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Sample records for reproductive health care

  1. Reproductive health care delivery.

    PubMed

    Lindgren, Mark C; Ross, Lawrence S

    2014-02-01

    Most patients in the United States with reproductive health disorders are not covered by their health insurance for these problems. Health insurance plans consider reproductive care as a lifestyle choice not as a disease. If coverage is provided it is, most often, directed to female factor infertility and advanced reproductive techniques, ignoring male factor reproductive disorders. This article reviews the history of reproductive health care delivery and its present state, and considers its possible future direction. PMID:24286778

  2. Managed care and reproductive health.

    PubMed

    Cohen, S S; Williams, D R

    1998-01-01

    Managed care poses special challenges to midwives providing reproductive health care. This is owing to the sensitive nature of issues surrounding reproductive health and aspects of managed care that may impede a woman's ability to obtain continuous, confidential, and comprehensive care from the provider of her choice. Variations across payers (ie, Medicare, Medicaid, and commercial insurers) regarding covered benefits and reimbursement of midwifery services also may create obstacles. Furthermore, some physicians and managed care organizations are embracing policies that threaten the ability of midwives to function as primary health care providers for women. Despite these hurdles, midwives have the potential to remain competitive in the new marketplace. This article underscores the importance of being knowledgeable about legislation and policy issues surrounding the financing of midwifery services, quality performance measurement for HMOs as they pertain to reproductive health, and discussions regarding which clinicians should be defined as primary care providers. PMID:9674347

  3. New reproductive technologies: Equity and access to reproductive health care.

    PubMed

    Henifin, M S

    1993-01-01

    While attention has focused on the promise of new reproductive technologies to provide cures for infertility, efforts aimed at preventing infertility have languished, and the major cause of infant morbidity and morality--lack of prenatal care--has worsened. This article explores the social and ethical issues arising out of the uses of three new reproductive technologies: surrogacy, in vitro fertilization, and prenatal screening. In addition, coerced medical interventions during pregnancy are described. Examination of the social circumstances surrounding the use of these medical technologies supports the conclusion that new reproductive technologies have increased, rather than decreased, inequities in access to and allocation of health care resources. PMID:17165238

  4. Using accountability to improve reproductive health care.

    PubMed

    George, Asha

    2003-05-01

    Accountability is best understood as a referee of the dynamics in two-way relationships, often between unequal partners. The literature on accountability distinguishes between political, fiscal, administrative, legal and constitutional accountability. This paper focuses on accountability mechanisms in health care and how they mediate between service providers and communities and between different kinds of health personnel at the primary health care level. It refers to case studies of participatory processes for improving sexual and reproductive health service delivery. Information, dialogue and negotiation are important elements that enable accountability mechanisms to address problems by supporting change and engagement between participants. In order to succeed, however, efforts towards better accountability that broaden the participation of users must take into account the social contexts and the policy and service delivery systems in which they are applied, address power relations and improve the representation of marginalised groups within communities and service delivery systems. PMID:12800713

  5. Reproductive health in India's primary health care system.

    PubMed

    Rao, M

    1997-01-01

    India's family planning program having reached a dead end, the government of India appointed an expert group to develop a new population policy for the country. While the group's report, submitted in May 1994, proclaimed a new orientation described as pro-poor, pro-nature, and pro-women, the recommendations of the report were criticized as not being serious about gender equity. The government of India, describing a new reproductive health care approach, envisions a paradigm shift in the family planning program strategy. Reproductive health is defined as a state in which people can reproduce and regulate their fertility, women are able to go through pregnancy and childbirth safely, the outcome of pregnancy is successful with regard to maternal and infant survival and well-being, and couples are able to have sexual relations free of the fear of pregnancy and of contracting disease. To further the discussion on the newly initiated reproductive health care approach, the faculty of the Center of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, New Delhi, organized a workshop for November 4-5, 1996, on the place of reproductive health in India's primary health care. The workshop brought together public health persons, clinicians, and health and women's rights activists. The author outlines the content of papers presented at the workshop. PMID:9230606

  6. Reproductive health care and minors' rights.

    PubMed

    Paul, E W; Klassel, D

    1984-01-01

    The right of minors under the US Constitution to reproductive health care services has been established and supersedes any state laws that may conflict with federal constitutional priciples. It has been ruled by the US Supreme Court that minors as well as adults possess a constitutional right to privacy, including the right to choose abortion without 3rd party consent. However, the states of Indiana, Lojisiana, Massachusetts, Missouri, North Dakota, and Rhode Island have enacted judicial bypass schemes that require parental consent for minors' abortions if an alternative procedure is also provided whereby the minor receives a confidential hearing before a neutral 3rd party. Several states further require parental notification for abortion, although legal challenges have been directed against these statutes. In terms of contraception, a New York statute that prohibited the sale of nonprescription contraceptives to those under 16 years of age was ruled to constitute an unconstitutional burden on minors' right to privacy. Moreover, parental consent to contraception cannot be imposed as a requirement in a federally funded family planning program. Attempts are being made to attach a parental consent requirement to family planning services provided under Title X, but this provision is considered to undercut desired adolescent participation in such programs and will be challenged on constitutional grounds. Claims by parents that the provision of contraceptive services to their children on a confidential basis violates parents' right to the care, custody, and nurture of their children have been rejected. Finally, standards promulgated by the American Bar Association provide that a minor of any age consent to medical services or counseling for family planning, contraception, or sexually transmitted diseases, excluding sterilization, and treatment related to pregnancy, including abortion. PMID:12339889

  7. Knowledge of adolescent girls regarding reproductive health care.

    PubMed

    Dash, Bijayalakshmi

    2012-01-01

    The period of adolescence (usually 15-19 years) is marked by physiological changes in the body, more so with females. Unfortunately sex and sex education continue to be taboo. A study was therefore conducted among adolescent girls of urban slum area of Niladribihar, Khurda district of Odisha. The sample consisted of 84 adolescent girls. The analysis showed that adolescent girls had average reproductive health care that can lead to numerous health problems and there is dire need of evolving measures to improve their knowledge on reproductive health care. Nursing professionals in hospital setting can significantly contribute in this area. PMID:23534171

  8. Reproductive Health Management for the Care of Women Veterans.

    PubMed

    Zephyrin, Laurie C

    2016-02-01

    There are more than 2 million women veterans living in the United States. Many women do not identify themselves as veterans. As women's health care providers, it is important to understand and recognize the potentially complex health and social needs of women veterans and the role of military service on their lives. The reproductive health needs of women veterans may be shaped by their military experiences and coexisting medical or mental health conditions. Military sexual trauma and combat exposure are common causes of posttraumatic stress disorder and can affect overall health and well-being. Screening for military service is important in all women, and inclusion of this as a key demographic variable in research and clinical encounters can further inform health care considerations. The following key topics are addressed: who are women veterans, health and social risk factors associated with a history of military service, reproductive health across the life course, military sexual trauma and reproductive health of women veterans, how to take a military history, and the essential role of women's health providers, including obstetrician-gynecologists, in enhancing health systems and providing high-quality care to veterans. PMID:26942369

  9. The Patient Protection and Affordable Care Act and Reproductive Health: Harnessing Data to Improve Care

    PubMed Central

    Stulberg, Debra

    2013-01-01

    The Patient Protection and Affordable Care Act (PPACA) has great potential to improve reproductive health through several components: expanded coverage of people of reproductive age; required coverage of many reproductive health services; and insurance exchange structures that encourage individuals and states to hold plans and providers accountable. These components can work together to improve reproductive health. But in order for this to work, consumers and states need information with which to assess plans. This review article summarizes state contracting theory and argues that states should use this structure to require health plans to collect and report meaningful data that patients, providers, plans, payers, and third-party researchers can access. Now that the Supreme Court has upheld the PPACA and states must set up health insurance exchanges, populations can benefit from improved care and outcomes through data transparency. PMID:23262767

  10. Predictors of Caregiver Supportive Behaviors towards Reproductive Health Care for Women with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Lin, Lan-Ping; Lin, Pei-Ying; Chu, Cordia M.; Lin, Jin-Ding

    2011-01-01

    Although many previous studies have begun to address the reproductive health needs of women with intellectual disabilities; however, the supportive behaviors of caregivers to assist their reproductive health is not well understood. Data from a cross-sectional survey of ""2009 National Survey on Reproductive Health Care Needs and Health Education…

  11. Primary Care Physicians’ Perceptions of Barriers To Preventive Reproductive Health Care In Rural Communities

    PubMed Central

    Chuang, Cynthia H.; Hwang, Sandra W.; McCall-Hosenfeld, Jennifer S.; Rosenwasser, Lara; Hillemeier, Marianne M.; Weisman, Carol S.

    2013-01-01

    CONTEXT Women residing in rural areas are less likely than urban women to receive preventive reproductive health care, but reasons for this disparity remain largely unexplored. METHODS In 2010, semistructured interviews were conducted with 19 rural primary care physicians in central Pennsylvania regarding their experiences in two domains of preventive reproductive health—contraceptive care and preconception care. Major themes were identified using a modified grounded theory approach. RESULTS Physicians perceived that they had a greater role in providing contraceptive care than did nonrural physicians and that contraceptives were widely accessible to patients in their communities; however, the scope of contraceptive services they provided varied widely. Participants were aware of the importance of optimal health prior to pregnancy, but most did not routinely initiate preconception counseling. Physicians perceived rural community norms of unintended pregnancies, large families, and indifference toward career and educational goals for young women as the biggest barriers to both contraceptive and preconception care, as these attitudes resulted in a lack of patient interest in family planning. Lack of time and resources were identified as additional barriers to providing preconception care. CONCLUSIONS Rural women’s low use of contraceptive and preconception care services may reflect that preventive reproductive health care is not a priority in rural communities, rather than that it is inaccessible. E3 orts to motivate rural women to engage in reproductive life planning, including more proactive counseling by providers, merit examination as ways to improve use of services. PMID:22681422

  12. Adolescents with Special Needs: Clinical Challenges in Reproductive Health Care.

    PubMed

    Quint, Elisabeth H

    2016-02-01

    Adolescents with special needs have unique reproductive health care needs related to their physical and cognitive issues. This review discusses some of the most common concerns that are encountered in clinical practice, as the clinician will partner with the adolescent and her family to guide her through the pubertal transition and to help navigate the risks and rights of reproduction. Families often seek anticipatory guidance before menarche on menstrual hygiene, abuse risk and sexuality and can be reassured that most teens with special needs do very well with menstruation. The clinician needs to evaluate the teenager's reproductive knowledge as well her risk for abuse and coercion and her ability to consent to sexual activity, if she requests contraception. Menstrual management is mostly based on the impact of the menstrual cycles on the teenager's life and activities. The adolescents may have a decreased ability to tolerate menses or pain, or experience changes in seizure pattern or altered mood. Hormonal treatment is often used to assist with menstrual hygiene, cyclical mood changes or dysmenorrhea. The goal of treatment can be complete amenorrhea, alleviate pain or regulate and decrease menstrual flow. The unique risks and benefits of hormonal treatment for this special population are highlighted. PMID:26542013

  13. Quality of reproductive health services at commune health stations in Viet Nam: implications for national reproductive health care strategy.

    PubMed

    Ngo, Anh D; Hill, Peter S

    2011-05-01

    This paper presents a qualitative study conducted in 2009 of provider and patient perceptions of primary level reproductive health services provided by commune health stations (CHSs), and the implications for Viet Nam's 2011-2020 National Strategy for Reproductive Health Care. In the three provinces of Thai Nguyen, Thua Thien Hue, and Vinh Long, we interviewed the heads of CHSs, held focus group discussions with midwives and women patients, and observed facilities. Half the 30 CHSs visited were in poor physical condition; the rest were newly renovated. However, the model of service delivery was largely unchanged from ten years before. Many appeared to fall short in meeting patient expectations in terms of modern medical equipment and technology, range of drug supplies, and levels of staff expertise. As a result, many women were turning to private doctors and public hospitals, at least in urban areas, or seeking medication from pharmacies. To make CHS clinics sustainable, promotion of access to reproductive health services should be undertaken concurrently with quality improvement. A responsive payment scheme must also be developed to generate revenues. Efforts should be made to reduce the unnecessary use of more costly services from private clinics and higher level public facilities. PMID:21555086

  14. Community Health Workers and Health Care Delivery: Evaluation of a Women's Reproductive Health Care Project in a Developing Country

    PubMed Central

    Wajid, Abdul; White, Franklin; Karim, Mehtab S.

    2013-01-01

    Background As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH) services in two areas with different levels of service in Punjab, Pakistan. Methods A cross-sectional survey was conducted to interview Married Women of Reproductive Age (MWRA). Information was collected on MWRA knowledge regarding danger signs during pregnancy, delivery, postnatal periods, and MNH care seeking behavior. After comparing MNH service utilization, the two areas were compared using a logistic regression model, to identify the association of different factors with the intervention after controlling for socio-demographic, economic factors and distance of the MWRA residence to a health care facility. Results The demographic characteristics of women in the two areas were similar, although socioeconomic status as indicated by level of education and better household amenities, was higher in the intervention area. Consequently, on univariate analysis, utilization of MNH services: antenatal care, TT vaccination, institutional delivery and use of modern contraceptives were higher in the intervention than control area. Nonetheless, multivariable analysis controlling for confounders such as socioeconomic status revealed that utilization of antenatal care services at health centers and TT vaccination during pregnancy are significantly associated with the intervention. Conclusions Our findings suggest positive changes in health care seeking behavior of women and families with respect to MNH. Some aspects of care still require attention, such as knowledge about danger signs and neonatal care, especially umbilical cord care. Despite overall success achieved so far in response to the Millennium Development Goals, over the past two decades decreases in maternal mortality are far from the 2015 target. This report identifies some of the key factors to improving MNH and serves as an interim measure of a

  15. Reproductive health care situation in Bosnia-Herzegovina.

    PubMed

    Dizdarevic-Stojkanovic, J

    1999-01-01

    The law legalizing abortion and implementing family planning, passed in former Yugoslavia in 1952, is still in effect in the newly created state of Bosnia-Herzegovina. This law has helped eliminate illegal, i.e. criminal, abortions, but existing arrangements providing family planning and promoting reproductive and sexual health are not effective enough, because too few people know enough about the rights to individual choice in family planning. The primary objective for the next twenty years is to educate the people--women, men and the young--about their rights to reproductive choice and sexual health, and about how to exercise those rights as fully and effectively as possible. Legal and financial assistance from WHO will be welcome, because the post-war Bosnian society and state lack funds for such initiatives. PMID:10536386

  16. Reproductive health care for asylum-seeking women - a challenge for health professionals

    PubMed Central

    2010-01-01

    Background Dealing with pregnancy, childbirth and the care of newborn babies is a challenge for female asylum seekers and their health care providers. The aim of our study was to identify reproductive health issues in a population of women seeking asylum in Switzerland, and to examine the care they received. The women were insured through a special Health Maintenance Organisation (HMO) and were attending the Women's Clinic of the University Hospital in Basel. We also investigated how the health professionals involved perceived the experience of providing health care for these patients. Methods A mixed methods approach combined the analysis of quantitative descriptive data and qualitative data obtained from semi-structured interviews with health care providers and from patients' files. We analysed the records of 80 asylum-seeking patients attending the Women's Clinic insured through an HMO. We conducted semi-structured interviews with 10 care providers from different professional groups. Quantitative data were analysed descriptively. Qualitative data analysis was guided by Grounded Theory. Results The principal health problems among the asylum seekers were a high rate of induced abortions (2.5 times higher than in the local population), due to inadequate contraception, and psychosocial stress due to the experience of forced migration and their current difficult life situation. The language barriers were identified as a major difficulty for health professionals in providing care. Health care providers also faced major emotional challenges when taking care of asylum seekers. Additional problems for physicians were that they were often required to act in an official capacity on behalf of the authorities in charge of the asylum process, and they also had to make decisions about controlling expenditure to fulfil the requirements of the HMO. They felt that these decisions sometimes conflicted with their duty towards the patient. Conclusion Health policies for asylum

  17. The Teen Outreach Reproductive Challenge: Improving Adolescent Health Care Delivery through Peer Education Projects

    ERIC Educational Resources Information Center

    DeMairo, Pauline; Dischell, Jackie; Jouthe, Sorahya A.; Horner, Andrea

    2008-01-01

    The Teen Outreach Reproductive CHallenge (TORCH) is a peer education program that provides information on various topics relevant to adolescent sexual health to a diverse audience, ranging from teens to health care providers. This information is disseminated through various projects by a group of New York City high-school students who are…

  18. Yes we can! Successful examples of disallowing 'conscientious objection' in reproductive health care.

    PubMed

    Fiala, Christian; Gemzell Danielsson, Kristina; Heikinheimo, Oskari; Guðmundsson, Jens A; Arthur, Joyce

    2016-06-01

    Reproductive health care is the only field in medicine where health care professionals (HCPs) are allowed to limit a patient's access to a legal medical treatment - usually abortion or contraception - by citing their 'freedom of conscience.' However, the authors' position is that 'conscientious objection' ('CO') in reproductive health care should be called dishonourable disobedience because it violates medical ethics and the right to lawful health care, and should therefore be disallowed. Three countries - Sweden, Finland, and Iceland - do not generally permit HCPs in the public health care system to refuse to perform a legal medical service for reasons of 'CO' when the service is part of their professional duties. The purpose of investigating the laws and experiences of these countries was to show that disallowing 'CO' is workable and beneficial. It facilitates good access to reproductive health services because it reduces barriers and delays. Other benefits include the prioritisation of evidence-based medicine, rational arguments, and democratic laws over faith-based refusals. Most notably, disallowing 'CO' protects women's basic human rights, avoiding both discrimination and harms to health. Finally, holding HCPs accountable for their professional obligations to patients does not result in negative impacts. Almost all HCPs and medical students in Sweden, Finland, and Iceland who object to abortion or contraception are able to find work in another field of medicine. The key to successfully disallowing 'CO' is a country's strong prior acceptance of women's civil rights, including their right to health care. PMID:26838273

  19. Community reactions to reproductive health care at three school-based clinics in Louisiana.

    PubMed

    Zeanah, P D; Morse, E V; Simon, P M; Stock, M; Pratt, J L; Sterne, S

    1996-09-01

    Despite the growing success of school-based health care during the past two decades, the issue of providing reproductive health care at school-based health centers remains controversial. In this article, focus group data from three school-based centers in Louisiana, each in different stages of development, demonstrates how the controversies about reproductive health may frame more general concerns about school-based care. In addition, community readiness to address directly problematic sexual behavior relates not only to the specific needs and priorities of the community but to recognition of the negative effect of the consequences of sexual behavior such as pregnancy, high drop out, and absenteeism rates on a community's educational, rather than social, goals and values. PMID:8884662

  20. The appropriateness of gatekeeping in the provision of reproductive health care for adolescents in Lithuania:the general practice perspective

    PubMed Central

    Jaruseviciene, Lina; Levasseur, Gwenola

    2006-01-01

    Background Adolescents' consultation of primary health care services remains problematic despite their accessibility. The reproductive health service seeking behavior of adolescents is the object of much research but little is known about how this behavior is influenced by the gatekeeping system. This study aimed to explore general practitioners' perceptions of the appropriateness of gatekeeping in adolescent reproductive health care. Methods Twenty in-depth interviews regarding factors affecting adolescent reproductive health care were carried out on a diverse sample of general practitioners and analyzed using grounded theory. Results The analysis identified several factors that shaped GPs' negative attitude to gatekeeping in adolescent reproductive health care. Its appropriateness in this field was questionable due to a lack of willingness on the part of GPs to provide reproductive health services for teenagers, their insufficient training, inadequately equipped surgeries and low perceived support for reproductive health service provision. Conclusion Since factors for improving adolescent reproductive health concern not only physicians but also the health system and policy levels, complex measures should be designed to overcome these barriers. Discussion of a flexible model of gatekeeping, encompassing both co-ordination of care provided by GPs and the possibility of patients' self-referral, should be included in the political agenda. Adolescents tend to under-use rather than over-use reproductive health services and every effort should be made to facilitate the accessibility of such services. PMID:16536876

  1. Linkages Within the Reproductive and Maternal Health Continuum of Care in Bangladesh.

    PubMed

    McDougal, Lotus; Rusch, Melanie L A; Silverman, Jay G; Raj, Anita

    2016-07-01

    The continuum of care (CoC) is a fundamental approach to reproductive, maternal, newborn, and child health policy and programs, but linkages along the CoC are inadequately understood. This article assesses linkages in reproductive and maternal health (RMH) services in Bangladesh using the 2011 Bangladesh Demographic and Health Survey (n = 7170). Antenatal care (ANC) was positively associated with skilled birth attendance (SBA) among both pre-pregnancy contraceptive users and nonusers. Among women who used pre-pregnancy contraceptives but did not receive skilled ANC, there was a 26% decreased odds of SBA. Pre-pregnancy contraceptive use increased the odds of postpartum contraceptive use, but neither ANC nor SBA was associated with postpartum contraceptive use. There are clear linkages within maternal health services and within reproductive health services, but linkages across life stages were variable. Removing barriers to accessing health services early and addressing barriers in the transitions within RMH care will facilitate sustained engagement along the CoC. PMID:27371578

  2. Reproductive health care seeking behavior among urban slum women of Delhi

    PubMed Central

    Elizabeth, Adhapillil Mathai; Khan, Abdul Mazeed; Rashid, Wahid

    2015-01-01

    Background: The study tries to understand what are the dimensions of Reproductive Health care seeking behavior among the urban slum women in Delhi, their level of awareness and treatment seeking patterns? Materials and Methods: The study was carried out in one of the slum in south district of Delhi. 253 women of reproductive age group were selected by systematic random sampling. Interpersonal interview was conducted to seek information on the selected parameter. Results: Around three/fourth women had undergone for blood pressure check up, weight recording and stomach/abdomen check up during pregnancy. Only 39.9% received advice on avoiding intake of medicine during pregnancy. About 14.6% mentioned that at least 40 days rest were required for resuming daily routine activities after delivery. Thus majority of these slum women are ignorant about the importance of post natal care which was necessary for post delivery care of the women and her infant. Conclusion: The correct knowledge on the importance of ANC and PNC and various checkups need to be carried out during pregnancy and postnatal period needs to be imparted to these women. Thus, health education and health promotion campaigns are needed for bring changes in the existing health-seeking behaviors among urban slum women. PMID:27462629

  3. Brazilian public policies for reproductive health: family planning, abortion and prenatal care.

    PubMed

    Guilhem, Dirce; Azevedo, Anamaria Ferreira

    2007-08-01

    This study is an ethical reflection on the formulation and application of public policies regarding reproductive health in Brazil. The Integral Assistance Program for Women's Health (PAISM) can be considered advanced for a country in development. Universal access for family planning is foreseen in the Brazilian legislation, but the services do not offer contraceptive methods for the population in a regular and consistent manner. Abortion is restricted by law to two cases: risk to the woman's life and rape. This reality favors the practice of unsafe abortion, which is the third largest cause of maternal death in Brazil. Legal abortion is regulated by the State and the procedure is performed in public health centers. However, there is resistance on the part of professionals to attend these women. Prenatal care is a priority strategy for promoting the quality of life of these women and of future generations. Nonetheless, it is still difficult for these women to access the prenatal care services and to have the required number of consultations. Moreover, managers and health professionals need to be made aware of the importance of implementing the actions indicated by the public policies in the area of sexual and reproductive health, favoring respect for autonomy in a context of personal freedom. PMID:17614992

  4. Posthumous Reproduction and Palliative Care

    PubMed Central

    Quinn, Gwendolyn; Bower, Bethanne; Zoloth, Laurie

    2011-01-01

    Abstract Posthumous reproduction is an issue fraught with legal, ethical, religious, and moral debate. The involvement of the hospice and palliative care community in this debate may be peripheral due to the fact that other health care professionals would be actually delivering the services. However, the hospice and palliative care community are more likely to treat patients considering posthumous reproduction as they near the end of their lives. This article provides the hospice and palliative care community with a review of the medical, ethical, and legal considerations associated with posthumous reproduction. Having knowledge of these issues, and a list of available resources, will be useful if hospice and palliative care staff find themselves facing a patient or family that is considering posthumous reproduction. PMID:21711126

  5. The green choices project: integrating environmental health education into reproductive health care settings.

    PubMed

    Worthington, Sandra; Armstrong, Kay; Debevec, Elie

    2010-01-01

    A national reproductive health organization developed the Green Choices project to educate staff and clients about how to live in healthier environments by reducing potentially harmful environmental exposures to toxicants. An advisory group, comprised of experts in environmental and reproductive health and literacy, defined the project's scope and common environmental exposures to address. The following educational materials were developed: an online staff environmental health 101 curriculum, an environmental health assessment tool for clients to identify their potential risks, and information sheets for each environmental exposure that described potential risks and ways to reduce risks. Beta-testing methods included baseline and follow-up surveys, one-on-one interviews, focus groups, and recommendations from experts. Staff and client feedback on the educational materials resulted in increased clarity, sensitivity, relevancy, and appeal. Environmental health experts ensured accuracy of information, and reading experts lowered the reading level from 12th to 6th grade. A campaign to disseminate environmental health information and educational materials nationally is under way. PMID:20838173

  6. Migrant Beer Promoters’ Experiences Accessing Reproductive Health Care in Cambodia, Laos, Thailand, and Vietnam: Lessons for Planners and Providers

    PubMed Central

    Webber, Gail C.; Spitzer, Denise L.; Somrongthong, Ratana; Dat, Truong Cong; Kounnavongsa, Somphone

    2014-01-01

    Migrant beer promoters in Cambodia, Laos, Thailand, and Vietnam were surveyed to determine their experiences in accessing reproductive health care services in the cities of Phnom Penh, Vientiane, Bangkok, and Hanoi. A total of 7 health care institutions were chosen as popular with migrant beer promoters. Staff at these institutions provided information on the institution, and 390 beer promoters were surveyed about their experiences while accessing services. There were discrepancies between findings from the staff interviews and the experiences of the beer promoters. In general, the migrant women were satisfied with the cost, location, friendliness of the health care providers, and knowledge and skills of the providers. They were less positive about confidentiality and waiting times, though many still agreed that these were not an issue. Health care planners and providers should take note of the issues affecting access to reproductive health care services for migrant women when they design and implement services. PMID:22743859

  7. Migrant beer promoters' experiences accessing reproductive health care in Cambodia, Laos, Thailand, and Vietnam: lessons for planners and providers.

