[Guidelines on medically assisted reproduction: legal issues and professional liability].

PubMed

Molinelli, A; Motroni Gherardi, S M; Picchioni, D M; Ventura, F

2007-08-01

The authors analyze the legal and medico-legal issues deriving from the recent Law No. 40 of February 19, 2004 concerning the Medically Assisted Reproduction. In particular, they analyze the contrasting points between the dispositions of Law No. 40/2004 and those of Law No. 194/1978 on the voluntary interruption of pregnancy, and they analyze the guidelines about the procedures and the techniques of the Medically Assisted Reproduction, issued by the Ministry of Health with D.M. of July 21, 2004. The Guidelines, as well as some sentences of several courts, lead to some reflections also about the consent and the professional liability, in particular considering the various moments of the medical action, from the first interview to the carrying out of the assisted reproduction techniques.

Scotland: inequalities in women's reproductive health.

PubMed

1999-01-01

This document reports a detailed information on the link between women's poverty and the provision of health care services in Glasgow, Scotland. Glasgow, Scotland was known as the second city of the British Empire and in spite of its wealth, a great number of its population suffers from poverty. In the 1990s, as a response to the inadequate health services provided to the impoverished women, the Family Planning and Sexual Health Directorate included the health needs of the city's female population. It emphasized three main areas of care: improved access, preventive health, and promotion of women's well-being. Seventeen model well-women clinics were conceived to provide a better access, and experts played an active part in the delivery of prioritized health issues through an educational program. An open-ended consultation on major health issues and discrete referral were utilized for the promotion of the women's emotional well-being. "Women Talking" mini-mags produced in 1993 which tackles issues relevant to women's health and the Women's Reproductive Health Services provide multidisciplinary approach offering reproductive health care to women who have social and health problems. This strategic response of Glasgow to these women had facilitated awareness on the links between the social and economic factors, and a confirmation that a continued availability of such appropriate services would prove beneficial to women with severe social problems.

Portrayals of reproductive and sexual health on prime-time television.

PubMed

Pariera, Katrina L; Hether, Heather J; Murphy, Sheila T; Buffington, Sandra de Castro; Baezconde-Garbanati, Lourdes

2014-01-01

Prime-time broadcast television provides health information and establishes norms for millions of people in the United States (Beck, 2004; Brodie et al., 2001; Murphy & Cody, 2003; Rideout, 2008). To understand what people may be learning about reproductive and sexual health, a content analysis was conducted of story lines from the 10 most popular prime-time television programs in 2009, 2010, and 2011. Variables that were measured included the frequency of reproductive and sexual health issues, the level of health information, the type of information portrayed, the gain and loss frames, the presence of stigma, the tone, and the type of role model portrayed. Eighty-seven of the 589 health story lines dealt with reproductive and sexual health, and the most common issues were pre- and postterm pregnancy complications. The majority of these story lines had a moderate or weak level of information and included specifics about treatment and symptoms but not prevention. Just over half of the issues were framed in terms of losses, meaning nonadoption of a behavior change will result in negative outcomes. Twenty-four percent of reproductive and sexual health story lines involved stigma-usually stigma related to sexually transmitted infections (STIs). Most story lines were portrayed as serious and the majority of issues happened to positive role models. The implications of these portrayals for the viewing public are discussed.

Men's Reproductive Health

MedlinePlus

... Reproductive Health Share Facebook Twitter Pinterest Email Print Men's Reproductive Health Reproductive health is an important component of men's overall health and well-being. Too often, males ...

Handbook for Educating on Adolescent Reproductive and Sexual Health. Book One, Understanding the Adolescents and Their Reproductive and Sexual Health: Guide to Better Educational Strategies [and] Book Two, Strategies and Materials on Adolescent Reproductive and Sexual Health Education.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Clearing House on Population Education and Communication.

This two-part handbook presents information on educating adolescents about reproductive and sexual health issues. "Book One, Understanding the Adolescents and Their Reproductive and Sexual Health: Guide to Better Educational Strategies" focuses on the demographic profile of adolescents as well as their fertility, sexual behavior, incidence of…

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

Male adolescent sexual and reproductive health care.

PubMed

Marcell, Arik V; Wibbelsman, Charles; Seigel, Warren M

2011-12-01

Male adolescents' sexual and reproductive health needs often go unmet in the primary care setting. This report discusses specific issues related to male adolescents' sexual and reproductive health care in the context of primary care, including pubertal and sexual development, sexual behavior, consequences of sexual behavior, and methods of preventing sexually transmitted infections (including HIV) and pregnancy. Pediatricians are encouraged to address male adolescent sexual and reproductive health on a regular basis, including taking a sexual history, performing an appropriate examination, providing patient-centered and age-appropriate anticipatory guidance, and delivering appropriate vaccinations. Pediatricians should provide these services to male adolescent patients in a confidential and culturally appropriate manner, promote healthy sexual relationships and responsibility, and involve parents in age-appropriate discussions about sexual health with their sons.

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.

Assessing political priority for reproductive health in Ethiopia.

PubMed

Prata, Ndola; Summer, Anna

2015-11-01

Ethiopia is among the top six countries contributing to the highest numbers of maternal deaths globally. The Ethiopian total fertility rate was estimated at 4.8 in 2011, and the use of contraceptives by married women was 29%. Lack of knowledge, cultural stigma surrounding abortion, and barriers to access of services contribute to persistently high rates of unsafe abortion and abortion-related mortality. This study seeks to assess the generation and institutionalization of political priority for reproductive health within the political systems of Ethiopia. Interviews with key policy makers, government ministers, academics, and leaders of prominent non-governmental organizations in Ethiopia between July 2010 and January 2011 were conducted, using Shiffman and Smith's Framework, to analyse the key actors and ideas behind the shift towards prioritization of reproductive health in Ethiopia, as well as the political context and primary characteristics of the issues that propelled progressive action in reproductive health in that country. Some of the key lessons point to the readiness of the Ethiopian government to reform and to improve the socio-economic status of the population. The role of civil society organizations working alongside the government was crucial to creating a window of opportunity in a changing political climate to achieve gains in reproductive health. To our knowledge, this is the first time Shiffman and Smith's Framework has been used for reproductive health policies. We conclude that Ethiopian experience fits well within this framework for understanding prioritization of global health issues and may serve as a model for other sub-Saharan African countries. Copyright © 2015 Elsevier Inc. All rights reserved.

Reproductive Health Issues for Adults with a Common Genomic Disorder: 22q11.2 Deletion Syndrome

PubMed Central

Chan, Chrystal; Costain, Gregory; Ogura, Lucas; Silversides, Candice K.; Chow, Eva W.C.

2015-01-01

22q11.2 deletion syndrome (22q11.2DS) is the most common microdeletion syndrome in humans. Survival to reproductive age and beyond is now the norm. Several manifestations of this syndrome, such as congenital cardiac disease and neuropsychiatric disorders, may increase risk for adverse pregnancy outcomes in the general population. However, there are limited data on reproductive health in 22q11.2DS. We performed a retrospective chart review for 158 adults with 22q11.2DS (75 male, 83 female; mean age 34.3 years) and extracted key variables relevant to pregnancy and reproductive health. We present four illustrative cases as brief vignettes. There were 25 adults (21>age 35 years; 21 female) with a history of one or more pregnancies. Outcomes for women with 22q11.2DS, compared with expectations for the general population, showed a significantly elevated prevalence of small for gestational age liveborn offspring (p<0.001), associated mainly with infants with 22q11.2DS. Stillbirths also showed elevated prevalence (p<0.05). Not all observed adverse events appeared to be attributable to transmission of the 22q11.2 deletion. Recurring issues relevant to reproductive health in 22q11.2DS included the potential impact of maternal morbidities, inadequate social support, unsafe sexual practices, and delayed diagnosis of 22q11.2DS and/or lack of genetic counseling. These preliminary results emphasize the importance of early diagnosis and long term follow-up that could help facilitate genetic counseling for men and women with 22q11.2DS. We propose initial recommendations for pre-conception management, educational strategies, pre-natal planning, and preparation for possible high-risk pregnancy and/or delivery. PMID:25579115

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.

SEXUAL AND REPRODUCTIVE HEALTH CONCERNS OF PERSONS WITH DISABILITY IN INDIA: AN ISSUE OF DEEP-ROOTED SILENCE.

PubMed

Sharma, Seema; Sivakami, Muthusamy

2018-05-18

SummaryGlobal estimates suggest that over a billion people live with a disability that is significant enough to affect their daily lives. According to the 2011 Indian Census, India alone has about 26.8 million people with disabilities. Research suggests that persons with disabilities (PwDs) in India are among the most neglected, stigmatized, poor and least educated of the world's population, and women with disabilities in India are the most marginalized, both socially and economically. They bear the triple burden of being discriminated against through being 'women' (socially marginal beings), 'disabled' (incapacitated, inefficient and undesirable) and 'women with disabilities' (the weakest of the weak), often becoming socially invisible. Although there has been a general recognition over the years that the educational and employment opportunities of PwDs in India need to be improved, their sexual needs and aspirations, sexuality concerns and sexual and reproductive health and rights have been largely ignored. The objective of this paper is to highlight the paucity of research on the sexual and reproductive health concerns of PwDs, particularly women, in the Indian context using existing literature on India, and to identify the possible reasons of this neglect. The study describes the obstacles faced by PwDs, particularly women, to acquiring good sexual and reproductive information and services, based on the results of empirical studies. Given the lack of research on this in India, the evidence largely comes from studies conducted elsewhere in the world. Lack of information and education about sexual health concerns, physical and/or infrastructural inaccessibility, judgemental provider attitudes, limited provider knowledge about disability issues and individual factors, including inhibitions about seeking health care and financial barriers, are identified as factors inhibiting the sexual and reproductive rights of people with disabilities in India.

Reproductive rights approach to reproductive health in developing countries

PubMed Central

Pillai, Vijayan K.; Gupta, Rashmi

2011-01-01

Background Research on reproductive health in developing countries focuses mostly on the role of economic development on various components of reproductive health. Cross-sectional and empirical research studies in particular on the effects of non-economic factors such as reproductive rights remain few and far between. Objective This study investigates the influence of two components of an empowerment strategy, gender equality, and reproductive rights on women's reproductive health in developing countries. The empowerment strategy for improving reproductive health is theoretically situated on a number of background factors such as economic and social development. Design Cross-national socioeconomic and demographic data from a number of international organizations on 142 developing countries are used to test a model of reproductive rights and reproductive health. Results The findings suggest that both economic and democratic development have significant positive effects on levels of gender equality. The level of social development plays a prominent role in promoting reproductive rights. It is found that reproductive rights channel the influences of social structural factors and gender equality on reproductive health. PMID:22184501

Reproductive rights approach to reproductive health in developing countries.

PubMed

Pillai, Vijayan K; Gupta, Rashmi

2011-01-01

Research on reproductive health in developing countries focuses mostly on the role of economic development on various components of reproductive health. Cross-sectional and empirical research studies in particular on the effects of non-economic factors such as reproductive rights remain few and far between. This study investigates the influence of two components of an empowerment strategy, gender equality, and reproductive rights on women's reproductive health in developing countries. The empowerment strategy for improving reproductive health is theoretically situated on a number of background factors such as economic and social development. Cross-national socioeconomic and demographic data from a number of international organizations on 142 developing countries are used to test a model of reproductive rights and reproductive health. The findings suggest that both economic and democratic development have significant positive effects on levels of gender equality. The level of social development plays a prominent role in promoting reproductive rights. It is found that reproductive rights channel the influences of social structural factors and gender equality on reproductive health.

Patient-provider communication and reproductive health among HIV-positive women in Rio de Janeiro, Brazil.

PubMed

Malta, Monica; Todd, Catherine S; Stibich, Mark A; Garcia, Thais; Pacheco, Diego; Bastos, Francisco I

2010-12-01

To qualitatively assess the influence of patient-provider communication on contraceptive choice among HIV-positive women in the context of universal antiretroviral therapy (ART) access. Focus group discussions (FGD; n=3), in-depth (IDI; n=15) and freelist interviews (FLI; n=36) were conducted with HIV-positive women aged 18-40 years recruited from public health units in Rio de Janeiro/Brazil. Of 70 participants, 49 used ART and the median time since HIV diagnosis was 6 years (range: 1-18). The majority of participants (71.4%) reported some degree of dissatisfaction with their health providers (usually lack of open dialogue) and a few reported experiences of stigma/prejudice during appointments. Intra, interpersonal and social factors modulated behaviors and reproductive health decisions, and those issues were rarely addressed by providers during HIV clinical care. Despite dramatic increases in survival and life quality after universal ART implementation in Brazil, reproductive health issues are neglected by multiple cadres of HIV health providers. Communication on reproductive health issues remains fragmented and potentially contradictory, compromising care in these settings. Adequate provider training to address reproductive health-related issues in a comprehensive, culturally sensitive manner and improved integration of HIV and reproductive health care are urgently needed in this setting. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Population, sexual and reproductive health, rights and sustainable development: forging a common agenda.

PubMed

Newman, Karen; Fisher, Sarah; Mayhew, Susannah; Stephenson, Judith

2014-05-01

This article suggests that sexual and reproductive health and rights activists seeking to influence the post-2015 international development paradigm must work with sustainable development advocates concerned with a range of issues, including climate change, environmental issues, and food and water security, and that a way of building bridges with these communities is to demonstrate how sexual and reproductive health and rights are relevant for these issues. An understanding of population dynamics, including urbanization and migration, as well as population growth, can help to clarify these links. This article therefore suggests that whether or not sexual and reproductive health and rights activists can overcome resistance to discussing "population", become more knowledgeable about other sustainable development issues, and work with others in those fields to advance the global sustainable development agenda are crucial questions for the coming months. The article also contends that it is possible to care about population dynamics (including ageing and problems faced by countries with a high proportion of young people) and care about human rights at the same time. It expresses concern that, if sexual and reproductive health and rights advocates do not participate in the population dynamics discourse, the field will be left free for those for whom respecting and protecting rights may be less of a priority. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Advancing adolescent sexual and reproductive health by promoting healthy relationships.

PubMed

Tharp, Andra Teten; Carter, Marion; Fasula, Amy M; Hatfield-Timajchy, Kendra; Jayne, Paula E; Latzman, Natasha E; Kinsey, Jennine

2013-11-01

The field of public health faces a challenge in preventing adverse sexual and reproductive health outcomes such as sexually transmitted diseases, unintended pregnancy, and dating and sexual violence among adolescents. Innovative approaches are needed to better address these issues. Focusing on healthy relationships is an emerging approach that may be used to promote adolescent sexual and reproductive health. In this report, we discuss the need for innovative and efficient strategies for adolescent sexual and reproductive health, the benefits of a healthy relationships approach, describe the need for a science-based conceptual framework on healthy relationships, and provide some considerations for developing a conceptual framework of healthy relationships in order to move the field of public health forward.

Reproductive Health Policy in Tunisia: Women's Right to Reproductive Health and Gender Empowerment.

PubMed

Amroussia, Nada; Goicolea, Isabel; Hernandez, Alison

2016-12-01

Although Tunisia is regarded as a pioneer in the Middle East and North Africa in terms of women's status and rights, including sexual and reproductive health and rights, evidence points to a number of persisting challenges. This article uses the Health Rights of Women Assessment Instrument (HeRWAI) to analyze Tunisia's reproductive health policy between 1994 and 2014. It explores the extent to which reproductive rights have been incorporated into the country's reproductive health policy, the gaps in the implementation of this policy, and the influence of this policy on gender empowerment. Our results reveal that progress has been slow in terms of incorporating reproductive rights into the national reproductive health policy. Furthermore, the implementation of this policy has fallen short, as demonstrated by regional inequities in the accessibility and availability of reproductive health services, the low quality of maternal health care services, and discriminatory practices. Finally, the government's lack of meaningful engagement in advancing gender empowerment stands in the way as the main challenge to gender equality in Tunisia.

Nurses on the Front Lines: Improving Adolescent Sexual and Reproductive Health Across Health Care Settings.

PubMed

Santa Maria, Diane; Guilamo-Ramos, Vincent; Jemmott, Loretta Sweet; Derouin, Anne; Villarruel, Antonia

2017-01-01

: Nurses care for adolescents in a variety of settings, including communities, schools, and public health and acute care clinics, which affords them many opportunities to improve adolescents' sexual and reproductive health and reduce the rates of unplanned pregnancy and sexually transmitted infections. To ensure that adolescents have access to sexual and reproductive health care (which includes both preventive counseling and treatment) in all nursing practice sites, nurses need to gain the knowledge and hone the skills required to deliver evidence-based counseling and services to adolescents and parents. Collectively, nurses can use their unique combination of knowledge and skills to make a positive impact on adolescent sexual and reproductive outcomes. Nurses have the capacity and opportunity to disseminate information about sexual and reproductive health to adolescents and their parents in communities, schools, public health clinics, and acute care settings. This article discusses the Society for Adolescent Health and Medicine's goals and recommendations, which address adolescent sexual and reproductive health as both a health care and a human rights issue.

Nurses on the Front Lines: Improving Adolescent Sexual and Reproductive Health Across Health Care Settings

PubMed Central

Maria, Diane Santa; Guilamo-Ramos, Vincent; Jemmott, Loretta Sweet; Derouin, Anne; Villarruel, Antonia

2017-01-01

Nurses care for adolescents in a variety of settings, including communities, schools, and public health and acute care clinics, which affords them many opportunities to improve adolescents’ sexual and reproductive health and reduce the rates of unplanned pregnancy and sexually transmitted infections. To ensure that adolescents have access to sexual and reproductive health care (which includes both preventive counseling and treatment) in all nursing practice sites, nurses need to gain the knowledge and hone the skills required to deliver evidence-based counseling and services to adolescents and parents. Collectively, nurses can use their unique combination of knowledge and skills to make a positive impact on adolescent sexual and reproductive outcomes. Nurses have the capacity and opportunity to disseminate information about sexual and reproductive health to adolescents and their parents in communities, schools, public health clinics, and acute care settings. This article discusses the Society for Adolescent Health and Medicine’s goals and recommendations, which address adolescent sexual and reproductive health as both a health care and a human rights issue. PMID:28030408

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…

Franchising reproductive health services.

