyn et al., 1989; Stephenson et al., 1996; De Vincenzi et al., 1997; Thackway et al., 1997); these are unlikely to be applicable to African populations because, unlike most women in developing countries, the women studied knew their HIV status, and modern contraceptive methods and pregnancy termination were more readily available and acceptable.
The reduced fertility observed among HIV–infected women might be due to fear of transmission to their children. However, recent developments of preventing parent-to-child transmission (PPTCT) might have encouraged HIV-infected women to consider childbearing and enjoy motherhood. Unfortunately, not many large-scale quantitative studies are conducted using random samples, and available studies are mostly clinical in nature trying to understand the reproductive effect of HIV/AISDS on ability to conceive and pregnancy outcomes. Hence, there is no good understanding of impact of HIV/AIDS on reproductive health care needs and fertility desires. In case of India, with the exception of study by Biradar et al., (2019) using the same data set that we are using for this study, we come across a qualitative study conducted in Tamil Nadu, India. This study throws some light on fertility desires, intensions and fertility decision making including the barriers women living with HIV/AIDS (WLHA) face in achieving their intended family size. The main barriers mentioned by the women, it seems, lack of family support, stigma and discrimination by the family members, anxiety about child rearing in case of their death and importantly the lack of knowledge about PPTCT (Halli et al., 2016). The authors are aware that their results based on qualitative study may not be generalizable and hence, suggested further research among WLHA in order to assist evidence-based policy development so that WLHA can exercise informed choices to fulfil their desired family size and sensitise health care providers about their needs.
Till date, studies have shown that HIV infection may affect fertility by influencing desires and intentions for having children. On the other hand, studies of fertility intentions among HIV-positive individuals have found mixed results mainly because of socio-cultural contexts and individual factors. It may be easier to the unmarried women to exercise their reproductive choices compared to married women who be pressurized by their husbands (Cooper et el., 2007). Even if there are some studies indicating that there is a relationship between perceived HIV risk and fertility desires among unsure women about their HIV status, however, the nature and magnitude of HIV effect is not clear. In fact, some studies using qualitative or correlation analysis found mixed results about the nature of relationship between HIV risk and fertility (Baylies, 2000; Yeatman, 2009; Moyo and Mbizvo, 2004; Rutenberg et el., 2000). It is also possible that WLHA may be worried that their children may become orphans if they perceive that their children have higher risk of dying because of their HIV infection (Grieser et al., 2001). Grieser et al., (2001) in their study in Zimbabwe also found that even if WLHA perceive higher mortality for their children because of their HIV status, yet they may not want to have more children in order to replace their children who have died. However, Gyimah and Rajulton (2004) in Ghana and Gyimash and Obeng (2004) in Kenya found women living with HIV/AIDS wanting to have more children in order to insure for possible negative impact on their children survival due to their HIV/AIDS status.
Like other women, WLHA have been arguing for their sexual and reproductive rights (Cooper et al., 2003; Sachin et al., 2009); and in their study in Brazil, Segurado and Paiva (2007) observed that HIV positive men may want to have more children and their desire might have been influenced by the prevailing socio-cultural context. Similarly, studies conducted elsewhere including India found that a HIV positive woman cannot decide unilaterally about her family size, and her spouse as well as other family members may be involved in deciding the family size because of cultural norms (Kanniappan et al., 2008; Sachin et al., 2009; Ko and Muecke, 2005; Oosterhoff et al., 2008). Other studies highlight economic factors by arguing children as future resource and economic security (Dyer et al., 2002; Dyer et al., 2008; Speizer & White, 2008; Ujiji 0, 2010). Interestingly, Biradar et al., (2019) observed other factors for deciding the family size by WLHA such as broader health system factors, influence of health care providers as well as stigma and discrimination.
Indians’ preference for sons over daughters is well known phenomenon (Dyson and Moore, 1983). In fact, this was also concern of British empire in India because of sex ratios in favour of males and practice of female infanticides (Miller, 1981). The recent publication of UNFPA on son preference in India include financial and emotional care especially in the old age of parents, burden of daughters because of widespread practice of dowries, family lineage and religious rites (Pande and Malhotra, 2006). This is true of general population in India but does it also apply to the couples who are HIV positive? In particular, how do factors that signal HIV and AIDS status influence the son preference-do HIV infected couples’ preferences become more gender egalitarian or does HIV status offer couples more efficient ways to implement unchanged gender-based preferences? A relevant question to millions of couples living with HIV in India is how they perceive daughters given the culture of strong son preference? An attempt is made in this study to throw some light on sex preference using the specially collected quantitative data on fertility attitudes and intensions in Northern Karnataka, India.