    PubMed

    Webber, Gail C; Spitzer, Denise L; Somrongthong, Ratana; Dat, Truong Cong; Kounnavongsa, Somphone

    2015-03-01

    Migrant beer promoters in Cambodia, Laos, Thailand, and Vietnam were surveyed to determine their experiences in accessing reproductive health care services in the cities of Phnom Penh, Vientiane, Bangkok, and Hanoi. A total of 7 health care institutions were chosen as popular with migrant beer promoters. Staff at these institutions provided information on the institution, and 390 beer promoters were surveyed about their experiences while accessing services. There were discrepancies between findings from the staff interviews and the experiences of the beer promoters. In general, the migrant women were satisfied with the cost, location, friendliness of the health care providers, and knowledge and skills of the providers. They were less positive about confidentiality and waiting times, though many still agreed that these were not an issue. Health care planners and providers should take note of the issues affecting access to reproductive health care services for migrant women when they design and implement services. PMID:22743859

  8. A geographical perspective on access to sexual and reproductive health care for women in rural Africa.

    PubMed

    Yao, Jing; Murray, Alan T; Agadjanian, Victor

    2013-11-01

    Utilization of sexual and reproductive health (SRH) services can significantly impact health outcomes, such as pregnancy and birth, prenatal and neonatal mortality, maternal morbidity and mortality, and vertical transmission of infectious diseases like HIV/AIDS. It has long been recognized that access to SRH services is essential to positive health outcomes, especially in rural areas of developing countries, where long distances as well as poor transportation conditions, can be potential barriers to health care acquisition. Improving accessibility of health services for target populations is therefore critical for specialized healthcare programs. Thus, understanding and evaluation of current access to health care is crucial. Combining spatial information using geographical information system (GIS) with population survey data, this study details a gravity model-based method to measure and evaluate access to SRH services in rural Mozambique, and analyzes potential geographic access to such services, using family planning as an example. Access is found to be a significant factor in reported behavior, superior to traditional distance-based indicators. Spatial disparities in geographic access among different population groups also appear to exist, likely affecting overall program success. PMID:24034952

  9. A geographical perspective on access to sexual and reproductive health care for women in rural Africa

    PubMed Central

    Yao, Jing; Murray, Alan T.; Agadjanian, Victor

    2015-01-01

    Utilization of sexual and reproductive health (SRH) services can significantly impact health outcomes, such as pregnancy and birth, prenatal and neonatal mortality, maternal morbidity and mortality, and vertical transmission of infectious diseases like HIV/AIDS. It has long been recognized that access to SRH services is essential to positive health outcomes, especially in rural areas of developing countries, where long distances as well as poor transportation conditions, can be potential barriers to health care acquisition. Improving accessibility of health services for target populations is therefore critical for specialized healthcare programs. Thus, understanding and evaluation of current access to health care is crucial. Combining spatial information using geographical information system (GIS) with population survey data, this study details a gravity model-based method to measure and evaluate access to SRH services in rural Mozambique, and analyzes potential geographic access to such services, using family planning as an example. Access is found to be a significant factor in reported behavior, superior to traditional distance-based indicators. Spatial disparities in geographic access among different population groups also appear to exist, likely affecting overall program success. PMID:24034952

  10. Situation analysis: assessing family planning and reproductive health services. Quality of care.

    PubMed

    1997-01-01

    This issue of Population Briefs contains articles on researches conducted by the Population Council concerning the delivery of quality of care, contraceptive development, safe abortion, family planning, demography, and medical anthropology. The cover story focuses on a systematic data collection tool called Situation Analysis that helps managers in program evaluation. This tool has a handbook entitled "The Situation Analysis Approach to Assessing Family Planning and Reproductive Health Services" that contains all the information needed to conduct a Situation Analysis study. The second article reports about a new contraceptive method, the two-rod levonorgestrel, which was developed at the Population Council and was recently approved by the US Food and Drug Administration. The third article reports on a medical abortion procedure that was proven to be safe, effective, and acceptable to women in developing countries. Moreover, the fourth article presents initial findings of the Community Health and Family Planning Project conducted in Northern Ghana. The fifth article discusses the paper written by the Population Council demographer, Mark Montgomery entitled "Learning and lags in mortality perceptions". Finally, the sixth article deals with another paper that reports on women's health perceptions and reproductive health in the Middle East. PMID:12295356

  11. Men's Reproductive Health

    MedlinePlus

    ... NICHD Research Information Clinical Trials Resources and Publications Men's Reproductive Health: Overview Skip sharing on social media ... Content Reproductive health is an important component of men's overall health and well-being. Too often, males ...

  12. Caring for Women Experiencing Reproductive Coercion.

    PubMed

    Grace, Karen Trister

    2016-01-01

    Reproductive coercion is behavior that interferes with a woman's decision making regarding reproductive health. It may consist of contraception sabotage and/or pressure to either carry a pregnancy to term or to have an abortion. Reproductive coercion may coexist with intimate partner violence and be associated with higher rates of unintended pregnancy. Midwives and other women's health care providers can play an integral role in identifying reproductive coercion and implementing harm-reduction strategies. PMID:26762543

  13. Improving worldwide reproductive health.

    PubMed

    Geary, J

    1993-01-01

    The 14th International Federation of Gynaecology and Obstetrics World Congress will be held in Montreal, Canada, in 1994, under the auspices of the Society of Obstetricians and Gynecologists of Canada. The World Congress will 1) promote and facilitate international cooperation in the field of obstetrics and gynecology, 2) develop and improve the exchange of information and ideas, and 3) encourage the adoption of an international perspective on issues of concern. The 1994 program will survey recent research advances and introduce new equipment, instruments, and pharmaceuticals. Issues addressed will include maternal mortality, reproductive technologies, continuing education, malignancy, family planning, and contraception. The Conference's symposia, industry-sponsored events, and cultural activities are being designed to increase speaker-audience interaction and to stimulate debate and the exchange of views. The continuing education goals are 1) to encourage appropriate research with valid and applicable results and 2) to extend the patient-counseling abilities of participating physicians. Canada's socialized health care system, which carefully scrutinizes new expensive technologies, will be highlighted for the international delegates. The scientific program will include 1) general topics 2) reproductive endocrinology, 3) maternal/fetal medicine, and 4) gynecological oncology. Poster sessions followed by open discourses and free communications sessions will facilitate the exchange of views and information. The overall goal of the conference is to improve reproductive health care for mothers and babies worldwide. PMID:12318476

  14. Zambia moves towards reproductive health.

    PubMed

    1997-01-01

    Several events in Zambia this year have marked the development of an integrated approach to reproductive health. A team met in March to draw up a national safe motherhood policy, plus strategies and guidelines. These were completed by April and are being distributed for comments. Clinical guidelines for safe motherhood in health centers have also been developed. These aim to reduce mortality and morbidity among mothers and infants by helping health workers to provide quality care to women at every stage of pregnancy and delivery. A reproductive health workshop was held in Ngwerere in May to create awareness of the concept of reproductive health, identify reproductive health problems in the area, propose solutions and outline activities. The 75 participants included community health workers, community leaders, teachers, youth leaders, and community members, as well as health workers and policymakers. The workshop was conducted in the local language so that those present were able to participate fully. June 1997 saw the official launch of Zambia's new policy framework, guidelines and strategy on family planning within reproductive health. The country's Minister of Health, Dr. Katele Kalumba, said the family planning guidelines were a sign of the government's commitment to providing a basic health care package for all Zambians. To promote widespread discussion of the whole concept of reproductive health, local newspapers printed feature articles with the headline "Let's talk reproductive health." The articles raised a variety of sensitive issues that ranged from safe sex and adolescent sexuality to safe motherhood and HIV prevention. Plans are going ahead in Zambia for drawing up a national training curriculum for safe motherhood and family planning. The curriculum for health workers will cover both pre-service and in-service training. PMID:12321356

  15. [Do reproductive health care practices create a risk of HIV, HVB, and HVC transmission? Case studies in Cambodia].

    PubMed

    Petitet, Pascale Hancart

    2010-01-01

    The processes involved in nosocomial transmission of HIV, HBV, and HCV nosocomial transmission have not been studied at a global level; little is known about them or about the underlying social and cultural logic that contributes to this transmission. Hospital hygiene has mainly been studied from a biological perspective until now. However, hospital hygiene is shaped by norms and sociocultural representations, and the increase or limitation of disease transmission always takes place within social relations. We need to analyse the practices related to hygiene from a cultural perspective, especially since norms are interpreted at the local level according to social and symbolic logic. Our paper aims to investigate these issues in the context of reproductive health care practices in Cambodia. We describe various perceptions, attitudes and roles of both medical and non-medical caregivers and show how they determine practices, as well as how sanitary, social and institutional contexts shape practices. Since 1995, public health institutions have provided contraceptive methods (condoms, oral or injectable contraceptives, contraceptive implants, intrauterine devices, and emergency contraception). Except for the free distribution of condoms, particularly by NGOs as part of HIV prevention programs, access to contraception is not free. Private clinics and local and international NGOs provide many of these services. Many women in both urban and rural areas seek reproductive health care in the informal sector, from caregivers who may or may not be trained. We thus wonder if these practices, as implemented in the formal and informal care sectors, create a risk for the transmission of HIV, HVB, and HVC. We analyse those issues in considering especially the injection of Depo-Provera, insertion of intrauterine devices, vaginal cleaning practices, and surgical abortion. This investigation of the sociocultural dimension of hygiene in the field of reproductive health care underlines

  16. Preconception care: promoting reproductive planning

    PubMed Central

    2014-01-01

    Introduction Preconception care recognizes that many adolescent girls and young women will be thrust into motherhood without the knowledge, skills or support they need. Sixty million adolescents give birth each year worldwide, even though pregnancy in adolescence has mortality rates at least twice as high as pregnancy in women aged 20-29 years. Reproductive planning and contraceptive use can prevent unintended pregnancies, unsafe abortions and sexually-transmitted infections in adolescent girls and women. Smaller families also mean better nutrition and development opportunities, yet 222 million couples continue to lack access to modern contraception. Method A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for adolescents, women and couples of reproductive age on MNCH outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture. Results Comprehensive interventions can prevent first pregnancy in adolescence by 15% and repeat adolescent pregnancy by 37%. Such interventions should address underlying social and community factors, include sexual and reproductive health services, contraceptive provision; personal development programs and emphasizes completion of education. Appropriate birth spacing (18-24 months from birth to next pregnancy compared to short intervals <6 months) can significantly lower maternal mortality, preterm births, stillbirths, low birth weight and early neonatal deaths. Conclusion Improving adolescent health and preventing adolescent pregnancy; and promotion of birth spacing through increasing correct and consistent use of effective contraception are fundamental to preconception care. Promoting reproductive planning on a wider scale is closely interlinked with the

  17. [Sexuality, reproductive health and violence against the African Brazilian women: aspects of interest for nursing care].

    PubMed

    da Cruz, Isabel Cristina Fonseca

    2004-12-01

    Based on the referential of the critical racial theory, a review of the literature was made with the objective of searching for information that leads to an affirmative professional action against racism and sexism, based on scientific evidences and culturally competent. It was evidenced that the sexuality, reproductive health and violence against African Brazilian women are themes with scarce literature, suggesting that racism and sexism occur by the omission and negligence of State to weigh on African Brazilian women's mobilization. The study concluded that institutional discrimination in health needs to be neutralized by affirmative actions regarding to African Brazilian women that must be implemented or strengthen to promote equity in health. PMID:15689003

  18. Male reproductive health and infertility.

    PubMed

    Frey, Keith A

    2010-09-01

    Primary care physicians have an essential role and opportunity in positively impacting the reproductive health of men. Although men are less likely than women to consistently seek preventive services, an office visit for any reason should be seen as an opportunity to introduce the idea of reproductive health. Additionally, primary care physicians can and should initiate the diagnostic workup for infertile couples in their practices. The initial assessment for the male partner consists of a thorough history and physical examination and appropriate laboratory tests, including a semen analysis. PMID:20705204

  19. Reproductive Health Risks Associated with Occupational Exposures to Antineoplastic Drugs in Health Care Settings: A Review of the Evidence

    PubMed Central

    Connor, Thomas H.; Lawson, Christina C.; Polovich, Martha; McDiarmid, Melissa A.

    2015-01-01

    Objectives Antineoplastic drugs are known reproductive and developmental toxicants. Our objective was to review the existing literature of reproductive health risks to workers who handle antineoplastic drugs. Methods A structured literature review of 18 peer-reviewed, English language publications of occupational exposure and reproductive outcomes was performed. Results While effect sizes varied with study size and population, occupational exposure to antineoplastic drugs appears to raise the risk of both congenital malformations and miscarriage. Studies of infertility and time-to-pregnancy also suggested an increased risk for sub-fertility. Conclusions Antineoplastic drugs are highly toxic in patients receiving treatment and adverse reproductive effects have been well documented in these patients. Healthcare workers with chronic, low level occupational exposure to these drugs also appear to have an increased risk of adverse reproductive outcomes. Additional precautions to prevent exposure should be considered. PMID:25153300

  20. Sexual and reproductive health needs of HIV-positive women in Botswana - a study of health care worker's views.

    PubMed

    Schaan, Michelle M; Taylor, Myra; Puvimanasinghe, John; Busang, Lesego; Keapoletswe, Koona; Marlink, Richard

    2012-01-01

    Botswana's HIV prevalence is one of the highest in the world at 31.8% in the 15-49 years antenatal population. Being HIV-positive for a woman presents unique challenges with regard to sexuality, child bearing, and partner relations. To ensure optimal sexual and reproductive health (SRH) of HIV-positive women, it is important to understand how health care workers (HCWs) are prepared to address SRH issues such as contraception, fertility desires, and partner violence. This study reports on a knowledge, attitudes, and practices (KAP) questionnaire completed by 98 HCWs from clinics located in and nearby Gaborone and analyzed using descriptive and nonparametric statistics. The majority of participants were nurses (43%), health educators (27%), and lay counselors (19%), 82% female, median age of 35 (Interquartile Range (IQR): 29.25-43.75). General HIV/AIDS knowledge was high with a median score of 8.0/9 (89%) (IQR: 8-9). However, the median SRH knowledge score was much lower at 6.0/10 (60%) (IQR: 4-7). Of the three groups, the SRH knowledge scores of lay counselors were significantly lower than nurses (p=0.024). The attitude scores pertaining to issues such as family planning, sexual violence, the health system's ability to offer SRH services, and personal ability to offer SRH services were moderately positive with a median score of 75% (IQR: 69-81%); although nearly 25% of respondents felt that it is irresponsible for an HIV-positive woman to want to have a child. When presented with a case study of an abused, HIV-positive pregnant woman, most respondents indicated they would offer supportive care without judgment; however 28% of respondents indicated they would express disapproval or disappointment for becoming pregnant when she knows she is HIV-positive. The low SRH knowledge scores together with discriminatory attitudes and practices emphasize the need for increased and ongoing training in SRH issues for all HCWs who provide care for HIV-positive women. PMID:22568549

  1. How Does Religious Affiliation Affect Women’s Attitudes Toward Reproductive Health Policy? Implications for the Affordable Care Act

    PubMed Central

    Patton, Elizabeth W.; Hall, Kelli Stidham; Dalton, Vanessa K.

    2015-01-01

    Structured Abstract Background Supreme Court cases challenging the Affordable Care Act (ACA) mandate for employer-provided reproductive health care have focused on religiously based opposition to coverage. Little is known about women’s perspectives on such reproductive health policies. Study Design Data were drawn from the Women’s Health Care Experiences and Preferences survey, a randomly selected, nationally representative sample of 1078 US women age 18–55. We examined associations between religious affiliation and attitudes toward employer-provided insurance coverage of contraception and abortion services, and the exclusion of religious institutions from this coverage. We used chi-square and multivariable logistic regression for analysis. Results Respondents self-identified as Baptist (18%), Protestant (Other Mainline, 17%), Catholic (17%), Other Christian (20%), Religious, Non-Christian (7%) or no affiliation (21%). Religious affiliation was associated with proportions of agreement for contraception (p = 0.03), abortion (p <0.01), and religious exclusion (p <0.01) policies. In multivariable models, differences in the odds of agreement varied across religious affiliations and frequency of service attendance. For example, compared to non-affiliated women, Baptists and Other Nondenominational Christians (but not Catholics) had lower odds of agreement with employer coverage of contraception (OR 0.63, 95% CI 0.4-0.1 and OR 0.57, CI 0.4–0.9, respectively); women who attended services weekly or more than weekly had lower odds of agreement (OR 0.53, 95% CI 0.3–0.8 and OR 0.33, CI 0.2–0.6, respectively), compared to less frequent attenders. Conclusions Recent religiously motivated legal challenges to employer-provided reproductive health care coverage may not represent the attitudes of many religious women. PMID:25727764

  2. Access to essential medicines for sexual and reproductive health care: the role of the pharmaceutical industry and international regulation.

    PubMed

    Cottingham, Jane; Berer, Marge

    2011-11-01

    The range of medicines and technologies that are essential for sexual and reproductive health care is well established, but access to them is far from universally assured, particularly in less developed countries. This paper shows how the pharmaceutical industry plays a major role in the lack of access to essential medicines for sexual and reproductive health care, by a) investing in products for profit-making reasons despite their negative health impact (e.g. hormone replacement therapy), b) marketing new essential medicines at prices beyond the reach of countries that most need them (e.g. HPV vaccines), and c) failing to invest in the development of new products (e.g. microbicides and medical abortion pills). Small companies, some of them non-profit-making, struggle to fill some of that demand (e.g. for female condoms). International patent protection contributes to high prices of medicines, and while international agreements such as compulsory licensing under TRIPS and the Medicines Patent Pool allow for mechanisms to enable poorer countries to get access to essential medicines, the obstacles created by "big pharma" are daunting. All these barriers have fostered a market in sub-standard medicines (e.g. fake medical abortion pills sold over the internet). An agenda driven by sexual and reproductive health needs, based on the right to health, must focus on universal access to essential medicines at prices developing countries can afford. We call for greater public investment in essential medicines, expanded production of affordable generic drugs, and the development of broad strategic plans, that include affordable medicines and technologies, for addressing identified public health problems, such as cervical cancer. PMID:22118143

  3. Quality of care in reproductive health programmes: education for quality improvement.

    PubMed

    Kwast, B E

    1998-09-01

    The provision of high quality maternity care will make the difference between life and death or lifelong maiming for millions of pregnant women. Barriers preventing access to affordable, appropriate, acceptable and effective services, and lack of facilities providing high quality obstetric care result in about 1600 maternal deaths every day. Education in its broadest sense is required at all levels and sectors of society to enhance policy formulation that will strengthen programme commitment, improve services with a culturally sensitive approach and ensure appropriate delegation of responsibility to health staff at peripheral levels. This paper is the second in series of three which addresses quality of care. The first (Kwast 1998) contains an overview of concepts, assessments, barriers and improvements of quality of care. The third article will describe selected aspects of monitoring and evaluation of quality of care. PMID:9856019

  4. Reproductive health in adolescence.

    PubMed

    Friedman, H L

    1994-01-01

    The health and well-being of adolescents is closely intertwined with their physical, psychological and social development, but this is put at risk by sexual and reproductive health hazards which are increasing in much of the world. Changes in population growth and distribution, the rise of telecommunications, the increase in travel and a decline in the family, as well as a generally earlier start of menarche and later age of marriage are contributing to an increase in unprotected sexual relations before marriage. This, combined with risks from early marriage, result in too early or unwanted pregnancy and childbirth, induced abortion in hazardous circumstances and sexually transmitted diseases, including HIV infection leading to AIDS. With more than half the world's population below the age of 25, and 4 out of 5 young people living in developing countries with inadequate access to prevention and care, there is an urgent need for action. Young women are particularly vulnerable. Mortality and morbidity from early pregnancy whether ending in childbirth or abortion, is much higher for the younger adolescent. Young women, especially those who have less formal education, are more vulnerable to pressures for marriage, or sexual relations before marriage, often with older men. Young people generally lack adequate knowledge about their own development and information on how to get help. Those who could help are rarely trained for working with adolescents, and services which are generally designed for adults or children often deter young people from getting help when they most need it. Policy and legislation relating to sexual and reproductive health issues are often contradictory, and unclear or unenforced.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8085368

  5. Health insurance coverage among women of reproductive age before and after implementation of the affordable care act

    PubMed Central

    Jones, Rachel K.; Sonfield, Adam

    2016-01-01

    Objectives The Affordable Care Act's expansions to Medicaid and private coverage are of particular importance for women of childbearing age, who have numerous preventive care and reproductive health care needs. Study design We conducted two national surveys, one in 2012 and one in 2015, collecting information about health insurance coverage and access to care from 8000 women aged 18–39. We examine type of insurance and continuity of coverage between time periods, including poverty status and whether or not women live in a state that expanded Medicaid coverage. Results The proportion of women who were uninsured declined by almost 40% (from 19% to 12%), though several groups, including US-born and foreign-born Latinas, experienced no significant declines. Among low-income women in states that expanded Medicaid, the proportion uninsured declined from 38% to 15%, largely due to an increase in Medicaid coverage (from 40% to 62%). Declines in uninsurance in nonexpansion states were only marginally significant. Conclusions Despite substantial improvements in health insurance coverage, significant gaps remain, particularly in states that have not expanded Medicaid and for Latinas. Implications This analysis examines changes in insurance coverage that occurred after the Affordable Care Act was implemented. While coverage has improved for many populations, sizeable gaps in coverage remain for Latinas and women in states that did not expand Medicaid. PMID:26802569

  6. Evidence-based reproductive health care in Cameroon: population-based study of awareness, use and barriers.

    PubMed Central

    Tita, Alan T. N.; Selwyn, Beatrice J.; Waller, D. Kim; Kapadia, Asha S.; Dongmo, Sylvestre

    2005-01-01

    OBJECTIVE: To estimate the prevalence of awareness and use of evidence-based reproductive health interventions and to describe the barriers associated with the use of evidence-based interventions among health providers in north-west Cameroon. METHODS: In February 2004, a population-based descriptive study of the awareness and use of 13 evidence-based interventions targeted health workers providing reproductive health care. Their awareness and use of a composite of four vital interventions was also evaluated. These were peripartum use of antiretrovirals to prevent transmission of HIV, antenatal corticosteroid administration, magnesium sulfate prophylaxis and active management of placental delivery with uterotonics. In-depth interviews with key informants were conducted as part of a qualitative substudy to discover the barriers to the use of evidence-based interventions. FINDINGS: Overall, 91.4% (328/359) of reproductive health workers were surveyed. Their awareness of evidence-based interventions varied from 29% for the use of antenatal corticosteroids to 97% for the use of iron and folic acid supplementation during pregnancy. Their use of these interventions ranged from 10.2% for antenatal corticosteroids to 94.8% for iron and folic acid supplementation. Only 50/322 (15.5%; 95% confidence interval (CI)=11.8-20.0) of health workers were aware of all four vital interventions, and only 12/312 (3.8%; 95% CI=2.0- 6.6) reported using all of them regularly. A total of 26 key informants participated in the qualitative substudy. A deficiency in the education and training of health workers, especially a lack of continuing education, was commonly identified as the most important barrier to their awareness of evidence-based practices. A lack of awareness and a lack of supplies and materials were the main barriers to practice. CONCLUSION: The awareness and practice of important evidence-based reproductive health interventions were less than optimal. To improve maternal and

  7. Overall adequacy of antenatal care in Oman: secondary analysis of national reproductive health survey data, 2008.

    PubMed

    El Aty, M A Abd; Meky, F A; Morsy, M; El Sayed, M K

    2014-12-01

    Despite the good health status of women and children in Oman, there are still some gaps to be filled. This study explored the adequacy of antenatal care (ANC) utilization of Omani ever-married women and the sociodemographic and health service determinants of adequate and sufficient ANC. In a secondary analysis of a national dataset (N = 1852 women), the percentages of women who had 4+ ANC visits, attended ANC in the 1st trimester and received care by trained personnel were 96.8%, 74.9% and 99.1% respectively. Overall adequacy of ANC (use and sufficiency of recommended basic services) for the surveyed women was 53.8%. After adjustment of other covariates, being pregnant with the 1st baby was the only significant predictor of overall adequacy of ANC (OR 2.2; 95% CI: 1.6-3.2). Greater awareness of the need for adequate ANC is required for mothers with more than one baby. PMID:25664516

  8. Young women and their reproductive health needs in a family practice setting: factors influencing care seeking in Vitoria, Brazil

    PubMed Central

    E St Louis, Michael; C Figueiredo, Ninive; Milbratz, Ildes; Page-Shafer, Kimberly

    2009-01-01

    Background. Young women often have diverse options for addressing their reproductive health and other health needs in urban settings. In Brazil, they may access care through the government-run Family Health Program (FHP). Understanding factors associated with service utilization can enhance access to and delivery of appropriate services. Objectives. To describe demographic, behavioural and clinical characteristics of young women accessing services through FHP in Vitória, Brazil. Methods. From March to December 2006, women aged 18–29 years were recruited into a population-based, household survey. Responses were analysed to assess previous 6 months utilization of FHP services in this population and characteristics associated with accessing care through this public family practice model. Results. Of 1200 eligible women identified, 1029 enrolled (85.7%). Median age was 23 (interquartile range 20–26) years, 42.7% were married or cohabitating with a male partner. A majority (72%) accessed FHP services in the preceding 6 months, principally for routine and gynaecological visits. Factors independently associated with seeking FHP included: ever tested for human immunodeficiency virus, using anal sex as contraceptive method and reporting a current vaginal discharge. Prior commercial sex work, previous diagnosis with an sexually transmitted infection or using oral sex as a contraceptive method were associated with less use of FHP services. Conclusions. A public option for delivery of FHP has attracted wide utilization across a cross-section of young women in Vitoria, Brazil. Greater sensitization to specific practices and needs of this population, especially around reproductive health, could further enhance the services provided by family practitioners. PMID:19770219

  9. Health care agents

    MedlinePlus

    Durable power of attorney for health care; Health care proxy; End-of-life - health care agent; Life support treatment - ... Respirator - health care agent; Ventilator - health care agent; Power of attorney - health care agent; POA - health care ...

  10. Reducing stigma in reproductive health.

    PubMed

    Cook, Rebecca J; Dickens, Bernard M

    2014-04-01

    Stigmatization marks individuals for disgrace, shame, and even disgust-spoiling or tarnishing their social identities. It can be imposed accidentally by thoughtlessness or insensitivity; incidentally to another purpose; or deliberately to deter or punish conduct considered harmful to actors themselves, others, society, or moral values. Stigma has permeated attitudes toward recipients of sexual and reproductive health services, and at times to service providers. Resort to contraceptive products, to voluntary sterilization and abortion, and now to medically assisted reproductive care to overcome infertility has attracted stigma. Unmarried motherhood has a long history of shame, projected onto the "illegitimate" (bastard) child. The stigma of contracting sexually transmitted infections has been reinvigorated with HIV infection. Gynecologists and their professional associations, ethically committed to uphold human dignity and equality, especially for vulnerable women for whom they care, should be active to guard against, counteract, and relieve stigmatization of their patients and of related service providers. PMID:24513258

  11. Cost Evaluation of Reproductive and Primary Health Care Mobile Service Delivery for Women in Two Rural Districts in South Africa

    PubMed Central

    Schnippel, Kathryn; Lince-Deroche, Naomi; van den Handel, Theo; Molefi, Seithati; Bruce, Suann; Firnhaber, Cynthia

    2015-01-01

    Background Cervical cancer screening is a critical health service that is often unavailable to women in under-resourced settings. In order to expand access to this and other reproductive and primary health care services, a South African non-governmental organization established a van-based mobile clinic in two rural districts in South Africa. To inform policy and budgeting, we conducted a cost evaluation of this service delivery model. Methods The evaluation was retrospective (October 2012–September 2013 for one district and April–September 2013 for the second district) and conducted from a provider cost perspective. Services evaluated included cervical cancer screening, HIV counselling and testing, syndromic management of sexually transmitted infections (STIs), breast exams, provision of condoms, contraceptives, and general health education. Fixed costs, including vehicle purchase and conversion, equipment, operating costs and mobile clinic staffing, were collected from program records and public sector pricing information. The number of women accessing different services was multiplied by ingredients-based variable costs, reflecting the consumables required. All costs are reported in 2013 USD. Results Fixed costs accounted for most of the total annual costs of the mobile clinics (85% and 94% for the two districts); the largest contributor to annual fixed costs was staff salaries. Average costs per patient were driven by the total number of patients seen, at $46.09 and $76.03 for the two districts. Variable costs for Pap smears were higher than for other services provided, and some services, such as breast exams and STI and tuberculosis symptoms screening, had no marginal cost. Conclusions Staffing costs are the largest component of providing mobile health services to rural communities. Yet, in remote areas where patient volumes do not exceed nursing staff capacity, incorporating multiple services within a cervical cancer screening program is an approach to

  12. Reproductive health characteristics of young Malawian women seeking post-abortion care.

    PubMed

    Levandowski, Brooke A; Pearson, Erin; Lunguzi, Juliana; Katengeza, Hans R

    2012-06-01

    Abortion is illegal in Malawi except when the pregnancy endangers the mother's life, yet complications of abortion account for the majority of admissions to gynecological wards. This study collected data on all post-abortion care (PAC) cases reporting to all PAC-providing health facilities in Malawi over a 30-day period. Of a total of 2,028 PAC clients, 20.9% were adolescents (age 10-19) and 29.6% were young adults (age 20-24). More than half of adolescents and almost 80% of young adults were married. Less than 5% of adolescents and 22.5% of young adults reported using contraception when they became pregnant. Being unmarried was associated with previous abortion and contraceptive use among young adults. These statistics indicate a high proportion of unwanted pregnancy and lack of access to modern contraception among young women. Programs to increase access to pregnancy prevention services and protect young women from unsafe abortions are greatly needed. PMID:22916557

  13. Environmental Health: Health Care Reform's Missing Pieces.

    ERIC Educational Resources Information Center

    Fadope, Cece Modupe; And Others

    1994-01-01

    A series of articles that examine environmental health and discuss health care reform; connections between chlorine, chlorinated pesticides, and dioxins and reproductive disorders and cancers; the rise in asthma; connections between poverty and environmental health problems; and organizations for health care professionals who want to address…

  14. Cross-border reproductive care: a committee opinion.

    PubMed

    2013-09-01

    Cross-border reproductive care (CBRC) is a growing worldwide phenomenon, raising questions about why assisted reproductive technology (ART) patients travel abroad, what harms and benefits may result, and what duties health care providers may have in advising and treating patients who travel for reproductive services. Cross-border care offers benefits and poses harms to ART stakeholders, including patients, offspring, providers, gamete donors, gestational carriers, and local populations in destination countries. PMID:23523262

  15. Perspectives of reproductive health.

    PubMed

    van Balen, F; Visser, A P

    1997-05-01

    This issue of Patient Education and Counseling is dedicated to reproductive health. The main focus is infertility as it is experienced in different of our world. In western societies, medical breakthroughs give couples with fertility problems a good chance to have a child. However, in many developing societies adequate medical treatment is only available for the upper classes, and many women keep going to traditional healers. In addition, the social consequences of childlessness are much greater than in western societies. Another focus of this issue is negative experiences regarding pregnancy. A very distressing experience is late pregnancy loss. Late pregnancy loss is different from infertility with respect to the tangibility of an object of grief, though it may also result in permanent childlessness. Other aspects of negative pregnancy experiences are exceptional physical reactions and recurrent induced abortions. Furthermore, two other elements of reproductive health are addressed in this issue: STD among female adolescents and gender aspects of gene technology. Finally, the ramifications of these various aspects of reproductive health on education and counseling are discussed. PMID:9197797

  16. The role of gender inequities in women’s access to reproductive health care: a population-level study of Namibia, Kenya, Nepal, and India

    PubMed Central

    Namasivayam, Amrita; Osuorah, Donatus C; Syed, Rahman; Antai, Diddy

    2012-01-01

    Background: The role of gender inequities in explaining women’s access to reproductive health care was examined in four countries (two sub-Saharan African and two South Asian countries). The extent of gender inequities varies across and within countries, and is rooted in the different cultural practices and gender norms within these different countries, and differences in the status and autonomy of women. Methods: Demographic and Health Survey data from women aged 15–49 years within these countries were analyzed with multivariate logistic regression analysis to examine the role of multidimensional characteristics of gender inequities, operationalized as access to skilled antenatal care, tetanus toxoid injection during pregnancy, and access to skilled antenatal care. Results: Significant associations were found between several dimensions of gender inequities (with the exception of decision-making autonomy) and reported use of maternal reproductive health care services. Several pathways of influence between the outcome and exposure variables were also identified. Conclusion: Dimensions of gender inequities (with the exception of decision-making autonomy) differentially influenced woman’s use of reproductive health care services, thus highlighting the urgent need for concerted and sustained efforts to change these harmful traditional values if several of these countries are to meet Millennium Development Goal-5. PMID:22927766

  17. Update: Interim Guidance for Health Care Providers Caring for Women of Reproductive Age with Possible Zika Virus Exposure--United States, 2016.