PubMed

Stephenson, Rob; Tsui, Amy Ong; Sulzbach, Sara; Bardsley, Phil; Bekele, Getachew; Giday, Tilahun; Ahmed, Rehana; Gopalkrishnan, Gopi; Feyesitan, Bamikale

2004-12-01

Networks of franchised health establishments, providing a standardized set of services, are being implemented in developing countries. This article examines associations between franchise membership and family planning and reproductive health outcomes for both the member provider and the client. Regression models are fitted examining associations between franchise membership and family planning and reproductive health outcomes at the service provider and client levels in three settings. Franchising has a positive association with both general and family planning client volumes, and the number of family planning brands available. Similar associations with franchise membership are not found for reproductive health service outcomes. In some settings, client satisfaction is higher at franchised than other types of health establishments, although the association between franchise membership and client outcomes varies across the settings. Franchise membership has apparent benefits for both the provider and the client, providing an opportunity to expand access to reproductive health services, although greater attention is needed to shift the focus from family planning to a broader reproductive health context.

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

Reproduction, women, and the workplace: legal issues.

PubMed

Bertin, J E

1986-01-01

Legal conflict has marked the effort to protect workers against reproductive injury, and legal activity in the management of occupational risks reflects a much broader range of important social issues, such as sexual discrimination in the workplace. This article describes the evolving law related to reproductive hazards that concern men, women and children.

Ethical issues in human reproduction: Islamic perspectives.

PubMed

Serour, G I

2013-11-01

Sexual and reproductive rights of women are essential components of human rights. They should never be transferred, renounced or denied for any reason based on race, religion, origin, political opinion or economic conditions. Women have the right to the highest attainable standard of health care for all aspects of their reproductive and sexual health (RSH). The principle of autonomy emphasizes the important role of women in the decision-making. Choices of women in reproduction, after providing evidence based information, should be respected. Risks, benefits and alternatives should be clearly explained before they make their free informed consent. Justice requires that all be treated with equal standard and have equal access to their health needs without discrimination or coercion. When resources are limited there is tension between the principle of justice and utility. Islamic perspectives of bioethics are influenced by primary Sharia namely the Holy Quran, authenticated traditions and saying of the Profit Mohamed (PBUH), Igmaa and Kias (analogy). All the contemporary ethical principles are emphasized in Islamic Shariaa, thus these principles should be observed when providing reproductive and sexual health services for Muslim families or communities. The Family is the basic unit in Islam. Safe motherhood, family planning, and quality reproductive and sexual health information and services and assisted reproductive technology are all encouraged within the frame of marriage. While the Shiaa sect permits egg donation, and surrogacy the Sunni sect forbids a third party contribution to reproduction. Harmful practices in RSH as FGM, child marriage and adolescent pregnancy are prohibited in Islam. Conscientious objection to treatment should not refrain the physician from appropriate referral.

Franchising Reproductive Health Services

PubMed Central

Stephenson, Rob; Tsui, Amy Ong; Sulzbach, Sara; Bardsley, Phil; Bekele, Getachew; Giday, Tilahun; Ahmed, Rehana; Gopalkrishnan, Gopi; Feyesitan, Bamikale

2004-01-01

Objectives Networks of franchised health establishments, providing a standardized set of services, are being implemented in developing countries. This article examines associations between franchise membership and family planning and reproductive health outcomes for both the member provider and the client. Methods Regression models are fitted examining associations between franchise membership and family planning and reproductive health outcomes at the service provider and client levels in three settings. Results Franchising has a positive association with both general and family planning client volumes, and the number of family planning brands available. Similar associations with franchise membership are not found for reproductive health service outcomes. In some settings, client satisfaction is higher at franchised than other types of health establishments, although the association between franchise membership and client outcomes varies across the settings. Conclusions Franchise membership has apparent benefits for both the provider and the client, providing an opportunity to expand access to reproductive health services, although greater attention is needed to shift the focus from family planning to a broader reproductive health context. PMID:15544644

Challenging machismo: promoting sexual and reproductive health with Nicaraguan men.

PubMed

Sternberg, P

2000-03-01

This article presents the results of a participatory exploration of male attitudes towards sexual and reproductive health issues in Nicaragua. Nicaraguan culture views men in a machismo concept. The study examined the knowledge, attitudes and behavior of men in relation to the social construction of masculinity: sexuality, reproduction, and fatherhood. Employing 90 men from both rural and urban communities, attitudes towards sexuality, reproduction, abortion and fatherhood were discussed. Several insights were gathered from the research, which explains men's behavior. Thus, it was deemed imperative that in empowering women by promoting sexual and reproductive health among men would require challenging male hegemony and persuading men to participate in health promotion. However, the setting and application of a men's agenda for sexual health promotion should not result in the curtailment of services for women because funds are being reallocated to men, nor should it give men the opportunity to more subtle forms of domination and exploitation.

Reproductive Health Policy in Tunisia

PubMed Central

Goicolea, Isabel; Hernandez, Alison

2016-01-01

Abstract Although Tunisia is regarded as a pioneer in the Middle East and North Africa in terms of women’s status and rights, including sexual and reproductive health and rights, evidence points to a number of persisting challenges. This article uses the Health Rights of Women Assessment Instrument (HeRWAI) to analyze Tunisia’s reproductive health policy between 1994 and 2014. It explores the extent to which reproductive rights have been incorporated into the country’s reproductive health policy, the gaps in the implementation of this policy, and the influence of this policy on gender empowerment. Our results reveal that progress has been slow in terms of incorporating reproductive rights into the national reproductive health policy. Furthermore, the implementation of this policy has fallen short, as demonstrated by regional inequities in the accessibility and availability of reproductive health services, the low quality of maternal health care services, and discriminatory practices. Finally, the government’s lack of meaningful engagement in advancing gender empowerment stands in the way as the main challenge to gender equality in Tunisia. PMID:28559685

ACOG Committee Opinion no. 598: Committee on Adolescent Health Care: The initial reproductive health visit.

PubMed

2014-05-01

: The initial visit for screening and the provision of reproductive preventive health care services and guidance should take place between the ages of 13 years and 15 years. The initial reproductive health visit provides an excellent opportunity for the obstetrician-gynecologist to start a patient-physician relationship, build trust, and counsel patients and parents regarding healthy behavior while dispelling myths and fears. The scope of the initial reproductive health visit will depend on the individual's need, medical history, physical and emotional development, and the level of care she is receiving from other health care providers. A general exam, a visual breast exam, and external pelvic examination may be indicated. However, an internal pelvic examination generally is unnecessary during the initial reproductive health visit, but may be appropriate if issues or problems are discovered in the medical history. Health care providers and office staff should be familiar with state and local statutes regarding the rights of minors to consent to health care services and the federal and state laws that affect confidentiality.

Trends in reproductive health knowledge following a health education intervention among adolescents in Zimbabwe.

PubMed

Rusakaniko, S; Mbizvo, M T; Kasule, J; Gupta, V; Kinoti, S N; Mpanju-Shumbushu, W; Sebina-Zziwa, J; Mwateba, R; Padayachy, J

1997-01-01

Unwanted teenage pregnancy, sexually transmitted infections and the attendant morbidity and mortality necessitate the need for understanding factors influencing adolescent sexuality and the implementation of programmes designed to improve their knowledge, reproductive behaviour, sexual and reproductive health. To determine the impact of an intervention package on knowledge levels of various reproductive health issues through trend analysis. Randomized controlled trial of a health education intervention in schools stratified for representativeness. Rural and urban secondary schools in Zimbabwe. 1,689 students recruited from 11 secondary schools in Mashonaland Central. Knowledge level before and after intervention. The demographic characteristics of the pupils at baseline, five months and nine months were comparable between the two groups. There was an overall increase in knowledge on menstruation. Students from the intervention schools were more likely to have correct knowledge over time on aspects of reproductive biology. A significant linear trend (p = 0.017) was observed in the area of family planning and contraception. A linear decreasing trend (p = 0.001) was observed on pregnancy risk. Though not significantly linear, the general trend of knowledge levels in all the areas of reproductive health, pregnancy risk, STDs and HIV/AIDS showed an upward trend, from 20% to 96%. Worth noting was that in all the areas the intervention group had knowledge above that in the control group. The reproductive health education intervention had an impact on aspects of reproductive biology and contraception as measured by the increased scoring at follow up when comparing intervention and control schools. The overall findings point to the need for early school based reproductive health education programmes incooperating correct information on reproductive biology and the prevention of subsequent reproductive morbidity by imparting information on non-risk behaviour during the early

Training in reproductive health and sexuality: the case of a regional program in Latin America.

PubMed

Ramos, S; Gogna, M

1997-01-01

Beginning in July 1993, a 5-year program has sought to provide social research, training, and technical assistance in reproductive health and sexuality in Argentina, Chile, Peru, and Colombia by 1) building research capacity and promoting an interdisciplinary approach to reproductive health and sexuality and 2) promoting a gender perspective to these issues. The target groups are women's nongovernmental organizations (NGOs); family planning, reproductive health, and women's health providers; and social scientists conducting health-related research. Training activities include regional workshops, a Regional Resident Fellowship Program to support graduate-level education, and provision of technical assistance. The first 3 years of the program have revealed that the basic training needs in these areas include 1) helping women's NGOs improve their record-keeping capacity, evaluation processes, theoretical and methodological background, and institutional-building ability; 2) sensitizing women's health providers to sociocultural dimension of health-illness issues and to a gender and human rights perspective; and 3) training social scientist researchers to apply their skills in applied research, develop their theoretical background, and improve research quality control procedures. The main challenges for training activities in the field of reproductive health and sexuality are posed by the complexity of the issues and their interdisciplinary nature.

Female unmarried adolescents' knowledge on selected reproductive health issues in two low performing areas of Bangladesh: an evaluation study.

PubMed

Kabir, Humayun; Saha, Nirod Chandra; Gazi, Rukhsana

2015-12-21

In Bangladesh, 24 % of the total populations are adolescents. Twelve months intervention was implemented under Demand-Based Reproductive Health Commodity Project (DBRHCP) in two low performing areas: rural Sub-district Nabiganj (population 323,357) and an urban slum in Dhaka city (population 141,912). We evaluated the changes in knowledge of female unmarried adolescents on selected reproductive health issues over the project period in two low performing areas of Bangladesh. A pre-post study design was adopted. Under DBRHCP, interventions were focused on training of government service providers, disseminating behaviour change materials within the targeted communities, and employing community-based health promoters (Community Support Group and Peer Promoters) to foster linkages between the community and providers. All households were enumerated. A baseline survey was conducted during November 2006 to March 2007 and an end-line survey was conducted during November 2008 to March 2009. Eight hundred female unmarried adolescents (12-19 years) were selected independently for each survey from each study area through systematic random sampling, capturing changes over the 12 months intervention period. Data was analyzed using SPSS. A chi-square test was used to assess the changes in knowledge between baseline and end-line among the female unmarried adolescents. Female unmarried adolescents had significantly increased knowledge at the end-line about measures to be taken during menstruation like: using clean and dry cloths. Overall, two-third of female unmarried adolescents knew about Family Planning (FP) methods in both study areas but had significantly increased knowledge on injectables and condoms at the end-line. Overall knowledge on Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDs) was markedly different in the urban and rural areas, but a significantly higher proportion of female unmarried adolescents knew about HIV/AIDs from relatives and

"Let Me Keep My Dead Husband's Sperm": Ethical Issues in Posthumous Reproduction.

PubMed

Panagiotopoulou, Nikoletta; Karavolos, Stamatios

2015-01-01

The feasibility of posthumous reproduction when the surviving partner is female has brought to light many ethical, moral, social, and legal issues. This review aims to summarize these issues and to assist clinicians who may be faced with such requests. A question list, used for health technologies assessment, was utilized in a question-answer approach as the review methodology. Of the 1,208 publications identified through a comprehensive literature search in biomedical, psychological, and ethical databases, 31 articles included arguments related to one or more questions from the predefined question set. Key stakeholders identified include the deceased, the requesting party, the resultant child, the physician, and society. Key ethical issues relevant to posthumous reproduction include the four traditional pillars of medical ethics--autonomy, beneficence, nonmaleficence, justice--as well as the stakeholders' rights and sociocultural attitudes. The ethical framework formulated by these issues has been incorporated in a clinical ethics decision-making tool that could prove useful to clinicians and decision makers. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

Exposure to hazardous substances and male reproductive health: a research framework.

PubMed Central

Moline, J M; Golden, A L; Bar-Chama, N; Smith, E; Rauch, M E; Chapin, R E; Perreault, S D; Schrader, S M; Suk, W A; Landrigan, P J

2000-01-01

The discovery in the mid-1970s that occupational exposures to pesticides could diminish or destroy the fertility of workers sparked concern about the effects of hazardous substances on male reproductive health. More recently, there is evidence that sperm quantity and quality may have declined worldwide, that the incidence of testicular cancer has progressively increased in many countries, and that other disorders of the male reproductive tract such as hypospadias and cryptorchidism may have also increased. There is growing concern that occupational factors and environmental chemical exposures, including in utero and childhood exposures to compounds with estrogenic activity, may be correlated with these observed changes in male reproductive health and fertility. We review the evidence and methodologies that have contributed to our current understanding of environmental effects on male reproductive health and fertility and discuss the methodologic issues which confront investigators in this area. One of the greatest challenges confronting researchers in this area is assessing and comparing results from existing studies. We elaborate recommendations for future research. Researchers in the field of male reproductive health should continue working to prioritize hazardous substances; elucidate the magnitude of male reproductive health effects, particularly in the areas of testicular cancer, hypospadias, and cryptorchidism; develop biomarkers of exposure to reproductive toxins and of reproductive health effects for research and clinical use; foster collaborative interdisciplinary research; and recognize the importance of standardized laboratory methods and sample archiving. PMID:11017884

Gender, sexual health and reproductive health promotion.

PubMed

Moeti, M R

1995-01-01

The underlying factors of poverty, migration, marginalization, lack of information and skills, disempowerment, and poor access to services which affect HIV/STD risk are also closely related to those which affect sexual and reproductive health. Reproductive health problems include unplanned and unwanted pregnancies, unsafe abortions, pregnancy-related illness and death, and STDs including HIV/AIDS. This interrelationship between factors is leading increasingly to the integration of HIV/STD education and prevention within the broader framework of sexual and reproductive health promotion. Such intervention allows the possible reinforcement of the impact of interventions upon important underlying factors and behaviors linked to individual, family, and community vulnerability to HIV/STDs as well as other reproductive health problems. Integration will also optimize the use of increasingly scarce resources and increase the likelihood of responses, interventions, and programs being sustainable. Sexual and reproductive health, placing HIV/STD prevention into context, and focus upon men are discussed.

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 Special Programme of Research in Human Reproduction (HRP), co-sponsored by the UNDP, UNFPA, WHO, and the World Bank, is celebrating 40 years of activities with an expansion of its mandate and new co-sponsors. When it began, in 1972, the main focus was on evaluating the acceptability, effectiveness, and safety of existing fertility-regulating methods, as well as developing new, improved modalities for family planning. In 1994, HRP not only made major contributions to the Plan of Action of the International Conference on Population and Development (ICPD); it also broadened its scope of work to include other aspects of health dealing with sexuality and reproduction, adding a specific perspective on gender issues and human rights. In 2002, HRP's mandate was once again broadened to include sexually transmitted infections and HIV/AIDS and in 2003 it was further expanded to research activities on preventing violence against women and its many dire health consequences. Today, the work of the Programme includes research on: the sexual and reproductive health of adolescents, women, and men; maternal and perinatal health; reproductive tract and sexually transmitted infections (including HIV/AIDS); family planning; infertility; unsafe abortion; sexual health; screening for cancer of the cervix in developing countries, and gender and reproductive rights. Additional activities by the Programme have included: fostering international cooperation in the field of human reproduction; the elaboration of WHO's first Global Reproductive Health Strategy; work leading to the inclusion of ICPD's goal 'reproductive health for all by 2015' into the Millennium Development Goal framework; the promotion of critical interagency statements on the public health, legal, and human rights implications of female genital mutilation and gender-biased sex selection. Finally, HRP has been involved in the creation of guidelines and tools, such as the 'Medical eligibility criteria for contraceptive use

Destigmatising abortion: expanding community awareness of abortion as a reproductive health issue in Ghana.

PubMed

Lithur, Nana Oye

2004-04-01

Traditional and cultural values, social perceptions, religious teachings and criminalisation have facilitated stigmatisation of abortion in Ghana. Abortion is illegal in Ghana except in three instances. Though the law allows for performance of abortion in three circumstances, the Ghana reproductive health service policy did not have any induced legal abortion services component to cover the three exceptions until it was revised in 2003. The policy only had 'unsafe and post-abortion' care components, and abortions performed in health facilities operated by the Ghana Health Service were performed under this component. Though the policy has been revised, women and girls who need abortion services in Ghana more often resort to the backstreet dangerous methods and procedures. Criminalisation of abortion and those who perform abortions has contributed to unsafe abortion, the second leading cause of maternal deaths in Ghana. Most of these are performed outside the formal health service structures. Traditionally, abortion is perceived as a shameful act and the community may shun and give a woman who has caused anabortion derogatory names. Would provision of legal abortion services be culturally acceptable within a Ghanaian community? Yes, if they are made aware of the reproductive health benefits of providing safe abortion services. Three major strategies that would help to destigmatise abortion in the community are (1) the liberal interpretation of the three exceptions to the law on abortion; (2) expanding community awareness of its reproductive health benefits; and (3) improving and increasing access to legal abortion services within the formal health facilities.

Reproductive issues in anorexia nervosa

PubMed Central

Hoffman, Elizabeth R; Zerwas, Stephanie C; Bulik, Cynthia M

2011-01-01

Despite a high prevalence of menstrual irregularities, women with anorexia nervosa are becoming pregnant. The physical and psychological demands of pregnancy and motherhood can represent an immense challenge for women already struggling with the medical and psychological stress of an eating disorder. This article summarizes key issues related to reproduction in women with anorexia nervosa, highlighting the importance of preconception counseling, adequate gestational weight gain, and sufficient pre- and post-natal nutrition. Postpartum issues including eating disorder symptom relapse, weight loss, breastfeeding, and risk of perinatal depression and anxiety are also discussed. PMID:22003362

Moral development and reproductive health decisions.