The study is conducted in 2012 in Bagalkot district of Northern Karnataka and it is a cross-sectional quantitative survey of 630 currently married HIV positive women selected using a stratified random sampling method. Since the study focuses on fertility intentions, the sample is limited to women aged between 15-29 years. Because the study is aimed at examining the fertility intentions of women living with HIV/AIDS (WLHA), the population universe consists of the women who know their HIV status. In Karnataka, people test for HIV in government facilities ie., integrated counseling and testing centers (ICTC). While the ICTC data would represent an ideal sampling frame for the study, it is highly confidential and hence not available. However, the large majority of the people who undergo HIV testing and test positive are members of the DIC+ in a district, one such DIC+ is Jeevana Jyothi-DIC+ in Bagalkot district where large proportion of the positives register. Moreover, this is the district, where the HIV prevalence in the state and in the country is highest. As access to the database from Jeevana Jyothi-DIC+ can be obtained for research purposes, the study used the database of DIC+ as a sampling frame.
Since the study population belonged to the most vulnerable group, an ethical clearance was obtained from the WHO’s Research Ethics Review Committee and Institutional Ethical Review Board of St John’s Medical College, Bangalore, Karnataka. Complete anonymity was maintained on the HIV status of the women and interviewers were given only the names and addresses without any mention or reference to the status. The research team kept the list strictly confidential and once the field work was completed, the list was shredded. No mention of names and addresses of the participants was recorded anywhere, including in the data.
The analysis was conducted using IBM’s Statistical Package for the Social Sciences (SPSS) version-20.0. Bivariate analysis was conducted to describe and understand the association of background characteristics with preference for sons and daughters using the model Chi-square. The multivariate logistic regression was used to assess the individual risk of the background characteristics after adjusting for the remaining characteristics.
The study recruited and interviewed a total of 633 respondents keeping in mind the objectives of the study. Appendix 1 is included to provide profile of the respondents. Of the 633 respondents interviewed after informed consent, 27% were less than 25 years with a mean age of about 26 years. Over 71 % were from the rural areas, about half of them were illiterate and 45% of the respondent’s husbands were illiterate too. Most of the respondents were from Hindu religion (94.5%), and 42
Examining the sex preference by characteristics of the respondents, Table 1 shows that the sex preference increased at present as compared to a time when having no child or not HIV positive. While younger one had a higher sex preference before, at present older respondents prefer to have the sex of the child, particularly boys. Interestingly urban and literate respondents seem to have higher sex preference as compared to their counterparts. Those started living with the husbands at younger age, husbands are older and age gap between respondent and husband is shorter were more likely to have preferred sex compare to their counterparts. The table also shows that the preference for both boys and girls increased as compared to earlier and the gap between percent preferred a boy and girl narrowed at present. The study therefore, suggest that though a large percent prefer both boys and girls, the narrowing of the percent between those preferring a boy and girl indicates that the sex preference probably is reduced since the HIV infection.
The study further assessed the changes in the desired family size at present compared to the time when the respondent was HIV negative and had no child. Figure 3 shows that the mean number of boys preferred reduced marginally, whereas the same increased for girl child. High level of sex preference was noticed prior to have any child and was HIV negative. The sex preference desired was 1.07 boys against 0.77 girls. However, after being tested HIV positive, the sex preference reduced and mean number of boys and girls desired was 1 boy, 0.9 girl child and 0.1 child of either sex. Further the gap between mean number of boys and girls reduced at present further suggest the reduced sex preference among women living with HIV.
The study examined the sex preference among women living with HIV/AIDS in Karnataka, India. The respondents selected in the study were young married women living with HIV and were selected from the district of Bagalkot. The profile of the respondents indicates that the mean age was slightly over 25 years, was largely residing in rural areas and about a half of them were illiterate. Though over 95% had an electrified house, 77% used open areas for defecation and large proportion was engaged in agricultural work. The district is one of the districts with very low Human Development Index in the state, though in the mean household income of the respondents (Rs 7300/-) suggest that the women had much better income as compared to the population in the district.