    PubMed

    Petersen, Emily E; Polen, Kara N D; Meaney-Delman, Dana; Ellington, Sascha R; Oduyebo, Titilope; Cohn, Amanda; Oster, Alexandra M; Russell, Kate; Kawwass, Jennifer F; Karwowski, Mateusz P; Powers, Ann M; Bertolli, Jeanne; Brooks, John T; Kissin, Dmitry; Villanueva, Julie; Muñoz-Jordan, Jorge; Kuehnert, Matthew; Olson, Christine K; Honein, Margaret A; Rivera, Maria; Jamieson, Denise J; Rasmussen, Sonja A

    2016-01-01

    CDC has updated its interim guidance for U.S. health care providers caring for women of reproductive age with possible Zika virus exposure to include recommendations on counseling women and men with possible Zika virus exposure who are interested in conceiving. This guidance is based on limited available data on persistence of Zika virus RNA in blood and semen. Women who have Zika virus disease should wait at least 8 weeks after symptom onset to attempt conception, and men with Zika virus disease should wait at least 6 months after symptom onset to attempt conception. Women and men with possible exposure to Zika virus but without clinical illness consistent with Zika virus disease should wait at least 8 weeks after exposure to attempt conception. Possible exposure to Zika virus is defined as travel to or residence in an area of active Zika virus transmission ( http://www.cdc.gov/zika/geo/active-countries.html), or sex (vaginal intercourse, anal intercourse, or fellatio) without a condom with a man who traveled to or resided in an area of active transmission. Women and men who reside in areas of active Zika virus transmission should talk with their health care provider about attempting conception. This guidance also provides updated recommendations on testing of pregnant women with possible Zika virus exposure. These recommendations will be updated when additional data become available. PMID:27031943

  18. Contraceptive care at the time of medical abortion: experiences of women and health professionals in a hospital or community sexual and reproductive health context

    PubMed Central

    Purcell, Carrie; Cameron, Sharon; Lawton, Julia; Glasier, Anna; Harden, Jeni

    2016-01-01

    Objective To examine experiences of contraceptive care from the perspective of health professionals and women seeking abortion, in the contexts of hospital gynaecology departments and a specialist sexual and reproductive health centre (SRHC). Materials and methods We conducted in-depth semistructured interviews with 46 women who had received contraceptive care at the time of medical abortion (gestation≤9 weeks) from one SRHC and two hospital gynaecology-department-based abortion clinics in Scotland. We also interviewed 25 health professionals (nurses and doctors) involved in abortion and contraceptive care at the same research sites. We analysed interview data thematically using an approach informed by the Framework method, and comparison was made between the two clinical contexts. Results Most women and health professionals felt that contraceptive counselling at abortion was acceptable and appropriate, if provided in a sensitive, nonjudgemental way. Participants framed contraceptive provision at abortion as significant primarily as a means of preventing subsequent unintended conceptions. Accounts of contraceptive decision making also presented tensions between the priorities of women and health professionals, around ‘manoeuvring’ women towards contraceptive uptake. Comparison between clinical contexts suggests that women's experiences may have been more positive in the SRHC setting. Conclusions Whilst abortion may be a theoretically and practically convenient time to address contraception, it is by no means an easy time to do so and requires considerable effort and expertise to be managed effectively. Training for those providing contraceptive care at abortion should explicitly address potential conflicts between the priorities of health professionals and women seeking abortion. Implications This paper offers unique insight into the detail of women and health professionals' experiences of addressing contraception at the time of medical abortion. The

  19. Linking household and facility data for better coverage measures in reproductive, maternal, newborn, and child health care: systematic review

    PubMed Central

    Do, Mai; Micah, Angela; Brondi, Luciana; Campbell, Harry; Marchant, Tanya; Eisele, Thomas; Munos, Melinda

    2016-01-01

    Background Currently many measures of intervention coverage obtained from household surveys do not measure actual health intervention/service delivery, resulting in a need for linking reports of care–seeking with assessments of the service environment in order to improve measurements. This systematic review aims to identify evidence of different methods used to link household surveys and service provision assessments, with a focus on reproductive, maternal, newborn and child health care, in low– and middle–income countries. Methods Using pre–defined search terms, articles published in peer–reviewed journals and the grey literature after 1990 were identified, their reference lists scanned and linking methods synthesized. Findings A total of 59 articles and conference presentations were carefully reviewed and categorized into two groups based on the linking method used: 1) indirect/ecological linking that included studies in which health care–seeking behavior was linked to all or the nearest facilities or providers of certain types within a geographical area, and 2) direct linking/exact matching where individuals were linked with the exact provider or facility where they sought care. The former approach was employed in 51 of 59 included studies, and was particularly common among studies that were based on independent sources of household and facility data that were nationally representative. Only eight of the 59 reviewed studies employed direct linking methods, which were typically done at the sub–national level (eg, district level) and often in rural areas, where the number of providers was more limited compared to urban areas. Conclusions Different linking methods have been reported in the literature, each category has its own set of advantages and limitations, in terms of both methodology and practicality for scale–up. Future studies that link household and provider/facility data should also take into account factors such as sources of data, the

  20. Availability of Reproductive Health Care Services at Schools and Subsequent Birth Outcomes among Adolescent Mothers

    ERIC Educational Resources Information Center

    Madkour, Aubrey S.; Xie, Yiqiong; Harville, Emily W.

    2016-01-01

    Background: Adverse birth outcomes are more common among adolescent versus adult mothers, but little is known about school-based services that may improve birth outcomes in this group. Methods: Data from Waves I and IV of the National Longitudinal Study of Adolescent Health were analyzed. Girls and women who gave birth to singleton live infants…

  1. Integrated community based child survival, reproductive health and water and sanitation program in Mkuranga district, Tanzania: a replicable model of good practices in community based health care

    PubMed Central

    Kema, Koronel Mashalla; Komwihangiro, Joseph; Kimaro, Saltiel

    2012-01-01

    Background Over decades, evidence has accumulated to justify the concern that top-down approaches do not work and may result in lack of program ownership and sustainability. As a result, participatory approaches have increasingly become popular. An example of such an approach is hereby presented. Description Working with AMREF, Mkuranga district significantly gained experience and improved its community participatory approaches in health development. AMREF's model of Community Based Health Care (CBHC) approaches was used to implement integrated Water and Sanitation, Child Survival and Reproductive health programs. Outcomes The project established functioning village health and water committees. A 45% increase in utilization of services was reported. Adequate nutrition status among children rose from 67.9% to 81%. Attendance of antenatal clinics rose from 35% to 70.2%. A total of 117 shallow wells, 21 boreholes and 25 rain water harvesting systems were established. Lessons learnt Based on this experience, we conclude that in order to achieve the Millennium Development Goals (MDGs) and the National Poverty Reduction Strategy (Mkukuta) targets, building partnerships with communities who are the target beneficiaries is a prerequisite and CBHC approach is a fundamental towards attaining those goals. Conclusion The model demonstrates that community participation is key to community empowerment, as well as community ownership and sustainability of health interventions. PMID:23467915

  2. Women's health: beyond reproductive years.

    PubMed

    Laskar, Ananya Ray

    2011-01-01

    With changing demographic profile India has more older women than men as life expectancy for women is 67.57 as against 65.46 for men. Gender differences in the aging process reflect biological, economic, and social differences. Both social and health needs of the older women are unique and distinctive as they are vulnerable. The social problems revolve around widowhood, dependency, illiteracy and lack of awareness about the policies and programmes from which they can benefit. Among the medical problems, vision (cataract) and degenerative joint disease top the list, followed by neurological problems. Lifestyle diseases form another single-most important group of health problems in the elderly women. The risk of cardiovascular disease doubles with the outcome being poorer than men. The most common causes of death among women above the age of 60 years are stroke, ischemic heart disease and COPD. Hypertensive heart disease and lower respiratory tract infections contribute to mortality in these women. Common malignancies viz. Cervical, breast and uterus in women are specific to them and account for a sizeable morbidity and mortality. In a study done at Lady Hardinge medical college in Delhi, Hypertension (39.6%) and obesity (12-46.8%) were very common in postmenopausal women. Half or more women had high salt and fat intake, low fruit and vegetable intake and stress. There is a need to recognize the special health needs of the women beyond the reproductive age, to be met through strengthening and reorienting the public health services at all levels starting from primary health care to secondary till tertiary care level with adequate referral linkages. All policies and programs need to have a gender perspective. At present there is lack of sensitization and appropriate training of the health personnel in dealing with the needs of elderly. Women too need to be aware to adopt healthy lifestyle and seek timely care. PMID:22298132

  3. Integrating reproductive health: myth and ideology.

    PubMed Central

    Lush, L.; Cleland, J.; Walt, G.; Mayhew, S.

    1999-01-01

    Since 1994, integrating human immunodeficiency virus/sexually transmitted disease (HIV/STD) services with primary health care, as part of reproductive health, has been advocated to address two major public health problems: to control the spread of HIV; and to improve women's reproductive health. However, integration is unlikely to succeed because primary health care and the political context within which this approach is taking place are unsuited to the task. In this paper, a historical comparison is made between the health systems of Ghana, Kenya and Zambia and that of South Africa, to examine progress on integration of HIV/STD services since 1994. Our findings indicate that primary health care in Ghana, Kenya and Zambia has been used mainly by women and children and that integration has meant adding new activities to these services. For the vertical programmes which support these services, integration implies enhanced collaboration rather than merged responsibility. This compromise between comprehensive rhetoric and selective reality has resulted in little change to existing structures and processes; problems with integration have been exacerbated by the activities of external donors. By comparison, in South Africa integration has been achieved through political commitment to primary health care rather than expanding vertical programmes (top-down management systems). The rhetoric of integration has been widely used in reproductive health despite lack of evidence for its feasibility, as a result of the convergence of four agendas: improving family planning quality; the need to improve women's health; the rapid spread of HIV; and conceptual shifts in primary health care. International reproductive health actors, however, have taken little account of political, financial and managerial constraints to implementation in low-income countries. PMID:10534902

  4. Facilitators and barriers to accessing reproductive health care for migrant beer promoters in Cambodia, Laos, Thailand and Vietnam: A mixed methods study

    PubMed Central

    2012-01-01

    Background The purpose of the research was to assess access to sexual and reproductive health services for migrant women who work as beer promoters. This mixed methods research was conducted in Phnom Penh, Cambodia, Bangkok, Thailand, Vientiane, Laos, and Hanoi, Vietnam during 2010 to 2011. Methods Focus groups were held with beer promoters and separate focus groups or interviews with key informants to explore the factors affecting beer promoters’ access to health care institutions for reproductive health care. The findings of the focus groups were used to develop a survey for beer promoters. This survey was conducted in popular health institutions for these women in each of the four Asian cities. Results Several common themes were evident. Work demands prevented beer promoters from accessing health care. Institutional factors affecting care included cost, location, environmental factors (e.g. waiting times, cleanliness and confidentiality) and service factors (e.g. staff attitudes, clinic hours, and availability of medications). Personal factors affecting access were shyness and fear, lack of knowledge, and support from family and friends. The survey of the beer promoters confirmed that cost, location and both environmental and service factors impact on access to health care services for beer promoters. Many beer promoters are sexually active, and a significant proportion of those surveyed rely on sex work to supplement their income. Many also drink with their clients. Despite a few differences amongst the surveyed population, the findings were remarkably similar across the four research sites. Conclusions Recommendations from the research include the provision of evening and weekend clinic hours to facilitate access, free or low cost clinics, and health insurance through employer or government plans which are easy to access for migrants. Other improvements that would facilitate the access of beer promoters to these services include increased funding to hire

  5. Male reproductive health and yoga

    PubMed Central

    Sengupta, Pallav; Chaudhuri, Prasenjit; Bhattacharya, Koushik

    2013-01-01

    Now-a-days reproductive health problems along with infertility in male is very often observed. Various Assisted Reproductive Technologies have been introduced to solve the problem, but common people cannot afford the cost of such procedures. Various ayurvedic and other alternative medicines, along with regular yoga practice are proven to be not only effective to enhance the reproductive health in men to produce a successful pregnancy, but also to regulate sexual desire in men who practice celibacy. Yoga is reported to reduce stress and anxiety, improve autonomic functions by triggering neurohormonal mechanisms by the suppression of sympathetic activity, and even, today, several reports suggested regular yoga practice from childhood is beneficial for reproductive health. In this regard the present review is aimed to provide all the necessary information regarding the effectiveness of yoga practice to have a better reproductive health and to prevent infertility. PMID:23930026

  6. Where Do Female Sex Workers Seek HIV and Reproductive Health Care and What Motivates These Choices? A Survey in 4 Cities in India, Kenya, Mozambique and South Africa

    PubMed Central

    Lafort, Yves; Greener, Ross; Roy, Anuradha; Greener, Letitia; Ombidi, Wilkister; Lessitala, Faustino; Haghparast-Bidgoli, Hassan; Beksinska, Mags; Gichangi, Peter; Reza-Paul, Sushena; Smit, Jenni A.; Chersich, Matthew; Delva, Wim

    2016-01-01

    Background A baseline cross-sectional survey among female sex workers (FSWs) was conducted in four cities within the context of an implementation research project aiming to improve FSWs’ access to HIV, and sexual and reproductive health (SRH) services. The survey measured where FSWs seek HIV/SRH care and what motivates their choice. Methods Using respondent-driven sampling (RDS), FWSs were recruited in Durban, South Africa (n = 400), Tete, Mozambique (n = 308), Mombasa, Kenya (n = 400) and Mysore, India (n = 458) and interviewed. RDS-adjusted proportions were estimated by non-parametric bootstrapping, and compared across cities using post-hoc pairwise comparison tests. Results Across cities, FSWs most commonly sought care for the majority of HIV/SRH services at public health facilities, most especially in Durban (ranging from 65% for condoms to 97% for HIV care). Services specifically targeting FSWs only had a high coverage in Mysore for STI care (89%) and HIV testing (79%). Private-for-profit clinics were important providers in Mombasa (ranging from 17% for STI care and HIV testing to 43% for HIV care), but not in the other cities. The most important reason for the choice of care provider in Durban and Mombasa was proximity, in Tete ‘where they always go’, and in Mysore cost of care. Where available, clinics specifically targeting FSWs were more often chosen because of shorter waiting times, perceived higher quality of care, more privacy and friendlier personnel. Conclusion The place where care is sought for HIV/SRH services differs substantially between cities. Targeted services have limited coverage in the African cities compared to Mysore. Convenience appears more important for choosing the place of care than aspects of quality of care. The best model to improve access, linking targeted interventions with general health services, will need to be tailored to the specific context of each city. PMID:27494412

  7. Home Health Care

    MedlinePlus

    ... Page Resize Text Printer Friendly Online Chat Home Health Care Home health care helps older adults live independently for as long ... need for long-term nursing home care. Home health care may include occupational and physical therapy, speech therapy, ...

  8. Indonesian survey looks at adolescent reproductive health.

    PubMed

    Achmad, S I; Westley, S B

    1999-10-01

    The Baseline Survey of Young Adult Reproductive Welfare in Indonesia, conducted from September to December 1998, provides information about young Indonesians on topics concerning work, education, marriage, family life, sexuality, fertility, and HIV/AIDS and other sexually transmitted diseases. The survey interviewed 4106 men and 3978 women aged 15-24 years in three provinces of Java. Survey findings showed that 42% of the women and 8% of the men are currently or have been married. There was a strong inverse relationship between marriage and schooling, which suggests that greater educational attainment and a higher average age at marriage are likely to go together. Although most young couples prefer to delay and space births, only half of currently married young women are using any type of contraception. These results indicate that there is a need for better reproductive health care as well as improved reproductive health education. Moreover, the current economic crisis has lead to a decline in the use of the private sector for health care. Instead, young people are using the less-expensive government services, and young women are turning to pharmacies and midwives rather than to private doctors to obtain contraceptives. These findings have several policy implications including the need for reproductive health programs that provide services needed by young people. PMID:12295693

  9. Disciplining the feminine: the reproduction of gender contradictions in the mental health care of women with eating disorders.

    PubMed

    Moulding, Nicole

    2006-02-01

    This paper provides insights into the way gendered assumptions operate within health care interventions for women with eating disorders. A multidisciplinary sample of Australian health care workers were interviewed about their approaches to treatment, and discourse analysis was used to uncover the discursive dynamics and power relations characterising their accounts of intervention. The paper demonstrates a contradictory positioning of anorexic patients in relation to autonomy and control within the two common psychiatric interventions of bed rest intervention and psychotherapy. The paper argues that this is based on gendered assumptions about selfhood and femininity in eating disorders that are reproduced in the therapeutic relationship through the operation of a gendered parent-child dynamic, with the health care worker as father or mother, and the anorexic patient as daughter. One of the main effects of this is to re-inscribe rather than challenge the discursive 'double bind' of femininity that has been widely implicated by post-structural feminists in producing eating disorders in the first place. The paper also considers the widely acknowledged problem of resistance to treatment in anorexia as a function of controlling treatments, and discusses psychiatrists' perspectives on addressing this dilemma. Finally, the paper examines the potential of feminist-informed understandings of eating disorders for overcoming the gendered dilemmas inherent within the dominant psycho-medical treatment paradigm. PMID:16095788

  10. Endocrine-Disrupting Chemicals and Reproductive Health.

    PubMed

    Zlatnik, Marya G

    2016-07-01

    This review discusses the evidence linking industrial chemicals to a variety of health and reproductive outcomes. Industrial chemical production has increased over the past 30 to 40 years. Basic science, animal models, and epidemiologic data suggest that certain chemicals may act as endocrine disruptors (substances that interfere with normal hormonal action) and may play an etiologic role in a number of conditions whose incidence has also increased during this same period. These include low birth weight, gestational diabetes, obesity, certain cancers, certain birth defects, and neurodevelopmental disorders such as attention deficit disorder and autism. In addition, some environmental chemicals may have epigenetic effects, resulting in transgenerational health impacts. The epidemiologic and experimental evidence that links chemicals such as plasticizers (eg, phthalates and phenols), flame retardants, perfluorinated compounds, and pesticides with adverse reproductive health outcomes is reviewed. Women's health care providers are the liaison between scientific research and their patients; they should educate themselves on the significance of environmental toxins to health. They are ideally positioned, not only to counsel and reassure pregnant women, but also to suggest practicable changes in dietary and lifestyle habits to improve their health. Furthermore, women's health care providers should advocate for regulatory changes that protect women and their families from the health effects of environmental toxins. PMID:27391253

  11. Men's reproductive and sexual health.

    PubMed

    Forrest, K A

    2001-05-01

    A broad definition of men's reproductive and sexual health (MRSH) includes medical (pathophysiological) matters such as sexually transmitted infections (STIs), developmental anomalies, malignancy, trauma, and infertility. It also includes psychosocial concerns: sexuality, contraception, disease prophylaxis, developmental and lifecycle issues, tobacco and drug use, sexual identity and orientation, and partnership issues. College men, of whom a large majority are sexually active, have a range of MRSH needs, including some that are particular to their age and social environment. To reach men effectively requires approaches that are somewhat different from those used with women. Clinicians in college health services are in an excellent position to help young men recognize the importance of reproductive health and sexual responsibility. College health services therefore should offer men screening; clinical diagnosis and treatment for MRSH conditions; and information, education, and counseling services, in a manner designed to meet their unique needs. PMID:11413943

  12. Male Involvement: Implications for Reproductive and Sexual Health Programs

    ERIC Educational Resources Information Center

    Edmunds, Lena; Rink, Elizabeth; Zukoski, Ann P.

    2004-01-01

    The sexual health needs of young males have been largely ignored in the field of reproductive health. Until recently, the health care needs of females have received the vast majority of attention from public health professionals and organizations with services focused on the prevention of teen pregnancy, sexually transmitted infections, and…

  13. Women and Reproductive Health: A Challenge for the Military.

    ERIC Educational Resources Information Center

    Bassoff, Betty Z.; Ortiz, Elizabeth T.

    Although the military health care system is the second largest in the nation serving approximately 6,000,000 people, little research has examined military reproductive health care services or their quality. Medical services can be provided by regional military medical centers and by base infirmaries and dispensaries. Often base infirmaries and…

  14. [Public health ethics and reproduction].

    PubMed

    Alexandrova-Yankulovska, S; Bozhinov, P; Bojinova, S

    2014-01-01

    Medical progress has enabled achievements that were not even thinkable earlier but at the same time society and public health have had to face new challenges. What are we ready to accept in the area of human reproduction? This paper aims at ethical analysis of Bulgarian laws on reproduction. The abortion debate nowadays has got new dimiension focusing not that much on its moral acceptability but rather on the acceptable indications for its performance. Is it ethical to perform abortion in case of undesired gender of the embryo or genetic malformations? Lots of moral issues mark the area of assisted reproduction which is due to the separation of the reproductive functions (ova, sperm and embryo donation, surrogacy), fragmentation of motherhood and fatherhood, differentiation of biological and social parenthood. Defining limits of acceptable interference or non-interference in human reproduction will never be easy, but dynamics of moral judgment shouldn't bother us. The rigidity of moral norms is what should be alarming because it threatens procreative autonomy. PMID:24919342

  15. Reproductive health, youth, and the law.

    PubMed

    Paxman, J M

    1984-01-01

    This article surveys legal and policy approaches to adolescent health care programs and presents data on the availability of sex education programs, contraception, and abortion for adolescents in selected countries in the developed and developing world. The age at which youth are considered legally able reach independent decisions on matters affecting their health varies from country to country, although there is a trend toward setting the "age of majority" at 18 years. There has also been a trend toward viewing laws that require parental consent to health care and treatment as a barrier to health rather than a form of protection. Alternative legal approaches to the dilemma of consent have included lowering the age of majority for purposes of medical treatment, permitting professionals tojude whether an adolescent has sufficient maturity to give consent, and the use of third-party consent (e.g. child advocate). Cultural diversity mitigates against a universal legal approach to reproductive health education. There is wide variation in the policy response to questions such as whether reproductive health education courses should be permitted within the school curriculum, whether they should be obligatory or elective, if there should be separate courses or integration of fertility-related material into existing courses, and whether the sexes should be separated for instruction. There is awareness that formal sex education programs in a school setting cannot reach the large number of adolescents outside the educational system, but laws regarding public dissemination of reproductive health information are often restrictive. Contraceptive-related law and policy affect who has access to contraception and under what conditions. Abortion law takes 2 different forms: those that establish the retionales on which a given pregnancy may be terminated and those that establish the formal procedural requirements that must be met. It is concluded that, overall, law and policy have

  16. Exploring the Feasibility of Service Integration in a Low-Income Setting: A Mixed Methods Investigation into Different Models of Reproductive Health and HIV Care in Swaziland

    PubMed Central

    Church, Kathryn; Wringe, Alison; Lewin, Simon; Ploubidis, George B.; Fakudze, Phelele; Mayhew, Susannah H.