PubMed

McFadden, E A

1996-01-01

This article reviews the concepts of biomedical ethics, the justice perspective, and the care perspective of moral development and moral decision making; integrates key aspects of each to women's reproductive health nursing practice; and gives examples of application of these models to use as a framework for the assessment of moral development in guiding women in making reproductive health decisions. Emphasis is placed on the need for an integrated approach to assessment of the recognition of and response to what an individual identifies as a moral dilemma. Discussion of two different perspectives, justice and caring, is presented with application to women's health concerns. Nurses are encouraged to assess their moral development and appraisal of issues that constitute moral dilemmas and their ensuing decision making processes and those of clients. Techniques for obtaining information about moral reasoning are suggested. Rather than a traditional framework for the assessment of moral development, the uniqueness of individual women's experiences as they pertain to the case context is recommended to assess the client's appraisal of the circumstances of a perceived moral situation from the client's vantage point.

Ethical Issues of Reproductive Technologies: Legal and Ethical.

ERIC Educational Resources Information Center

Kammler, Kim

Ethical issues which surround the reproductive technologies being used to assist infertile couples include social impact, surrogacy, access to service and confidentiality. The use of reproductive technologies does not appear to cause harm, and often does a lot of good for the family and society. Surrogacy could be a valuable tool for the infertile…

Development and Adaptation of Iranian Youth Reproductive Health Questionnaire

PubMed Central

Mousavi, Abbas; Keramat, Afsaneh; Vakilian, Katayon; Esmaeili Vardanjani, Safar Ali

2013-01-01

Iran is a young country, and sexual behavior is shaped in this period. This research aimed to provide an assessment tool to evaluate Iranian youth reproductive health. This multistage research was conducted to design a valid questionnaire in the domains of knowledge, attitude, and behavior of the youth in order to evaluate behavior change programs. For this reason, after conducting a careful literature review and a qualitative research, the questionnaire was prepared. Forward and backward translations were performed. Professionals and students were used to make sure of qualitative and quantitative content and face validity. After conducting the pilot study on 100 students and eliminating defects in performance, reliability was evaluated by test-retest and Cronbach's alpha was calculated. In this study, out of 268 questions, 198 were retained after face and content validity. Self-efficacy of communication with father and mother, self-efficacy of condom use, and self-efficacy of abstinence had the highest Cronbach's alpha. Moreover, communication with parents regarding reproductive health issues and attitude to abstinence had a high Cronbach's alpha, as well. It seems to be a good instrument for assessment of Iranian reproductive health, and we are going to assess youth reproductive health in the future. PMID:23984084

Women Connect! Strengthening communications to meet sexual and reproductive health challenges.

PubMed

Pillsbury, Barbara; Mayer, Doe

2005-06-01

Women's nongovernmental organizations (NGOs) have significant comparative advantage for addressing sexual and reproductive health challenges facing women and families. This article describes an initiative to assist women's NGOs in developing greater skills using media and information communication technology for communicating women's health messages. Participating women's groups in Africa undertook innovative media projects--radio broadcasts on human immunodeficiency virus (HIV) and family planning, an antiviolence campaign, media campaigns on avoiding teen pregnancy--and designed websites, established Internet cafés, and downloaded health information from the Internet. Lessons learned offer guidance for collaboration with women's NGOs everywhere to strengthen communication for addressing critical sexual and reproductive health issues.

Creating understanding of reproductive health. Exchanges.

PubMed

1997-02-01

Yoko Komiyama, senior commentator of the Japan Broadcasting Corporation; Miyuki Nakamura, senior staff writer of Nihon Keizai Shimbun's Lifestyle News Department; and Miki Morimoto, staff writer for the Center for Research and Analysis on Global Issues Project 21, Asahi Shimbun, were introduced to population and reproductive health issues and the situation of women in Nepal during a December 8-16 interregional study tour. JOICFP selected the participants and organized an itinerary which provided insights into multilateral cooperation between UNFPA and the Ministry of Health (MOH) of Nepal, bilateral assistance between the Japan International Cooperation Agency and MOH, and nongovernmental organization collaboration between the Family Planning Association of Nepal and JOICFP. Upon returning to Japan, these representatives of three of Japan's major mass media groups shared their experiences with the general public through reports in newspapers, and on radio and television.

Reproductive health and genetic testing in the Third World.

PubMed

Penchaszadeh, V B

1993-09-01

New reproductive genetics means recently developed techniques to prevent the birth of children with specific defects or genetic diseases by testing individuals for sickle cell anemia, the thalassemias, Tay-Sachs disease, cystic fibrosis, or Down syndrome. Third World health services have many deficiencies with high maternal mortality rates (30-40 fold higher than in developed countries), the low percentage of births delivered by health personnel, the high rates of low birth weight babies, and high child malnutrition and infant mortality rates. The main issues in women's reproductive health are fertility regulation, abortion, maternal mortality, sexually transmitted diseases, and infertility. As a result of expansion in contraceptive use worldwide, the total fertility rate in developing countries has declined from 6.1 in 1965 to 3.9 in 1990. It is estimated that, worldwide, 36-53 million induced abortions are performed each year, most of them in developing nations. WHO estimates that more than 500,000 women die each year because of complications of pregnancy, most in developing countries. More than 95% of the 13 million estimated deaths of children under 5 years of age have occurred in these countries. Approximately 200 million people carry a potentially pathologic hemoglobinopathy gene, and about 250,000 children are born every year with hemoglobinopathy, most of them in the developing world. Reproductive genetic testing in big cities and in private for-profit ventures cater to the socioeconomic elite. Amniocentesis is often misused for fetal sex determination to abort female fetuses in India. Currently, in Cuba virtually every pregnant woman is tested for sickle cell trait and maternal serum alpha-fetoprotein levels between 15 and 20 weeks of gestation. It is predicted that the judicious use of reproductive genetic testing will be possible when health and quality of life issues are addressed properly.

Engaging media in communicating research on sexual and reproductive health and rights in sub-Saharan Africa: experiences and lessons learned.

PubMed

Oronje, Rose Ndakala; Undie, Chi-Chi; Zulu, Eliya Msiyaphazi; Crichton, Joanna

2011-06-16

The mass media have excellent potential to promote good sexual and reproductive health outcomes, but around the world, media often fail to prioritize sexual and reproductive health and rights issues or report them in an accurate manner. In sub-Saharan Africa media coverage of reproductive health issues is poor due to the weak capacity and motivation for reporting these issues by media practitioners. This paper describes the experiences of the African Population and Health Research Center and its partners in cultivating the interest and building the capacity of the media in evidence-based reporting of reproductive health issues in sub-Saharan Africa. The paper utilizes a case study approach based primarily on the personal experiences and reflections of the authors (who played a central role in developing and implementing the Center's communication and policy engagement strategies), a survey that the Center carried out with science journalists in Kenya, and literature review. The African Population and Health Research Center's media strategy evolved over the years, moving beyond conventional ways of communicating research through the media via news releases and newspaper stories, to varying approaches that sought to inspire and build the capacity of journalists to do evidence-based reporting of reproductive health issues. Specifically, the approach included 1) enhancing journalists' interest in and motivation for reporting on reproductive health issues through training and competitive grants for outstanding reporting ; 2) building the capacity of journalists to report reproductive health research and the capacity of reproductive health researchers to communicate their research to media through training for both parties and providing technical assistance to journalists in obtaining and interpreting evidence; and 3) establishing and maintaining trust and mutual relationships between journalists and researchers through regular informal meetings between journalists and

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

Are Men's Reproductive Health Problems and Sexual Behavior Predictors of Welfare?

PubMed

Amoo, Emmanuel O; Oni, Gholahan A; Ajayi, Mofoluwake P; Idowu, Adenike E; Fadayomi, Theophilus O; Omideyi, Adekunbi K

2017-05-01

The study examined men's reproductive health problems and sexual behavior and their implications for men's welfare in Nigeria. It used the Nigeria Demographic and Health Survey data set of 2013. The analysis used only male recode files, representing 17,359 males. The dependent variable is the computed wealth index, which was selected as proxy for welfare condition. Analysis involved univariate and multivariate levels. The findings indicated that 49.3% of the respondents currently have more than one sexual partner. The total lifetime sexual partner index identifies 70.2% of the men interviewed have had at least two sexual partners in their lifetime. It revealed that men who experience reproductive health challenges, such as sexually transmitted infections and genital ulcer, are 44% and 93%, respectively, less likely to enjoy good welfare condition. It also indicated that men in urban area are 7.256 times more likely to enjoy good welfare condition compared with their rural counterparts. There is a negative association between total lifetime sexual partnerships and exposure to good welfare. The study concludes that social workers, marriage counselors, other health personnel, and policy makers need to focus on the practice of multiple sexual partnership and reproductive health diseases as major determinants of men's welfare. The authors suggest that the index of welfare should include reproductive health issues and indicators of sexual behavior. Also, there is need for the establishment of specialized reproductive health care services and centers that are accessible to all men for effective servicing of reproductive health needs of men in the country.

Catalyzing a Reproductive Health and Social Justice Movement.

PubMed

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

2016-04-01

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. This paper synthesizes three current, interrelated approaches to addressing MCH challenges-life course theory, preconception health, and social justice/reproductive equity. 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.

[Monitoring of environmental pollution in Armenia and certain issues on reproductive health and cytogenetic status of organism].

PubMed

Tadevosian, N S; Muradian, S A; Tadevosian, A E; Khachatrian, B G; Dzhandzhapanian, A N; Parsadanian, G G; Pogosian, S B; Gevorkian, N B; Guloian, A A

2012-01-01

Investigations aimed at the study on the state of environment from the point of pollution by organochlorine pesticides and their metabolites (HCH, DDT, DDE and DDD), as well as on possible unfavorable impact due to carriage of mentioned persistent organic pollutants (POPs) towards reproductive health and cytogenetic status of organism were done. In parallel, monitoring of possible mutagenic components of the environment was also conducted. As to obtained data, residues of organochlorine pesticides are continually determined with high frequency both in environmental media, agricultural foodstuffs and biomedia of rural population of observed region (Aragatsotn marz, Armenia). No changes in mutagenic background were registered. The represented results of the study make fragment of complex social-hygienic, monitoring investigations on environmental quality that would further serve as a platform for working out the recommendations on reduction of environmental pollution and improvement of health protection issues in Armenia.

Health Literacy and Women's Reproductive Health: A Systematic Review

PubMed Central

Vitko, Michelle; O'Conor, Rachel; Bailey, Stacy Cooper

2016-01-01

Abstract Background: Health literacy is thought to impact women's reproductive health, yet no comprehensive systematic reviews have been conducted on the topic. Our objective was to systematically identify, investigate, and summarize research on the relationship between health literacy and women's reproductive health knowledge, behaviors, and outcomes. Methods: PRISMA guidelines were used to guide this review. English language, peer-reviewed research articles indexed in MEDLINE as of February 2015 were searched, along with study results posted on Clinicaltrials.gov. Articles were included if they (1) described original data-driven research conducted in developed countries, (2) were published in a peer-reviewed journal, (3) measured health literacy using a validated assessment, (4) reported on the relationship between health literacy and reproductive health outcomes, related knowledge, or behaviors, and (5) consisted of a study population that included reproductive age women. Results: A total of 34 articles met eligibility criteria and were included in this review. Data were abstracted from articles by two study authors using a standardized form. Abstracted data were then reviewed and summarized in table format. Overall, health literacy was associated with reproductive health knowledge across a spectrum of topics. It was also related to certain health behaviors, such as prenatal vitamin use and breastfeeding. Its relationship with other reproductive behaviors and outcomes remains unclear. Conclusions: Health literacy plays an important role in reproductive knowledge and may impact behaviors and outcomes. While further research is necessary, healthcare providers should utilize health literacy best practices now to promote high-quality care for patients. PMID:27564780

Reproductive health awareness of school-going, unmarried, rural adolescents.

PubMed

Gupta, Neeru; Mathur, A K; Singh, M P; Saxena, N C

2004-09-01

In 1996, India included Adolescent Health in Reproductive and Child Heatlh Programme. This Task-Force Study was planned to test the awareness level of adolescents regarding various reproductive health issues and to identify lacunae in knowledge, particularly in legal minimum age of marriage, number of children, male preference, contraceptive practices, about STIs /AIDS etc. It was a multicentre study, done in rural co-education/higher secondary schools of 22 districts located in 14 states through Human Reproductive Research Centre (HRRC's) of the Indian Council of Medical Research (ICMR). A sample of 8453 school going adolescents (aged 10-19 years) was surveyed by means of open ended, self-administered questionnaires maintaining confidentiality. Mean age of adolescents was 14.3 +/- 3.4 years. Awareness of legal minimum age of marriage was present in more than half of adolescents. Attitude towards marriage beyond 21 years in boys and 18 years in girls was favorable. Mean number of children desired was 2.2 +/- 1.4. However, number of children desired by boys (2.2+/-1.6) was significantly more (p< 0.000) than those desired by girls (2.0+/-1.1). More boys (23.7%) than girls (9.4%) wanted three or more children with male preference. Only 19.8% of adolescents were aware of at least one method of contraception. Only two-fifth (39.5%) were aware of AIDS and less than one-fifth (18%) were aware of STDs and most of them thought it is same as AIDS. Awareness of at least one method of immunization was present in three-fifth (60.1%) of students. It was least for DPT (13.5%) and most (55%) were aware of polio only. Awareness of all Reproductive Health matters was more in boys than girls and more in late teens (15-19) than earlier teens (10-14). The study showed tremendous lacunae in awareness of all Reproductive Health (RH) matters. There is a need for evolving information, education, and communication strategies to focus on raising awareness on RH and gender related issues. A

Nigerian lawyers and reproductive health rights: a survey of knowledge, practices and opinions on law reforms among the bar and bench in north eastern Nigeria.

PubMed

Mairiga, Abdulkarim Garba; Geidam, Ado Dan'azumi; Bako, Babagana; Ibrahim, Abdullahi

2012-03-01

The objective of this study was to determine the knowledge and attitudes of practicing Nigerian lawyers towards issues relating to reproductive health and reproductive rights, and their opinions about abortion law reform. It was a population- based study which consisted of interviews with practicing lawyers in north-east Nigeria. The results showed poor knowledge of issues related to reproductive health and reproductive rights among the lawyers. However, the majority (56.9%) disagreed that a woman can practice family planning without the consent of her husband. The prevalence of contraceptive use among the lawyers was low and attitude to abortion law not satisfactory. Only few lawyers (22.4%) supported safe abortion in cases of failed contraception. We conclude that reproductive health advocates must target legal professionals with a view to educating them on issues relating to sexual and reproductive health and rights. Lawyers in Nigeria should undergo capacity building in reproductive health laws and be encouraged to specialize in reproductive rights protection as obtainable in other developed countries.

Sexual and Reproductive Health Information Sources Preferred by Out-of-School Adolescents in Rural Southwest Uganda

ERIC Educational Resources Information Center

Nobelius, Ann-Maree; Kalina, Bessie; Pool, Robert; Whitworth, Jimmy; Chesters, Janice; Power, Robert

2010-01-01

This paper defines how out-of-school adolescents from Masaka District in rural southwest Uganda currently receive sexual and reproductive health information and how they would prefer to receive that information. Information adolescents feel they lack falls into three broad categories: sexual and reproductive health issues, the negotiation of sex…

Reproductive Health in the Adolescent and Young Adult Cancer Patient: An Innovative Training Program for Oncology Nurses

PubMed Central

Vadaparampil, Susan T.; Hutchins, Nicole M.; Quinn, Gwendolyn P.

2012-01-01

In 2008, approximately 69,200 AYAs were diagnosed with cancer, second only to heart disease for males in this age group. Despite recent guidelines from professional organizations and clinical research that AYA oncology patients want information about reproductive health topics and physician support for nurses to address these issues with patients, existing research finds few oncology nurses discuss this topic with patients due to barriers such as lack of training. This article describes an innovative eLearning training program, entitled Educating Nurses about Reproductive Issues in Cancer Healthcare (ENRICH). The threefold purpose of this article is to: (1) highlight major reproductive health concerns relevant to cancer patients, (2) describe the current status of reproductive health and oncology communication and the target audience for the training, and (3) present a systematic approach to curriculum development, including the content analysis and design stages as well as the utilization of feedback from a panel of experts. The resulting 10-week curriculum contains a broad-based approach to reproductive health communication aimed at creating individual- and practice-level change. PMID:23225072

Women, work and health: issues and implications for worksite health promotion.

PubMed

Collins, B S; Hollander, R B; Koffman, D M; Reeve, R; Seidler, S

1997-01-01

This paper identifies issues related to worksite health promotion programs for women by examining ways that work factors, health behaviors, family roles and responsibilities, and women's health are linked. Work conditions may affect women uniquely, as in the case of chemical exposure affecting reproductive health; disproportionately, such as the interaction between work and family roles; or differently from men, as in women's experience of stress in the workplace. The focus is on the differences and uniqueness of working women's health. Drawing on a public health perspective, implications for consideration by worksite health promotion programs specialist, human resource managers, and researchers are presented.

Invoking conscientious objection in reproductive health care: evolving issues in Peru, Mexico and Chile.

PubMed

Casas, Lidia

2009-11-01

As Latin American countries seek to guarantee sexual and reproductive health and rights, opponents of women's rights and reproductive choice have become more strident in their opposition, and are increasingly claiming conscientious objection to providing these services. Conscientious objection must be seen in the context of the rights and interests at stake, including women's health needs and right to self-determination. An analysis of law and policy on conscientious objection in Peru, Mexico and Chile shows that it is being used to erode women's rights, especially where it is construed to have no limits, as in Peru. Conscientious objection must be distinguished from politically-motivated attempts to undermine the law; otherwise, the still fragile re-democratisation processes underway in Latin America may be placed at risk. True conscientious objection requires that a balance be struck between the rights of the objector and the health rights of patients, in this case women. Health care providers are entitled to their beliefs and to have those beliefs accommodated, but it is neither viable nor ethically acceptable for conscientious objectors to exercise this right without regard for the right to health care of others, or for policy and services to be rendered ineffectual because of individual objectors.