The number of children ever born among positive women was 2.15, which is more or less same as the reported fertility levels in the district as the mean children ever born to women aged 20-24 and 25-29 years was respectively 1.75 and 2.57 in the state (DLHS-2, 2007-8). The study also showed that about 93% of the children ever born surviving (2.01 children surviving among 2.15 ever born. Overall, 29% respondents had a child death with an average of 1.25 children died suggests that a large proportion of the positive women experience child deaths. The child death is relatively high among these respondents, and possibly the young age at start of living with husband.
There was a very high level of sex preference prior to HIV infection, and boys have been often preferred, though a significant proportion also was undecided on the child’s sex. Though the percent women desired to have a boy or daughter increased at present compared to the desired family size before being positive, the reduced gap between preference of boys and girls suggests a reduced sex preference for boys since tested positive. That is, the study noticed a significant reduction in sex preference among respondents after being tested positive as compared to prior to having any child and was HIV negative. While younger women had a higher sex preference before, at present older respondents prefer to have the sex of the child, particularly boys. Interestingly urban and literate respondents seem to have higher sex preference as compared to their counterparts. Those started living with the husbands at younger age, husbands are older and age gap between respondent and husband is shorter were more likely to have preferred sex compare to their counterparts.
The reduced sex preference among the WLHAs may be due to higher prevalence of pregnancy wastage and child death because 28% of the women started living with the current husband before the age of 15 years and 73% respondents started living with the current husband before they are 18 years. Hence, HIV positive women may just want healthy children irrespective of the sex. Other researchers using the same data have also shown that 17% respondents experienced a still birth or abortions, 37% percent experienced at least 2 still births or abortions, indicating higher rate of multiple pregnancy wastages among the respondents (Isac et al., 2017). Large proportion of the pregnancy wastage was as a result of spontaneous abortion (81%), though 22% and 17% of the respondents respectively experienced pregnancy wastage as a result of still birth or induced abortion respectively. Overall, 29% respondents had a child death with an average of 1.25 children suggests that a large proportion of the positive women experience child deaths. Surprisingly, WLHA living in urban areas and educated have shown higher preference for sons, this seems to contradict UNFPA study showing women’s education as the single most significant factor in reducing son preference (Pande and Malhotra, 2006). Since, the WLHAs are likely to be “afraid of HIV transmission to their children”, it is possible that urban and educated WLHAs may be aware of the PPTCT (prevention of mother-to-child transmission) facilities in the state.
IMPLICATIONS
Despite the risks associated with pregnancy, our data suggest that HIV-infected women are likely to become pregnant to achieve their desired family size. However, like other mothers, it is quite natural among the WLHA desiring healthy babies and prevent vertical transmission. The policy makers should be sensitive to Indian socio-cultural context where childbearing is encouraged and hence, WLHA should have the same rights and privileges like other women. Based on the findings of the study, Biradar et al., (2019) argue that WLHA might be reluctant to discuss fertility intensions with health care providers because of possible negative reactions. Before WLHA’s making any decision about their fertility intensions in including the decision about their sex preference, they should be encouraged to discuss with health care providers. It is possible that prevention of perinatal transmission programs in combination with ART may alter women and men's attitudes in favour of childbearing. The findings of this study seem to suggest the need for explicit policies recognizing reproductive rights and choices of WLHA. The HIV/AIDS policies especially in northern rural districts of Karnataka where HIV prevalence is much higher should have health counselling services informing the available PPTC services and healthier reproductive options. Moreover, decision-making about pregnancy may be complicated for people living with HIV, as other factors play an important role in reproductive decisions. People living with HIV are often stigmatized. Lack of adequate parenting resources may also be common, especially among women with HIV living in poverty and belong to SC/ST and other backward castes.
Declarations
Ethics approval
Since the study population belonged to the most vulnerable population, an ethical clearance was obtained from the WHO’s Research Ethics Review Committee and Institutional Ethical Review Board of St John’s Medical College. Complete anonymity was maintained on the HIV status of the women and interviewers were given only the names and addresses without any mention or reference to the status. The research team kept the list strictly confidential and once the field work was completed, the list was shredded. No mention of names and addresses of the participants was recorded anywhere, including in the data. The data is password protected
Conflict of interests
The authors have no conflicts of interest to declare.
Funding
This study received no specific grant from any funding agency, commercial entity or not-for-profit organisation.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