    2015-01-01

    Integrating reproductive health (RH) with HIV care is a policy priority in high HIV prevalence settings, despite doubts surrounding its feasibility and varying evidence of effects on health outcomes. The process and outcomes of integrated RH-HIV care were investigated in Swaziland, through a comparative case study of four service models, ranging from fully integrated to fully stand-alone HIV services, selected purposively within one town. A client exit survey (n=602) measured integrated care received and unmet family planning (FP) needs. Descriptive statistics were used to assess the degree of integration per clinic and client demand for services. Logistic regression modelling was used to test the hypothesis that clients at more integrated sites had lower unmet FP needs than clients in a stand-alone site. Qualitative methods included in-depth interviews with clients and providers to explore contextual factors influencing the feasibility of integrated RH-HIV care delivery; data were analysed thematically, combining deductive and inductive approaches. Results demonstrated that clinic models were not as integrated in practice as had been claimed. Fragmentation of HIV care was common. Services accessed per provider were no higher at the more integrated clinics compared to stand-alone models (p>0.05), despite reported demand. While women at more integrated sites received more FP and pregnancy counselling than stand-alone models, they received condoms (a method of choice) less often, and there was no statistical evidence of difference in unmet FP needs by model of care. Multiple contextual factors influenced integration practices, including provider de-skilling within sub-specialist roles; norms of task-oriented routinised HIV care; perceptions of heavy client loads; imbalanced client-provider interactions hindering articulation of RH needs; and provider motivation challenges. Thus, despite institutional support, factors related to the social context of care inhibited

  17. Linkages among reproductive health, maternal health, and perinatal outcomes.

    PubMed

    Bhutta, Zulfiqar A; Lassi, Zohra S; Blanc, Ann; Donnay, France

    2010-12-01

    Some interventions in women before and during pregnancy may reduce perinatal and neonatal deaths, and recent research has established linkages of reproductive health with maternal, perinatal, and early neonatal health outcomes. In this review, we attempted to analyze the impact of biological, clinical, and epidemiologic aspects of reproductive and maternal health interventions on perinatal and neonatal outcomes through an elucidation of a biological framework for linking reproductive, maternal and newborn health (RHMNH); care strategies and interventions for improved perinatal and neonatal health outcomes; public health implications of these linkages and implementation strategies; and evidence gaps for scaling up such strategies. Approximately 1000 studies (up to June 15, 2010) were reviewed that have addressed an impact of reproductive and maternal health interventions on perinatal and neonatal outcomes. These include systematic reviews, meta-analyses, and stand-alone experimental and observational studies. Evidences were also drawn from recent work undertaken by the Child Health Epidemiology Reference Group (CHERG), the interconnections between maternal and newborn health reviews identified by the Global Alliance for Prevention of Prematurity and Stillbirth (GAPPS), as well as relevant work by the Partnership for Maternal, Newborn and Child Health. Our review amply demonstrates that opportunities for assessing outcomes for both mothers and newborns have been poorly realized and documented. Most of the interventions reviewed will require more greater-quality evidence before solid programmatic recommendations can be made. However, on the basis of our review, birth spacing, prevention of indoor air pollution, prevention of intimate partner violence before and during pregnancy, antenatal care during pregnancy, Doppler ultrasound monitoring during pregnancy, insecticide-treated mosquito nets, birth and newborn care preparedness via community-based intervention

  18. Sexual and reproductive health and rights in changing health systems

    PubMed Central

    Sen, Gita; Govender, Veloshnee

    2015-01-01

    Sexual and reproductive health and rights (SRHR) are centrally important to health. However, there have been significant shortcomings in implementing SRHR to date. In the context of health systems reform and universal health coverage/care (UHC), this paper explores the following questions. What do these changes in health systems thinking mean for SRHR and gender equity in health in the context of renewed calls for increased investments in the health of women and girls? Can SRHR be integrated usefully into the call for UHC, and if so how? Can health systems reforms address the continuing sexual and reproductive ill health and violations of sexual and reproductive rights (SRR)? Conversely, can the attention to individual human rights that is intrinsic to the SRHR agenda and its continuing concerns about equality, quality and accountability provide impetus for strengthening the health system? The paper argues that achieving equity on the UHC path will require a combination of system improvements and services that benefit all, together with special attention to those whose needs are great and who are likely to fall behind in the politics of choice and voice (i.e., progressive universalism paying particular attention to gender inequalities). PMID:25536851

  19. Sexual and reproductive health and rights in changing health systems.

    PubMed

    Sen, Gita; Govender, Veloshnee

    2015-01-01

    Sexual and reproductive health and rights (SRHR) are centrally important to health. However, there have been significant shortcomings in implementing SRHR to date. In the context of health systems reform and universal health coverage/care (UHC), this paper explores the following questions. What do these changes in health systems thinking mean for SRHR and gender equity in health in the context of renewed calls for increased investments in the health of women and girls? Can SRHR be integrated usefully into the call for UHC, and if so how? Can health systems reforms address the continuing sexual and reproductive ill health and violations of sexual and reproductive rights (SRR)? Conversely, can the attention to individual human rights that is intrinsic to the SRHR agenda and its continuing concerns about equality, quality and accountability provide impetus for strengthening the health system? The paper argues that achieving equity on the UHC path will require a combination of system improvements and services that benefit all, together with special attention to those whose needs are great and who are likely to fall behind in the politics of choice and voice (i.e., progressive universalism paying particular attention to gender inequalities). PMID:25536851

  20. Young women's reproductive health survey.

    PubMed

    Lewis, H

    1987-08-12

    A survey of reproductive health issues was conducted on 15 year old Hutt Valley secondary school girls by means of a self-administered anonymous questionnaire. The prevalence of sexual intercourse in the sample was 29%. Sixteen percent of the sexually active respondents used no method of contraception. Knowledge of reproductive health facts and contraception was poor both amongst sexually experienced and inexperienced respondents. Twenty-six percent relied on peers for this information, with mothers, teachers and books being other important sources cited. Respondents requested more information on sexually transmitted diseases, contraception and sexual relationships. Most would like this information more readily accessible. Preferred sources of information mentioned were: parents, books, films/videos, family planning clinics and friends. PMID:3455514

  1. Home health care

    MedlinePlus

    ... and exercises, wound care, and daily living. Home health care nurses can help manage problems with your wound, ... Centers for Medicare and Medicaid Services. Home health care: what it is and what to expect. ... ...

  2. Respiratory Home Health Care

    MedlinePlus

    ... Healthy Living > Living With Lung Disease > Respiratory Home Health Care Font: Aerosol Delivery Oxygen Resources Immunizations Pollution Nutrition ... Disease Articles written by Respiratory Experts Respiratory Home Health Care Respiratory care at home can contribute to improved ...

  3. Essential medicines for reproductive health: developing evidence based interagency list

    PubMed Central

    Logez, Sophie; Jayasekar, Shalini; Moller, Helene; Ahmed, Kabir; Patel, Margaret Usher

    2011-01-01

    Objectives: Although poor reproductive health constitutes a significant proportion of the disease burden in developing countries, essential medicines for reproductive health are often not available to the population. The objective was to analyze the guiding principles for developing national Essential Medicines Lists (EML). The second objective was to compare the reproductive health medicines included on these EMLs to the 2002 WHO/UNFPA list of essential drugs and commodities for reproductive health. Another objective was to compare the medicines included in existing international lists of medicines for reproductive health. Methods: The authors calculated the average number of medicines per clinical groups included in 112 national EMLs and compared these average numbers with the number of medicines per clinical group included on the WHO/UNFPA List. Additionally, they compared the content of the lists of medicines for reproductive health developed by various international agencies. Results: In 2003, the review of the 112 EMLs highlighted that medicines for reproductive health were not consistently included. The review of the international lists identified inconsistencies in their recommendations. The reviews’ outcomes became the catalyst for collaboration among international agencies in the development of the first harmonized Interagency List of Essential Medicines for Reproductive Health. Additionally, WHO, UNFPA and PATH published guidelines to support the inclusion of essential medicines for reproductive health in national medicine policies and EMLs. The Interagency List became a key advocacy tool for countries to review their EMLs. In 2009, a UNFPA/WHO assessment on access to reproductive health medicines in six countries demonstrated that the major challenge was that the Interagency List had not been updated recently and was inconsistently used. Conclusion: The addition of cost-effective medicines for reproductive health to EMLs can result in enhanced equity

  4. Gender violence and reproductive health.

    PubMed

    Diniz, S G; d'Oliveira, A F

    1998-12-01

    The available literature reflects the growing interest in gender violence and reproductive health. Violence is generally studied by identifying pathologies, measuring their demands on services and evaluating their repercussions on fetal outcome. Institutional violence, however, has received little attention and is mainly concerned with the consequences of inappropriate use of technologies. Data from the Sexuality and Health Feminist Collective shows that among patients, 20.5% stated that they have never talked about their sexual life with their partners; 38.3% stated that they have had sexual intercourse against their will, including situations ranging from sexual harassment to rape which was referred by 12.3% of them. One of the most relevant issues arising from the anamnesis and interviews of these women was the violence to which they were submitted by health services. The high prevalence of violent situations indicates the urgency of incorporating an approach which deals with gender violence and promotes the empowerment of women into the routine of reproductive health services. PMID:10075210

  5. Can Reproductive Health Voucher Programs Improve Quality of Postnatal Care? A Quasi-Experimental Evaluation of Kenya’s Safe Motherhood Voucher Scheme

    PubMed Central

    Watt, Claire; Abuya, Timothy; Warren, Charlotte E.; Obare, Francis; Kanya, Lucy; Bellows, Ben

    2015-01-01

    This study tests the group-level causal relationship between the expansion of Kenya’s Safe Motherhood voucher program and changes in quality of postnatal care (PNC) provided at voucher-contracted facilities. We compare facilities accredited since program inception in 2006 (phase I) and facilities accredited since 2010-2011 (phase II) relative to comparable non-voucher facilities. PNC quality is assessed using observed clinical content processes, as well as client-reported outcome measures. Two-tailed unpaired t-tests are used to identify differences in mean process quality scores and client-reported outcome measures, comparing changes between intervention and comparison groups at the 2010 and 2012 data collection periods. Difference-in-differences analysis is used to estimate the reproductive health (RH) voucher program’s causal effect on quality of care by exploiting group-level differences between voucher-accredited and non-accredited facilities in 2010 and 2012. Participation in the voucher scheme since 2006 significantly improves overall quality of postnatal care by 39% (p=0.02), where quality is defined as the observable processes or components of service provision that occur during a PNC consultation. Program participation since phase I is estimated to improve the quality of observed maternal postnatal care by 86% (p=0.02), with the largest quality improvements in counseling on family planning methods (IRR 5.0; p=0.01) and return to fertility (IRR 2.6; p=0.01). Despite improvements in maternal aspects of PNC, we find a high proportion of mothers who seek PNC are not being checked by any provider after delivery. Additional strategies will be necessary to standardize provision of packaged postnatal interventions to both mother and newborn. This study addresses an important gap in the existing RH literature by using a strong evaluation design to assess RH voucher program effectiveness on quality improvement. PMID:25835713

  6. Integrating reproductive health services into HIV care: strategies for successful implementation in a low-resource HIV clinic in Lilongwe, Malawi

    PubMed Central

    Phiri, Sam; Feldacker, Caryl; Chaweza, Thomas; Mlundira, Linly; Tweya, Hannock; Speight, Colin; Samala, Bernadette; Kachale, Fannie; Umpierrez, Denise; Haddad, Lisa

    2016-01-01

    Background Lighthouse Trust operates two public HIV testing, treatment and care clinics in Lilongwe, Malawi, caring for over 26 000 people living with HIV, 23 000 of whom are on antiretroviral treatment (ART). In August 2010, Lighthouse Trust piloted a step-wise integration of sexual and reproductive health (SRH) services into routine HIV care at its Lighthouse clinic site. The objectives were to increase uptake of family planning (FP), promote long-term reversible contraceptive methods, and increase access, screening and treatment for cervical cancer using visual inspection with acetic acid. Methods and results Patients found integrated SRH/ART services acceptable; service availability appeared to increase uptake. Between August 2010 and May 2014, over 6000 women at Lighthouse received FP education messages. Of 859 women who initiated FP, 55% chose depot medroxyprogesterone acetate, 19% chose an intrauterine contraceptive device, 14% chose oral contraceptive pills, and 12% chose an implant. By May 2014, 21% of eligible female patients received cervical cancer screening: 11% (166 women) had abnormal cervical findings during screening for cervical cancer and underwent further treatment. Conclusions Several lessons were learned in overcoming initial concerns about integration. First, our integrated services required minimal additional resources over those needed for provision of HIV care alone. Second, patient flow improved during implementation, reducing a barrier for clients seeking multiple services. Lastly, analysis of routine data showed that the proportion of women using some form of modern contraception was 45% higher at Lighthouse than at Lighthouse's sister clinic where services were not integrated (42% vs 29%), providing further evidence for promotion of SRH/ART integration. PMID:25902815

  7. Primary Health Care.

    ERIC Educational Resources Information Center

    Lauffer, Sandra, Ed.

    1979-01-01

    This report contains 13 articles and book/film reviews on various topics related to the diffusion of health care information in developing countries; beginning with two articles which define primary health care, and suggest principles related to the community, communication, and the health practitioner upon which primary health care should be…

  8. A pilot study to evaluate incorporating eye care for children into reproductive and child health services in Dar-es-Salaam, Tanzania: a historical comparison study

    PubMed Central

    2014-01-01

    Background Many blinding eye conditions of childhood are preventable or treatable, particularly in developing countries. However, primary eye care (PEC) for children is poorly developed, leading to unnecessary visual loss. Activities for control by health workers entail interventions for systemic conditions (measles, vitamin A deficiency), identification and referral of children with sight threatening conditions and health education for caregivers. This pilot study evaluated integrating a package of activities to promote child eye health into Reproductive and Child Health (RCH) services in Dar-es-Salaam, Tanzania. Methods Design: historical comparison study. Fifteen Clinical Officers and 15 nurses in 15 randomly selected RCH clinics were trained in PEC for children in July 2010. They were given educational materials (poster and manual) and their supervisors were orientated. Knowledge and practices were assessed before and 3 weeks after training. One year later their knowledge and practices were compared with a different group of 15 Clinical Officers and 15 nurses who had not been trained. Results Before training staff had insufficient knowledge to identify, treat and refer children with eye diseases, even conjunctivitis. Some recommended harmful practices or did not know that cataract requires urgent referral. Eye examination, vitamin A supplementation of mothers after delivery and cleaning the eyes at birth with instillation of antibiotics (Crede’s prophylaxis) were not routine, and there were no eye-specific educational materials. Three weeks after training several clinics delivering babies started Crede’s prophylaxis, vitamin A supplementation of women after delivery increased from 83.7% to 100%, and all staff included eye conditions in health education sessions. At one year, trained staff were more likely to correctly describe, diagnose and treat conjunctivitis (z=2.34, p=0.04)(30%-vs-60.7%). Mystery mothers observed health education sessions in 7/10 RCH

  9. Vacation health care

    MedlinePlus

    ... and help you avoid problems. Talk to your health care provider or visit a travel clinic 4 - 6 ... If you are taking medicine, talk to your health care provider before leaving. Carry all medicines with you ...

  10. Vacation health care

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/001937.htm Vacation health care To use the sharing features on this page, ... and help you avoid problems. Talk to your health care provider or visit a travel clinic 4 to ...

  11. American Health Care Association

    MedlinePlus

    ... Resources Affordable Care Act Clinical Practice Emergency Preparedness Finance Health Information Technology ICD-10 Integrity Medicaid Medicare ... Facility Operations Affordable Care Act Clinical Emergency Preparedness Finance Health Information Technology Integrity Medicaid Medicare Patient Privacy ...

  12. National Health Care Survey

    Cancer.gov

    This survey encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.

  13. Inequity in India: the case of maternal and reproductive health

    PubMed Central

    Sanneving, Linda; Trygg, Nadja; Saxena, Deepak; Mavalankar, Dileep; Thomsen, Sarah

    2013-01-01

    Background Millennium Development Goal (MDG) 5 is focused on reducing maternal mortality and achieving universal access to reproductive health care. India has made extensive efforts to achieve MDG 5 and in some regions much progress has been achieved. Progress has been uneven and inequitable however, and many women still lack access to maternal and reproductive health care. Objective In this review, a framework developed by the Commission on Social Determinants of Health (CSDH) is used to categorize and explain determinants of inequity in maternal and reproductive health in India. Design A review of peer-reviewed, published literature was conducted using the electronic databases PubMed and Popline. The search was performed using a carefully developed list of search terms designed to capture published papers from India on: 1) maternal and reproductive health, and 2) equity, including disadvantaged populations. A matrix was developed to sort the relevant information, which was extracted and categorized based on the CSDH framework. In this way, the main sources of inequity in maternal and reproductive health in India and their inter-relationships were determined. Results Five main structural determinants emerged from the analysis as important in understanding equity in India: economic status, gender, education, social status (registered caste or tribe), and age (adolescents). These five determinants were found to be closely interrelated, a feature which was reflected in the literature. Conclusion In India, economic status, gender, and social status are all closely interrelated when influencing use of and access to maternal and reproductive health care. Appropriate attention should be given to how these social determinants interplay in generating and sustaining inequity when designing policies and programs to reach equitable progress toward improved maternal and reproductive health. PMID:23561028

  14. Speaking out for sexual and reproductive health.

    PubMed

    Nowrojee, S

    1993-01-01

    The view was presented that the living conditions of South Asian women do not allow for information, power, or support for controlling their own sexuality and reproductive health. Western biases are frequently incorporated into women's programs. The Asian rules governing women's sexuality are governed by sexism, racism, and class consciousness. Asian reproductive policies and programs need to break the silences, destroy the stereotypes, and give women control of their own sexuality and health. Cultures in South Asia prevent open discussion of sexuality, and the female body is considered "unclean." The perception of the Asian women who emigrated to the US is replete with visions of exotic sex or tightly controlled segregation. Asian males were denied involvement with American women. American servicemen abroad have used Asian women in the sex industry; the stereotyped Asian woman is "exotically beautiful, submissive, and willing." Stereotyped American pornography depicts female images in the Kama Sutra in a distorted way. The Asian community does not provide women with the information, tools, and services needed for Asian women to protect themselves from the consequences of unwanted and unprotected sex. The Asian community uses fear and shame to control women's sexuality outside the reproductive role. It is difficult for Asian women to exercise control over their own bodies or exercise reproductive choice. Decisions are made by husbands and families and may be dependent on the sex of the children born. Sexually transmitted diseases are not adequately diagnosed or treated. Asian women need to continue to speak out and to challenge the external controls on their sexuality. The consequences of the stereotyping and controls on Asian women's expression of sexuality are negative feelings about sexuality, lack of attention to proper gynecological care, and a lower likelihood of protection against unwanted pregnancy and sexually transmitted diseases. PMID:12290479

  15. Maternal mortality and morbidity. Women's reproductive health in Tanzania.

    PubMed

    Alloo, F

    1994-01-01

    Sexuality is a taboo for women in a patriarchal society. Tanzania has inadequate reproductive health care. Aspects of reproductive health are dealt with in safe motherhood or maternal and child health programs. Tanzania's health policy is based on women as mothers; it does not refer to women's right. For women in Tanzania, reproductive health is the right to live. Thousands of Tanzanian women die every year due to maternal complications. In an effort to contribute to the improvement of the conditions in health institutions and the advancement of women's status in the country, the Tanzania Media Women's Association (TAMWA) and the Medical Women's Association of Tanzania (MEWATA) joined in the organization of a Reproductive Health Meeting in Dar es Salaam. At the conference, major factors causing maternal mortality and morbidity, such as complications of abortion, anaemia in pregnancy, hypertensive disorders in pregnancy and puerperal sepsis, were discussed. A World Health Organization (WHO) report indicated that maternal mortality in Tanzania was 200-400/100,000 live births, while a survey conducted by MEWATA showed that maternal deaths at the Muhimbili Medical Center in the capital were 754/100,000 live births in 1991. Many maternal deaths could be prevented if hospitals were be properly equipped. Tanzanian women's poor health results in large part from their low socioeconomic status, poor nutrition, lack of income and employment. TAMWA chairperson Fatma Alloo and Dr. Kimambo (Ministry of Health) endorsed a national women's health movement to demand a government commitment to a holistic reproductive health policy. PMID:12288398

  16. Health care informatics.

    PubMed

    Siau, Keng

    2003-03-01

    The health care industry is currently experiencing a fundamental change. Health care organizations are reorganizing their processes to reduce costs, be more competitive, and provide better and more personalized customer care. This new business strategy requires health care organizations to implement new technologies, such as Internet applications, enterprise systems, and mobile technologies in order to achieve their desired business changes. This article offers a conceptual model for implementing new information systems, integrating internal data, and linking suppliers and patients. PMID:12670013

  17. Promoting environmentally responsible health care.

    PubMed

    Gaudry, Jacqueline; Skiehar, Kimberly

    2007-01-01

    Dioxins, polyvinyl chloride and di(2-ethylhexyl) phthalate are the three main toxins interfering with the goal to maintain a healthy environment, according to the international organization Health Care Without Harm (2004). Exposure to these chemicals has been linked to cancer, as well as reproductive, cardiac, hepatic and developmental disorders (Tickner, Schettler, Guidotti, McCally, and Rossi, 2001). Health-care clients are potentially exposed to these toxins every day: polyvinyl chloride equipment, such as i.v. bags and tubing, is widely used in hospitals, and medical incineration practices emit dioxins into the air (Chlorine Chemistry Council, 2006). Nurses are uniquely positioned to play an active role in environmentally responsible health care through education, advocacy and the implementation of measures to reduce medical wastage and exposure to these chemical toxins (Canadian Nurses Association, 2005). PMID:17269580

  18. Health Care Indicators

    PubMed Central

    Donham, Carolyn S.; Maple, Brenda T.; Letsch, Suzanne W.

    1993-01-01

    This regular feature of the journal includes a discussion of each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the availability of more comprehensive data. PMID:25372574

  19. Health Care Indicators

    PubMed Central

    Donham, Carolyn S.; Maple, Brenda T.; Letsch, Suzanne W.

    1993-01-01

    This regular feature of the journal includes a discussion of each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the availability of more comprehensive data. PMID:25372246

  20. Health Care Indicators

    PubMed Central

    Letsch, Suzanne W.; Maple, Brenda T.; Cowan, Cathy A.; Donham, Carolyn S.

    1991-01-01

    This regular feature of the journal includes a section on each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10114933

  1. Health Care Indicators

    PubMed Central

    Maple, Brenda T.; Cowan, Cathy A.; Donham, Carolyn S.; Letsch, Suzanne W.

    1991-01-01

    This regular feature of the journal includes a section on each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10122365

  2. Health Care Indicators

    PubMed Central

    Cowan, Cathy A.; Donham, Carolyn S.; Letsch, Suzanne W.; Maple, Brenda T.; Lazenby, Helen C.

    1992-01-01

    This regular feature of the journal includes a section on each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10120177

  3. Health care in Brazil.

    PubMed Central

    Haines, A

    1993-01-01

    Brazil has great geopolitical importance because of its size, environmental resources, and potential economic power. The organisation of its health care system reflects the schisms within Brazilian society. High technology private care is available to the rich and inadequate public care to the poor. Limited financial resources have been overconcentrated on health care in the hospital sector and health professionals are generally inappropriately trained to meet the needs of the community. However, recent changes in the organisation of health care are taking power away from federal government to state and local authorities. This should help the process of reform, but many vested interests remain to be overcome. A link programme between Britain and Brazil focusing on primary care has resulted in exchange of ideas and staff between the two countries. If primary care in Brazil can be improved it could help to narrow the health divide between rich and poor. Images p503-a p504-a p505-a PMID:8448465

  4. Effects of the 2010 Haiti Earthquake on Women's Reproductive Health.

    PubMed

    Behrman, Julia Andrea; Weitzman, Abigail

    2016-03-01

    This article explores the effects of the 2010 Haiti earthquake on women's reproductive health, using geocoded data from the 2005 and 2012 Haiti Demographic and Health Surveys. We use geographic variation in the destructiveness of the earthquake to conduct a difference-in-difference analysis. Results indicate that heightened earthquake intensity reduced use of injectables-the most widely used modern contraceptive method in Haiti-and increased current pregnancy and current unwanted pregnancy. Analysis of impact pathways suggests that severe earthquake intensity significantly increased women's unmet need for family planning and reduced their access to condoms. The earthquake also affected other factors that influence reproductive health, including women's ability to negotiate condom use in their partnerships. Our findings highlight how disruptions to health care services following a natural disaster can have negative consequences for women's reproductive health. PMID:27027990

  5. Health sector reform and reproductive health in Latin America and the Caribbean: strengthening the links.

    PubMed Central

    Langer, A.; Nigenda, G.; Catino, J.

    2000-01-01

    Many countries in Latin America and the Caribbean (LAC) are currently reforming their national health sectors and also implementing a comprehensive approach to reproductive health care. Three regional workshops to explore how health sector reform could improve reproductive health services have revealed the inherently complex, competing, and political nature of health sector reform and reproductive health. The objectives of reproductive health care can run parallel to those of health sector reform in that both are concerned with promoting equitable access to high quality care by means of integrated approaches to primary health care, and by the involvement of the public in setting health sector priorities. However, there is a serious risk that health reforms will be driven mainly by financial and/or political considerations and not by the need to improve the quality of health services as a basic human right. With only limited changes to the health systems in many Latin American and Caribbean countries and a handful of examples of positive progress resulting from reforms, the gap between rhetoric and practice remains wide. PMID:10859860

  6. HealthCare.gov

    MedlinePlus

    ... ask for more info Site Search Search Need health insurance? See if you qualify You can enroll in ... September 01 Start the school year strong with health insurance See More Footer Resources About the Affordable Care ...

  7. Focusing on reproductive health for adolescents.

    PubMed

    1995-06-01

    JOICFP is producing a still photo video consisting of three segments from photos shot in Bangladesh (April 22 - May 2), Thailand (May 2-15), and Mexico (June 29 - July 7) in 1995. The first segment highlights the daily life of a husband, aged 20, and his wife, Moni, aged 14. Moni married at age 13, before the onset of menstruation, and now serves and feeds her husband's large extended family. The Family Planning Association of Bangladesh (FPAB), the local implementing agent of the Sustainable Community-based Family Planning/Maternal and Child Health (FP/MCH) Project with Special Focus on Women, which is supported by the United Nations Population Fund (UNFPA) and executed by JOICFP, introduced Moni to the concept of reproductive health and encouraged her to join other women in activities designed to improve their health and raise their economic status. The second segment depicts the life of a former commercial sex worker who is undergoing occupational skill development training promoted by the Population and Community Development Association. The girl is now a leader of teenagers in her village; she works to change attitudes that sent her to work as a prostitute with an estimated 150,000 other poor rural teenage women. The third segment focuses on teen pregnancy and the efforts of the Mexican Foundation for Family Planning (MEXFAM) in the areas of health care and education for adolescents. PMID:12289887

  8. Health Care System Accessibility

    PubMed Central

    Steinberg, Annie G; Barnett, Steven; Meador, Helen E; Wiggins, Erin A; Zazove, Philip

    2006-01-01

    BACKGROUND People who are deaf use health care services differently than the general population; little research has been carried out to understand the reasons. OBJECTIVE To better understand the health care experiences of deaf people who communicate in American Sign Language. DESIGN Qualitative analyses of focus group discussions in 3 U.S. cities. PARTICIPANTS Ninety-one deaf adults who communicate primarily in American Sign Language. MEASUREMENTS We collected information about health care communication and perceptions of clinicians' attitudes. We elicited stories of both positive and negative encounters, as well as recommendations for improving health care. RESULTS Communication difficulties were ubiquitous. Fear, mistrust, and frustration were prominent in participants' descriptions of health care encounters. Positive experiences were characterized by the presence of medically experienced certified interpreters, health care practitioners with sign language skills, and practitioners who made an effort to improve communication. Many participants acknowledged limited knowledge of their legal rights and did not advocate for themselves. Some participants believed that health care practitioners should learn more about sociocultural aspects of deafness. CONCLUSIONS Deaf people report difficulties using health care services. Physicians can facilitate change to improve this. Future research should explore the perspective of clinicians when working with deaf people, ways to improve communication, and the impact of programs that teach deaf people self-advocacy skills and about their legal rights. PMID:16499543

  9. Achieving health care affordability.

    PubMed

    Payson, Norman C

    2002-10-01

    Not all plans are jumping headlong into the consumer-centric arena. In this article, the CEO of Oxford Health Plans discusses how advanced managed care can achieve what other consumer-centric programs seek to do--provide affordable, quality health care. PMID:12391815

  10. Lean health care.

    PubMed

    Hawthorne, Henry C; Masterson, David J

    2013-01-01

    Principles of Lean management are being adopted more widely in health care as a way of improving quality and safety while controlling costs. The authors, who are chief executive officers of rural North Carolina hospitals, explain how their organizations are using Lean principles to improve quality and safety of health care delivery. PMID:23802475

  11. Developing primary health care.

    PubMed Central

    Jarman, B; Cumberlege, J

    1987-01-01

    Primary health care is best provided by a primary health care team of general practitioners, community nurses, and other staff working together from good premises and looking after the population registered with the practice. It encourages personal and continuing care of patients and good communication among the members of the team. Efforts should be made to foster this model of primary care where possible and also to evaluate its effectiveness. Community services that are not provided by primary care teams should be organised on a defined geographical basis, and the boundaries of these services should coincide as much as possible. Such arrangements would facilitate effective community care and health promotion and can be organised to work well with primary care teams. The patient's right to freedom of choice of a doctor, however, should be retained, as it adds flexibility to the rigidity of fixed geographically based services. PMID:3119003

  12. Controversies in faith and health care.

    PubMed

    Tomkins, Andrew; Duff, Jean; Fitzgibbon, Atallah; Karam, Azza; Mills, Edward J; Munnings, Keith; Smith, Sally; Seshadri, Shreelata Rao; Steinberg, Avraham; Vitillo, Robert; Yugi, Philemon

    2015-10-31

    Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer. Buddhism, Christianity, Hinduism, Islam, Judaism, and traditional beliefs have similarities and differences in their viewpoints. Improved understanding by health-care providers of the heterogeneity of viewpoints, both within and between faiths, and their effect on health care is important for clinical medicine, public-health programmes, and health-care policy. Increased appreciation in faith leaders of the effect of their teachings on health care is also crucial. This Series paper outlines some faith-related controversies, describes how they influence health-care provision and uptake, and identifies opportunities for research and increased interaction between faith leaders and health-care providers to improve health care. PMID:26159392

  13. Sexual and reproductive health and rights in public health education.

    PubMed

    Allotey, Pascale A; Diniz, Simone; Dejong, Jocelyn; Delvaux, Thérèse; Gruskin, Sofia; Fonn, Sharon

    2011-11-01

    This paper addresses the challenges faced in mainstreaming the teaching of sexual and reproductive health and rights into public health education. For this paper, we define sexual and reproductive health and rights education as including not only its biomedical aspects but also an understanding of its history, values and politics, grounded in gender politics and social justice, addressing sexuality, and placed within a broader context of health systems and global health. Using a case study approach with an opportunistically selected sample of schools of public health within our regional contexts, we examine the status of sexual and reproductive health and rights education and some of the drivers and obstacles to the development and delivery of sexual and reproductive health and rights curricula. Despite diverse national and institutional contexts, there are many commonalities. Teaching of sexual and reproductive health and rights is not fully integrated into core curricula. Existing initiatives rely on personal faculty interest or short-term courses, neither of which are truly sustainable or replicable. We call for a multidisciplinary and more comprehensive integration of sexual and reproductive health and rights in public health education. The education of tomorrow's public health leaders is critical, and a strategy is needed to ensure that they understand and are prepared to engage with the range of sexual and reproductive health and rights issues within their historical and political contexts. PMID:22118142

  14. Equity of access to and utilization of reproductive health services in Thailand: national Reproductive Health Survey data, 2006 and 2009.