Reproductive health/family planning and the health of infants, girls and women.

PubMed

Sadik, N

1997-01-01

The 1994 International Conference on Population and Development developed international consensus amongst health providers, policy makers, and group representing the whole of civil society regarding the concept of reproductive health and its definition. In line with this definition, reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being by preventing and solving reproductive health problems. Reproductive health care saves lives and prevents significant levels of morbidity through family planning programmes, antenatal, delivery and post-natal services, prevention and management programmes for reproductive tract infections (including sexually transmitted diseases and HIV/AIDS), prevention of abortion and management of its complications, cancers of the reproductive system, and harmful practices that impact on reproductive function. Reproductive health care needs are evident at all stages of the life cycle and account for a greater proportion of disability adjusted life years (DALYS) in girls and women than in boys and men. Reproductive health protects infant health by enabling birth spacing and birth limitation to be practiced through family planning. The prevention and early detection of reproductive tract infections, including sexually transmitted diseases and HIV, through the integration of preventive measures in family planning service delivery not only improves the quality of care provided but is also directly responsible for improvement in survival and health of infants. Addressing harmful practices such as son preference, sex selection, sexual violence and female genital mutilation complements the positive impact of planned and spaced children through family planning services on infant mortality and the reproductive health of young girls and women. They are also in addition to prenatal, delivery and postnatal services, positive determinants of low maternal mortality and

Reproductive health in women with serious mental illnesses.

PubMed

Ozcan, Neslihan Keser; Boyacıoğlu, Nur E; Enginkaya, Semra; Dinç, Hüsniye; Bilgin, Hülya

2014-05-01

To determine what problems female psychiatric patients have in terms of reproductive health. The reproductive health problems faced by female psychiatric patients are matters that have been neglected in the areas of both psychiatry and women's health. This study aims to make a contribution from Turkey to the literature in this neglected field. The study is descriptive and was conducted with 292 female patients treated in an acute inpatient psychiatric ward. Data were collected through face-to-face interviews and a questionnaire based on the literature and prepared by the researchers which was designed to determine the kinds of reproductive health issues the patients were experiencing. It was found that compared with healthy women, the distinctive features of the participants in terms of sexuality were more negative; in particular, patients diagnosed with bipolar disorder were more likely to have been forced by their partners to have sex, they had suffered from rape or sexually transmitted diseases, the majority of those who had previous sexual experience had tried to use contraceptives but had been unable to continue using them, they were most likely to choose the method of withdrawal for contraception, their rates of pregnancy and abortion were high, they received less antenatal care, and they were more likely to have smoked during pregnancy. It was found that female patients with psychiatric disorders had more negative attributes with regard to marriage, sexuality, family planning, maternal characteristics and pregnancy, compared with a corresponding healthy population. The results of this study may be useful for nurses in the clinical field for calling an attention and raising an awareness of the reproductive health problems of women with psychiatric disorders, taking the necessary preventive measures, and developing damage-reducing strategies. © 2013 John Wiley & Sons Ltd.

Influence of internal migration on reproductive health in Myanmar: results from a recent cross-sectional survey.

PubMed

Sudhinaraset, May; Diamond-Smith, Nadia; Thet, May Me; Aung, Tin

2016-03-09

Maternal and reproductive health remains a significant public health issue in Myanmar. Little data exists on women's health issues, including social and demographic influences. While past studies have demonstrated rural/urban health disparities, an increasingly important population resulting from urban growth in Myanmar is the internal migrant population, individuals moving within the country for better job or educational opportunities. Past studies suggest that women make up more than half of internal migrants, yet there is a dearth of information on this new wave of migration, particularly on women's reproductive health issues. The objective of this study is to assess the influence of women's migration in Myanmar on reproductive health outcomes, including delivering in a facility, using a skilled birth attendant, and using a modern method of family planning. Data from a cross-sectional household survey using multistage cluster sampling design conducted between September to October 2014 was used to assess the accessibility and the use of maternal and child health products and services. A total of 1800 currently married women of reproductive age, including 348 from urban and 1452 from rural areas, were recruited to complete surveys. A set of multivariable regressions was performed to assess reproductive health outcomes and predictors. Across health indicators, female migrants had better health outcomes compared to non-migrants. Controlling for demographic characteristics, migrants were 1.60 times more likely to use a modern form of family planning compared to non-migrants (p < 0.01) and use antenatal care during pregnancy (p < 0.05). While not statistically significant, migrants were 1.29 times more likely to deliver with a skilled attendant and 1.08 times more likely to deliver in a facility. This study found that female migrants in Myanmar reported better health outcomes compared to non-migrant women in regards to family planning and maternal health

Generating public awareness in Africa. Advocacy for reproductive health: Africa.

PubMed

Nyong'o, D

1996-01-01

In 1995 the IPPF Africa Region undertook advocacy missions to six countries in the region to sensitize national leaders about family planning (FP). This mission was governed by the six challenges laid down in the IPPF's strategic plan, Vision 2000, and the program of action of the International Conference on Population and Development (ICPD) held in Cairo in 1994. In Ethiopia, Kenya, and Tanzania the concerns were adolescent sexuality, family life education, and services to youth. In Uganda unsafe abortion; while in the Central African Republic and Guinea sexual and reproductive health, unsafe abortion, the sexuality of youth, and the empowerment of women were the main issues. Documentation packages prepared for the mission included annual reports, periodicals, conference reports, booklets, and position papers. The target audiences were political leaders, national, regional, and international organizations, religious, educational, and media leaders, and the public. Press conferences were organized and lobbying was conducted with national family planning associations to strengthen networking and coalition building. In Ethiopia the IPPF president's visit pertained to the sexuality of young people. In Kenya the mission coincided with the controversy of introducing family life education in primary schools. A seminar in Nairobi brought together 100 influential people who came to an agreement on the necessity of such education. In Tanzania the advocacy team crusaded for reproductive health services for young people. The country's president fully supported FP activities even allowing the use of hospitals and health centers for the distribution of contraceptives. There was a visit to a teenage mothers' center providing vocational training and reproductive health counseling in Dar es Salaam. In Uganda UNFPA, USAID, and national family planning association representatives met to forge closer working relations and examine the issue of tax exemption for imported contraceptives

Global Survey of National Constitutions: Mapping Constitutional Commitments to Sexual and Reproductive Health and Rights.

PubMed

Pizzarossa, Lucía Berro; Perehudoff, Katrina

2017-12-01

General Comment No. 22, issued in 2016 by the Committee on Economic, Social and Cultural Rights (CESCR), clarifies states' legal duties to respect, protect, and fulfill the right to sexual and reproductive health (SRH). Our study analyzes domestic constitutions around the world to investigate whether and to what extent the right to sexual and reproductive health is respected, protected, and fulfilled; to what extent these provisions are inclusive and non-discriminatory; and to what degree the interlinkages between this and other human rights are acknowledged. Of the 195 constitutions accessed, 27 enshrine sexual and/or reproductive health, and seven adopt restrictive approaches to this right. In the 27 constitutions, provisions most frequently enshrine respect of one's sexual health and family planning decisions, the protection of sexual health, and the provision of reproductive health care and family planning services (fulfillment). Most of the 27 constitutions fail to adequately respect reproductive health rights; to protect reproductive health, family planning, and abortion services from third-party interference; and to fulfill all dimensions of sexual health and access to abortion. Three of the 27 constitutions enshrine a universal right to SRH, and additional constitutions protect specific vulnerable groups (such as women, children) and/or restrict the scope of rights holders to couples. Among the 27 constitutions, nine explicitly link the right to sexual and reproductive health to the rights to education, science, and/or to make autonomous decisions about sexuality and reproduction. Our results can serve as a baseline measure to track constitutional reforms in pursuit of the realization of sexual and reproductive health and rights, and as building blocks for future lawmakers committed to realizing these rights through domestic legal reform.

Sexual and reproductive health and rights of older men and women: addressing a policy blind spot.

PubMed

Aboderin, Isabella

2014-11-01

Global debate on required policy responses to issues of older persons has intensified over the past 15 years, fuelled by a growing awareness of the rapid ageing of populations. Health has been a central focus, but scrutiny of global policies, human rights instruments and reports reveals that just as older people are excluded from sexual and reproductive health and rights agendas, so are issues of sexual and reproductive health and rights wholly marginal to current agendas focused on older people. A critical question is whether the policy lacuna reflects a dearth of research evidence or a faulty translation of existing knowledge. A reading of the current research landscape and literature, summarised in this paper, strongly suggests it is the former. To be sure, sexuality in old age is a burgeoning field of scientific inquiry. What the existing knowledge and discourse fail to provide is an engagement with, and elucidation of, the broader sexual and reproductive health and rights agenda as it relates to older persons. A concerted research effort is needed to provide a basis for developing policy guidance and for pinpointing essential indicators and establishing necessary data systems to enable a routine tracking of progress. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Provider perceptions of reproductive health service quality in jordanian public community health centers.

PubMed

Al-Qutob, Raeda; Nasir, Laeth S

2008-05-01

Enhancing the quality of reproductive health care delivery in developing countries is a key prerequisite to increased utilization and sustainability of these services in the target population. Our objective was to assess the perception of quality of reproductive health (RH) care services provided by Jordanian Ministry of Health community-based centers from the perspective of service providers in these settings. A purposeful nationwide sample of 50 primary health care providers took part in five focus group discussions with the purpose of exploring their perceptions of the quality of care provided by their centers and perceived barriers to the provision of quality RH care. Health care providers felt that the quality of RH care provided by their centers was suboptimal. Focus group participants reported numerous barriers to the provision of high quality-care in the clinical setting. These included issues related to patient overload, patient and physician characteristics, as well as problems inherent to supervisory and administrative functions. Exploring and aligning goals and expectations of RH care providers and administrators may result in improvements in the quality of RH care service delivery and morale in public health settings in Jordan, which is a requirement for public sector reform.

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.

Reproductive health problems loom in LDCs.

PubMed

1995-01-01

According to reports from the Program for Appropriate Technology in Health (PATH) and the World Bank, women in less developed countries (LDCs) suffer the greatest risk due to reproductive health problems. At any given time, a woman in a LDC is more likely than not to have at least 1 reproductive health problem that could be treated by a primary care provider or counseling and referral ("Women's Reproductive Health: The Role of Family Planning Programs," a PATH report). Among diseases for which cost-effective interventions exist (treatments or preventive measures), reproductive health problems account for the majority of the disease burden (a measure of healthy years lost due to disability or premature death) among women aged 15-44. A study of 650 women in India found that more than 50% reported specific gynecological problems; clinical examination found more than 90% had 1 or more such problems. In a study of 509 nonpregnant women in rural Egypt, it was discovered that more than 52% had a reproductive tract infection, 56% had some form of uterine prolapse, 14% had a urinary tract infection, and 11% had an abnormal Pap smear. Major reproductive health problems continue into menopause; cervical cancer, which is linked to reproductive tract infections and early and frequent childbearing, strikes 400,000 women in LDCs each year. Sexually transmitted disease (STD) and human immunodeficiency virus (HIV) infections are also problems; women are twice as likely as men to contact gonorrhea from an infected sex partner, and 14 million women will have been infected with HIV by the year 2000 (WHO estimate). Treatment is often unsought by women because they do not understand the risk, are unaware of the symptoms, or fear the stigma of attending a clinic. If all the women who wanted to control their fertility had access to family planning services, maternal mortality would decrease by nearly 50%. Reproductive health services (routine gynecological care, perinatal care, family

DOH to integrate reproductive health in health care delivery.

PubMed

According to a Department of Health (DOH) official speaking at the recent Reproductive Health Advocacy Forum in Zamboanga City, the concept of reproductive health (RH) is now on the way to being fully integrated into the Philippines' primary health care system. The DOH is also developing integrated information, education, and communication material for an intensified advocacy campaign on RH among target groups in communities. The forum was held to enhance the knowledge and practice of RH among health, population and development program managers, field workers, and local government units. In this new RH framework, family planning becomes just one of many concerns of the RH package of services which includes maternal and child health, sexuality education, the prevention and treatment of abortion complications, prevention of violence against women, and the treatment of reproductive tract infections. Of concern, however, the Asian economic crisis has led the Philippine government to reduce funding, jeopardizing the public sector delivery of basic services, including reproductive health care. The crisis has also forced other governments in the region to reassess their priorities and redirect their available resources into projects which are practical and sustainable.

Progress on youth reproductive health.

PubMed

1998-06-01

The first round table meeting to review progress in implementing the Programme of Action of the 1994 International Conference on Population and Development was convened in April 1998 to consider progress on adolescent reproductive health and rights. The 30 participants from 24 countries concluded that while many countries have made progress, attitudes still need to be changed among those who continue to believe that provision of reproductive health services to adolescents leads to promiscuity. The topics considered during the meeting included: 1) improving accessibility and quality of information and services; 2) creating an "enabling environment" for adolescent reproductive health; 3) enhancing the role of parents and schools in providing sex education; 4) using national laws and policies to protect youth health and rights; and 5) mobilizing private sector and private foundation resources. The round table recommended that adolescent reproductive health programs 1) involve diverse groups of young people in the development of programs, services, and materials; 2) cooperate with a wide variety of other agencies; 3) encourage open discussions of sexuality; 4) train youth as peer counselors; 5) hire youth as paid staff; 6) use a range of quality communication resources; 7) train health care professionals who deal with adolescents; 8) develop evaluation indicators for social and emotional well-being; 9) increase youth access to the formal health sector; and 10) use the visibility of women's groups to promote young women's interests. The round table also asked UN agencies to strengthen their support for youth programs.

Breastfeeding and feminism: A focus on reproductive health, rights and justice

PubMed Central

Labbok, Miriam H; Smith, Paige Hall; Taylor, Emily C

2008-01-01

The annual Breastfeeding and Feminism Symposia aim to reposition breastfeeding as a valued part of women's (re)productive lives and rights. The symposia are designed to raise the profile of breastfeeding within the women's advocacy and feminist studies' communities, and to increase recognition among breastfeeding supporters that breastfeeding promotion could receive more socio-political support by partnering with those concerned with women's reproductive health, rights and justice, women's economic advancement, and the elimination of social, economic and health inequities. The third symposium (2007) sought to build dialogue and increase communications between and among these diverse communities. The nine articles presented in this thematic series were selected by the journal editors, and represent the core discussions at the symposium. This editorial presents the areas of synergy and strategies for action that emerged from the discussions. These strategies and this thematic issue are intended to reassert the momentum that evolved among participants, and to stimulate involvement among individuals and organizations not in attendance in promoting breastfeeding as a women's reproductive health, rights and justice concern. PMID:18680575

Breastfeeding and feminism: a focus on reproductive health, rights and justice.

PubMed

Labbok, Miriam H; Smith, Paige Hall; Taylor, Emily C

2008-08-04

The annual Breastfeeding and Feminism Symposia aim to reposition breastfeeding as a valued part of women's (re)productive lives and rights. The symposia are designed to raise the profile of breastfeeding within the women's advocacy and feminist studies' communities, and to increase recognition among breastfeeding supporters that breastfeeding promotion could receive more socio-political support by partnering with those concerned with women's reproductive health, rights and justice, women's economic advancement, and the elimination of social, economic and health inequities. The third symposium (2007) sought to build dialogue and increase communications between and among these diverse communities. The nine articles presented in this thematic series were selected by the journal editors, and represent the core discussions at the symposium. This editorial presents the areas of synergy and strategies for action that emerged from the discussions. These strategies and this thematic issue are intended to reassert the momentum that evolved among participants, and to stimulate involvement among individuals and organizations not in attendance in promoting breastfeeding as a women's reproductive health, rights and justice concern.

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. © The Author(s) 2013.

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. © 2015 American Cancer Society.

Sexual and reproductive health needs of sex workers: two feminist projects in Brazil.

PubMed

Chacham, Alessandra S; Diniz, Simone G; Maia, Mônica B; Galati, Ana F; Mirim, Liz A

2007-05-01

The sexual and reproductive health needs of sex workers have been neglected both in research and public health interventions, which have almost exclusively focused on STI/HIV prevention. Among the reasons for this are the condemnation, stigma and ambiguous legal status of sex work. This paper describes work carried out by two feminist NGOs in Brazil, Mulher e Saúde (MUSA) in Belo Horizonte and Coletivo Feminista Sexualidade e Saúde in São Paulo, to promote sexual and reproductive health for sex workers. MUSA's project "In the Battle for Health", was begun in 1992; sex workers were trained as peer educators and workshops were offered on self-care for sex workers and their clients. In São Paulo, the Coletivo project "Get Friendly with Her", begun in 2002, offers clinic consultations and self-care workshops on sexuality, contraception, STI/HIV prevention and self-examination. Health care needs during menstruation and unhealthy vaginal practices led to promotion of the diaphragm as a contraceptive, for prevention of reproductive tract infection and to catch menstrual blood. Meeting the sexual and reproductive health needs of sex workers depends on the promotion of their human rights, access to health care without discrimination, and attention to psychosocial health issues, alcohol and drug abuse, and violence from clients, partners, pimps and police.

Vulnerability and sexual and reproductive health among Zambian secondary school students.

PubMed

Warenius, Linnéa; Pettersson, Karen O; Nissen, Eva; Höjer, Bengt; Chishimba, Petronella; Faxelid, Elisabeth

2007-01-01

The present study aimed to explore secondary school students' needs in relation to sexual and reproductive health in order to inform efforts to improve the quality of health services available to young people. The study involved data collection from 716 11-22-year-old students in four secondary schools in an urban area in Zambia. Students completed a questionnaire and were invited to write down any inquiries they had regarding sexuality and reproduction. Findings revealed that boys and girls lack adequate information about human reproduction and STIs, including HIV. To avoid misconceptions and myths, they also need clear information on contraceptives and masturbation. Responses indicate that young people would welcome guidance and support related to contraception, pregnancy, abortion and STIs/HIV, but also on love and relationships. Culture, religion and gender are important factors influencing sexuality and sexual abuse. These issues need to be taken into consideration when developing youth-friendly programmes for young people.