    PubMed

    Kongsri, Suratchada; Limwattananon, Supon; Sirilak, Supakit; Prakongsai, Phusit; Tangcharoensathien, Viroj

    2011-05-01

    This study assessed trends in equity of access to reproductive health services and service utilization in terms of coverage of family planning, antenatal care and skilled birth attendance in Thailand. Two health indicators were measured: the prevalence of low birthweight and exclusive breastfeeding. Equity was measured against the combined urban-rural areas and geographic regions, women's education level and quintiles of household assets index. The study used data from two nationally representative household surveys, the 2006 and 2009 Reproductive Health Surveys. Very high coverage of family planning (79.6%), universal antenatal care (98.9%) and skilled birth attendance (99.7%), with very small socioeconomic and geographic disparities, were observed. The public sector played a dominant role in maternity care (90.9% of all deliveries in 2009). The private sector also had a role among the higher educated, wealthier women living in urban areas. Public sector facilities, followed by drug stores, were a major supplier of contraception, which had a high use rate. High coverage and low inequity were the result of extensive investment in the health system by successive governments, in particular primary health care at district and sub-district levels, reaching universality by 2002. While maintaining these achievements, methodological improvements in measuring low birthweight and exclusive breastfeeding for future reproductive health surveys are recommended. PMID:21555089

  15. Health Care Indicators

    PubMed Central

    Donham, Carolyn S.; Letsch, Suzanne W.; Maple, Brenda T.; Singer, Naphtale; Cowan, Cathy A.

    1991-01-01

    Contained in this regular feature of the journal is a section on each of the following four topics community hospital statistics; employment, hours, and earnings in the private health sector; prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10112766

  16. Health Care Indicators

    PubMed Central

    Cowan, Cathy A.; Letsch, Suzanne W.; Levit, Katharine R.; Maple, Brenda T.; Stewart, Madie W.

    1991-01-01

    This regular feature of the journal includes a section on each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10110874

  17. [World plan for reproductive autonomy and health].

    PubMed

    Ospina, P

    1994-06-01

    The principal objective of the Third International Conference on Population and Development to be held in Cairo in 1994 is to achieve consensus on a Plan of Action to reinforce reproductive rights of individuals, who bear ultimate responsibility for slowing population growth. The Plan of Action should be adopted by all the peoples of the world in order to stabilize population growth during the next twenty years by means of programs to provide family planning and reproductive health services. The preliminary conference document incorporated recommendations and proposals of two preparatory committees, five regional conferences, six expert meetings, 109 countries, and over 400 nongovernmental organizations from around the world. At current rates of growth, the world's 5.7 billion inhabitants will increase to 9.1 billion by the year 2025, vastly increasing pressure on already limited resources and ecosystems. The central theme of the first World Population Conference in Bucharest in 1974 was the close relationship between population growth and socioeconomic development. The 1974 World Population Plan of Action stressed development of strategies to achieve a better quality of life and rapid socioeconomic development. Recommendations of the 1984 World Population Conference in Mexico remained centered on implementation of the Bucharest Plan of Action with a few additions. Although progress has been achieved in meeting the goals of the Bucharest Plan of Action, growth rates of some developing countries have actually increased. Poverty, unemployment, illiteracy, and discrimination against women are still obstacles to socioeconomic development, and contraceptive usage has not reached optimal levels. Urban migration remains excessive. Progress for many countries over the past decade has been directly related to increasing the access of women to health care and family planning. Themes related to women's status and rights will be incorporated in the 1994 Cairo Conference. The

  18. Reproductive health and blurred professional boundaries.

    PubMed

    Chavkin, W; Breitbart, V

    1996-01-01

    We recognize that many of the issues raised are not simple. Our proposal calls for the same thoughtful deliberation applied in other settings to be brought to bear on reproductive health care. Some have already tried alternative approaches. In Albuquerque, New Mexico, a university hospital neonatologist and the district attorney have collaborated to create an alternative to sentencing program for women who are arrested for drug-related crimes and found to be both pregnant and drug addicted. Rather than proceed with criminal sanctions, these women are offered entry into a drug treatment program that is geared to families with young children and run by the pediatrics department. Here, the physician and the district attorney collaboratively responded in ways congruent with the professional integrity of each. In another example in Portland, Oregon, physicians, drug treatment providers, and child protective social service representatives cooperatively defeated a legislative proposal to mandatorily test and report pregnant women for illicit drug use and, instead, formed a task force to jointly develop state policy regarding the issue. Drug use, HIV infection, child abuse, and poverty are all cause for alarm. Yet it is critical that our frustration about these difficult problems not be translated into blaming individuals for "deviance," or into short-term inadequate responses. In developing policy we should consider the impact on the legal and ethical rights and obligations of both patient and physician. For every course, we should evaluate both immediate and long-term efficacy, the consequences for the doctor-patient relationship, and the consequences for medical integrity. In the midst of the present regulatory and fiscal turmoil affecting health care, we urge physicians to be careful and deliberate in the policies they embrace and the actions they take. PMID:8932462

  19. Gonadal function and reproductive health in women with HIV infection

    PubMed Central

    Yalamanchi, Swaytha; Dobs, Adrian; Greenblatt, Ruth M.

    2014-01-01

    Synopsis Most HIV infections among women occur early in reproductive life, which highlights the importance of understanding the impact of HIV on reproductive functions, and also the potential implications of reproductive function and aging on the course of HIV disease. HIV infection may influence reproductive biology via multiple mechanisms including: potential directs effects on HIV on the hypothalamic-pituitary-gonadal axes, implications of HIV-related immune dysfunction on reproductive biology, effects of antiretroviral treatments on reproductive functions and the impact of treatment related immune reconstitution on reproductive health. Ovarian function is a crucial component of reproductive biology in women, but standard assessment methods are of limited applicability to women with some chronic diseases, such as HIV. New antiretroviral treatments have the potential to increase the ease of conception planning, and to improve fertility. Drug-drug interactions between antiretroviral medications and hormonal contraceptives are potentially significant and merit careful provider attention. While HIV infection is not a major cause of infertility, high level viremia and low CD4 lymphocyte counts are associated with reduced fertility rates. Conception and pregnancy can now be achieved without transmission of HIV to sexual partner or new born, but complications of pregnancy may be more common in HIV infected women than uninfected women. PMID:25169564

  20. Health-Care Hub

    ERIC Educational Resources Information Center

    Bowman, Darcia Harris

    2004-01-01

    The Broad Acres clinic is one of 1,500 school-based health centers nationwide that bring a wide range of medical, nutritional, and mental-health care to millions of students and their families. The centers provide an important safety net for children and adolescents--particularly the more than 10 million today who lack health insurance, according…

  1. Health care in Africa.

    PubMed

    Brown, M S

    1984-07-01

    This is the third and last article reporting professional exchange tours between American nurses and nurses of other countries. In this article, the health care system of Kenya is discussed and comparisons made between this system and our own. Out of this comparison come several insights into our own way of doing things and possibilities for improving them. "Health Care in the Soviet Union" appeared in the April 1984 issue of The Nurse Practitioner. "Health Care in China" appeared in the May 1984 issue of the journal. PMID:6462542

  2. Towards universal health coverage for reproductive health services in Ethiopia: two policy recommendations.

    PubMed

    Onarheim, Kristine Husøy; Taddesse, Mieraf; Norheim, Ole Frithjof; Abdullah, Muna; Miljeteig, Ingrid

    2015-01-01

    Reproductive health services are crucial for maternal and child health, but universal health coverage is still not within reach in most societies. Ethiopia's goal of universal health coverage promises access to all necessary services for everyone while providing protection against financial risk. When moving towards universal health coverage, health plans and policies require contextualized knowledge about baseline indicators and their distributions. To understand more about the factors that explain coverage, we study the relationship between socioeconomic and geographic factors and the use of reproductive health services in Ethiopia, and further explore inequalities in reproductive health coverage. Based on these findings, we discuss the normative implications of these findings for health policy. Using population-level data from the Ethiopian Demographic and Health Survey (2011) in a multivariate logistic model, we find that family planning and use of antenatal care are associated with higher wealth, higher education and being employed. Skilled attendance at birth is associated with higher wealth, higher education, and urban location. There is large variation between Addis Ababa (the capital) and other administrative regions. Concentration indices show substantial inequalities in the use of reproductive health services. Decomposition of the concentration indices indicates that difference in wealth is the most important explanatory factor for inequality in reproductive health coverage, but other factors, such as urban setting and previous health care use, are also associated with inequalities. When aiming for universal health coverage, this study shows that different socioeconomic factors as well as health-sector factors should be addressed. Our study re-confirms the importance of a broader approach to reproductive health, and in particular the importance of inequality in wealth and geography. Poor, non-educated, non-employed women in rural areas are

  3. Continuing Trends in Health and Health Care

    ERIC Educational Resources Information Center

    Wilson, Ronald W.; And Others

    1978-01-01

    Discusses current trends in health and health care, assesses significance of current data, and investigates causes and implications of the data for future health and health care. For journal availability, see SO 506 144. (Author/DB)

  4. Managed health care.

    PubMed

    Curtiss, F R

    1989-04-01

    The fundamental components of managed-care plans are described; the development of managed-care programs is discussed; and the impact of managed care on pharmacy services and the price, quality, and accessibility of health care are reviewed. Health care can be considered to be managed when at least one of the following fundamental components is present: prospective pricing, "UCR" (usual, customary, and reasonable) pricing of services, peer review, mandatory use review, benefit redesign, capitation payments, channeling, quality criteria, and health promotion. The managed-care industry consists of health maintenance organizations (HMOs), preferred provider organizations (PPOs), and managed fee-for-service plans. Managed-care reimbursement principles involve transferring some or all of the impetus for controlling use of services to the health-care provider. Means by which this is done include prospective pricing, services bundling, price discounts and negotiated fees, and capitation financing and reimbursement. Financial risk-sharing arrangements with providers--including hospitals, physicians, pharmacies, and home-care companies--are necessary for any managed-care plan to attain true control over its service costs. Use-review and use-management services are also fundamental to containing health-care spending. These include retrospective, concurrent, and prospective reviews of the necessity and appropriateness of medical services. Use management, like services bundling and prospective pricing, has been more effective in reducing costs of hospital inpatient services than costs associated with ambulatory care. Per case payments and services bundling have made individual charges for items irrelevant to hospital revenue. This has forced hospital pharmacy managers to become more sensitive to cost management. Drug formularies, improved productivity, and use of prescribing protocols are means by which hospital pharmacies have controlled costs. However, since shorter hospital

  5. Home health care

    MedlinePlus

    ... Skilled nursing - home health; Skilled nursing - home care; Physical therapy - at home; Occupational therapy - at home; Discharge - home ... being in the hospital, skilled nursing center, or rehabilitation facility. You should probably be able to go ...

  6. Health care automation companies.

    PubMed

    1995-12-01

    Health care automation companies: card transaction processing/EFT/EDI-capable banks; claims auditing/analysis; claims processors/clearinghouses; coding products/services; computer hardware; computer networking/LAN/WAN; consultants; data processing/outsourcing; digital dictation/transcription; document imaging/optical disk storage; executive information systems; health information networks; hospital/health care information systems; interface engines; laboratory information systems; managed care information systems; patient identification/credit cards; pharmacy information systems; POS terminals; radiology information systems; software--claims related/computer-based patient records/home health care/materials management/supply ordering/physician practice management/translation/utilization review/outcomes; telecommunications products/services; telemedicine/teleradiology; value-added networks. PMID:10153839

  7. Reproductive health professionals' adoption of emerging technologies for health promotion.

    PubMed

    Smith, Peggy B; Buzi, Ruth S

    2014-12-01

    The purpose of this study was to assess reproductive health professionals' familiarity with and use of various electronic technologies to support health promotion. The study also examined the relationship between demographic characteristics and attitudes and beliefs of the effectiveness of new technologies and perceived barriers for usage. A total of 165 reproductive health professionals at two conferences related to reproductive health in the United States completed the study survey. Personal and organizational factors affected the adoption of electronic technologies for health promotion. This included lack of knowledge, skills, and confidence as well as privacy concerns. The results of the study also suggested that being from an older generation was associated with having lower levels of knowledge, skills, and confidence in using new media. These findings highlight the importance of creating learning opportunities on the use of new technology for health promotion as well as addressing specific perceived barriers among reproductive health professionals in order to promote the adoption of these technologies. PMID:25411221

  8. Impact of the environment on reproductive health.

    PubMed

    1991-01-01

    The WHO workshop on the impact of the environment on reproductive health is summarized. Topics include the nature of environmental factors affecting reproductive health, environmental factors blamed for declining sperm quantity and quality, the effects of natural and man-made disasters on reproductive health, chemical pollutants, how the environment damages reproductive health, and research needs for better research methodologies and surveillance data. Recommendations are made to: 1) promote international research collaboration with an emphasis on consistency of methodological approaches for assessing developmental and reproductive toxicity, on development of improved surveillance systems and data bases, an strengthening international disaster alert and evaluation systems; 2) promote research capabilities for multidisciplinary studies, for interactive studies of the environment and cellular processes, and for expansion of training and education; and 3) take action on priority problems of exposure to chemical, physical, and biological agents, of exposure to pesticides among specific populations, and of inadequate screening methods for identification of environmental chemicals. The costs of environmental injury to reproduction include subfertility, intrauterine growth retardation, spontaneous abortion, and various birth defects. Developed country's primary threats are from chemical pollution, radiation, and stress. There is a large gap in knowledge. Caution is urged in understanding the direct relationship between environmental causes and infertility. Sexual health is difficult to assess and research is suggested. Exposure to excessive vitamin A and toxic chemicals are cited as agents probably having serious effects on malformations. Sperm quality has declined over the decades; there is speculation about the potential causes. The effects of radiation such as at Chernobyl are described. Toxic chemical exposure such as in Bhopal, India killed thousands. Neurological

  9. 'Halfway people': refugee views of reproductive health services.

    PubMed

    Whelan, A; Blogg, J

    2007-01-01

    The objective of this study was to identify factors that facilitate or hinder access to, use of, and satisfaction with reproductive health services in refugee settings, from the perspective of beneficiaries. Rapid appraisal methods included 46 focus group discussions and interviews with over 800 refugees, audits of 14 health facilities, referral hospital reviews, exit interviews with clients, and interviews with health workers. The study was conducted between February and April 2004 in 11 sites in Uganda, Republic of Congo, and Yemen. Reproductive health was clearly on the policy agenda in all countries with stable refugee sites, but problems with implementation and resources were identified. The quality of services was variable, with high staff turnover in some areas affecting relationships with refugee clients. Referral hospitals in host countries were not all equipped to deal with obstetric and other emergencies of either local or refugee populations, including deficiencies in safe blood supplies and antibiotics. Diagnosis and treatment of STIs and HIV/AIDS was frequently inadequate. Gender based violence was the least well addressed aspect of reproductive health. Interest and knowledge about family planning was high, but acceptance was low. It was concluded that progress has been made in reproductive health services for refugees since 1994, however, urgent advocacy and action is required to sustain and improve the situation. Local implementing partners need more support and supervision to develop appropriate service models and to maintain an acceptable standard of care. PMID:19283634

  10. Controlling Health Care Costs

    ERIC Educational Resources Information Center

    Dessoff, Alan

    2009-01-01

    This article examines issues on health care costs and describes measures taken by public districts to reduce spending. As in most companies in America, health plan designs in public districts are being changed to reflect higher out-of-pocket costs, such as higher deductibles on visits to providers, hospital stays, and prescription drugs. District…

  11. Health care and AIDS.

    PubMed

    Peck, J; Bezold, C

    1992-07-01

    The acquired immune deficiency syndrome (AIDS) is a harbinger for change in health care. There are many powerful forces poised to transform the industrialized health care structure of the twentieth century, and AIDS may act as either a catalyst or an amplifier for these forces. AIDS could, for example, swamp local resources and thereby help trigger national reform in a health care system that has already lost public confidence. AIDS can also hasten the paradigm shift that is occurring throughout health care. Many of the choices society will confront when dealing with AIDS carry implications beyond health care. Information about who has the disease, for example, already pits traditional individual rights against group interests. Future information systems could make discrimination based upon medical records a nightmare for a growing number of individuals. Yet these systems also offer the hope of accelerated progress against not only AIDS but other major health threats as well. The policy choices that will define society's response to AIDS can best be made in the context of a clearly articulated vision of a society that reflects our deepest values. PMID:10119289

  12. Health care technology assessment

    NASA Astrophysics Data System (ADS)

    Goodman, Clifford

    1994-12-01

    The role of technology in the cost of health care is a primary issue in current debates concerning national health care reform. The broad scope of studies for understanding technological impacts is known as technology assessment. Technology policy makers can improve their decision making by becoming more aware, and taking greater advantage, of key trends in health care technology assessment (HCTA). HCTA is the systematic evaluation of the properties, impacts, and other attributes of health care technologies, including: technical performance; clinical safety and efficacy/effectiveness; cost-effectiveness and other economic attributes; appropriate circumstances/indications for use; and social, legal, ethical, and political impacts. The main purpose of HCTA is to inform technology-related policy making in health care. Among the important trends in HCTA are: (1) proliferation of HCTA groups in the public and private sectors; (2) higher standards for scientific evidence concerning technologies; (3) methodological development in cost analyses, health-related quality of life measurement, and consolidation of available scientific evidence (e.g., meta-analysis); (4) emphasis on improved data on how well technologies work in routine practice and for traditionally under-represented patient groups; (5) development of priority-setting methods; (6) greater reliance on medical informatics to support and disseminate HCTA findings.

  13. Enhancing transgender health care.

    PubMed Central

    Lombardi, E

    2001-01-01

    As awareness of transgender men and women grows among health care educators, researchers, policymakers, and clinicians of all types, the need to create more inclusive settings also grows. Greater sensitivity and relevant information and services are required in dealing with transgender men and women. These individuals need their identities to be recognized as authentic, they need better access to health care resources, and they need education and prevention material appropriate to their experience. In addition, a need exists for activities designed to enhance understanding of transgender health issues and to spur innovation. PMID:11392924

  14. The sexuality connection in reproductive health.

    PubMed

    Dixon-Mueller, R

    1993-01-01

    Sexuality and power relations based on gender are relevant to researchers, policymakers, and service providers in the reproductive health field, because they underlie virtually all of the behaviors and conditions that their programs address. Yet, a review of conventional treatments in the demographic and family planning literature reveals that, when they consider these topics at all, researchers typically adopt narrow definitions of sexual behavior and focus almost exclusively on risks of pregnancy and disease. This article proposes an analytic framework as a guide to researchers and family planning providers. It relates four dimensions of sexuality to reproductive health outcomes and concludes that family planning policies and programs should address a broader spectrum of sexual behaviors and meanings, consider questions of sexual enjoyment as well as risk, and confront ideologies of male entitlement that threaten women's sexual and reproductive rights and health. PMID:8296329

  15. [Quality of health care].

    PubMed

    Medina, J L; De Melo, P C

    2000-01-01

    Quality assurance is a relatively recent concern but already plays a major role in health care management and provision. Quality involves the definition of a comprehensive programme tailored by realistic and effective objectives and norms that include the structured review of procedures (namely clinical audits) and the use of up-to-date protocols. The involvement and motivation of health professionals, together with an adequate internal and external communication strategy, play a key role in the planning and application of these programmes. The use of programmed assessment, based on a solid knowledge of current practice, should have practical implications, optimising procedures in order to improve the quality of care. This commitment towards quality in health care should go far beyond governmental policy and should have clear support from health professionals. PMID:11234496

  16. Containing Health Care Costs

    PubMed Central

    Derzon, Robert A.

    1980-01-01

    As the federal government shifted from its traditional roles in health to the payment for personal health care, the relationship between public and private sectors has deteriorated. Today federal and state revenue funds and trusts are the largest purchasers of services from a predominantly private health system. This financing or “gap-filling” role is essential; so too is the purchaser's concern for the costs and prices it must meet. The cost per person for personal health care in 1980 is expected to average $950, triple for the aged. Hospital costs vary considerably and inexplicably among states; California residents, for example, spend 50 percent more per year for hospital care than do state of Washington residents. The failure of each sector to understand the other is potentially damaging to the parties and to patients. First, and most important, differences can and must be moderated through definite changes in the attitudes of the protagonists. PMID:6770551

  17. Negotiating care: reproductive tract infections in Vietnam.

    PubMed

    Whittaker, Maxine

    2002-01-01

    Through case studies of two women, this paper uses a taskonomy approach to analyze rural Vietnamese women's narratives of prevention, treatment and management of vaginal discharge to illustrate care seeking, health practice and the pragmatism of their action. The research is based upon ethnographic research undertaken by the author between 1995 and 1997 in a rural district in northern Vietnam. This exploration illustrates the complexities of women's rationalities and the web of influences upon their choices-the health seeking culture as practiced. The women's narratives are also placed within the broader context of gender, power and health systems that structure their decision making. The author discusses how social and economic resource factors influence the choices women make regarding when to begin treatment for vaginal discharge and where to seek care. She concludes that women use their understanding of the relationships between health, living conditions and diseases on a day-to-day basis and that the practice of managing vaginal discharge is mediated by concepts of body, self and the body politic in Vietnam. PMID:12216991

  18. Youth reproductive health services in Bulawayo, Zimbabwe.

    PubMed

    Mashamba, Alethea; Robson, Elsbeth

    2002-12-01

    This study examines young people's access to reproductive healthcare services via an urban youth advisory centre in Bulawayo, Zimbabwe. The aim is to explain why teenagers do not always use existing health services. Data from exit questionnaires with users and focus groups with non-users are analysed to evaluate service accessibility. Analysis suggests that even where clinics are spatially accessible, barriers to access include temporal factors, lack of factual knowledge and stigmatisation. The paper concludes that spatial accessibility is not the only factor necessary to ensure equal access to health services. Recommendations are made towards tackling young people's unmet needs for reproductive healthcare services. PMID:12399216

  19. Adolescent Health Care in School-Based Health Centers. Position Statement

    ERIC Educational Resources Information Center

    National Assembly on School-Based Health Care, 2008

    2008-01-01

    School-based health centers (SBHCs) are considered one of the most effective strategies for delivering preventive care, including reproductive and mental health care services, to adolescents--a population long considered difficult to reach. National Assembly on School-Based Health Care (NASBHC) recommends practices and policies to assure…

  20. How Obamacare will impact reproductive health.

    PubMed

    Brezina, Paul R; Shah, Anish A; Myers, Evan R; Huang, Andy; DeCherney, Alan H

    2013-05-01

    For many years, health care delivery in the United States was accomplished through a complicated and evolving series of publicly and privately available insurance programs. In recent years, the increasing cost of health care as well as the relatively large number of individuals without any health care insurance coverage has prompted repeated attempts to modify or overhaul the current health care delivery paradigm. The largest legislative change to this system occurred on March 23, 2010, when President Barack Obama signed into law the Patient Protection and Affordable Care Act (PPACA).The PPACA is a multifaceted and sweeping piece of legislation. The law introduces a myriad number of changes into both public and private health insurance. Understanding the law, its implications, and how to navigate through these changes is essential to provide high-quality health care to patients. Although the law or parts of it are still at risk of being modified either through judicial or political action, it is important to recognize the current aspects of the law to understand any future modifications. Providing health care coverage in the United States is sure to be as it has always been: a constantly changing and evolving set of private and public policies that carry with them significant complexities and challenges. Health care providers must constantly strive to maximize access to and quality of medical care in whatever paradigm evolves in the future. PMID:23609149

  1. Gender issues in reproductive health: a review.

    PubMed

    Adinma, Echendu D; Adinma, Brian-D J I

    2011-01-01

    Gender, for its impact on virtually every contemporary life issue, can rightly be regarded as a foremost component of reproductive health. Reproductive health basically emphasises on people and their rights to sexuality, reproduction, and family planning, and the information to actualize these right, which has been inextricably linked to development at the International Conference on Population and Development (ICPD) held in Cairo, Egypt, in 1994. Women's sexual and reproductive rights became recognised as universal human right, violations of which occur in some reproductive health areas including gender concerns. Gender inequality and inequity encompass gender based violence as well as gender discrimination which cuts across the life cycle of the woman; attitudes, religious and cultural practices of various nations; and issues related to employment, economy, politics, and development. The redress of gender inequality is a collective responsibility of nations and supranational agencies. Nations should adopt a framework hinged on three pedestals--legal, institutional and policy, employing the three recommended approaches of equal treatment, positive action, and gender mainstreaming. PMID:21970255

  2. Primary care and health reform.

    PubMed

    Calman, Neil S; Golub, Maxine; Shuman, Saskia

    2012-01-01

    Skyrocketing health care costs are burdening our people and our economy, yet health care indicators show how little we are achieving with the money we spend. Federal and state governments, along with public-health experts and policymakers, are proposing a host of new initiatives to find solutions. The Patient Protection and Affordable Care Act is designed to address both the quality and accessibility of health care, while reducing its cost. This article provides an overview of models supported by the Affordable Care Act that address one or more goals of the "Triple Aim": better health care for individuals, better health outcomes in the community, and lower health care costs. The models described below rely on the core principles of primary care: comprehensive, coordinated and continuous primary care; preventive care; and the sophisticated implementation of health information technology designed to promote communication between health care providers, enhance coordination of care, minimize duplication of services, and permit reporting on quality. These models will support better health care and reduced costs for people who access health care services but will not address health outcomes in the community at large. Health care professionals, working in concert with community-based organizations and advocates, must also address conditions that influence health in the broadest sense to truly improve the health of our communities and reduce health care costs. PMID:22976358

  3. Health care interactional suffering in palliative care.

    PubMed

    Beng, Tan Seng; Guan, Ng Chong; Jane, Lim Ee; Chin, Loh Ee

    2014-05-01

    A secondary analysis of 2 qualitative studies was conducted to explore the experiences of suffering caused by interactions with health care providers in the hospital setting. Interview transcripts from 20 palliative care patients and 15 palliative care informal caregivers in University Malaya Medical Centre were thematically analyzed. The results of health care interactional suffering were associated with themes of attention, understanding, communication, competence, and limitation. These 5 themes may serve as a framework for the improvement in interaction skills of health care providers in palliative care. PMID:23689367

  4. Youth Reproductive & Sexual Health in Nigeria

    ERIC Educational Resources Information Center

    Sampson, Melodi

    2010-01-01

    Nearly one third of Nigeria's total population of 148.1 million is between the ages of 10 and 24. Nigerian adolescents' sizeable share of the population makes them integral to the country's social, political and economic development. Nigeria's development is compromised by the sexual and reproductive health issues afflicting its youth. Lack of…

  5. Values in health care.

    PubMed

    Gish, O

    1984-01-01

    The first part of the paper is concerned with the health care values of various groups; namely, those which are resource oriented, disease oriented, political decision-makers, organized sellers and purchasers of health care and patients. These groups are further divided according to selected political/ideological and socio-economic characteristics, essentially along capitalist and socialist lines. Some of the ways in which the values held by these groups are determined, formulated and, by implication at least, changed and the political, economic and other bases for some of their practical applications are identified. The second part of the paper focuses upon values in public health education and related practice. It is argued that to become more useful to the 'health of the public' the new public health worker will have to become more activist, assuming an adversarial stance toward the market economy in capitalist countries and oppressive governmental structures everywhere. A wider integration of knowledge concerning the effects of health of all types of economic, social and political practices is required; this, in turn, would contribute to the emergence of alternative forms of public health analysis and practice. The recognition of wider forms of public health leadership should follow, coupled with organizational changes directed at the greater participation of popular groupings in all types of public health activities. PMID:6484620

  6. Reproductive health: a right for refugees and internally displaced persons.

    PubMed

    Austin, Judy; Guy, Samantha; Lee-Jones, Louise; McGinn, Therese; Schlecht, Jennifer

    2008-05-01

    Continued political and civil unrest in low-resource countries underscores the ongoing need for specialised reproductive health services for displaced people. Displaced women particularly face high maternal mortality, unmet need for family planning, complications following unsafe abortion, and gender-based violence, as well as sexually transmitted diseases, including HIV. Relief and development agencies and UN bodies have developed technical materials, made positive policy changes specific to crisis settings and are working to provide better reproductive health care. Substantial gaps remain, however. The collaboration within the field of reproductive health in crises is notable, with many agencies working in one or more networks. The five-year RAISE Initiative brings together major UN and NGO agencies from the fields of relief and development, and builds on their experience to support reproductive health service delivery, advocacy, clinical training and research. The readiness to use common guidance documents, develop priorities jointly and share resources has led to smoother operations and less overlap than if each agency worked independently. Trends in the field, including greater focus on internally displaced persons and those living in non-camp settings, as well as refugees in camps, the protracted nature of emergencies, and an increasing need for empirical evidence, will influence future progress. PMID:18513603

  7. Promotion of adolescent reproductive health and healthy living. Malaysia.

    PubMed

    1999-12-01

    This article discusses a 3-year project, "Promotion of Adolescent Reproductive Health and Healthy Living," which was implemented by the Federation of Family Planning Associations, Malaysia. The project seeks to achieve the following: 1) development of a reproductive health of adolescent module (RHAM) for trainers and educators; 2) training of trainers; 3) sharing of adolescent reproductive health experiences in Asian countries; and 4) setting up three service models in Sabah, Selangor, and Terengganu to provide reproductive health (RH) care to adolescents and youth. The first part of the RHAM with the trainer's manual has been finalized and will be tested in a workshop. The second part, a teacher's guide, is under preparation. A series of training on the use of the RHAM will be conducted including a 5-day national workshop, which will be followed by several state level workshops. The three service models being set up have specific orientations. The Sabah model is putting up a youth clinic for adolescents within its clinic network. The Selangor model is developing a Youth Resource Center for training and youth involvement in RH activities. Lastly, the Terengganu family planning association (FPA) has developed a Youth Center web site, which features the history, mission, and activities of the Terengganu FPA. PMID:12158246

  8. Understanding your health care costs

    MedlinePlus

    ... as X-rays or MRIs Rehab, physical or occupational therapy, or chiropractic care Mental health, behavioral health, or substance abuse care Hospice, home health, skilled nursing, or durable medical equipment Prescription drugs Dental and ...

  9. Male reproductive health and environmental xenoestrogens.

    PubMed Central

    Toppari, J; Larsen, J C; Christiansen, P; Giwercman, A; Grandjean, P; Guillette, L J; Jégou, B; Jensen, T K; Jouannet, P; Keiding, N; Leffers, H; McLachlan, J A; Meyer, O; Müller, J; Rajpert-De Meyts, E; Scheike, T; Sharpe, R; Sumpter, J; Skakkebaek, N E

    1996-01-01

    Male reproductive health has deteriorated in many countries during the last few decades. In the 1990s, declining semen quality has been reported from Belgium, Denmark, France, and Great Britain. The incidence of testicular cancer has increased during the same time incidences of hypospadias and cryptorchidism also appear to be increasing. Similar reproductive problems occur in many wildlife species. There are marked geographic differences in the prevalence of male reproductive disorders. While the reasons for these differences are currently unknown, both clinical and laboratory research suggest that the adverse changes may be inter-related and have a common origin in fetal life or childhood. Exposure of the male fetus to supranormal levels of estrogens, such as diethlylstilbestrol, can result in the above-mentioned reproductive defects. The growing number of reports demonstrating that common environmental contaminants and natural factors possess estrogenic activity presents the working hypothesis that the adverse trends in male reproductive health may be, at least in part, associated with exposure to estrogenic or other hormonally active (e.g., antiandrogenic) environmental chemicals during fetal and childhood development. An extensive research program is needed to understand the extent of the problem, its underlying etiology, and the development of a strategy for prevention and intervention. Images Figure 3. A Figure 3. B Figure 3. C Figure 3. D Figure 3. E Figure 3. F PMID:8880001

  10. Funding Rural Health Care.

    ERIC Educational Resources Information Center

    Moore, Kim

    This paper provides first-time grant writers with suggestions on how to approach a private funding source. While intended for rural health care advocates, the remarks are equally applicable for educators and others. The rural crisis has produced many heart-rending stories about medically indigent people, but there is a lack of reliable statistics…

  11. New constitutionalism and the social reproduction of caring institutions.

    PubMed

    Gill, Stephen; Bakker, Isabella

    2006-01-01

    This essay analyzes neo-liberal economic agreements and legal and political frameworks or what has been called the "new constitutionalism," a governance framework that empowers market forces to reshape economic and social development worldwide. The article highlights some consequences of new constitutionalism for caring institutions specifically, and for what feminists call social reproduction more generally: the biological reproduction of the species; the reproduction of labor power; and the reproduction of social institutions and processes associated with the creation and maintenance of communities. New constitutional governance frameworks fundamentally reshape conditions under which the care of human beings takes place. Caring institutions once governed by enabling professions geared to universal care are now determined increasingly by market values and private forces, and driven directly by the profit motive. This is one of the reasons why neo-liberalism is increasingly contested in both the North and the global South. PMID:16532302

  12. Vitamin D - roles in women's reproductive health?

    PubMed Central

    2011-01-01

    In the past few years a growing interest in vitamin D can be observed in the lay and biomedical literature due to findings demonstrating a low vitamin D status in the population. In addition to its importance for the regulation of calcium and phosphorus homeostasis recent epidemiologic studies have observed relationships between low vitamin D levels and multiple disease states. This secosteroid hormone also regulates the expression of a large number of genes in reproductive tissues implicating a role for vitamin D in female reproduction. In this report we summarize the recent evidence that vitamin D status influences female reproductive and pregnancy outcomes. Human and animal data suggest that low vitamin D status is associated with impaired fertility, endometriosis and polycystic ovary syndrome. Evidence from observational studies shows higher rates of preeclampsia, preterm birth, bacterial vaginosis and gestational diabetes in women with low vitamin D levels. However, confirmation of experimental observations establishing an association of vitamin D deficiency with adverse reproductive outcomes by high quality observational and large-scale randomized clinical trials is still lacking. The determination of optimal 25(OH)D3 levels in the reproductive period and the amount of vitamin D supplementation required to achieve those levels for the numerous actions of vitamin D throughout a woman's life would have important public health implications. PMID:22047005

  13. The pluralism problem in cross-border reproductive care.

    PubMed

    Storrow, R F

    2010-12-01

    Outlawing well established forms of assisted reproduction places obstacles in the path of couples who wish to attain their reproductive goals with medical assistance. One effect of restrictive reproductive laws that has received widespread attention is cross-border reproductive travel. In Europe, such travel is permitted by the policy of free movement of persons that is a cornerstone of the democratic and economic stability of the European Union. Cross-border reproductive travel fails to promote moral and political pluralism in democratic states for three primary reasons. First, the opportunity for patients to go abroad for treatment tempers organized resistance to the law and allows government to pass stricter regulations than it otherwise might. Second, cross-border reproductive care has been shown to have deleterious extraterritorial effects that undermine the articulated rationales behind restrictive reproductive laws. Third, laws that generate demand for cross-border reproductive care often fail to satisfy the standard of proportionality that restrictions on human reproduction must meet. PMID:20940141

  14. Vitamin D in Reproductive Health and Pregnancy.

    PubMed

    Mousa, Aya; Abell, Sally; Scragg, Robert; de Courten, Barbora

    2016-03-01

    Vitamin D has been primarily known for its role in maintaining calcium and phosphorus homeostasis and promoting healthy bone mineralization. Emerging evidence suggests that vitamin D may have a plethora of other functions including cardiometabolic and immunological effects and a role in modulating human reproductive processes. Despite this, vitamin D deficiency (VDD) remains highly prevalent worldwide due to the limited availability of foods that are naturally high or fortified with vitamin D, increased sun avoidance behaviors and use of sunscreen due to fear of skin cancer, and increased sedentary indoor lifestyles, especially among those of reproductive age. This review examines current and emerging evidence for the role of vitamin D in reproductive health including in fertility, conception, and pregnancy outcomes, and outlines areas for future research. We found that existing evidence is based primarily on animal models and in vitro studies with some recent support from observational studies in humans. While these studies indicate that VDD may be a risk factor for adverse fertility and pregnancy outcomes, there is insufficient evidence to establish causality. Future efforts to clarify the benefits of vitamin D in reproductive health may bring about practical, simple, and cost-effective means of improving fertility and pregnancy outcomes. PMID:27228115

  15. Sexual and reproductive health for all: a call for action.

    PubMed

    Fathalla, Mahmoud F; Sinding, Steven W; Rosenfield, Allan; Fathalla, Mohammed M F

    2006-12-01

    At the United Nations International Conference on Population and Development in Cairo in 1994, the international community agreed to make reproductive health care universally available no later than 2015. After a 5-year review of progress towards implementation of the Cairo programme of action, that commitment was extended to include sexual, as well as reproductive, health and rights. Although progress has been made towards this commitment, it has fallen a long way short of the original goal. We argue that sexual and reproductive health for all is an achievable goal--if cost-effective interventions are properly scaled up; political commitment is revitalised; and financial resources are mobilised, rationally allocated, and more effectively used. National action will need to be backed up by international action. Sustained effort is needed by governments in developing countries and in the donor community, by inter-governmental organisations, non-governmental organisations, civil society groups, the women's health movement, philanthropic foundations, the private for-profit sector, the health profession, and the research community. PMID:17161731

  16. Ethical issues relating to reproduction control and women's health.

    PubMed

    Schenker, J G; Eisenberg, V H

    1997-07-01

    oppression of women. The practice has to be stopped. Recognition of the fetus as a 'patient' has a potential effect on women's right for autonomy; they have no legal obligation to undergo invasive procedures and to risk their health for the sake of their fetuses. The woman carries ethical obligations toward her fetus. This obligation should not be enforced by the law. At present women bear most of the burden of reproductive health. All of them have a right of access to fertility regulation. Governments and society must ensure the women's equal rights to health care just as men have in the regulation of their fertility. PMID:9253679

  17. Tracking humanitarian funding for reproductive health: a systematic analysis of health and protection proposals from 2002-2013

    PubMed Central

    2015-01-01

    (26.2%), and lastly, family planning (14.9%). Conclusion Findings show that more agencies are responding to humanitarian appeals by proposing to implement reproductive health programs and receiving increased aid over the twelve year period. While such developments are welcome, project descriptions show comparatively limited attention and programming for family planning and abortion care in particular. PMID:25798188

  18. Care for the Health Care Provider.

    PubMed

    Kunin, Sharon Brown; Kanze, David Mitchell

    2016-03-01

    Pretravel care for the health care provider begins with an inventory, including the destination, length of stay, logistical arrangements, type of lodging, food and water supply, team members, personal medical needs, and the needs of the community to be treated. This inventory should be created and processed well in advance of the planned medical excursion. The key thing to remember in one's planning is to be a health care provider during one's global health care travel and not to become a patient oneself. This article will help demonstrate the medical requirements and recommendations for such planning. PMID:26900113

  19. Understanding your health care costs

    MedlinePlus

    ... This is the payment you make for certain health care provider visits and prescriptions. It is a set ... about lower-cost facilities and medicines. Understanding your health care costs can help you save money when managing ...

  20. Defining quality in health care.

    PubMed

    Buck, A S

    1992-05-01

    The difficulty and importance of developing and implementing a definition of quality in health care is discussed. Some current definitions are considered, and a recommended definition of quality health care is presented. PMID:1630660

  1. Cross-border assisted reproduction care in Asia: implications for access, equity and regulations.

    PubMed

    Whittaker, Andrea

    2011-05-01

    This paper gives an overview of the global commercialised market in assisted reproduction treatment in low-resource countries in Asia and raises concerns about access and equity, the potential commercial exploitation of the bodies of subaltern women to service the demand for donated ova and surrogate pregnancy, and the need for protections through regulations. A lack of systematic data about cross-border reproductive care is a significant obstacle to debate and policy intervention. Little is known about the extent, experience or conditions of cross-border reproductive care outside of Europe and the United States. Further research is needed in Asia on the local effects of this trade upon local health systems, couples seeking care, and those women whose body tissues and nurturing capacities facilitate it. More attention needs to be paid to the provision of publicly funded reproductive health services to address the inequitable distribution of treatment and to investigate means to regulate this trade by governments, international NGOs, professional organisations and civil society groups in developing countries. The global trade in assisted reproduction challenges us to balance the rights of individuals to pursue health care across national borders with the rights of those providing services to meet their needs, especially vulnerable groups in situations of economic disparity. PMID:21555091

  2. Prenatal Screening, Reproductive Choice, and Public Health

    PubMed Central

    Wilkinson, Stephen

    2015-01-01

    One widely held view of prenatal screening (PNS) is that its foremost aim is, or should be, to enable reproductive choice; this is the Pure Choice view. The article critiques this position by comparing it with an alternative: Public Health Pluralism. It is argued that there are good reasons to prefer the latter, including the following. (1) Public Health Pluralism does not, as is often supposed, render PNS more vulnerable to eugenics-objections. (2) The Pure Choice view, if followed through to its logical conclusions, may have unpalatable implications, such as extending choice well beyond health screening. (3) Any sensible version of Public Health Pluralism will be capable of taking on board the moral seriousness of abortion and will advocate, where practicable, alternative means of reducing the prevalence of disease and disability. (4) Public Health Pluralism is at least as well-equipped as the Pure Choice model to deal with autonomy and consent issues. PMID:25521971

  3. Prenatal screening, reproductive choice, and public health.

    PubMed

    Wilkinson, Stephen

    2015-01-01

    One widely held view of prenatal screening (PNS) is that its foremost aim is, or should be, to enable reproductive choice; this is the Pure Choice view. The article critiques this position by comparing it with an alternative: Public Health Pluralism. It is argued that there are good reasons to prefer the latter, including the following. (1) Public Health Pluralism does not, as is often supposed, render PNS more vulnerable to eugenics-objections. (2) The Pure Choice view, if followed through to its logical conclusions, may have unpalatable implications, such as extending choice well beyond health screening. (3) Any sensible version of Public Health Pluralism will be capable of taking on board the moral seriousness of abortion and will advocate, where practicable, alternative means of reducing the prevalence of disease and disability. (4) Public Health Pluralism is at least as well-equipped as the Pure Choice model to deal with autonomy and consent issues. PMID:25521971

  4. Biological control of vaginosis to improve reproductive health

    PubMed Central

    Mastromarino, P.; Hemalatha, R.; Barbonetti, A.; Cinque, B.; Cifone, M.G.; Tammaro, F.; Francavilla, F.

    2014-01-01

    The human vaginal microbiota plays an important role in the maintenance of a woman's health, as well as of her partner's and newborns’. When this predominantly Lactobacillus community is disrupted, decreased in abundance and replaced by different anaerobes, bacterial vaginosis (BV) may occur. BV is associated with ascending infections and obstetrical complications, such as chorioamnionitis and preterm delivery, as well as with urinary tract infections and sexually transmitted infections. In BV the overgrowth of anaerobes produces noxious substances like polyamines and other compounds that trigger the release of pro-inflammatory cytokines interleukin (IL)-1 β and IL-8. BV can profoundly affect, with different mechanisms, all the phases of a woman's life in relation to reproduction, before pregnancy, during fertilization, through and at the end of pregnancy. BV can directly affect fertility, since an ascending dissemination of the involved species may lead to tubal factor infertility. Moreover, the increased risk of acquiring sexually transmitted diseases contributes to damage to reproductive health. Exogenous strains of lactobacilli have been suggested as a means of re-establishing a normal healthy vaginal flora. Carefully selected probiotic strains can eliminate BV and also exert an antiviral effect, thus reducing viral load and preventing foetal and neonatal infection. The administration of beneficial microorganisms (probiotics) can aid recovery from infection and restore and maintain a healthy vaginal ecosystem, thus improving female health also in relation to reproductive health. PMID:25673551

  5. Child Care Health Connections, 2002.

    ERIC Educational Resources Information Center

    Guralnick, Eva, Ed.; Zamani, Rahman, Ed.; Evinger, Sara, Ed.; Dailey, Lyn, Ed.; Sherman, Marsha, Ed.; Oku, Cheryl, Ed.; Kunitz, Judith, Ed.

    2002-01-01

    This document is comprised of the six 2002 issues of a bimonthly newsletter on children's health for California's child care professionals. The newsletter provides information on current and emerging health and safety issues relevant to child care providers and links the health, safety, and child care communities. Regular features include columns…

  6. Universal coverage and its impact on reproductive health services in Thailand.

    PubMed

    Tangcharoensathien, Viroj; Tantivess, Sripen; Teerawattananon, Yot; Auamkul, Nanta; Jongudoumsuk, Pongpisut

    2002-11-01

    Thailand has recently introduced universal health care coverage for 45 million of its people, financed by general tax revenue. A capitation contract model was adopted to purchase ambulatory and hospital care, and preventive care and promotion, including reproductive health services, from public and private service providers. This paper describes the health financing system prior to universal coverage, and the extent to which Thailand has achieved reproductive health objectives prior to this reform. It then analyses the potential impact of universal coverage on reproductive health services. Whether there are positive or negative effects on reproductive health services will depend on the interaction between three key aspects: awareness of entitlement on the part of intended beneficiaries of services, the response of health care providers to capitation, and the capacity of purchasers to monitor and enforce contracts. In rural areas, the district public health system is the sole service provider and the contractual relationship requires trust and positive engagement with purchasers. We recommend an evidence-based approach to fine-tune the reproductive health services benefits package under universal coverage, as well as improved institutional capacity for purchasers and the active participation of civil society and other partners to empower beneficiaries. PMID:12557643

  7. Rethinking care through social reproduction: articulating circuits of migration.

    PubMed

    Kofman, Eleonore

    2012-01-01

    Care has come to dominate much feminist research on globalized migrations and the transfer of labor from the South to the North, while the older concept of reproduction had been pushed into the background but is now becoming the subject of debates on the commodification of care in the household and changes in welfare state policies. This article argues that we could achieve a better understanding of the different modalities and trajectories of care in the reproduction of individuals, families, and communities, both of migrant and nonmigrant populations by articulating the diverse circuits of migration, in particular that of labor and the family. In doing this, I go back to the earlier North American writing on racialized minorities and migrants and stratified social reproduction. I also explore insights from current Asian studies of gendered circuits of migration connecting labor and marriage migrations as well as the notion of global householding that highlights the gender politics of social reproduction operating within and beyond households in institutional and welfare architectures. In contrast to Asia, there has relatively been little exploration in European studies of the articulation of labor and family migrations through the lens of social reproduction. However, connecting the different types of migration enables us to achieve a more complex understanding of care trajectories and their contribution to social reproduction. PMID:22611577

  8. Post-Disaster Reproductive Health Outcomes

    PubMed Central

    Zotti, Marianne E.; Williams, Amy M.; Robertson, McKaylee; Horney, Jennifer; Hsia, Jason

    2015-01-01

    We examined methodological issues in studies of disaster-related effects on reproductive health outcomes and fertility among women of reproductive age and infants in the United States (US). We conducted a systematic literature review of 1,635 articles and reports published in peer-reviewed journals or by the government from January 1981 through December 2010. We classified the studies using three exposure types: (1) physical exposure to toxicants; (2) psychological trauma; and (3) general exposure to disaster. Fifteen articles met our inclusion criteria concerning research focus and design. Overall studies pertained to eight different disasters, with most (n = 6) focused on the World Trade Center attack. Only one study examined pregnancy loss, i.e., occurrence of spontaneous abortions post-disaster. Most studies focused on associations between disaster and adverse birth outcomes, but two studies pertained only to post-disaster fertility while another two examined it in addition to adverse birth outcomes. In most studies disaster-affected populations were assumed to have experienced psychological trauma, but exposure to trauma was measured in only four studies. Furthermore, effects of both physical exposure to toxicants and psychological trauma on disaster-affected populations were examined in only one study. Effects on birth outcomes were not consistently demonstrated, and study methodologies varied widely. Even so, these studies suggest an association between disasters and reproductive health and highlight the need for further studies to clarify associations. We postulate that post-disaster surveillance among pregnant women could improve our understanding of effects of disaster on the reproductive health of US pregnant women. PMID:22752348

  9. Health care reforms in Poland.

    PubMed

    Baginska, Ewa

    2004-01-01

    This paper examines the shape of the recently reformed health care system in Poland. Until December 31,1998 everyone had access to free health care and the medical institutions were financed by the State. Since January 1, 1999, under the provisions of the Universal Health Insurance Act, hospitals became independent from the State budget and gained more financial resources for their activities. 17 regional health insurance funds contract for medical services with hospitals and individual practices. Most services provided to the insured are paid by the funds that receive premiums, but some are still financed from the State budget. The revised legislation on Medical Care Establishments intended to create a better management of health care institutions and administrative control over the quality of care. The system has been severely criticised: it is too bureaucratic, there are too many insurance funds, patients have experienced problems with access to health care, particularly to special treatment or to treatment available outside the area of the health insurance fund to which the patient belongs. The new Minister for Health suggested that the 17 funds should be replaced by 5 "health funds" that would finance health care and be closely connected to the local government answerable for their activities. This paper will deal with the scope of health care packages, the conditions of provision of health services, obligations of health care providers, patient rights, and the quality of health care. PMID:15685913

  10. Redirecting health care spending: consumer-directed health care.

    PubMed

    Nolin, JoAnn; Killackey, Janet

    2004-01-01

    In an environment of rising health care costs, defined contribution plans and closely related consumer-directed health plans are emerging as a possible next phase in health plan development and offer new opportunities for the nursing profession. PMID:15586479

  11. Outbreaks in Health Care Settings.

    PubMed

    Sood, Geeta; Perl, Trish M

    2016-09-01

    Outbreaks and pseudo-outbreaks in health care settings can be complex and should be evaluated systematically using epidemiologic tools. Laboratory testing is an important part of an outbreak evaluation. Health care personnel, equipment, supplies, water, ventilation systems, and the hospital environment have been associated with health care outbreaks. Settings including the neonatal intensive care unit, endoscopy, oncology, and transplant units are areas that have specific issues which impact the approach to outbreak investigation and control. Certain organisms have a predilection for health care settings because of the illnesses of patients, the procedures performed, and the care provided. PMID:27515142

  12. Catalyzing a Reproductive Health and Social Justice Movement.

    PubMed

    Verbiest, Sarah; Malin, Christina Kiko; Drummonds, Mario; Kotelchuck, Milton

    2016-04-01

    Objectives The maternal and child health (MCH) community, partnering with women and their families, has the potential to play a critical role in advancing a new multi-sector social movement focused on creating a women's reproductive and economic justice agenda. Since the turn of the twenty-first century, the MCH field has been planting seeds for change. The time has come for this work to bear fruit as many states are facing stagnant or slow progress in reducing infant mortality, increasing maternal death rates, and growing health inequities. Methods This paper synthesizes three current, interrelated approaches to addressing MCH challenges-life course theory, preconception health, and social justice/reproductive equity. Conclusion Based on these core constructs, the authors offer four directions for advancing efforts to improve MCH outcomes. The first is to ensure access to quality health care for all. The second is to facilitate change through critical conversations about challenging issues such as poverty, racism, sexism, and immigration; the relevance of evidence-based practice in disenfranchised communities; and how we might be perpetuating inequities in our institutions. The third is to develop collaborative spaces in which leaders across diverse sectors can see their roles in creating equitable neighborhood conditions that ensure optimal reproductive choices and outcomes for women and their families. Last, the authors suggest that leaders engage the MCH workforce and its consumers in dialogue and action about local and national policies that address the social determinants of health and how these policies influence reproductive and early childhood outcomes. PMID:26740226

  13. Proceedings of the Summit on Environmental Challenges to Reproductive Health and Fertility: Executive Summary

    PubMed Central

    Woodruff, Tracey J.; Carlson, Alison; Schwartz, Jackie M.; Giudice, Linda C.

    2008-01-01

    The 2007 Summit on “Environmental Challenges to Reproductive Health and Fertility” convened scientists, health care professionals, community groups, political representatives and the media to hear presentations on the impact of environmental contaminants on reproductive health and fertility and to discuss opportunities to improve health through research, education, communication and policy. Environmental reproductive health focuses on exposures to environmental contaminants, particularly during critical periods of development, and their potential effects on future reproductive health, including conception, fertility, pregnancy, adolescent development and adult health. Approximately 87,000 chemical substances are registered for use in commerce in the US, with ubiquitous human exposures to environmental contaminants in air, water, food and consumer products. Exposures during critical windows of susceptibility may result in adverse effects with lifelong and even intergenerational health impacts. Effects can include impaired development and function of the reproductive tract and permanently altered gene expression, leading to metabolic and hormonal disorders, reduced fertility and fecundity and illnesses such as testicular, prostate, uterine and cervical cancers later in life. This executive summary reviews effects of pre- and post-natal exposures on male and female reproductive health and provides a series of recommendations for advancing the field in the areas of research, policy, health care and community action. PMID:18275883

  14. Epigenetics: A key paradigm in reproductive health

    PubMed Central

    Bunkar, Neha; Pathak, Neelam; Lohiya, Nirmal Kumar

    2016-01-01

    It is well established that there is a heritable element of susceptibility to chronic human ailments, yet there is compelling evidence that some components of such heritability are transmitted through non-genetic factors. Due to the complexity of reproductive processes, identifying the inheritance patterns of these factors is not easy. But little doubt exists that besides the genomic backbone, a range of epigenetic cues affect our genetic programme. The inter-generational transmission of epigenetic marks is believed to operate via four principal means that dramatically differ in their information content: DNA methylation, histone modifications, microRNAs and nucleosome positioning. These epigenetic signatures influence the cellular machinery through positive and negative feedback mechanisms either alone or interactively. Understanding how these mechanisms work to activate or deactivate parts of our genetic programme not only on a day-to-day basis but also over generations is an important area of reproductive health research. PMID:27358824

  15. [Toxocariasis: spread and impact on reproductive health].

    PubMed

    Gasanova, T A

    2003-01-01

    To study the prevalence of toxocariasis and its impact on the reproductive health of inhabitants in the Saratov Region, enzyme immunoassay was used to examine 1404 patients, including 210 children, 912 females, and 282 males. Toxocariasis was shown to be a risk factor of male (oligoasthenozoospermia) and female (tuboperitoneal) infertility. The high incidence of toxocariasis in females with reproductive dysfunction (recurrent abortion) and an aggravated obstetric history complicated by chronic renal diseases is indicative of the existence of the urogenital form of toxocariasis. Toxocariasis greatly increases a risk of giving birth to a baby with clinical manifestations of intrauterine infection (IUI), promotes homeostatic disorder and the formation of long-term pathology in babies with IUI. At the same time, there was a significant relationship of abnormal cardiotocograms to toxocariasis and to the presence of Trichomonas, Mycoplasma, Chlamydia, and Cytomegalovirus. PMID:14727482

  16. Psychology's Role in Health Care.

    ERIC Educational Resources Information Center

    American Psychological Association, Washington, DC.