[Reproductive health of women. Family planning and "reproductive rights" in Germany].

PubMed

Helfferich, C

2013-02-01

The WHO (World Health Organization) definition of reproductive health establishes reproductive rights for women and men. This includes the capability to reproduce and the freedom to decide, if, when, and how often to do so. In this article the implementation of these rights in Germany is evaluated, focusing on selected aspects of family planning. Findings from empirical studies, surveys, and official registers on fertility intentions, on births, on contraception, and on abortion are compiled. Moreover, the influence of social aspects on reproductive health (education, migration background) is discussed. Records show high standards regarding information and access to contraceptives; however, more action and research are needed in three regards. First, men and women have fewer children than they would like to have, and the desire to have (more) children is deferred systematically. Second, the number and rate of abortions should be reduced. And third, more attention should be paid to social determinants that influence the access to reproductive health. Furthermore, the special needs of migrants should be taken into account.

Teaching Trainees to Deliver Adolescent Reproductive Health Services

PubMed Central

Shah, Brandi; Chan, Serena H.; Perriera, Lisa; Gold, Melanie A.; Akers, Aletha Y.

2015-01-01

OBJECTIVE Delivery of reproductive services to adolescents varies by specialty and has been linked to differences in clinical training. Few studies have explored how different specialties’ graduate medical education (GME) programs prepare providers to deliver adolescent reproductive services. We explored the perceptions of resident physicians regarding their training in delivering adolescent reproductive health services. DESIGN Between November 2008 and February 2009, nine focus groups were conducted with graduate medical trainees in three specialties that routinely care for adolescents. The semi-structured discussions were audio-recorded, transcribed and analyzed using an inductive approach to content analysis. SETTING Large, urban academic medical center in Pittsburgh, Pennsylvania PARTICIPANTS 54 resident trainees in pediatrics, family medicine and obstetrics/gynecology INTERVENTIONS None MAIN OUTCOMES Trainees’ perspectives regarding the didactic teaching and clinical training in providing adolescent reproductive services RESULTS Five themes emerged reflecting trainees’ beliefs regarding the best practices GME programs can engage in to ensure that trainees graduate feeling competent and comfortable delivering adolescent reproductive services. Trainees believed programs need to: 1) Provide both didactic lectures as well as diverse inpatient and outpatient clinical experiences; 2) Have faculty preceptors skilled in providing and supervising adolescent reproductive services; 3) Teach skills for engaging adolescents in clinical assessments and decision-making; 4) Train providers to navigate confidentiality issues with adolescents and caregivers; and 5) Provide infrastructure and resources for delivering adolescent reproductive services. CONCLUSIONS The three specialties differed in how well each of the five best practices were reportedly addressed during GME training. Policy recommendations are provided. PMID:26542014

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. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Indonesia. Adolescent reproductive health forms part of 5th country programme cycle.

PubMed

1995-01-01

Indonesia is now entering the Fifth Country Program Cycle of Population. The reproductive health and family well-being of the youth forms part of the country program. In order to translate this component into concrete action program, a project document in its first draft was developed for UNFPA (UN Population Fund) funding by the government and with the assistance of UNFPA CST, Bangkok and UNFPA Field Office in Jakarta. The project aims to raise the level of commitment and degree of participation of families, particularly parents, for developing among their pre-adolescent and adolescent children a better understanding of the concepts/process of adolescent reproductive health and desirable attitudes and values dealing with family well-being. This is to be achieved through family-centered learning approaches that will contribute to the adoption of the small, happy, and prosperous family norm. To achieve this goal, the project will develop national capacity by creating management teams, developing sets of training and counseling materials, delivering key messages through the media, upgrading skills in adolescent counseling and developing better understanding of adolescent reproductive health and family well-being issues among the facilitators. The strategy to be used is to set up small groups of 20-30 families which will regularly meet to discuss adolescent problems and issues with the help of cadres. They will be supported by provincial reproductive health and family well-being counseling centers which will also be set up to handle serious cases difficult for parents to handle. These centers, to be run by NGOs, will provide counseling services to parents and youth, evolve innovative and culturally acceptable counseling techniques, and at the same time serve as material and information collection, development and dissemination centers. The project will be launched in collaboration with seven NGOs in seven selected provinces. It is currently under review by UNFPA and

Women, war, and reproductive health in developing countries.

PubMed

Pillai, Vijayan; Wang, Ya-Chien; Maleku, Arati

2017-01-01

Globally, millions of people are affected by war and conflicts every year. However, women have increasingly suffered the greatest harm by war in more different ways than men. We conceptualize a reproductive rights approach toward examining the effects of war on women's reproductive health in developing countries. Given the rising concerns of exclusion to adequately address women's rights, sexual and gender-based violence, and post-conflict accountability, we specifically focus on the limitations of the Minimum Initial Service Package, a UN-sponsored reproductive health service program in conflict zones while offering a broad reproductive rights-based conceptual lens for examining reproductive health care services in war-torn areas. In addition, we discuss the roles social workers may play at both micro and macro levels in war-torn areas to bring about both short term and long term gains in women's reproductive health.

Incentives, population policy, and reproductive rights: ethical issues.

PubMed

Isaacs, S L

1995-01-01

The governments of most Asian countries have used incentives or disincentives as a population policy strategy. In the 1960s the Indian government offered money or gifts to acceptors at mass sterilization campaigns. In the late 1960s through the 1970s Singapore enacted legislation penalizing large families, including delivery fees for the third and subsequent children, denying them government housing and a choice of schools. There were also rewards to small families. During the late 1970s China started its own 1-child policy with the objective of limiting the population to 1.2 billion by the year 2000. Incentives included monthly welfare or nutritional allowances; priorities in housing, education, and medical care; and expanded maternity benefits. Disincentives included fines, deductions from salaries, withdrawal of maternity leave, health coverage, and allowances. There have also been charges of forced sterilization and abortion, which led to the US termination of funding to UNFPA because of its support of China's program. Incentives and disincentives raise the ethical issue of how to balance governmental actions attempting to control population growth against individual reproductive rights. In practice abuse has been rampant, therefore voluntary choice in childbearing should not be infringed upon no matter how strong the government interest is. To this effect some standards are proposed: 1) Governments restricting reproductive choice have the burden of demonstrating that continued population growth threatens the survival of society. 2) The people who are subject to the policy must agree that it is valid. 3) Measures that are less restrictive of voluntary reproductive choice should be tried and proved ineffective before more restrictive measures are employed. 4) The burdens of restrictive measures should be distributed equitably. 5) Penalties that directly punish children for being a high order child should not be used at all.

Male involvement in reproductive health among scheduled tribe: experience from Khairwars of central India.

PubMed

Saha, Kalyan B; Singh, Neeru; Chatterjee Saha, Uma; Roy, Jyotirmoy

2007-01-01

Indian tribal men's lack of participation in reproductive health not only damages their own health, but also contributes to the reproductive ill health of their female partners and children. In India the involvement of men in such matters is a new concept. There is a paucity of data particularly on Scheduled tribesmen's knowledge and the extent of their participation in reproductive health. This inhibits planning. The present study aims to understand the involvement of Scheduled tribesmen in reproductive health and the barriers to their involvement by generating a database from the Khairwar tribe of Central India. A door-to-door survey on knowledge, attitude and practice relating to aspects of reproductive health was conducted by canvassing a pre-designed interview schedule among 15-40 year old, currently married Khairwar males in the Sidhi district of Madhya Pradesh, India. As far as reproductive morbidity is concerned, only 17% of the respondents had heard of HIV/AIDS, and most had no proper knowledge of its transmission. Although 74% of the respondents had heard about reproductive tract infections, the majority of them were unaware of the mechanism of transmission and seriousness of the problem. The duel role of condoms, both as a method of family planning and a protective measure against sexually transmitted infections, was also unknown to them. Approximately 59% of the males were aware of family planning but only 13% were using any method (mostly female sterilization) at the time of survey. Their view on the ideal number of children (3.56) exceeded the actual number of children born and living. High infant and child mortality influenced their preference for higher fertility. Very few among them (29%) had knowledge of antenatal care. They expressed faulty knowledge, myths and unhelpful attitudes towards sexual health matters. The study revealed the male Scheduled tribe population's lack of knowledge and misinformation regarding male sexual health issues, the

A review of reproductive health research, guidelines and related gaps for women living with HIV

PubMed Central

Loutfy, Mona R.; Sonnenberg-Schwan, Ulrike; Margolese, Shari; Sherr, Lorraine

2012-01-01

The study of pregnancy and motherhood in women living with HIV (WLWH) has concentrated on the health of the unborn baby and the prevention of mother-to-child transmission, whereas consideration of the broader aspects of women's reproductive health has been largely overlooked. The rights of WLWH with respect to their reproductive health should be exactly the same as non-HIV-positive women, however, inequalities exist due to discrimination and also because the treatment guidelines used in the care of women are often based on insufficient evidence. The purpose of this article is to review the available literature on reproductive health issues for WLWH and to identify gaps requiring further investigation. Our review indicates that further research is warranted into a number of aspects of reproductive health among WLWH. Currently, access to the relevant reproductive health resources and services, such as advice on contraception and fertility services, for WLWH is far from optimal in many developed countries and most developing countries. More data are needed on the most appropriate family planning options with the consideration of drug interactions between contraceptives and antiretroviral therapy and the risk of HIV transmission. Also, more research is needed to improve understanding of the maternal health challenges facing WLWH. Similarly, our understanding of the impact of HIV on the physical and emotional health of pregnant women and new mothers is far from complete. Answering these questions and countering these inequalities will help to ensure the reproductive health and child-bearing intentions of WLWH become an integral part of HIV medicine. PMID:23088551

Culture and religious beliefs in relation to reproductive health.

PubMed

Arousell, Jonna; Carlbom, Aje

2016-04-01

An increasing number of contemporary research publications acknowledge the influence of religion and culture on sexual and reproductive behavior and health-care utilization. It is currently hypothesized that religious influences can partly explain disparities in sexual and reproductive health outcomes. In this paper, we will pay particular attention to Muslims in sexual and reproductive health care. This review reveals that knowledge about devout Muslims' own experience of sexual and reproductive health-care matters is limited, thus providing weak evidence for modeling of efficient practical guidelines for sexual and reproductive health care directed at Muslim patients. Successful outcomes in sexual and reproductive health of Muslims require both researchers and practitioners to acknowledge religious heterogeneity and variability, and individuals' possibilities to negotiate Islamic edicts. Failure to do so could lead to inadequate health-care provision and, in the worst case, to suboptimal encounters between migrants with Muslim background and the health-care providers in the receiving country. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Gains on women's health issues made at UN conference on women.

PubMed

1995-09-15

Beginning on August 30, representatives from more than 180 UN member states and women's rights advocates from every continent convened in the People s Republic of China for the much-anticipated UN Fourth World Conference on Women (FWCW) in Beijing and the Nongovernmental Organization (NGO) Forum in Huairou. The Forum, which ran through September 8, boasted 20,000 attendees. Participants conducted numerous workshops, staged multiple demonstrations, and strategized about how to lobby governments negotiating the FWCW Platform for Action. That document focuses on eliminating discrimination against women in twelve key issue areas: poverty, education, health, violence against women, armed conflict, economic structures, women in decision making, policy and program planning, human rights, media and communications, environment, and the girl child. During debate over the section, issues such as sexual rights, sexual health abortion and adolescents' rights to reproductive health information sparked the greatest opposition from conservative forces. Government delegates approved the health section in its entirety by September 13, whereby they confirmed the commitments made at the International Conference on Population and Development (ICPD) in Cairo in September 1994. Paragraph 97 states that the human rights of women include their right to have control over their sexuality, including sexual and reproductive health, free of discrimination and violence and also calls for equal relationships between women and men in sexual relations and reproduction. Paragraph 107 calls on governments to review laws containing punitive measures against women who have undergone illegal abortions. Finally, Paragraph 108 (e) takes into account the rights of the child to access to information, privacy, confidentiality, respect and informed consent on matters concerning sexuality and reproduction. FWCW was scheduled to conclude on September 15. Governmental delegates had not yet finished negotiating

Reproductive endocrine issues in men with sickle cell anemia.

PubMed

Huang, A W; Muneyyirci-Delale, O

2017-07-01

In patients with sickle cell anemia, the sickling of red blood cells is known to cause end-organ damage by infarction. In some men who are affected by sickle cell anemia, the obstruction of venous outflow of the penis causes priapism, which could lead to erectile dysfunction. There is also evidence that the disease is linked to other reproductive issues in men-specifically delayed puberty, low testosterone, and sperm abnormalities-although the causes of these problems are less clear. Treatment of sickle cell anemia can have effects on the reproductive system as well. This review summarizes the findings from various publications pertaining to reproductive endocrinology, along with their conclusions and discrepancies. © 2017 American Society of Andrology and European Academy of Andrology.

A comprehensive reproductive health program in the workplace.

PubMed

Brooks, L; Merkel, S F; Glowatz, M; Comstock, M L; Shoner, L G

1994-04-01

This paper summarizes the reproductive health component of the AT&T Bell Laboratories occupational health program. The comprehensive R&D Reproductive Health Program is a collaborative effort between the Health Services Group and the Environmental Health & Safety Center. It provides a tailored curriculum to occupational health nurses and physicians so that they may respond to employee questions and concerns with detailed information and with referrals to appropriate subject-matter experts. Expanding on the typical regulatory approaches of hazard communication and right-to-know, the program encourages employees of both sexes to learn about workplace, environmental, and lifestyle aspects of reproductive and developmental health.

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

[Human rights, maternal mortality and reproductive health].

PubMed

Cook, R J

1993-06-01

This work examines reproductive health within the framework of human rights assured by various international conventions, and analyzes the high maternal mortality rates of developing countries as a violation of several guaranteed rights. The 1st of 3 main sections of the report discusses the failure of governments to make protection of women's reproductive health a priority. Historically, women's principal role has been to bear children, and no recognition was given to the cost in health of accomplishing this duty. Women's reproductive health has created controversies in many traditional juridical systems because of its relation to human sexuality and morals. WHO has estimated that some 500,000 maternal deaths occur each year, with 25-50% resulting from unsafe abortions. The causes of maternal mortality often have their roots in the poor nutrition or inadequate health care provided to the woman long before the 1st pregnancy. Early and frequent pregnancies and heavy physical labor are among the many factors that contribute to maternal death. Laws to protect women's health may be lacking or may not be applied. For example, many countries have no legal minimum age for marriage. To combat the traditional negligence, a new viewpoint is emerging which views women's reproductive health as a condition in which childbearing occurs in a state of physical, mental, and social wellbeing. It implies that women have the capacity to reproduce, regulate their fertility, and enjoy sexual relations. Laws that deny access to reproductive health services or place obstacles or conditions in the way are coming under question as violations of basic human rights of women protected by international conventions. The main such convention discussed in this article is the Convention on the Elimination of All Forms of Discrimination Against Women, although several other conventions are relevant to protecting women's reproductive health. If international law on human rights is to become truly

Reproductive technologies and the quality of offspring in Asia: reproductive pioneering and moral pragmatism?

PubMed

Sleeboom-Faulkner, Margaret

2010-02-01

This paper highlights a number of theoretical issues relevant to this special issue of Culture, Health & Sexuality on the quality of offspring, including gender selection, ecofeminism, eugenics, reproductive agency, moral pioneering and reproductive pragmatism in China, India and Japan. First, it discusses various approaches to choice in sex selection, focusing on an instrumentalist and an ecofeminist approach. Second, it discusses issues of reproductive choice in the light of various concepts of eugenics and power, which have been used to characterise the relationship between the state, the individual and prenatal genetic testing. Third, it queries Foucault's notion of biopower in relation to reproductive agency. In reviewing the evidence, the chapter raises questions about how women and parents in Asian societies can be understood in terms of 'reproductive pragmatism', 'empowerment' and/or 'moral pioneering' when faced with the use of new reproductive technologies in modern societies.

Assessment of adolescents' communication on sexual and reproductive health matters with parents and associated factors among secondary and preparatory schools' students in Debremarkos town, North West Ethiopia.

PubMed

Shiferaw, Kasiye; Getahun, Frehiwot; Asres, Getahun

2014-01-08

Sexuality and reproductive health are among the most fundamental aspects of life. Poor parental involvement in preparing young people for safe sexual life and good reproductive health was part of the blame for the lack of skills on sexual decision making. Despite the growing needs, there is no adequate health service or counseling specifically suitable for this specific age group and research on the role of parents in this process has yielded inconsistent results. The objective of the study is to assess adolescents' communication on sexual and reproductive health issues with parents and associated factors among secondary and preparatory schools students in Debremarkos town. School based study was conducted among secondary and preparatory schools students in Debremarkos town, from April 8 to 21, 2012. Multistage sampling and self administered questionnaires were employed. The proportion of the students who had discussion on sexual & reproductive health issues with their parent was found to be 254 (36.9%). Mother who able to read and write (AOR = 2; 95% CI 1.3 to 3.1), adolescents accepting discussion of sexual & reproductive health issues (AOR = 2.5 95% CI 1.3 to 4.5), adolescents who ever got SRH information (AOR = 2; 95% CI 1.4 to 2.9), adolescents who ever had sexual intercourse (AOR = 1.7; 95% CI 1.1 to 2.6) were found to have significant positive associations, and being grade 12 students (AOR = 0.4; 95% CI 0.2 to 0.7) and having less than three family size (AOR = 0.5; 95% CI 0.2 to 0.9) showed significant negative associations. Study unveils that parent -adolescent communications on sexual and reproductive health issues is low, only about one third of the students were communicating on SRH issues. Therefore; there is a need to equip and educate parents on different sexual & reproductive health issues. Comprehensive family life education should also be initiated for the students and parents.