    This information packet contains eight two- to three-page publications from the American Psychological Association series "Psychological Services for the 21st Century, Psychology's Role in Health Care: Studying Human Behavior; Promoting Health; Saving Health Care Dollars; Providing Mental Health Services." The focus of the series is the connection…

  17. CRITICAL WINDOWS FOR REPRODUCTIVE HEALTH IN CHILDREN AND ADOLESCENTS

    EPA Science Inventory

    This workgroup report addresses the central question: what are the critical windows during development (pre-conception through puberty) when exposure to xenobiotics may have the greatest adverse impact on subsequent reproductive health. The reproductive system develops in stages...

  18. Reproductive Health in the United States: A Review of the Recent Social Work Literature.

    PubMed

    Wright, Rachel L; Bird, Melissa; Frost, Caren J

    2015-10-01

    Reproductive health is an important area affecting a woman's overall health and well-being. The examination of reproductive health and barriers to care is pertinent to the social work profession and should be a focus of social work practice, education, research, and advocacy. The authors conducted a literature search of articles published in the social work literature from 2010 to 2014. The findings reveal important published articles that increase our knowledge of the reproductive health of women in the United States. Most published articles focused on pregnancy and birth outcomes. Articles also addressed sexually transmitted infections; abortion; intimate partner violence; prostitution; access to care; cancer screening; views toward contraception; hysterectomies; breastfeeding; menopause; and the intersection of reproductive rights, religion, and social justice. This review also identified unexamined areas that require further social work attention and consideration. PMID:26489350

  19. Care and the self: biotechnology, reproduction, and the good life

    PubMed Central

    Murray, Stuart J

    2007-01-01

    This paper explores a novel philosophy of ethical care in the face of burgeoning biomedical technologies. I respond to a serious challenge facing traditional bioethics with its roots in analytic philosophy. The hallmarks of these traditional approaches are reason and autonomy, founded on a belief in the liberal humanist subject. In recent years, however, there have been mounting challenges to this view of human subjectivity, emerging from poststructuralist critiques, such as Michel Foucault's, but increasingly also as a result of advances in biotechnology itself. In the face of these developments, I argue that the theoretical relevance and practical application of mainstream bioethics is increasingly under strain. Traditionalists will undoubtedly resist. Together, professional philosopher-bioethicists, public health policymakers, and the global commercial healthcare industry tend to respond conservatively by shoring up the liberal humanist subject as the foundation for medical ethics and consumer decision-making, appealing to the familiar tropes of reason, autonomy, and freedom. I argue for a different approach to bioethics, and work towards a new way to conceive of ethical relations in healthcare – one that does not presume a sovereign subject as the basis of dignity, personhood or democracy. Instead, I am critical of the narrow instantiations of reason, autonomy, and freedom, which, more recently, have been co-opted by a troubling neo-liberal politics of the self. Thus, I am critical of current trends in medical ethics, often running in tandem with corporate-governmental models of efficiency, accountability, and so-called evidence-based best practices. As an example of such market-driven conceptions of subjectivity, I discuss the paradigm of "self-care." Self-care shores up the traditional view of the self as a free agent. In this sense, self-care is looked upon favourably by mainstream bioethics in its focus on autonomy, while healthcare policy endorses this

  20. Care and the self: biotechnology, reproduction, and the good life.

    PubMed

    Murray, Stuart J

    2007-01-01

    This paper explores a novel philosophy of ethical care in the face of burgeoning biomedical technologies. I respond to a serious challenge facing traditional bioethics with its roots in analytic philosophy. The hallmarks of these traditional approaches are reason and autonomy, founded on a belief in the liberal humanist subject. In recent years, however, there have been mounting challenges to this view of human subjectivity, emerging from poststructuralist critiques, such as Michel Foucault's, but increasingly also as a result of advances in biotechnology itself. In the face of these developments, I argue that the theoretical relevance and practical application of mainstream bioethics is increasingly under strain. Traditionalists will undoubtedly resist. Together, professional philosopher-bioethicists, public health policymakers, and the global commercial healthcare industry tend to respond conservatively by shoring up the liberal humanist subject as the foundation for medical ethics and consumer decision-making, appealing to the familiar tropes of reason, autonomy, and freedom.I argue for a different approach to bioethics, and work towards a new way to conceive of ethical relations in healthcare--one that does not presume a sovereign subject as the basis of dignity, personhood or democracy. Instead, I am critical of the narrow instantiations of reason, autonomy, and freedom, which, more recently, have been co-opted by a troubling neo-liberal politics of the self. Thus, I am critical of current trends in medical ethics, often running in tandem with corporate-governmental models of efficiency, accountability, and so-called evidence-based best practices. As an example of such market-driven conceptions of subjectivity, I discuss the paradigm of "self-care." Self-care shores up the traditional view of the self as a free agent. In this sense, self-care is looked upon favourably by mainstream bioethics in its focus on autonomy, while healthcare policy endorses this model

  1. Betting against health care.

    PubMed

    Appleby, C

    1996-06-20

    Health care firms of all types helped fuel the biggest short-selling frenzy in the New York Stock Exchange's history, recently hitting a record 2.2 billion shares. While some analysts say this means nothing, the fact is that many investors are "shorting" the stock; in other words, they're betting against it. What appears as a lack of confidence may be nothing more than a simple quirk of Wall Street. Good, bad or indifferent, selling short is no tall tale. PMID:8640268

  2. Access to health care

    PubMed Central

    Fortin, Martin; Maltais, Danielle; Hudon, Catherine; Lapointe, Lise; Ntetu, Antoine Lutumba

    2005-01-01

    OBJECTIVE To explore access to health care for patients presenting with multiple chronic conditions and to identify barriers and factors conducive to access. DESIGN Qualitative study with focus groups. SETTING Family practice unit in Chicoutimi (Saguenay), Que. PARTICIPANTS Twenty-five male and female adult patients with at least four chronic conditions but no cognitive disorders or decompensating conditions. METHODS For this pilot study, only three focus group discussions were held. MAIN FINDINGS The main barriers to accessing follow-up appointments included long waits on the telephone, automated telephone-answering systems, and needing to attend at specific times to obtain appointments. The main barriers to specialized care were long waiting times and the need to get prescriptions and referrals from family physicians. Factors reported conducive to access included systematic callbacks and the personal involvement of family physicians. Good communication between family physicians and specialists was also perceived to be an important factor in access. CONCLUSION Systematic callbacks, family physicians’ personal efforts to obtain follow-up visits, and better physician-specialist communication were all suggested as ways to improve access to care for patients with multiple chronic conditions. PMID:16926944

  3. Mapping of reproductive health financing: methodological challenges.

    PubMed

    Pradhan, Jalandhar; Sidze, Estelle Monique; Khanna, Anoop; Beekink, Erik

    2014-10-01

    Low level of funding for reproductive health (RH) is a cause for concern, given that RH service utilization in the vast majority of the developing world is well below the desired level. Though there is an urgent need to track the domestic and international financial resource flows for RH, the instruments through which financial resources are tracked in developing countries are limited. In this paper we examined the methodological and conceptual challenges of monitoring financial resources for RH services at international and national level. At the international level, there are a number of estimates that highlights the need for financial resources for RH programmes but the estimates vary significantly. At the national level, Reproductive Health Accounts (RHA) in the framework of National Health Accounts (NHA) is considered to be the ideal source to track domestic financial flows for RH activities. However, the weak link between data production by the RHA and its application by the stakeholders as well as lack of political will impedes the institutionalization of RHA at the country level. PMID:25200968

  4. Migrant health care: creativity in primary care.

    PubMed

    Artemis, L

    1996-01-01

    Historically, migrant health care services have always been in a precarious position for funding. The government currently proposes major cuts in federally and state-funded programs for indigent and underserved populations, making this state of precariousness the rule, rather than the exception. The primary care practitioner, therefore, must provide quality, cost-effective care with minimal resources. Case studies illustrate how services can be provided using creativity and community resources. PMID:9447073

  5. The future of health care.

    PubMed

    Grossman, J H

    1992-10-01

    Future changes in patient care to curb costs and refocus on health versus medical care are discussed, and efforts at the New England Medical Center (NEMC) to measure patient outcomes and reorganize the delivery of care are described. Medical care is not the only determinant of an individual's health; lifestyle choices and the community also play important roles. The rate of increase in the cost of medical care must be contained. The future of health-care reform will be predicated on packages for the administration of care; for any given condition, all of the elements of medical care would be combined so that clinical and functional outcomes are achieved at a given price (episode-of-illness pricing). The success of medical care should be determined on the basis of the patient's ability to function, not on clinical indicators alone. Also, the prices for new generations of drugs should be determined on whether the new drugs improve patients' quality of life. Health-care professionals in hospitals should not be divided according to their specialties; instead, they should compose multidisciplinary teams that can care for patients over time. NEMC is developing a process and structure in which various health-care professionals work together to design health-care plans that cover a full episode of illness. The future of health care will also be influenced by global trends, including international medical-care inflation, standardization of process and outcome measurements, and a shift in emphasis from medicine to health. The health-care industry is in transition as this country searches for the best way to improve the health and functioning of each citizen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1442820

  6. Reproductive health patterns: Georgia versus Australia.

    PubMed

    Asatiani, T; Abuladze, N; Ward, H; Angel, P

    2015-03-01

    The review compares a few reproductive indicators - fertility, abortion and contraception in both a developing (Georgia) and a developed (Australia) country. Fertility, abortion and contraception figures in both countries tend to reflect the attitude and the degree of development of each countries sexual health education and their use of effective contraception. Further research is required to accurately evaluate the need and access of Georgian women to modern methods of family planning and their knowledge of the benefits of modern contraception that can assist to reduce pregnancy termination rate. In Australia better insight is needed on how to facilitate a shift to more efficacious long-term contraceptives across all age groups. PMID:25879552

  7. Norway at ICPD+10: international assistance for reproductive health does not reflect domestic policies.

    PubMed

    Austveg, Berit; Sundby, Johanne

    2005-05-01

    Norway has a long history of good reproductive health care, with some of the world's best reproductive health indicators. Early reduction of maternal mortality, good services for abortion, contraception and sexually transmitted diseases, a low rate of adolescent pregnancies and a low number people with HIV are examples, achieved through an integrated, publicly provided and funded health care package. Official Norwegian development assistance started in 1952. Emphasis on family planning assistance dates back to 1966, making Norway one of the most consistent donors to family planning and reproductive health programmes. Norway also had a high profile at the International Conference on Population and Development and strongly supported the Programme of Action. Since then, while multilateral support in these areas has stayed high, bilateral support has been downscaled. Overall, international assistance does not reflect the domestic approach to reproductive health services. Norway has given little development support to improvement of maternity services, avoided the issues of abortion and post-coital contraception, and passed up opportunities to support adolescent services. Prevention and treatment of infertility has hardly been an issue. Revitalisation of the reproductive rights discourse in Norway could provide a basis for the protection of reproductive health care domestically, and for policy discussions and decisions in relation to Norway's development assistance. PMID:16035594

  8. Evaluation of Skill-oriented Training on Enhanced Syndromic Case Management (ESCM) of Reproductive Tract Infections / Sexually Transmitted Infections (RTI/STIs) of Care Providers from Three-tier Health-care System of Gujarat

    PubMed Central

    Sharma, Rashmi; Prajapati, Shailesh; Patel, Brijesh; Kumar, Pradeep

    2016-01-01

    Background: Enhanced syndromic case management (ESCM) deals with reproductive tract and sexually transmitted infections. Capacity building of service providers not only boosts the program but also inputs from them improve the quality of services. Objectives: To (1) identify problem areas from providers' perspectives and the gaps in knowledge and application and (2) assess the gains (if any) through pre and post-training evaluation. Materials and Methods: A total of 121 participants (medical/para medical) from various medical colleges, district/sub-district hospitals/ community health centers, and urban dispensaries across Gujarat were trained at a teaching institute. Trainings were of 2-3 days duration involving different learning methodology. Pre- and post-training evaluation were done on a designed pro forma and data were entered in MS office Excel 2007. Gains in knowledge/skills if any were assessed by comparing pre-/post-evaluation responses and applying test of significance (x2 test). Observations: Out of total 121 participants, half (60) were doctors and the rest were paramedics [staff nurse (SN) and lab technicians (LT)]. Doctors revealed significant gain in basics of reproductive tract infections (RTI) and sexually transmitted infections (STI), syndrome identification, STI/HIV co-infection, and ESCM and less gain in asymptomatic STI/ complications, vulnerability, male reproductive organs, causes of vaginal/urethral discharge, STI complications, cervical cancer screening, and limitation of syndromic management. Gain was statistically significant in basics of RTI/STI amongst adolescent in paramedics; lab technicians showed significant gain in knowledge of laboratory-related areas. Conclusion: Assessment revealed (1) poor baseline knowledge and (2) gains following training sometimes significant and other times not significant even in core areas. Quality monitoring and contents/ methodologies modification are essential for robust trainings. Gains in skills

  9. Nurses cut health care costs.

    PubMed

    Dunham-Taylor, J; Oldaker, J; DeCapua, T; Manley, N K; Oprian, B; Wrestler, J

    1993-12-01

    Nurses are a value-added and cost-savings component of health care, yet others frequently impede nurse efforts. Nurses, coupled with business, can contribute to cutting health care costs by (a) increasing dialogue with business leaders on effective cost-cutting measures across health care, (b) supporting nurse leaders who are capable of administering key community positions, (c) involving whole communities in wellness/health promotion and/or disease prevention programs, (d) encouraging more home health care alternatives; and (e) supporting nurse-related entrepreneurial efforts. PMID:8228142

  10. Transformational leadership in health care.

    PubMed

    Trofino, J

    1995-08-01

    One of the most important evolutionary forces in transforming health care is the shift from management to leadership in nursing. The transformational leader will be the catalyst for expanding a holistic perspective, empowering nursing personnel at all levels and maximizing use of technology in the movement beyond even patient-centered health care to patient-directed health outcomes. PMID:7630599

  11. National Health Care Skill Standards.

    ERIC Educational Resources Information Center

    National Consortium on Health Science and Technology Education, Okemos, MI.

    This document presents the National Health Care Skill Standards, which were developed by the National Consortium on Health Science and Technology and West Ed Regional Research Laboratory, in partnership with educators and health care employers. The document begins with an overview of the purpose and benefits of skill standards. Presented next are…

  12. Reproductive health of Gulf War veterans

    PubMed Central

    Doyle, Patricia; Maconochie, Noreen; Ryan, Margaret

    2006-01-01

    In this review we summarize the scientific literature on reproductive health following deployment to the first Gulf war by armed service personnel. All the studies examined had methodological limitations, making interpretation difficult. Nonetheless we conclude that for male veterans there is no strong or consistent evidence to date for an effect of service in the first Gulf war on the risk of major, clearly defined, birth defects or stillbirth in offspring conceived after deployment. Effects on specific rare defects cannot be excluded at this stage since none of the studies had the statistical power to examine them. For miscarriage and infertility, there is some evidence of small increased risks associated with service, but the role of bias is likely to be strong. For female veterans, there is insufficient information to make robust conclusions, although the weight of evidence to date does not indicate any major problem associated specifically with deployment to the Gulf. None of the studies have been able to examine risk according particular exposures, and so possible associations with specific exposures for smaller groups of exposed veterans cannot be excluded. We suggest that the way forward to address the question of veterans' reproductive health with confidence in the future is prospective surveillance following deployment. Anything less will result in further problems of interpretation and continued anxiety for parents, as well as prospective parents, in the armed forces. PMID:16687262

  13. Reproductive health of Gulf War veterans.

    PubMed

    Doyle, Patricia; Maconochie, Noreen; Ryan, Margaret

    2006-04-29

    In this review we summarize the scientific literature on reproductive health following deployment to the first Gulf war by armed service personnel. All the studies examined had methodological limitations, making interpretation difficult. Nonetheless we conclude that for male veterans there is no strong or consistent evidence to date for an effect of service in the first Gulf war on the risk of major, clearly defined, birth defects or stillbirth in offspring conceived after deployment. Effects on specific rare defects cannot be excluded at this stage since none of the studies had the statistical power to examine them. For miscarriage and infertility, there is some evidence of small increased risks associated with service, but the role of bias is likely to be strong. For female veterans, there is insufficient information to make robust conclusions, although the weight of evidence to date does not indicate any major problem associated specifically with deployment to the Gulf. None of the studies have been able to examine risk according particular exposures, and so possible associations with specific exposures for smaller groups of exposed veterans cannot be excluded. We suggest that the way forward to address the question of veterans' reproductive health with confidence in the future is prospective surveillance following deployment. Anything less will result in further problems of interpretation and continued anxiety for parents, as well as prospective parents, in the armed forces. PMID:16687262

  14. Information Technology Outside Health Care

    PubMed Central

    Tuttle, Mark S.

    1999-01-01

    Non-health-care uses of information technology (IT) provide important lessons for health care informatics that are often overlooked because of the focus on the ways in which health care is different from other domains. Eight examples of IT use outside health care provide a context in which to examine the content and potential relevance of these lessons. Drawn from personal experience, five books, and two interviews, the examples deal with the role of leadership, academia, the private sector, the government, and individuals working in large organizations. The interviews focus on the need to manage technologic change. The lessons shed light on how to manage complexity, create and deploy standards, empower individuals, and overcome the occasional “wrongness” of conventional wisdom. One conclusion is that any health care informatics self-examination should be outward-looking and focus on the role of health care IT in the larger context of the evolving uses of IT in all domains. PMID:10495095

  15. The health care learning organization.

    PubMed

    Hult, G T; Lukas, B A; Hult, A M

    1996-01-01

    To many health care executives, emphasis on marketing strategy has become a means of survival in the threatening new environment of cost attainment, intense competition, and prospective payment. This paper develops a positive model of the health care organization based on organizational learning theory and the concept of the health care offering. It is proposed that the typical health care organization represents the prototype of the learning organization. Thus, commitment to a shared vision is proposed to be an integral part of the health care organization and its diagnosis, treatment, and delivery of the health care offering, which is based on the exchange relationship, including its communicative environment. Based on the model, strategic marketing implications are discussed. PMID:10158798

  16. Gypsies and health care.

    PubMed Central

    Sutherland, A

    1992-01-01

    Gypsies in the United States are not a healthy group. They have a high incidence of heart disease, diabetes mellitus, and hypertension. When they seek medical care, Gypsies often come into conflict with medical personnel who find their behavior confusing, demanding, and chaotic. For their part, Gypsies are often suspicious of non-Gypsy people and institutions, viewing them as a source of disease and uncleanliness. Gypsy ideas about health and illness are closely related to notions of good and bad fortune, purity and impurity, and inclusion and exclusion from the group. These basic concepts affect everyday life, including the way Gypsies deal with eating and washing, physicians and hospitals, the diagnosis of illness, shopping around for cures, and coping with birth and death. PMID:1413769

  17. Flourishing in Health Care.

    PubMed

    Edgar, Andrew; Pattison, Stephen

    2016-06-01

    The purpose of this paper is to offer an account of 'flourishing' that is relevant to health care provision, both in terms of the flourishing of the individual patient and carer, and in terms of the flourishing of the caring institution. It is argued that, unlike related concepts such as 'happiness', 'well-being' or 'quality of life', 'flourishing' uniquely has the power to capture the importance of the vulnerability of human being. Drawing on the likes of Heidegger and Nussbaum, it is argued that humans are at once beings who are autonomous and thereby capable of making sense of their lives, but also subject to the contingencies of their bodies and environments. To flourish requires that one engages, imaginatively and creatively, with those contingencies. The experience of illness, highlighting the vulnerability of the human being, thereby becomes an important experience, stimulating reflection in order to make sense of one's life as a narrative. To flourish, it is argued, is to tell a story of one's life, realistically engaging with vulnerability and suffering, and thus creating a framework through which one can meaningful and constructively go on with one's life. PMID:26846370

  18. "Cloud" health-care workers.

    PubMed Central

    Sherertz, R. J.; Bassetti, S.; Bassetti-Wyss, B.

    2001-01-01

    Certain bacteria dispersed by health-care workers can cause hospital infections. Asymptomatic health-care workers colonized rectally, vaginally, or on the skin with group A streptococci have caused outbreaks of surgical site infection by airborne dispersal. Outbreaks have been associated with skin colonization or viral upper respiratory tract infection in a phenomenon of airborne dispersal of Staphylococcus aureus called the "cloud" phenomenon. This review summarizes the data supporting the existence of cloud health-care workers. PMID:11294715

  19. Health and Disability: Partnerships in Health Care

    ERIC Educational Resources Information Center

    Tracy, Jane; McDonald, Rachael

    2015-01-01

    Background: Despite awareness of the health inequalities experienced by people with intellectual disability, their health status remains poor. Inequalities in health outcomes are manifest in higher morbidity and rates of premature death. Contributing factors include the barriers encountered in accessing and receiving high-quality health care.…

  20. The special programme of research in human reproduction: forty years of activities to achieve reproductive health for all.

    PubMed

    Benagiano, Giuseppe; d'Arcangues, Catherine; Harris Requejo, Jennifer; Schafer, Alessandra; Say, Lale; Merialdi, Mario

    2012-01-01

    ', the 'Global handbook for family planning providers', the 'Definition of core competencies in primary health care', and designing tools for operationalizing a human rights approach to sexual and reproductive health programmes. PMID:23146950

  1. Smokers' rights to health care.

    PubMed Central

    Persaud, R

    1995-01-01

    The question whether rights to health care should be altered by smoking behaviour involves wideranging implications for all who indulge in hazardous behaviours, and involves complex economic utilitarian arguments. This paper examines current debate in the UK and suggest the major significance of the controversy has been ignored. That this discussion exists at all implies increasing division over the scope and purpose of a nationalised health service, bestowing health rights on all. When individuals bear the cost of their own health care, they appear to take responsibility for health implications of personal behaviour, but when the state bears the cost, moral obligations of the community and its doctors to care for those who do not value health are called into question. The debate has far-reaching implications as ethical problems of smokers' rights to health care are common to situations where health as a value comes into conflict with other values, such as pleasure or wealth. PMID:8558542

  2. Maternal health care focus in Bolivian campaign.

    PubMed

    1995-02-01

    Maternal health care is one of the focuses of Bolivia's new reproductive health campaign. The campaign, which uses television, radio and print media to get its message across, has the slogan "Your health is in your hands." Prenatal and postnatal care, as well as safe delivery, form one of the campaign's target areas. Others are family planning, breast-feeding, and the prevention of illegal abortions. The Bolivian campaign, which has a logo showing a child's tiny hand grasping a parent's finger, is supported by the Population Communication Services project of the Johns Hopkins School of Public Health, Baltimore, US. Bolivia has the highest maternal mortality in the western hemisphere. "The need to create an awareness of reproductive health is vital, with the risk of a Bolivian woman dying during pregnancy or childbirth 60 times that for a woman in Europe or the US," according to Dr. Phyllis Piotrow, director of Johns Hopkins' Center for Communication Programs. Further, Bolivia has the second highest infant mortality rate in the western hemisphere after Haiti. PMID:12319470

  3. Space age health care delivery

    NASA Technical Reports Server (NTRS)

    Jones, W. L.

    1977-01-01

    Space age health care delivery is being delivered to both NASA astronauts and employees with primary emphasis on preventive medicine. The program relies heavily on comprehensive health physical exams, health education, screening programs and physical fitness programs. Medical data from the program is stored in a computer bank so epidemiological significance can be established and better procedures can be obtained. Besides health care delivery to the NASA population, NASA is working with HEW on a telemedicine project STARPAHC, applying space technology to provide health care delivery to remotely located populations.

  4. Community experiences and perceptions of reproductive health vouchers in Kenya

    PubMed Central

    2013-01-01

    Background Research on demand-side health care financing approaches such as output-based aid (OBA) programs have focused on evaluating the role of the programs improving such outcomes as utilization of services and quality of services with limited focus on the experiences and perceptions of the target communities. This paper examines community members’ views of the output-based aid voucher program in Kenya. Methods A household survey was conducted in 2010 among 1,336 women aged 15-49 years living in the catchment areas of contracted health facilities in three districts participating in the voucher program (Kisumu, Kiambu and Kitui). Twenty seven focus group discussions were conducted with voucher users, non-users, opinion leaders and voucher distributors in the three districts as well as in Nairobi. Analysis of the quantitative data involved frequency distributions and cross-tabulations. Qualitative data were transcribed and analyzed by adopting framework analysis and further triangulation of themes across respondents. Results Majority (84%) of survey respondents had heard about the safe motherhood voucher compared to 24% and 1% that had heard about the family planning and gender-based violence recovery services (GBVRS) vouchers respectively. Similarly, 20% of the respondents had used the safe motherhood voucher compared to 2% for family planning and none for the GBVRS vouchers. From the community members’ perspectives, the voucher program is associated with improvements in access to health services for poor women, improved quality of care, and empowerment of women to make health care decisions. However, community members cited difficulties in accessing some accredited health facilities, limitations with the system of selling vouchers, lack of male involvement in women’s reproductive health issues, and poor understanding of the benefits associated with purchasing the voucher. Conclusion The findings of this paper showed that the voucher program in Kenya is

  5. Rights of HIV positive people to sexual and reproductive health: parenthood.

    PubMed

    Segurado, Aluisio Cotrim; Paiva, Vera

    2007-05-01

    In many areas of the globe most HIV infection is transmitted sexually or in association with pregnancy, childbirth and breastfeeding, raising the need for sexual and reproductive health and HIV/AIDS initiatives to be mutually reinforcing. Many people with HIV, who are in good health, will want to have children, and highly active antiretroviral therapy provides women and men living with AIDS the possibility of envisaging new life projects such as parenthood, because of a return to health. However, there are still difficult choices to face concerning sexuality, parenthood desires and family life. Structural, social and cultural issues, as well as the lack of programmatic support, hinder the fulfilment of the right to quality sexual and reproductive health care and support for having a family. This paper addresses the continuum of care involved in parenthood for people living with HIV, from pregnancy to infant and child care, and provides evidence-based examples of policies and programmes that integrate sexual and reproductive health interventions with HIV/AIDS care in order to support parenthood. Focusing on parenthood for people living with and affected by HIV, that is, focusing on the couple rather than the woman as the unit of care, the individual or the set of adults who are responsible for raising children, would be an innovative programmatic advance. Going beyond maternal and child health care to providing care and support for parents and others who are responsible for raising children is especially relevant for those living with HIV infection. PMID:17531747

  6. Knowledge, attitudes, and practices in reproductive and sexual health

    PubMed Central

    Beckwith, Jessica

    2006-01-01

    To help support and direct the Lions Club's construction of a Community Health Clinic specializing in Reproductive and Sexual Health, this descriptive study began in November of 2004 and was completed in May 2005. The sample consists of 552 high school students in Rumiñahui County, and surveys were used to study four principle themes: reproductive and sexual health education, family planning, sexually transmitted infections, and domestic violence. The results show a widespread lack of accurate and adequate information about reproductive and sexual health. Statistically significant variables studied include sex, age, monthly income, and age of first sexual experience. Female sex, younger age, lower monthly income, and younger age of first sexual experience all contribute to a lower quality of reproductive and sexual health, in terms of having less information about and access to these four aspects of reproductive and sexual health. PMID:18523623

  7. Congress enacts health care reform.

    PubMed

    2010-03-01

    Health care reform at last: After nearly a century of effort by Presidents from Theodore Roosevelt on down, the Congress finally agreed on and President Barack Obama signed into law a system that covers most Americans, regulates sharp insurance practices, and embraces a paradigm shift from acute institutionally focused care to chronic disease management based on home and community-based care. PMID:20465039

  8. Health care for children in foster care.

    PubMed

    Bean, Andrea; Gamino, Laura; Pierce, Priscilla; Shropshire, Deborah; Wallace, Kristina

    2004-09-01

    Every month 6,600 children in Oklahoma live under the custody of the state, most as result of being abused or neglected by their own families. The state provides medical care to these children via the Medicaid program. The American Academy of Pediatrics(AAP) has set forth a guideline for optimal care of these children. We discuss the current Oklahoma health care system for foster children and suggest changes that may move Oklahoma in the direction of the AAP recommendations. A more uniform, organized medical system may not only meet a foster child's medical needs but may also provide a degree of continuity to an otherwise discontinuous process. PMID:15540570

  9. Foster Care and Child Health.

    PubMed

    McDavid, Lolita M

    2015-10-01

    Children in foster care need more from health providers than routine well-child care. The changes in legislation that were designed to prevent children from languishing in foster care also necessitate a plan that works with the child, the biological family, and the foster family in ensuring the best outcome for the child. This approach acknowledges that most foster children will return to the biological family. Recent research on the effect of adverse childhood experiences across all socioeconomic categories points to the need for specifically designed, focused, and coordinated health and mental health services for children in foster care. PMID:26318955

  10. Contagious Ideas from Health Care

    ERIC Educational Resources Information Center

    Chaffee, Ellen

    2009-01-01

    Financial problems plague both higher education and health care, two sectors that struggle to meet public expectations for quality services at affordable rates. Both higher education and health care also have a complex bottom line, heavy reliance on relatively autonomous professionals, and clients who share personal responsibility for achieving…

  11. Prospects for Health Care Reform.

    ERIC Educational Resources Information Center

    Kastner, Theodore

    1992-01-01

    This editorial reviews areas of health care reform including managed health care, diagnosis-related groups, and the Resource-Based Relative Value Scale for physician services. Relevance of such reforms to people with developmental disabilities is considered. Much needed insurance reform is not thought to be likely, however. (DB)

  12. Women Veterans Health Care: Frequently Asked Questions

    MedlinePlus

    ... Program Overview » Outreach Materials » FAQs Women Veterans Health Care Menu Menu Womens Health Women Veterans Health Care ... can I call for more help? What health care services are available to women Veterans? A full ...