Assessment of adolescents’ communication on sexual and reproductive health matters with parents and associated factors among secondary and preparatory schools’ students in Debremarkos town, North West Ethiopia

PubMed Central

2014-01-01

Background Sexuality and reproductive health are among the most fundamental aspects of life. Poor parental involvement in preparing young people for safe sexual life and good reproductive health was part of the blame for the lack of skills on sexual decision making. Despite the growing needs, there is no adequate health service or counseling specifically suitable for this specific age group and research on the role of parents in this process has yielded inconsistent results. Objective The objective of the study is to assess adolescents’ communication on sexual and reproductive health issues with parents and associated factors among secondary and preparatory schools students in Debremarkos town. Methods School based study was conducted among secondary and preparatory schools students in Debremarkos town, from April 8 to 21, 2012. Multistage sampling and self administered questionnaires were employed. Results The proportion of the students who had discussion on sexual & reproductive health issues with their parent was found to be 254 (36.9%). Mother who able to read and write (AOR = 2; 95% CI 1.3 to 3.1), adolescents accepting discussion of sexual & reproductive health issues (AOR = 2.5 95% CI 1.3 to 4.5), adolescents who ever got SRH information (AOR = 2; 95% CI 1.4 to 2.9), adolescents who ever had sexual intercourse (AOR = 1.7; 95% CI 1.1 to 2.6) were found to have significant positive associations, and being grade 12 students (AOR = 0.4; 95% CI 0.2 to 0.7) and having less than three family size (AOR = 0.5; 95% CI 0.2 to 0.9) showed significant negative associations. Conclusion and recommendation Study unveils that parent –adolescent communications on sexual and reproductive health issues is low, only about one third of the students were communicating on SRH issues. Therefore; there is a need to equip and educate parents on different sexual & reproductive health issues. Comprehensive family life education should also be initiated for

Resource flows for health care: Namibia reproductive health sub-accounts.

PubMed

Mbeeli, Thomas; Samahiya, Muine; Ravishankar, Nirmala; Zere, Eyob; Kirigia, Joses M

2011-12-24

Implementing initiatives to achieve the targets of MDG 5 requires sufficient financial resources that are mobilized and utilized in an equitable, efficient and sustainable manner. Informed decision making to this end requires the availability of reliable health financing information. This is accomplished by means of Reproductive Health (RH) sub-account, which captures and organizes expenditure on RH services in two-dimensional tables from financing sources to end users. The specific objectives of this study are: (i) to quantify total expenditure on reproductive health services; and (ii) to examine the flow of RH funds from sources to end users. The RH sub-account was part of the general National Health Accounts exercise covering the Financial Years 2007/08 and 2008/09. Primary data were collected from employers, medical aid schemes, donors and government ministries using questionnaire. Secondary data were obtained from various documents of the Namibian Government and the health financing database of the World Health Organization. Data were analyzed using a data screen designed in Microsoft Excel. RH expenditure per woman of reproductive age was US$ 148 and US$ 126 in the 2007/08 and 2008/09 financial years respectively. This is by far higher than what is observed in most African countries. RH expenditure constituted more than 10-12% of the total expenditure on health. Out-of-pocket payment for RH was minimal (less than 4% of the RH spending in both years). Government is the key source of RH spending. Moreover, the public sector is the main financing agent with programmatic control of RH funds and also the main provider of services. Most of the RH expenditure is spent on services of curative care (both in- and out-patient). The proportion allocated for preventive and public health services was not more than 5% in the two financial years. Namibia's expenditure on reproductive health is remarkable by the standards of Africa and other middle-income countries. However

Impact of Hurricane Exposure on Reproductive Health Outcomes, Florida, 2004.

PubMed

Grabich, Shannon C; Robinson, Whitney R; Konrad, Charles E; Horney, Jennifer A

2017-08-01

Prenatal hurricane exposure may be an increasingly important contributor to poor reproductive health outcomes. In the current literature, mixed associations have been suggested between hurricane exposure and reproductive health outcomes. This may be due, in part, to residual confounding. We assessed the association between hurricane exposure and reproductive health outcomes by using a difference-in-difference analysis technique to control for confounding in a cohort of Florida pregnancies. We implemented a difference-in-difference analysis to evaluate hurricane weather and reproductive health outcomes including low birth weight, fetal death, and birth rate. The study population for analysis included all Florida pregnancies conceived before or during the 2003 and 2004 hurricane season. Reproductive health data were extracted from vital statistics records from the Florida Department of Health. In 2004, 4 hurricanes (Charley, Frances, Ivan, and Jeanne) made landfall in rapid succession; whereas in 2003, no hurricanes made landfall in Florida. Overall models using the difference-in-difference analysis showed no association between exposure to hurricane weather and reproductive health. The inconsistency of the literature on hurricane exposure and reproductive health may be in part due to biases inherent in pre-post or regression-based county-level comparisons. We found no associations between hurricane exposure and reproductive health. (Disaster Med Public Health Preparedness. 2017;11:407-411).

The Holy See on sexual and reproductive health rights: conservative in position, dynamic in response.

PubMed

Coates, Amy L; Hill, Peter S; Rushton, Simon; Balen, Julie

2014-11-01

The Holy See has engaged extensively in United Nations negotiations on issues concerning sexual and reproductive health rights as they have emerged and evolved in a dynamic global agenda over the past two decades. A meta-narrative review of the mission's official statements was conducted to examine the positions, discourses and tensions across the broad range of agendas. The Holy See represents a fundamentally conservative and stable position on a range of sexual and reproductive health rights concerns. However, the mission has been dynamic in the ways in which it has forwarded its arguments, increasingly relying upon secularised technical claims and empirical evidence; strategically interpreting human rights norms in ways consistent with its own position; and framing sexuality and reproduction in the context of "the family". Seen in the broader context of a "religious resurgence" in international relations, and in light of the fact that the Holy See has frequently sought to form alliances with conservative State and non-State actors, these findings make an important contribution to understanding the slow progress as well as the potential obstacles that lie ahead in the battle to realise sexual and reproductive health rights in a changing global political environment. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Global issues in women's health.

PubMed

Sciarra, John J

2009-01-01

World population growth in the past century has taxed the ability of healthcare systems in low-income countries to provide reproductive health care. Maternal mortality and morbidity, sexually transmitted diseases, and cervical cancer are major problems. Expansion of reproductive health services, training of appropriate medical personnel, and elevating the status of women in society are all necessary and appropriate solutions to improve the health of women in low-income countries.

Women’s Preferred Sources for Primary and Mental Health Care: Implications for Reproductive Health Providers

PubMed Central

Harris, Lisa H.; Dalton, Vanessa K.

2016-01-01

Purpose To describe women’s preferences for reproductive health providers as sources of primary and mental health care. Methods Secondary data analysis of the Women’s Health Care Experiences and Preferences Study, an internet survey conducted in September 2013 of 1,078 women aged 18–55 randomly sampled from a U.S. national probability panel. We estimated women’s preferred and usual sources of care (reproductive health providers, generalists, other) for various primary care and mental health care services using weighted statistics and multiple logistic regression. Main Findings Among women using healthcare in the past five years (n=981), 88% received primary and/or mental health care, including routine medical check-up (78%), urgent/acute (48%), chronic disease (27%), depression/anxiety (21%), stress (16%), and IPV (2%) visits. Of those, reproductive health providers were the source of check-up (14%), urgent/acute (3%), chronic disease (6%), depression/anxiety (6%), stress (11%), and intimate partner violence (3%) services. Preference for specific reproductive health-provided primary/mental health care services ranged from 7–20%. Among women having used primary/mental health care services (N=894), more women (1–17%) preferred than had received primary/mental health care from reproductive health providers. Nearly a quarter (22%) identified reproductive health providers as their single most preferred source of care. Contraceptive use was the strongest predictor of preference for reproductive health-provided primary/mental health care (Odds Ratios range 2.11–3.30). Conclusions Reproductive health providers are the sole source of healthcare for a substantial proportion of reproductive-aged women – the same groups at risk for unmet primary and mental health care needs. Findings have implications for reproductive health providers’ role in comprehensive women’s healthcare provision and potentially for informing patient-centered, integrated models of

Assessing public-private reproductive health efforts to reach young married couples in rural Bangladesh.

PubMed

Khatun, Mahmuda; Mahboob-E-Alam; Nazneen, Quamrun Nahar

Young married couples (YMC) in Bangladesh receive insufficient attention from service providers for reproductive health and family planning needs. The ACQUIRE Project, undertaken by EngenderHealth, Bangladesh, provides intervention for service providers, social and local leaders, and mothers-in-law as effective agents of channeling information to YMCs. EngenderHealth, in collaboration with the public sector, examined the extent to which an intervention program enhances overall quality of services, respondents' knowledge and attitude, and service-seeking behavior related to reproductive health issues. A quasi-experimental design with two matching groups, one watching the intervention, was used. The endline survey was carried out 10 months after the Baseline survey. Key informants interviews and FGDs were conducted. The findings were mixed. Importantly, young married men and women need friendly services and service providers with positive attitudes.

'Man Up': the importance and strategy for placing male reproductive health centre stage in the political and research agenda.

PubMed

Barratt, Christopher L R; De Jonge, Christopher J; Sharpe, Richard M

2018-04-01

Approximately 1 in 20 young men today have sperm counts low enough to impair fertility, whereas this may not have been the case historically. The cause(s) of such a decline in male reproductive health is unknown, despite it being a global health issue. Concomitantly, little progress has been made in answering fundamental questions in andrology or in developing new diagnostic tools or alternative management strategies to ICSI in infertile men. We advocate formulation of a detailed roadmap for male reproductive health to facilitate development of a research agenda that highlights the present unmet needs and key unanswered questions, and seeks to deliver effective funding and investment to address them. This vision we term 'a Male Reproductive Health Ecosystem'.

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.

Connecting Police Violence With Reproductive Health.

PubMed

Premkumar, Ashish; Nseyo, Onouwem; Jackson, Andrea V

2017-01-01

Since the police-involved deaths of Michael Brown and Freddie Gray, activists have argued for connecting police violence with reproductive justice. We argue that systematic violence, including police violence, should be evaluated in relation to reproductive health outcomes of individual patients and communities. Beyond emphasizing the relationship between violence and health outcomes, both qualitative and epidemiologic data can be used by activists and caregivers to effectively care for individuals from socially marginalized communities.

Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy.

PubMed

Harper, Joyce; Geraedts, Joep; Borry, Pascal; Cornel, Martina C; Dondorp, Wybo J; Gianaroli, Luca; Harton, Gary; Milachich, Tanya; Kääriäinen, Helena; Liebaers, Inge; Morris, Michael; Sequeiros, Jorge; Sermon, Karen; Shenfield, Françoise; Skirton, Heather; Soini, Sirpa; Spits, Claudia; Veiga, Anna; Vermeesch, Joris Robert; Viville, Stéphane; de Wert, Guido; Macek, Milan

2014-08-01

How has the interface between genetics and assisted reproduction technology (ART) evolved since 2005? The interface between ART and genetics has become more entwined as we increase our understanding about the genetics of infertility and we are able to perform more comprehensive genetic testing. In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and ART and published an extended background paper, recommendations and two Editorials. An interdisciplinary workshop was held, involving representatives of both professional societies and experts from the European Union Eurogentest2 Coordination Action Project. In March 2012, a group of experts from the European Society of Human Genetics, the European Society of Human Reproduction and Embryology and the EuroGentest2 Coordination Action Project met to discuss developments at the interface between clinical genetics and ART. As more genetic causes of reproductive failure are now recognized and an increasing number of patients undergo testing of their genome prior to conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and PGD may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from RCTs to substantiate that the technique is both effective and efficient. Whole genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving, but still remains very

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

[Investigation and Analysis on shift work female workers' and the impact on reproductive health].

PubMed

Yu, C Y; Yu, W L; Xu, M; Xing, Z L

2018-02-20

Objective: To investigate the distribution of shift work of female workers in different industries and the relationship between shift work and reproductive health, then provide reference for the female workers' labor protection. Methods: From June to September 2016, cluster sampling questionnaire survey was performed among female workers from 11 industries including electronics, medicine and health, pharmacy. To investigate the general information, shift - work information, reproductive health and childbearing history of these female workers. Results: A total of 63 711 usable questionnaires were collected, resulting in a response rate of 96.94%.A total of 13 546 workers worked in shifts, accounting for 21.26%, the highest proportion was in the medical industry 30.61%, metallurgy 30.81%, petrochemical engineerin 26.78% respectively. Compared with the workers who did not work in shifts, those who worked in shifts had significantly higher rate of abnormal menstruation, rate of reproductive system infection in married workers, the rate of infertility (χ(2)=19.108、10.673、21.510, P <0.05) ; Compared with the workers who did not work in nightshifts, those who worked in nightshifts had significantly higher rate of abnormal menstruation, rate of reproductive system infection among married workers and rate of infertility (χ(2)=140.043、71.901、29.024, P <0.01) . Conclusion: The highest rate of shift work was in the medical industry, metallurgy, petrochemical engineering industry. Workers who worked in shifts have serious reproductive health issues, the occurrence of abnormal menstruation, reproductive system infection and infertility may associated with shift work.

Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy

PubMed Central

Harper, Joyce C; Geraedts, Joep; Borry, Pascal; Cornel, Martina C; Dondorp, Wybo; Gianaroli, Luca; Harton, Gary; Milachich, Tanya; Kääriäinen, Helena; Liebaers, Inge; Morris, Michael; Sequeiros, Jorge; Sermon, Karen; Shenfield, Françoise; Skirton, Heather; Soini, Sirpa; Spits, Claudia; Veiga, Anna; Vermeesch, Joris Robert; Viville, Stéphane; de Wert, Guido; Macek, Milan

2013-01-01

In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and assisted reproductive technology (ART), and published an extended background paper, recommendations and two Editorials. Seven years later, in March 2012, a follow-up interdisciplinary workshop was held, involving representatives of both professional societies, including experts from the European Union Eurogentest2 Coordination Action Project. The main goal of this meeting was to discuss developments at the interface between clinical genetics and ARTs. As more genetic causes of reproductive failure are now recognised and an increasing number of patients undergo testing of their genome before conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and preimplantation genetic diagnosis (PGD) may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from randomised clinical trials to substantiate that the technique is both effective and efficient. Whole-genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (International Standards Organisation – ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving but still remains very heterogeneous and often contradictory. The lack of legal harmonisation and uneven access to infertility treatment and PGD/PGS fosters considerable cross-border reproductive care in Europe and beyond. The aim of this paper is to complement previous publications and

Public reproductive health and 'unintended' pregnancies: introducing the construct 'supportability'.

PubMed

Macleod, Catriona Ida

2016-09-01

In this Perspectives paper, I outline the limitations of the concept of 'intentionality' in public reproductive health understandings of pregnancy. 'Intentionality', 'plannedness', 'wantedness' and 'timing' place individual cognitions, psychology and/or behaviors at the center of public health conceptualizations of pregnancies, thereby leaving the underlying social and structural dynamics under-examined. I propose a model that places 'supportability' at the center of thinking about pregnancies and that allows for an analysis of the intersection of individual cognitions, emotions and behavior with micro-level interactive spaces and macro-level issues. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Reproductive health in Romania: reversing the Ceausescu legacy.

PubMed

Hord, C; David, H P; Donnay, F; Wolf, M

1991-01-01

As a result of the restrictive reproductive health policies enforced under the 25-year Ceausescu dictatorship, Romania ended the 1980s with the highest recorded maternal mortality of any country in Europe--159 deaths per 100,000 live births in 1989. An estimated 87 percent of these maternal deaths were caused by illegal and unsafe abortion. Under the Ceausescu regime, all contraceptive methods were forbidden and induced abortion was available only for women who met extremely narrow criteria. Immediately after the December 1989 revolution that overthrew Ceausescu, the new government removed restrictions on contraceptive use and legalized abortion. This legislative change has had beneficial effects on women's health, seen in the drop in maternal mortality in 1990 to 83 deaths per 100,000 live births--almost half the ratio in 1989. In addition, changes instituted since the revolution have led to the improved availability of reproductive health services and to the creation of new educational and training opportunities related to reproductive health services and to the creation of new educational and training opportunities related to reproductive health. The newly created contraceptive and abortion services have presented health system managers and policymakers with many challenges as they work to expand the availability of high-quality, comprehensive reproductive health care in a setting of economic hardship, political unrest, insufficient infrastructure, and outdated medical knowledge and practice.

Targeting reproductive health to reduce poverty.

PubMed

1999-01-01

An article highlighting the comment made by Dr. Joe Kasonde regarding the reduction of poverty by uplifting the reproductive health. Better health services had been the focus of poverty reduction and improvement of economic status especially in the Central and Eastern Europe following the decline in their Gross Domestic Product in 1989. As a result, a drop in maternal nutritional status, increase in maternal morbidity and the number of sexually transmitted diseases (STD)-infected mothers were reported. Socioeconomic progress was proposed to be achieved by targeting the reproductive health of the population. In Central Asian republics, a high incidence of nutrition anemia and deprivation was noted that would most likely bring about economic hardship. Reports reveal a rise in the number of maternal mortality due to the high cost of health services as a result of economic crisis, while other mothers prefer abortion. Statistics showed 95% of maternal mortality between the 1989 and 1996 was caused by unsafe abortion. An increase in the number of persons infected with syphilis and other STDs reported in 1995 was induced by poverty. A strategy was proposed to reverse the economic situation through the promotion of better reproductive health services.

Community embedded reproductive health interventions for adolescents in Latin America: development and evaluation of a complex multi-centre intervention

PubMed Central

2013-01-01

Background Adolescents in Latin America are at high risk for unwanted and unplanned pregnancies, which often result in unsafe abortions or poor maternal health outcomes. Both young men and women in the region face an increased risk of sexually transmitted infections due to inadequate sexual and reproductive health information, services and counselling. To date, many adolescent health programmes have targeted a single determinant of sexual and reproductive health. However, recent evidence suggests that the complexity of sexual and reproductive health issues demands an equally multi-layered and comprehensive approach. Methods This article describes the development, implementation and evaluation design of the community-embedded reproductive health care for adolescents (CERCA) study in three Latin American cities: Cochabamba (Bolivia), Cuenca (Ecuador) and Managua (Nicaragua). Project CERCA’s research methodology builds on existing methodological frameworks, namely: action research, community based participatory research and intervention-mapping. The interventions in each country address distinct target groups (adolescents, parents, local authorities and health providers) and seek improvement of the following sexual health behaviours: communication about sexuality, sexual and reproductive health information-seeking, access to sexual and reproductive health care and safe sexual relationships. In Managua, we implemented a randomised controlled study, and in Cochabamba and Cuenca we adopted a non-randomised controlled study to evaluate the effectiveness of Project CERCA interventions, in addition to a process evaluation. Discussion This research will result in a methodological framework that will contribute to the improved design and implementation of future adolescent sexual and reproductive health interventions. Trial registration ClinicalTrials.gov (NCT01722084) PMID:23311647

Women's Sexual Health and Reproductive Function After SCI.

PubMed

Courtois, Frédérique; Alexander, Marcalee; McLain, Amie B Jackson

2017-01-01

Sexual function and to a lesser extent reproduction are often disrupted in women with spinal cord injuries (SCI), who must be educated to better understand their sexual and reproductive health. Women with SCI are sexually active; they can use psychogenic or reflexogenic stimulation to obtain sexual pleasure and orgasm. Treatment should consider a holistic approach using autonomic standards to describe remaining sexual function and to assess both genital function and psychosocial factors. Assessment of genital function should include thoracolumbar dermatomes, vulvar sensitivity (touch, pressure, vibration), and sacral reflexes. Self-exploration should include not only clitoral stimulation, but also stimulation of the vagina (G spot), cervix, and nipples conveyed by different innervation sources. Treatments may consider PDE5 inhibitors and flibanserin on an individual basis, and secondary consequences of SCI should address concerns with spasticity, pain, incontinence, and side effects of medications. Psychosocial issues must be addressed as possible contributors to sexual dysfunctions (eg, lower self-esteem, past sexual history, depression, dating habits). Pregnancy is possible for women with SCI; younger age at the time of injury and at the time of pregnancy being significant predictors of successful pregnancy, along with marital status, motor score, mobility, and occupational scores. Pregnancy may decrease the level of functioning (eg, self-care, ambulation, upper-extremity tasks), may involve complications (eg, decubitus ulcers, weight gain, urological complications), and must be monitored for postural hypotension and autonomic dysreflexia. Taking into consideration the physical and psychosocial determinants of sexuality and childbearing allows women with SCI to achieve positive sexual and reproductive health.

Women's Sexual Health and Reproductive Function After SCI

PubMed Central

Alexander, Marcalee; McLain, Amie B. (Jackson)

2017-01-01

Sexual function and to a lesser extent reproduction are often disrupted in women with spinal cord injuries (SCI), who must be educated to better understand their sexual and reproductive health. Women with SCI are sexually active; they can use psychogenic or reflexogenic stimulation to obtain sexual pleasure and orgasm. Treatment should consider a holistic approach using autonomic standards to describe remaining sexual function and to assess both genital function and psychosocial factors. Assessment of genital function should include thoracolumbar dermatomes, vulvar sensitivity (touch, pressure, vibration), and sacral reflexes. Self-exploration should include not only clitoral stimulation, but also stimulation of the vagina (G spot), cervix, and nipples conveyed by different innervation sources. Treatments may consider PDE5 inhibitors and flibanserin on an individual basis, and secondary consequences of SCI should address concerns with spasticity, pain, incontinence, and side effects of medications. Psychosocial issues must be addressed as possible contributors to sexual dysfunctions (eg, lower self-esteem, past sexual history, depression, dating habits). Pregnancy is possible for women with SCI; younger age at the time of injury and at the time of pregnancy being significant predictors of successful pregnancy, along with marital status, motor score, mobility, and occupational scores. Pregnancy may decrease the level of functioning (eg, self-care, ambulation, upper-extremity tasks), may involve complications (eg, decubitus ulcers, weight gain, urological complications), and must be monitored for postural hypotension and autonomic dysreflexia. Taking into consideration the physical and psychosocial determinants of sexuality and childbearing allows women with SCI to achieve positive sexual and reproductive health. PMID:29339874

Women with epilepsy: clinically relevant issues

PubMed Central

Bangar, Santosh; Shastri, Abhishek; El-Sayeh, Hany; Cavanna, Andrea E.

2016-01-01

Summary Women with epilepsy (WWE) face specific challenges throughout their lifespan due to the effects of seizures and antiepileptic drugs on hormonal function, potentially affecting both sexual and reproductive health. This review article addresses the most common issues of practical relevance to clinicians treating WWE: epidemiology and clinical presentations (including catamenial epilepsy), contraception, reproductive and sexual dysfunction, pregnancy, lactation, menopause-related issues (including bone health), and mental health aspects. Awareness of these gender-specific issues and implementation/adaptation of effective interventions for WWE results in significantly improved health-related quality of life in this patient population. PMID:27678205

Sexual and reproductive health is our business.

PubMed

Sarjeant, H

1993-01-01

The Family Planning Association of Trinidad and Tobago (FPATT) has decided that integration of the concept of sexual and reproductive health into regular family planning activities is the best way to increase the contraceptive prevalence rate. A more holistic approach to service provision is being developed. On the basis of survey findings that early sexual activity, low contraceptive use, and limited knowledge are widespread among young people, this population group has been selected as a focus. FPATT has asked for a TT$1 million subsidy to intensify sex education programs in the schools. Issues discussed include human sexuality, values clarification, relationships, problems affecting teenagers, parenting, rape and incest, and family planning. FPATT also conducts training sessions for teachers and parents. Since young people tend to respond best to peers, peer counseling is emphasized. Education is also offered at large industrial sites, private homes in small communities, and government health centers.

The reach and impact of social marketing and reproductive health communication campaigns in Zambia

PubMed Central

Van Rossem, Ronan; Meekers, Dominique

2007-01-01

Background Like many sub-Saharan African countries, Zambia is dealing with major health issues, including HIV/AIDS, family planning, and reproductive health. To address reproductive health problems and the HIV/AIDS epidemic in Zambia, several social marketing and health communication programs focusing on reproductive and HIV/AIDS prevention programs are being implemented. This paper describes the reach of these programs and assesses their impact on condom use. Methods This paper assesses the reach of selected radio and television programs about family planning and HIV/AIDS and of communications about the socially marketed Maximum condoms in Zambia, as well as their impact on condom use, using data from the 2001–2002 Zambia Demographic and Health Survey. To control for self-selection and endogeneity, we use a two-stage regression model to estimate the effect of program exposure on the behavioural outcomes. Results Those who were exposed to radio and television programs about family planning and HIV/AIDS were more likely to have ever used a condom (OR = 1.16 for men and 1.06 for women). Men highly exposed to Maximum condoms social marketing communication were more likely than those with low exposure to the program to have ever used a condom (OR = 1.48), and to have used a condom at their last sexual intercourse (OR = 1.23). Conclusion Findings suggest that the reproductive health and social marketing campaigns in Zambia reached a large portion of the population and had a significant impact on condom use. The results suggest that future reproductive health communication campaigns that invest in radio programming may be more effective than those investing in television programming, and that future campaigns should seek to increase their impact among women, perhaps by focusing on the specific constrains that prevent females from using condoms. PMID:18088437

The reach and impact of social marketing and reproductive health communication campaigns in Zambia.

PubMed

Van Rossem, Ronan; Meekers, Dominique

2007-12-18

Like many sub-Saharan African countries, Zambia is dealing with major health issues, including HIV/AIDS, family planning, and reproductive health. To address reproductive health problems and the HIV/AIDS epidemic in Zambia, several social marketing and health communication programs focusing on reproductive and HIV/AIDS prevention programs are being implemented. This paper describes the reach of these programs and assesses their impact on condom use. This paper assesses the reach of selected radio and television programs about family planning and HIV/AIDS and of communications about the socially marketed Maximum condoms in Zambia, as well as their impact on condom use, using data from the 2001-2002 Zambia Demographic and Health Survey. To control for self-selection and endogeneity, we use a two-stage regression model to estimate the effect of program exposure on the behavioural outcomes. Those who were exposed to radio and television programs about family planning and HIV/AIDS were more likely to have ever used a condom (OR = 1.16 for men and 1.06 for women). Men highly exposed to Maximum condoms social marketing communication were more likely than those with low exposure to the program to have ever used a condom (OR = 1.48), and to have used a condom at their last sexual intercourse (OR = 1.23). Findings suggest that the reproductive health and social marketing campaigns in Zambia reached a large portion of the population and had a significant impact on condom use. The results suggest that future reproductive health communication campaigns that invest in radio programming may be more effective than those investing in television programming, and that future campaigns should seek to increase their impact among women, perhaps by focusing on the specific constrains that prevent females from using condoms.

Educational Strategies to Help Students Provide Respectful Sexual and Reproductive Health Care for Lesbian, Gay, Bisexual, and Transgender Persons.

PubMed

Walker, Kelly; Arbour, Megan; Waryold, Justin

2016-11-01

Graduate medical, nursing, and midwifery curricula often have limited amounts of time to focus on issues related to cultural competency in clinical practice, and respectful sexual and reproductive health care for all individuals in particular. Respectful health care that addresses sexual and reproductive concerns is a right for everyone, including those who self-identify as lesbian, gay, bisexual, or transgender (LGBT). LGBT persons have unique reproductive health care needs as well as increased risks for poor health outcomes. Both the World Health Organization and Healthy People 2020 identified the poor health of LGBT persons as an area for improvement. A lack of educational resources as well as few student clinical experiences with an LGBT population may be barriers to providing respectful sexual and reproductive health care to LGBT persons. This article offers didactic educational strategies for midwifery and graduate nursing education programs that may result in reducing barriers to the provision of respectful sexual and reproductive health care for LGBT clients. Specific ideas for implementation are discussed in detail. In addition to what is presented here, other educational strategies and clinical experiences may help to support students for caring for LGBT persons prior to entrance into clinical practice. © 2016 by the American College of Nurse-Midwives.

Health workers' attitudes toward sexual and reproductive health services for unmarried adolescents in Ethiopia.

PubMed

Tilahun, Mesfin; Mengistie, Bezatu; Egata, Gudina; Reda, Ayalu A

2012-09-03

Adolescents in developing countries face a range of sexual and reproductive health problems. Lack of health care service for reproductive health or difficulty in accessing them are among them. In this study we aimed to examine health care workers' attitudes toward sexual and reproductive health services to unmarried adolescents in Ethiopia. We conducted a descriptive cross-sectional survey among 423 health care service providers working in eastern Ethiopia in 2010. A pre-tested structured questionnaire was used to collect data. Descriptive statistics, chi-square tests and logistic regression were performed to drive proportions and associations. The majority of health workers had positive attitudes. However, nearly one third (30%) of health care workers had negative attitudes toward providing RH services to unmarried adolescents. Close to half (46.5%) of the respondents had unfavorable responses toward providing family planning to unmarried adolescents. About 13% of health workers agreed to setting up penal rules and regulations against adolescents that practice pre-marital sexual intercourse. The multivariate analysis indicated that being married (OR 2.15; 95% CI 1.44 - 3.06), lower education level (OR 1.45; 95% CI 1.04 - 1.99), being a health extension worker (OR 2.49; 95% CI 1.43 - 4.35), lack of training on reproductive health services (OR 5.27; 95% CI 1.51 - 5.89) to be significantly associated with negative attitudes toward provision of sexual and reproductive services to adolescents. The majority of the health workers had generally positive attitudes toward sexual and reproductive health to adolescents. However, a minority has displayed negatives attitudes. Such negative attitudes will be barriers to service utilization by adolescents and hampers the efforts to reduce sexually transmitted infections and unwanted pregnancies among unmarried adolescents. We therefore call for a targeted effort toward alleviating negative attitudes toward adolescent

Four perspectives of women's health. Workshop participants talk about women's health issues in four countries. [Malaysia].

PubMed

Kaur, P

1994-01-01

The program officer of the SIEC Project of the Federation of Family Planning Associations, Malaysia (FFPA,M) granted an interview to JOICFP News during JOICFP's IEC Workshop for the Production of Video Script for Women's Health in Tokyo, Japan. FFPA,M provides comprehensive reproductive health services, including family planning services, pap smear screenings, breast examination, annual medical checkups, and premarital and marital counseling for women. Around 50% of married women use family planning. More than 90% of contraceptive users are familiar with at least one family planning method. FFPA,M is focusing on marginalized women. As Malaysia industrializes, rural-urban migration occurs. Young women comprise many of the new factory workers. FFPA,M provides family life education for these women and strives to help them achieve reproductive health and rights. The enthusiasm for women's issues exhibited at the workshop by both male and female participants pleased FFPA,M's program officer.

Accessing sexual and reproductive health care and information: Perspectives and recommendations from young Asian American women.

PubMed

Frost, Madeline; Cares, Alexa; Gelman, Katie; Beam, Rita

2016-12-01

Understanding the influence of culture on how sexual and reproductive health is perceived and addressed in Asian American communities is important for the effective provision of care and health information. This study aimed to explore how and when sexual and reproductive health information is shared within Asian American families and communities, barriers and facilitators to accessing sexual and reproductive health care and information for young Asian American women, and their recommendations to improve access. Qualitative data were collected through six focus groups conducted with a total of 33 young Asian American women. The majority of participants reported that stigma created a barrier to discussing these topics within their families and communities, and discussed ways in which they confidentially seek out care and information. Responses varied with respect to participants' preferred means of increasing access to care and information; some recommended strategies that would increase communication about these issues in their families and communities, while others expressed a desire to maintain confidentiality. These findings suggest that diversified strategies are needed to connect Asian American women with sexual and reproductive health care and information in order to meet their varied preferences, including strategies that are community-driven and culturally appropriate. Copyright © 2016 Elsevier B.V. All rights reserved.

Choosing Pre-conception Planning for Women/Families: Counselling and Informed Consent (Part 2) - Pre-conception Reproductive Planning, Lifestyle, Immunization, and Psychosocial Issues.

PubMed

Wilson, R Douglas

2017-12-06

To inform reproductive and other health care providers about pre-conception evaluation, including considerations for reproductive planning, lifestyle modification, immunization status and attitudes, and psychosocial issues. This counselling information can be used for patient education and planning and possible pre-conception and/or prenatal testing. This information may allow for improved risk assessment when pre-conception counselling for individual patients and their families is used. CONSIDERATIONS FOR PRE-CONCEPTION CARE (PART 2) REGARDING PRE-CONCEPTION REPRODUCTIVE PLANNING, LIFESTYLE, IMMUNIZATIONS, AND PSYCHOSOCIAL ISSUES: CONSIDERATION FOR CARE STATEMENTS: For this review article, the Consideration for Care Statements use the Grading of Recommendations, Assessment, Development and Evaluations strength and quality principles because they are comparable for the clinician and the patient/public user. For example, "Strong" for clinicians is defined as "the recommendation would apply to most individuals. Formal discussion aids are not likely to be needed to help individuals make decisions consistent with their values and preferences." For patients/the public, "Strong" is defined as, "we believe most people in this situation would want the recommended course of actions and only a small number would not." Quality of evidence (High, Moderate, Low) is based on the confidence that the true effect lies close to that of the estimate of the effect. In addition, the Canadian Task Force on Preventive Health Care key to evidence statements and grading of recommendations are included. PubMed, Medline, and the Cochrane Database were searched until May 2017, using appropriate key words (i.e., preconception, reproductive planning, lifestyle modification, immunization risks and benefits, psychosocial pregnancy factors/issues). Grey (unpublished) literature was identified through searching websites of health technology assessment and health technology assessment

Marriage characteristics and reproductive health of adolescents in Turkey: findings from Demographic and Health Surveys 1998 and 2008.

PubMed

Tezcan, Sabahat; Adali, Tuğba

2012-01-01

Adolescent marriage is an important issue given its social and medical consequences. This study focuses on the recent trends in adolescent marriage and reproductive health in Turkey to provide insights for action. Data from the Demographic and Health Surveys of 1998 and 2008 were used. Adolescent marriage and reproductive health indicators were assessed for urban-rural residences, demographic regions and educational levels. Logistic regression was used to predict marriage and birth in adolescence. Despite the decrease in the proportion of married adolescents from 1998 to 2008, the findings suggest no improvement in some marriage characteristics. In both surveys, over 60% of ever-married adolescents had been pregnant at least once. There is an increase in contraceptive use and antenatal care. Our findings showed that in Turkey, women living in rural areas, from poor households, with more traditional parental families, with less education, and who are not working are more likely to get married in their adolescent ages.

Human reproductive issues in space

NASA Technical Reports Server (NTRS)

Santy, Patricia A.; Jennings, Richard T.

1992-01-01

A review of reproductive functioning in animal species studied during space flight demonstrated that most species were affected significantly by the absence of gravity and/or the presence of radiation. These two factors induced alterations in normal reproductive functioning independently of, as well as in combination with, each other. Based on animal models, several potential problem areas regarding human reproductive physiology and functioning in the space environment were identified. While there are no current space flight investigations, the animal studies suggest priorities for future research in human reproduction. Such studies will be critical for the successful colonization of the space frontier.

Work-related reproductive, musculoskeletal and mental disorders among working women--history, current issues and future research directions.

PubMed

Kishi, Reiko; Kitahara, Teruyo; Masuchi, Ayumi; Kasai, Setsuko

2002-04-01

According to the recent changes of working environments and socio-economical conditions, the proportion of working women are increasing in Japan. Characteristics of occupational workload and stress of Japanese working women are consistent with those in many industrialized countries except man-dominant culture. In this review we describe the history, current issues, and future research directions on occupational health of working women, especially focused on reproductive health, work-related musculo-skeletal disorders (WMSDs), and mental disorders. In the reproductive health survey, traditionally main concern was about pregnancy outcomes, then fecundity studies, such as time to pregnancy, became topics recently. Future research will be shifted to outcomes not only during pregnancy but also disorders of hormonal balance and climacterium or health conditions after menopause. WMSDs are reviewed on mainly gender difference and its causative factors. Historically, mental health of working women in Japan has focused on the job stress of nurses. We compare results with a lot of recent researches in Europe and U.S.A., where interaction between occupational stress and family roles were studied. It is not easy to predict the prospective status of female workers in Japan, but social, workplace and familial supports will enhance their health promotion.