  13. Reproductive health and AIDS prevention in sub-Saharan Africa: the case for increased male participation.

    PubMed

    Mbizvo, M T; Bassett, M T

    1996-03-01

    Reproduction is a dual commitment, but so often in much of the world, it is seen as wholly the woman's responsibility. She bears the burden not only of pregnancy and childbirth but also the threats from excessive child bearing, some responsibility for contraception, infertility investigation and often undiagnosed sexually transmitted diseases (STDs) including AIDS. Failure to target men in reproductive health interventions has weakened the impact of reproductive health care programmes. The paper proposes that sophisticated and dynamic strategies in Africa and elsewhere which target women's reproductive health and research (such as control of STDs including AIDS, family planning, infertility investigation) require complementary linkage to the study and education of men. Men's perceptions, as well as determinants of sexual behavioural change and the socioeconomic context in which STDs, including AIDS, become rife, should be reviewed. There is a need to study and foster change to reduce or prevent poor reproductive health outcomes; to identify behaviours which could be adversely affecting women's reproductive health. Issues of gender, identity and tolerance as expressed through sexuality and procreation need to be amplified in the context of present risks in reproductive health. Researchers and providers often ignore the social significance of men. This paper reviews the impact of male dominance, as manifested through reproductive health and sexual decisions, against the background of present reproductive health problems. A research agenda should define factors at both macro and micro levels that interact to adversely impinge on reproductive health outcomes. This should be followed up by well-developed causal models of the determinants of positive reproductive health-promoting behaviours. Behaviour specific influences in sexual partnership include the degree of interpersonal support towards prevention, for example, of STDs, unwanted pregnancy or maternal deaths

  14. Health care's service fanatics.

    PubMed

    Merlino, James I; Raman, Ananth

    2013-05-01

    The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life. PMID:23898737

  15. Academic Health Centers and Health Care Reform.

    ERIC Educational Resources Information Center

    Miles, Stephen H.; And Others

    1993-01-01

    A discussion of the role of academic health centers in health care reform efforts looks at the following issues: balancing academic objectivity and social advocacy; managing sometimes divergent interests of centers, faculty, and society; and the challenge to develop infrastructure support for reform. Academic health centers' participation in…

  16. Soviet health care and perestroika.

    PubMed Central

    Schultz, D S; Rafferty, M P

    1990-01-01

    Health and health care in the Soviet Union are drawing special attention during these first years of perestroika, Mikhail Gorbachev's reform of Soviet political and economic life. This report briefly describes the current state of Soviet health and medical care, Gorbachev's plans for reform, and the prospects for success. In recent years the Soviet Union has experienced a rising infant mortality rate and declining life expectancy. The health care system has been increasingly criticized for its uncaring providers, low quality of care, and unequal access. The proposed measures will increase by 50 percent the state's contribution to health care financing, encourage private medicine on a small scale, and begin experimentation with capitation financing. It seems unlikely that the government will be able to finance its share of planned health improvements, or that private medicine, constrained by the government's tight control, will contribute much in the near term. Recovery of the Soviet economy in general as well as the ability of health care institutions to gain access to Western materials will largely determine the success of reform of the Soviet health care system. PMID:2297064

  17. Soviet health care and perestroika.

    PubMed

    Schultz, D S; Rafferty, M P

    1990-02-01

    Health and health care in the Soviet Union are drawing special attention during these first years of perestroika, Mikhail Gorbachev's reform of Soviet political and economic life. This report briefly describes the current state of Soviet health and medical care, Gorbachev's plans for reform, and the prospects for success. In recent years the Soviet Union has experienced a rising infant mortality rate and declining life expectancy. The health care system has been increasingly criticized for its uncaring providers, low quality of care, and unequal access. The proposed measures will increase by 50 percent the state's contribution to health care financing, encourage private medicine on a small scale, and begin experimentation with capitation financing. It seems unlikely that the government will be able to finance its share of planned health improvements, or that private medicine, constrained by the government's tight control, will contribute much in the near term. Recovery of the Soviet economy in general as well as the ability of health care institutions to gain access to Western materials will largely determine the success of reform of the Soviet health care system. PMID:2297064

  18. Contributions of the Nurses’ Health Studies to Reproductive Health Research

    PubMed Central

    Rich-Edwards, Janet W.; Gaskins, Audrey J.; Farland, Leslie V.; Terry, Kathryn L.; Zhang, Cuilin; Missmer, Stacey A.

    2016-01-01

    Objectives. To review the Nurses’ Health Study’s (NHS’s) contribution to identifying risk factors and long-term health consequences of reproductive events. Methods. We performed a narrative review of the NHS I, NHS II, NHS3, and Growing Up Today Study (GUTS) publications between 1976 and 2016. Results. Collection of detailed reproductive history to identify breast cancer risk factors allowed the NHS to document an association between menstrual irregularities, a proxy for polycystic ovary syndrome (PCOS), and increased risk of diabetes and cardiovascular disease. The NHS II found that infertility associated with ovulation problems and gestational diabetes are largely preventable through diet and lifestyle modification. It also identified developmental and nutritional risk factors for pregnancy loss, endometriosis, and uterine leiomyomata. As women in NHS II age, it has become possible to address questions regarding long-term health consequences of pregnancy complications and benign gynecologic conditions on chronic disease risk. Furthermore, the NHS3 and GUTS are allowing new lines of research into human fertility, PCOS, and transgenerational effects of environmental exposures. Conclusions. The multigenerational resources of the NHSs and GUTS, including linkages of related individuals across cohorts, can improve women’s health from preconception through late adulthood and onto the next generation. PMID:27459445

  19. [A Maternal Health Care System Based on Mobile Health Care].

    PubMed

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals. PMID:27382731

  20. Women still bearing the blows in reproductive health.

    PubMed

    1992-01-01

    Only women can experience the health threats of pregnancy and childbirth. Responsibility for the survival, growth, and development of children falls mainly on their shoulders. Sexually transmitted diseases cause more severe effects in women than men. Women are 3 times more likely to use contraceptives than men Yet female contraceptive methods are more of a threat to health an are male methods. Even though infertility occurs in both men and women, in most countries, women face its negative social and psychological effects more often than do men. Besides, almost everywhere, social and economic indicators show women to be of lower status than men. For example, female literacy rates in developing countries are 33% lower than those of male, even though leaders have known for a long time that female education improves use of health care and family planning services. Furthermore, females are at a disadvantage from birth in terms of education, nutrition, and society which places them at high risk of adverse health. Some societies even endorse method to prevent women from enjoying sexual intercourse. Premarital sex and adolescent pregnancy are increasing worldwide, which adds to women's already high burden. In Argentina, women less than 18 years of age, especially those in rural areas and little education, have higher fertility rates than those older than 18 years. They tend to be ignorant of reproductive processes, but familiar with contraceptives; yet, only 40% of sexually active adolescents had ever used them. Besides, teenage males think that concern about becoming pregnant is the female's responsibility. Indeed, women's status and reproductive health are interrelated. Ability to regulate their own fertility strengthens women's status, but if they cannot do so, they cannot go to school, be employable, or make their own decisions. PMID:12344677

  1. A Comparative Study on Knowledge about Reproductive Health among Urban and Rural Women of Bangladesh

    PubMed Central

    Haque, Monoarul; Hossain, Sharmin; Rumana Ahmed, Kazi; Sultana, Taslima; Chowdhury, Hasina Akhter; Akter, Jesmin

    2015-01-01

    Objective: To compare the level of knowledge on reproductive health among urban and rural women of selected area of Bangladesh. Materials and methods: A descriptive cross-sectional study was undertaken among 200 women selected purposively from different rural and urban areas of Bangladesh. Data were collected using a semi-structured interviewer-administered questionnaire by face to face interview. Knowledge level was analyzed according to poor, moderate and good knowledge by pre-defined knowledge scoring. Results: Mean age of the respondents was 26 years and majority (66%) of them was housewives. Most of them (61%) had completed their primary level education. Around three-fourth of them belongs to lower-middle income group. Overall level of reproductive health knowledge was more evident among urban reproductive aged women than rural counterparts (p < 0.001). Moreover, significant knowledge gap was found regarding family planning (p = 0.005), care during pregnancy (p < 0.001), safe motherhood (p = 0.002), newborn care (p = 0.009) and birth spacing (p <0.001) between urban and rural women. Family members were the major source of information in both groups. Conclusion: A wide knowledge gap was found between Bangladeshi urban and rural respondents regarding their reproductive behaviors. Government and concerned organizations should promote and strengthen various health education programs to focus on reproductive health, especially among reproductive aged women in rural area. PMID:25904966

  2. Health-care market robust.

    PubMed

    Merkel, Jayne

    2004-01-01

    Construction of health care facilities hit an all-time high in 2002 totalling about $16 billion of work. As baby boomers age health care construction will soar, because seniors are the largest consumers of health care The top five firms--Perkins & Will, HDR, HKS, NBBJ, and Ellerbe Becket--monopolize about 20 percent of the work. H.R. 1 increases Medicare payments to rural hospitals by $25 billion over 10 years--so help is on the way for facilities that are languishing. PMID:15077503

  3. Home health care in France.

    PubMed

    Charles, B

    1990-02-23

    Home health care in France has a long tradition, but is limited in its development. Since 1970 hospitals are by law permitted to extend services at home. Apart from this, patient associations are a driving force in the organization of home health care. There is a trend to more home health care, but this is hampered by splitting of responsibilities of local, departmental or central authorities. The hospital pharmacist is recommended to focus on his scientific and technical competence. Improved relations between community pharmacists and hospital pharmacists are advocated. PMID:2314994

  4. Five Steps to Safer Health Care

    MedlinePlus

    ... to Safer Health Care Five Steps to Safer Health Care: Patient Fact Sheet This information is for reference ... safety is one of the Nation's most pressing health care challenges. A 1999 report by the Institute of ...

  5. Rural health care: redefining access.

    PubMed

    Collins, Chris

    2015-01-01

    The population and demographics of rural America are shifting once again. As our nation's unprecedented health care reform unfolds, it is becoming clear that rural communities have unique strengths, and capitalizing on these strengths can position them well for this health care transformation. Equally important are the distinct challenges that--with careful planning, attention, and resources--can be transformed into opportunities to thrive in the new health care environment. The North Carolina Institute of Medicine's Task Force on Rural Health recently published a report that highlights the strengths and challenges of rural communities [1]. In order to fully leverage these opportunities, we must continue to acknowledge the fundamental importance of access to basic health care, while also broadening our discussion to collectively tackle the additional components necessary to create healthy, thriving rural communities. As we reexamine the needs of rural communities, we should broaden our discussions to include an expansion of the types of access that are necessary for strengthening rural health. Collaboration, successful recruitment and retention, availability of specialty services, quality care, and cost effectiveness are some of the issues that must come into discussions about access to services. With this in mind, this issue of the NCMJ explores opportunities to strengthen the health of North Carolina's rural communities. PMID:25621473

  6. The Stigma of Reproductive Health Services Utilization by Unmarried Women

    PubMed Central

    Mohammadi, Fatemeh; Kohan, Shahnaz; Mostafavi, Firoozeh; Gholami, Ali

    2016-01-01

    Background: Fear of the stigma associated with reproductive health services has always been one of the reasons why youth and unmarried individuals avoid making use of such services. This stigma imposes a great deal of mental stress, fear, and depression on patients and causes delays in the diagnosis and treatment of their conditions. Objectives: This paper explores the concept of stigma in the context of the utilization of reproductive health services by unmarried women. Patients and Methods: This study is qualitative in nature. Purposive sampling was employed, and semi-structured interviews were conducted with 16 unmarried women, five midwives, and two physicians. The data were analyzed using the conventional content analysis method. Results: Four main categories constituted the general concept concerning the stigma suffered by unmarried women for using reproductive health services, i.e., prevalent stereotypical thinking patterns in society, the fear of being judged and labeled by others, discrimination, and feeling ashamed of seeking reproductive health services. Conclusions: The findings indicated that society associates reproductive health issues with sexual relations, which in turn shapes the stigma and places limitations on unmarried women for using reproductive health services. Thus, while reproductive health services are planned and provided to unmarried women, strategies are demanded for overcoming this stigma. PMID:27247794

  7. Will Boeing Change Health Care?

    PubMed

    Stempniak, Marty

    2015-12-01

    Big employers like Boeing and Intel are directly contracting with hospitals in an effort to control health care prices. Some hospital CEOs see direct contracting as the future, while others wonder how they can participate. PMID:26837134

  8. Czechoslovakia's changing health care system.

    PubMed Central

    Raffel, M W; Raffel, N K

    1992-01-01

    Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It was planned and managed by the government, financed by general tax money, operated in a highly centralized, bureaucratic fashion, and provided service at no direct charge at the time of service. In recent years, the health care system had been deteriorating as the health of the people had also been declining. Life expectancy, infant mortality rates, and diseases of the circulatory system are higher than in Western European countries. In 1989, political changes occurred in Czechoslovakia that made health care reform possible. Now health services are being decentralized, and the ownership of hospitals is expected to be transferred to communities, municipalities, churches, charitable groups, or private entities. Almost all health leaders, including hospital directors and hospital department heads, have been replaced. Physicians will be paid according to the type and amount of work performed. Perhaps the most important reform is the establishment of an independent General Health Care Insurance Office financed directly by compulsory contributions from workers, employers, and government that will be able to negotiate with hospitals and physicians to determine payment for services. PMID:1454975

  9. Model Child Care Health Policies.

    ERIC Educational Resources Information Center

    Aronson, Susan; Smith, Herberta

    Drawn from a review of policies at over 100 child care programs nationwide, the model health policies presented in this report are intended for adaptation and selective use by out-of-home child care facilities. Following an introduction, the report presents model policy forms with blanks for adding individualized information for the following…

  10. [Corruption and health care system].

    PubMed

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions. PMID:26016214

  11. The priority of health care.

    PubMed

    Green, R M

    1983-11-01

    The economic recession, the mounting costs of medical technology, and the weakening of public support for welfare state ideals have led to philosophical qualification of the right of equal access to health care by writers like Norman Daniels and Lawrence Stern. Green rejects their arguments and reiterates the claim that a Rawlsian theory of justice provides an appropriate way of thinking about the right to health care, which should be treated on a par with basic civil liberties. PMID:6655385

  12. Delivering Health Care and Mental Health Care Services to Children in Family Foster Care after Welfare and Health Care Reform.

    ERIC Educational Resources Information Center

    Simms, Mark D.; Freundlich, Madelyn; Battistelli, Ellen S.; Kaufman, Neal D.

    1999-01-01

    Describes the essential features of a health care system that can meet the special needs of children in out-of-home care. Discusses some of the major recent changes brought about by welfare and health care reform. Notes that it remains to be seen whether the quality of services will improve as a result of these reforms. (Author)

  13. Health care utilisation in India.

    PubMed

    Duggal, R

    1994-02-01

    India has a plurality of health care systems as well as different systems of medicine. The government and local administrations provide public health care in hospitals and clinics. Public health care in rural areas is concentrated on prevention and promotion services to the detriment of curative services. The rural primary health centers are woefully underutilized because they fail to provide their clients with the desired amount of attention and medication and because they have inconvenient locations and long waiting times. Public hospitals provide 60% of all hospitalizations, while the private sector provides 75% of all routine care. The private sector is composed of an equal number of qualified doctors and unqualified practitioners, with a greater ratio of unqualified to qualified existing in less developed states. In rural areas, qualified doctors are clustered in areas where government services are available. With a population barely able to meet its nutritional needs, India needs universalization of health care provision to assure equity in health care access and availability instead of a large number of doctors who are profiting from the sicknesses of the poor. PMID:12288588

  14. Helping You Choose Quality Behavioral Health Care

    MedlinePlus

    Helping You Choose Quality Behavioral Health Care Selecting quality behavioral health care services for yourself, a relative or friend requires special thought and attention. The Joint Commission on ...

  15. Reproductive health and the environment: Counseling patients about risks.

    PubMed

    Haruty, Bella; Friedman, Julie; Hopp, Stephanie; Daniels, Ryane; Pregler, Janet

    2016-05-01

    Endocrine-disrupting chemicals (EDCs) are associated with reproductive complications such as infertility, pregnancy complications, poor birth outcomes, and child developmental abnormalities, although not all chemicals of concern are EDCs. Pregnant patients and women of childbearing age need reasonable advice about environmental contaminants and reproductive health. PMID:27168513

  16. Should Reproductive Anatomy Be Taught in University Health Courses?

    ERIC Educational Resources Information Center

    Powell, Brent; Fletcher, J. Sue

    2013-01-01

    There has been little research on undergraduate reproductive anatomy education. This pilot study explores knowledge of anatomical reproductive anatomy among university students in a lower division and upper division health course. Using a Qualtrics survey program, a convenience sample of 120 lower division and 157 upper division students for a…

  17. Health care entrepreneurship: financing innovation.

    PubMed

    Grazier, Kyle L; Metzler, Bridget

    2006-01-01

    Entrepreneurship is often described as the ability to create new ventures from new or existing concepts, ideas and visions. There has been significant entrepreneurial response to the changes in the scientific and social underpinnings of health care services delivery. However, a growing portion of the economic development driving health care industry expansion is threatened further by longstanding use of financing models that are suboptimal for health care ventures. The delayed pace of entrepreneurial activity in this industry is in part a response to the general economy and markets, but also due to the lack of capital for new health care ventures. The recent dearth of entrepreneurial activities in the health services sector may also due to failure to consider new approaches to partnerships and strategic ventures, despite their mutually beneficial organizational and financing potential. As capital becomes more scarce for innovators, it is imperative that those with new and creative ideas for health and health care improvement consider techniques for capital acquisition that have been successful in other industries and at similar stages of development. The capital and added expertise can allow entrepreneurs to leverage resources, dampen business fluctuations, and strengthen long term prospects. PMID:16583848

  18. Agents of Change for Health Care Reform

    ERIC Educational Resources Information Center

    Buchanan, Larry M.

    2007-01-01

    It is widely recognized throughout the health care industry that the United States leads the world in health care spending per capita. However, the chilling dose of reality for American health care consumers is that for all of their spending, the World Health Organization ranks the country's health care system 37th in overall performance--right…

  19. Sexual and reproductive health in cystic fibrosis: a life-course perspective.

    PubMed

    Frayman, Katherine B; Sawyer, Susan M

    2015-01-01

    Adolescents and adults with cystic fibrosis now approach developmental milestones, including sexual and reproductive ones, at a similar time to their healthy peers. Yet, their sexual and reproductive health (SRH) is profoundly affected by their disease, and their SRH decisions can substantially affect their health. Navigation of SRH milestones in the context of cystic fibrosis needs education, guidance, and access to SRH services. In this Review, we discuss scientific knowledge of SRH in patients with cystic fibrosis across the life course and clinical practices for SRH within cystic fibrosis care. We identify crucial gaps in SRH education of patients and their access to resources and then present a model of care for provision of developmentally appropriate SRH education and care within cystic fibrosis services across the life course. This model emphasises the central importance of the cystic fibrosis team and service links to primary and specialist SRH care. PMID:25529340

  20. The importance of assessing priorities of reproductive health concerns among adolescent and young adult patients with cancer.

    PubMed

    Murphy, Devin; Klosky, James L; Reed, Damon R; Termuhlen, Amanda M; Shannon, Susan V; Quinn, Gwendolyn P

    2015-08-01

    Visions for the future are a normal developmental process for adolescents and young adults (AYAs) with and without cancer, and these visions often include expectations of sexual and romantic relationships. AYA cancer survivors indicate reproductive health is an issue of great importance and more attention is needed in the health care setting throughout the cancer experience, beginning at diagnosis. Various practice guidelines are predominately focused on fertility; are intended to influence survivorship care plans; and do not encompass the broad scope of reproductive health that includes romantic partnering, friendships, body image, sexuality, sexual identity, fertility, contraception, and more. Although interventions to reduce reproductive health-related sequelae from treatment are best approached as an evolving process, practitioners are not certain of the priorities of these various reproductive health content areas. Strategies incongruent with the reproductive health priorities of AYAs will likely thwart adequate follow-up care and foster feelings of isolation from the treatment team. Research is needed to identify these priorities and ensure discussions of diverse content areas. This review explored various domains of reproductive health and emphasized how understanding the priorities of the AYA cancer cohort will guide future models of care. PMID:26054052

  1. How Humanae vitae has advanced reproductive health1

    PubMed Central

    Doroski, Derek M.

    2014-01-01

    By encouraging doctors and scientists to improve the regulation of births through the observation of natural fertility rhythms, Humanae vitae promoted the development of natural family planning (NFP). The study of NFP has lead to NFP-based methodologies in reproductive healthcare that are promoting advances in treatment of infertility, miscarriage, and a number of reproductive health disorders. In contrast, the contraceptive mentality has stunted the development of reproductive healthcare. Humanae vitae has provided a great gift to science and reproductive healthcare that all Catholics should be proud of. PMID:25249708

  2. Health Care Becomes an Industry

    PubMed Central

    Rastegar, Darius A.

    2004-01-01

    The delivery of health care is in the process of “industrialization” in that it is undergoing changes in the organization of work which mirror those that began in other industries a century ago. This process is characterized by an increasing division of labor, standardization of roles and tasks, the rise of a managerial superstructure, and the degradation (or de-skilling) of work. The consolidation of the health care industry, the fragmentation of physician roles, and the increasing numbers of nonphysician clinicians will likely accelerate this process. Although these changes hold the promise of more efficient and effective health care, physicians should be concerned about the resultant loss of autonomy, disruption of continuity of care, and the potential erosion of professional values. PMID:15053287

  3. Help Yourself to Health Care.

    ERIC Educational Resources Information Center

    Snyder, Sarah

    A booklet on health care for limited English speakers provides information on choosing the right doctor, buying medicine, paying the bill, and the individual's role in maintaining his or her health. Cartoons, questions and puzzles concerning the message in cartoons and narrative passages, checklists about an individual's personal habits related to…

  4. Health care's 100 most wired.

    PubMed

    Solovy, A; Serb, C

    1999-02-01

    They're wired all right, and America's 100 most techno-savvy hospitals and health systems share one more thing: a commitment to using technology to link with employees, patients, suppliers, and insurers. "We want to be a health care travel agency for our community," says one chief information officer. "And we see Internet technology as a key." PMID:10081454

  5. A conceptual framework for the social analysis of reproductive health.

    PubMed

    Price, Neil L; Hawkins, Kirstan

    2007-03-01

    The dominant conceptual framework for understanding reproductive behaviour is highly individualistic. In this article, it is demonstrated that such a conceptualization is flawed, as behaviour is shaped by social relations and institutions. Using ethnographic evidence, the value of a social analysis of the local contexts of reproductive health is highlighted. A framework is set out for conducting such a social analysis, which is capable of generating data necessary to allow health programmes to assess the appropriate means of improving the responsiveness of service-delivery structures to the needs of the most vulnerable. Six key issues are identified in the framework for the analysis of social vulnerability to poor reproductive health outcomes. The key issues are: poverty and livelihood strategies, gender, health-seeking behaviour, reproductive behaviour, and access to services. The article concludes by briefly identifying the key interventions and strategies indicated by such an analysis. PMID:17615901

  6. A Conceptual Framework for the Social Analysis of Reproductive Health

    PubMed Central

    Hawkins, Kirstan

    2007-01-01

    The dominant conceptual framework for understanding reproductive behaviour is highly individualistic. In this article, it is demonstrated that such a conceptualization is flawed, as behaviour is shaped by social relations and institutions. Using ethnographic evidence, the value of a social analysis of the local contexts of reproductive health is highlighted. A framework is set out for conducting such a social analysis, which is capable of generating data necessary to allow health programmes to assess the appropriate means of improving the responsiveness of service-delivery structures to the needs of the most vulnerable. Six key issues are identified in the framework for the analysis of social vulnerability to poor reproductive health outcomes. The key issues are: poverty and livelihood strategies, gender, health-seeking behaviour, reproductive behaviour, and access to services. The article concludes by briefly identifying the key interventions and strategies indicated by such an analysis. PMID:17615901

  7. Health care in Armenia today.

    PubMed Central

    Farmer, R G; Chobanian, A V

    1994-01-01

    Although one of the smallest of the new independent states of the former Soviet Union, the Republic of Armenia has an ancient tradition and a strong ethnic identification, greatly enhanced by the diaspora. In addition to the problems following the dissolution of the Soviet Union, Armenia has had to contend with a draining war in Nagorno-Karabakh and the after-effects of a devastating earthquake in 1988. Humanitarian efforts have ranged from emergency supply deliveries to longer-term sustainable health care partnerships. The United States government, through the Agency for International Development, has organized such partnerships, partially as a result of a multinational mission in 1992 and a subsequent hospital-to-hospital program developed by the American International Health Alliance. We describe the current state of health care in Armenia and some of the problems that need to be addressed to improve health care services to its citizens. PMID:8023481

  8. Health Care Provider Initiative Strategic Plan

    ERIC Educational Resources Information Center

    National Environmental Education & Training Foundation, 2012

    2012-01-01

    This document lays out the strategy for achieving the goals and objectives of NEETF's "Health Care Provider Initiative." The goal of NEETF's "Health Care Provider Initiative" is to incorporate environmental health into health professionals' education and practice in order to improve health care and public health, with a special emphasis on…

  9. National Health Care Reform, Medicaid, and Children in Foster Care.

    ERIC Educational Resources Information Center

    Halfon, Neal; And Others

    1994-01-01

    Outlines access to health care for children in out-of-home care under current law, reviews how health care access for these children would be affected by President Clinton's health care reform initiative, and proposes additional measures that could be considered to improve access and service coordination for children in the child welfare system.…

  10. Reproductive health financing in Kenya: an analysis of national commitments, donor assistance, and the resources tracking process.

    PubMed

    Sidze, Estelle M; Pradhan, Jalandhar; Beekink, Erik; Maina, Thomas M; Maina, Beatrice W

    2013-11-01

    Understanding the flow of resources at the country level to reproductive health is essential for effective financing of this key component of health. This paper gives a comprehensive picture of the allocation of resources for reproductive health in Kenya and the challenges faced in the resource-tracking process. Data are drawn from Kenyan budget estimates, reproductive health accounts, and the Resource Flows Project database and compare budgets and spending in 2005-06 with 2009-10. Despite policies and programmes in place since 1994, services for family planning, maternity care and infant and child health face serious challenges. As regards health financing, the government spends less than the average in sub-Saharan Africa, while donor assistance and out-of-pocket expenditure for health are high. Donor assistance to Kenya has increased over the years, but the percentage of funds devoted to reproductive health is lower than it was in 2005. We recommend an increase in the budget and spending for reproductive health in order to achieve MDG targets on maternal mortality and universal access to reproductive health in Kenya. Safety nets for the poor are also needed to reduce the burden of spending by households. Lastly, we recommend the generation of more comprehensive reproductive health accounts on a regular basis. PMID:24315070