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. © 2012 APJPH.

A policy analysis of the problem of the reproductive health of women in the workplace.

PubMed

Kotch, J B; Ossler, C C; Howze, D C

1984-06-01

Many occupations in which women comprise the majority of the workforce involve exposure to biological, physical, and chemical hazards. Potential reproductive effects of work-related substances include impaired reproductive capacity, mutagenesis, teratogenesis, and transplacental carcinogenesis. However, female-dominated occupations tend to be only minimally regulated by the US Occupational Safety and Health Administration, and the corporate response to the issue of reproductive and fetal health has been to institute "protective discrimination policies" such as the demotion or exclusion of women of childbearing age from certain jobs. This article rates the effectiveness of alternate policy responses to increase women's occupational health and safety through use of a series of analysis criteria: equity, efficiency, preference satisfaction, right to privacy, avoidance of stigma, and unintended consequences. Policy options include the following: 1) do nothing, 2) leave current policies intact while supporting a research program to document the health consequences of specific occupational risks to women's reproductive health, 3) restrict women for who pregnancy is not ruled out from occupations or work areas known or suspected to be hazardous, 4) improve working conditions for all women, and 5) improve working conditions for all workers. Policy analysis suggests the working conditions of all workers should be improved. This alternative reduces inequity, eliminates stigma, maintains privacy, and honors preferences. Implementation of this policy would be expensive, requiring an increase in knowledge of the effects of industrial substances on female and male reproductive health, expansion of the technical capacity to control occupational hazards, and an increase in the resources of programs that monitor and regulate occupational health. However, this approach is in accord with growing concern that workers should not have to compromise their health to keep their jobs.

Women's Perceptions of Reproductive Health in Three Communities around Beirut, Lebanon

PubMed Central

Kaddour, Afamia; Hafez, Raghda; Zurayk, Huda

2006-01-01

The aim of this study was to elicit definitions of the concept of reproductive health among women in three communities around Beirut, Lebanon, as part of the reproductive health component of a larger Urban Health Study. The communities were characterised by poverty, rural-urban mobility and heterogeneous refugee and migrant populations. A random sample of 1,869 women of reproductive age completed a questionnaire, of whom a sub-sample of 201 women were randomly selected. The women's understanding of good reproductive health included three major themes, which were expressed differently in the three communities. Their understanding included good physical and mental health, and underscored the need for activities promoting health. Their ability to reproduce and raise children, practise family planning and birth spacing, and go through pregnancy and motherhood safely were central to their reproductive duties and their social status. Finally, they saw reproductive health within the context of economic status, good marital relations and strength to cope with their lives. These findings point to the need to situate interventions in the life course of women, their health and that of their husbands and families; the importance of reproduction not only from a health services point of view, but also as regards women's roles and responsibilities within marriage and their families; and taking account of the harsh socio-economic conditions in their communities. A 2005 Reproductive Health Matters. All rights reserved. PMID:16035595

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.

Advocating change in Palestine. Advocacy for reproductive health: Palestine.

PubMed

Wolmuth, P

1996-01-01

The Palestinian Family Planning and Protection Association (PFPPA) recently implemented a new strategic plan based on the Strategic Plan of the International Planned Parenthood Federation (IPPF) aimed at the empowerment of women. Advocacy is the central part of the program with preparing the services and dealing with the issue of population. In early 1995 a round of meetings in the West Bank and the Gaza Strip launched the plan with new programs for women, youth, men, information, education, and communication, and service provision to start in January 1996. In Gaza the Youth Program is well under way. Five members were selected from each of 50 groups for a 1-week training course in Gaza City in November 1995. The topics included: mutual respect between husband and wife, discussion of the role of family planning in the context of Islam, the rights and wrongs of polygamy, and the hotly debated issue of sex segregation in education. The PFPPA staff was initially apprehensive about the new youth and women's program plans to broaden family planning to women's empowerment and sexual and reproductive health. An IPPF-sponsored video was also shown in Hebron, West Bank, on the problem of early marriage. It featured Palestinian women: one with 12 children who was married at age 13; a mother whose husband wanted to marry off their 12-year-old daughter; and portrayed pressure from husbands and other family members to produce many children. The new strategy engendered debate in the West Bank and Gaza among village women and young people, while in the meantime the training of government health workers started in sexual and reproductive health counseling. In the village of Tkooi, near Bethlehem, a counselor held sessions on the oppression of women and psycho-physiological problems and stress. A lawyer also summarized women's economic and property rights, which most of them were unaware of.

Sexual and reproductive health of Portuguese adolescents.

PubMed

Mendes, Neuza; Palma, Fátima; Serrano, Fátima

2014-01-01

As adolescent pregnancy and sexually transmitted infections (STIs) are major sources of morbidity, preventing them is an important health goal for Portuguese society. To review data on the knowledge, attitudes and statistics on sexual and reproductive health. A systematic review was conducted including peer-reviewed articles addressing issues influencing the sexuality of Portuguese adolescents (aged 13 to 19), published up to 2011 and conducted in any type of setting. After crossing-cleaning the reference list, 33 articles were included. The rate of sexual activity by Portuguese adolescents is high (44%-95%), but there has been an increase in the age of intercourse debut (currently 15.6 years). Early commencement of sexual intercourse is associated with smoking and regular alcohol consumption. Condoms are the most frequently chosen contraceptive method for first (76%-96%) and subsequent (52%-69%) sexual encounters. The perception of a double standard in sex still exists in teenage culture for both genders and influence behavior. There are significant differences between migrant and native adolescents: African adolescents initiate sexual intercourse at earlier ages and are more likely to have unprotected sex. Only one-third of Portuguese teenagers have ever visited a health facility to seek counseling concerning contraception or STIs, and less than half have ever attended classes on reproductive health. Very few (12%) have knowledge about Chlamydia trachomatis infection. The prevalence of STIs in Portuguese youth is unknown. The adolescent fertility rate is still high (14.7 births per 1000 females aged 15-19 years), but it, as well as the rate of abortion, is steadily decreasing. There is still a long way to go towards promoting a resourceful young population. Citizens and institutions must focus on increasing both the competence of youths and external supports. Information must be provided systematically and health services must have greater accessibility. Studies

Knowledge of and attitudes towards sexual and reproductive health in adults in Shiraz: a need for further education.

PubMed

Khajehei, M; Ziyadlou, S; Ghanizadeh, A

2013-12-01

Sexual health influences general well-being and the overall quality of life of all men and women. This study in Shiraz, Islamic Republic of Iran, aimed to assess the level of knowledge of and attitudes towards sexual and reproductive health among adults. In a cross-sectional study in 2010, 276 men and 281 women were recruited at pre-marital counselling courses and completed a 33-item anonymous questionnaire in private. The overall level of knowledge of men and women was low. Both men and women had low scores on knowledge of genital anatomy, sexually transmitted infections and contraceptive use. The majority of participants had positive attitudes towards implementing educational programmes on sexual and reproductive health issues for young adults and prior to marriage. Efficient educational programmes providing up-to-date information about sexual and reproductive health are needed in the Islamic Republic of Iran.

Chlamydia trachomatis and Genital Mycoplasmas: Pathogens with an Impact on Human Reproductive Health

PubMed Central

Ljubin-Sternak, Sunčanica; Meštrović, Tomislav

2014-01-01

The most prevalent, curable sexually important diseases are those caused by Chlamydia trachomatis (C. trachomatis) and genital mycoplasmas. An important characteristic of these infections is their ability to cause long-term sequels in upper genital tract, thus potentially affecting the reproductive health in both sexes. Pelvic inflammatory disease (PID), tubal factor infertility (TFI), and ectopic pregnancy (EP) are well documented complications of C. trachomatis infection in women. The role of genital mycoplasmas in development of PID, TFI, and EP requires further evaluation, but growing evidence supports a significant role for these in the pathogenesis of chorioamnionitis, premature membrane rupture, and preterm labor in pregnant woman. Both C. trachomatis and genital mycoplasmas can affect the quality of sperm and possibly influence the fertility of men. For the purpose of this paper, basic, epidemiologic, clinical, therapeutic, and public health issue of these infections were reviewed and discussed, focusing on their impact on human reproductive health. PMID:25614838

Reproductive health rights and survival: The voices of mothers experiencing homelessness.

PubMed

Cronley, Courtney; Hohn, Kris; Nahar, Shamsun

2018-03-01

Women experiencing homelessness report higher rates of reproductive health-related traumas, including unplanned pregnancy, miscarriage, and abortion than their non-homeless peers. Using phenomenological hermeneutic methods, we sought to understand the reproductive health histories of women currently experiencing homelessness (N = 20, 25-61 years old, Mage = 38.33, SDage = 9.33) analyzing data collected between June 2014 and July 2015 in north central Texas. Three key themes highlight the essence of the women's experiences: (1) unexpected pregnancy-pregnancy just happened, (2) loss of reproductive health rights-I was broken, and (3) resilience-giving back and looking forward to good things. Many of the women became mothers through unexpected pregnancies, and overnight found that their lives were transformed irrevocably. Often unexpected pregnancy was the result or cause of a lack of ownership over their reproductive health and led to prolonged health-related traumas. Over time, though, many of the women whom we interviewed re-expressed resilience through social support, housing assistance, and a sense of giving back to society. Results indicate that reproductive health care providers require training to identify the relationship among unexpected pregnancy, reproductive health-related traumas, and housing insecurity. Providers can help preserve women's reproductive health rights through education and empowerment.

Advancing a conceptual model to improve maternal health quality: The Person-Centered Care Framework for Reproductive Health Equity.

PubMed

Sudhinaraset, May; Afulani, Patience; Diamond-Smith, Nadia; Bhattacharyya, Sanghita; Donnay, France; Montagu, Dominic

2017-11-06

Background: Globally, substantial health inequities exist with regard to maternal, newborn and reproductive health. Lack of access to good quality care-across its many dimensions-is a key factor driving these inequities. Significant global efforts have been made towards improving the quality of care within facilities for maternal and reproductive health. However, one critically overlooked aspect of quality improvement activities is person-centered care. Main body: The objective of this paper is to review existing literature and theories related to person-centered reproductive health care to develop a framework for improving the quality of reproductive health, particularly in low and middle-income countries. This paper proposes the Person-Centered Care Framework for Reproductive Health Equity, which describes three levels of interdependent contexts for women's reproductive health: societal and community determinants of health equity, women's health-seeking behaviors, and the quality of care within the walls of the facility. It lays out eight domains of person-centered care for maternal and reproductive health. Conclusions: Person-centered care has been shown to improve outcomes; yet, there is no consensus on definitions and measures in the area of women's reproductive health care. The proposed Framework reviews essential aspects of person-centered reproductive health care.

Sexual and reproductive health and rights and mHealth in policy and practice in South Africa.

PubMed

Waldman, Linda; Stevens, Marion

2015-05-01

Information and Communications Technology (ICT) offers enormous opportunity and innovation to improve public health and health systems.This paper explores the intersections between mHealth and sexual and reproductive health and rights in both policy and practice. It is a qualitative study, informed by policy review and key informant interviews. Three case studies provide evidence of what is happening on the ground in relation to ICTs and reproductive health and rights. We argue that in terms of policy, there is little overlap between health rights and communication technology. In the area of practice, however, significant interventions address aspects of reproductive health. At present, the extent to which mHealth addresses the full range of reproductive justice and sexual and reproductive health and rights is limited, particularly in terms of government initiatives. The paper argues that mHealth projects tend to avoid contentious aspects of sexual health, while addressing favourable topics such as pregnancy and motherhood. The ways in which information is framed in mHealth mirrors current gaps within sexual and reproductive health and rights, where a limited and conservative lens predominates, and which may result in narrow programming and implementation of services. Copyright © 2015. Published by Elsevier Ltd.

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

Women's perceptions of reproductive health in three communities around Beirut, Lebanon.

PubMed

Kaddour, Afamia; Hafez, Raghda; Zurayk, Huda

2005-05-01

The aim of this study was to elicit definitions of the concept of reproductive health among women in three communities around Beirut, Lebanon, as part of the reproductive health component of a larger Urban Health Study. The communities were characterised by poverty, rural-urban mobility and heterogeneous refugee and migrant populations. A random sample of 1,869 women of reproductive age completed a questionnaire, of whom a sub-sample of 201 women were randomly selected. The women's understanding of good reproductive health included three major themes, which were expressed differently in the three communities. Their understanding included good physical and mental health, and underscored the need for activities promoting health. Their ability to reproduce and raise children, practise family planning and birth spacing, and go through pregnancy and motherhood safely were central to their reproductive duties and their social status. Finally, they saw reproductive health within the context of economic status, good marital relations and strength to cope with their lives. These findings point to the need to situate interventions in the life course of women, their health and that of their husbands and families; the importance of reproduction not only from a health services point of view, but also as regards women's roles and responsibilities within marriage and their families; and taking account of the harsh socio-economic conditions in their communities.

The global reproductive health market: U.S. media framings and public discourses about transnational surrogacy.

PubMed

Markens, Susan

2012-06-01

During the first decade of the 21st century a new "dramatic story" about the growing global surrogacy industry brought renewed attention to surrogacy as a social problem and a health policy issue. This paper asks: What cultural assumptions about gender, family and the global reproductive health market are revealed in current U.S. media coverage of and public discourses about surrogacy? From a qualitative analysis of prominent news accounts of surrogacy that were published in 2008, New York Times articles and blogs published on the topic between 2006 and 2010, and over 1000 online reader comments to these articles, I identify key frames used to discursively construct and debate the international surrogacy market. This study reveals the distinct contrast between the occasions when reproductive labor is rhetorically distanced from commodification processes and when it is linked to those processes. The findings contribute to intersectional analyses of assisted reproductive practices and women's health/bodies/gametes. In particular, this study's analysis of recent media framings of and public discourses about surrogacy across the globe serves as another illustration that national/classed/racialized bodies continue to be reproductively stratified via differently gendered discourses about women, motherhood and family. Copyright © 2011 Elsevier Ltd. All rights reserved.

Reproductive health experiences of women with cardiovascular disease.

PubMed

Chor, Julie; Oswald, Lora; Briller, Joan; Cowett, Allison; Peacock, Nadine; Harwood, Bryna

2012-11-01

Limited research exists exploring contraceptive and pregnancy experiences of women with cardiovascular diseases. We conducted semistructured interviews with reproductive-age women with chronic hypertension or peripartum cardiomyopathy exploring thoughts and behaviors regarding future fertility. Transcribed interviews were coded and analyzed identifying salient themes. We interviewed 20 women with chronic hypertension and 10 women with peripartum cardiomyopathy. Women described a spectrum of perspectives regarding the relationship between disease and fertility: from complete disconnect to full integration of diagnosis and future fertility plans. Integration of reproductive and cardiovascular health was influenced by and reflected in circumstances of diagnosis, pregnancy-related experiences, contraception-related experiences and conceptualization of disease risk related to reproductive health. Providers must better understand how women perceive and consider their reproductive and cardiovascular health in order to optimize contraceptive care of women with cardiovascular disease and help them make safe, informed decisions about future fertility. Copyright © 2012 Elsevier Inc. All rights reserved.

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.

Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy. European Society of Human Genetics and European Society of Human Reproduction and Embryology.

PubMed

Harper, Joyce C; Geraedts, Joep; Borry, Pascal; Cornel, Martina C; Dondorp, Wybo; Gianaroli, Luca; Harton, Gary; Milachich, Tanya; Kääriäinen, Helena; Liebaers, Inge; Morris, Michael; Sequeiros, Jorge; Sermon, Karen; Shenfield, Françoise; Skirton, Heather; Soini, Sirpa; Spits, Claudia; Veiga, Anna; Vermeesch, Joris Robert; Viville, Stéphane; de Wert, Guido; Macek, Milan

2013-11-01

In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and assisted reproductive technology (ART), and published an extended background paper, recommendations and two Editorials. Seven years later, in March 2012, a follow-up interdisciplinary workshop was held, involving representatives of both professional societies, including experts from the European Union Eurogentest2 Coordination Action Project. The main goal of this meeting was to discuss developments at the interface between clinical genetics and ARTs. As more genetic causes of reproductive failure are now recognised and an increasing number of patients undergo testing of their genome before conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and preimplantation genetic diagnosis (PGD) may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from randomised clinical trials to substantiate that the technique is both effective and efficient. Whole-genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (International Standards Organisation - ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving but still remains very heterogeneous and often contradictory. The lack of legal harmonisation and uneven access to infertility treatment and PGD/PGS fosters considerable cross-border reproductive care in Europe and beyond. The aim of this paper is to complement previous publications and provide

Trade-offs between reproduction and health in free-ranging African striped mice.

PubMed

Schoepf, I; Pillay, N; Schradin, C

2017-05-01

Energy is limited and must be allocated among competing life-history traits. Reproduction is considered one of the most energetically demanding life-history stages. Therefore, the amount of energy an individual invests in reproduction might carry fitness costs through reduced energy allocation to other activities such as health maintenance. We investigated whether reproduction impacts health in the seasonally breeding African striped mouse (Rhabdomys pumilio). We measured health in individuals that reproduced (breeders) and individuals that did not reproduce (their adult offspring) and tested whether: (1) breeders' health before reproduction was similar to that of their offspring (representing a baseline); (2) breeders' health deteriorated after reproduction; (3) breeders' health after reproduction was worse than that of their offspring. We collected blood samples from 12 breeding females and 11 breeding males both at the onset and at the end of the breeding season and from 12 adult daughters and 11 adult sons that did not reproduce at the end of the breeding season. Health was assessed using serum biochemistry analysis with VetScan Abaxis. Breeders differed considerably in their health before and after reproduction, particularly in parameters associated with digestion (lower amylase in males), metabolism (lower albumin, alkaline phosphatase, creatinine and glucose), osmoregulation (lower potassium and phosphorous in females) and immunity (higher globulin and altered alanine aminotransferase). Our results suggest that with the onset of breeding striped mice shifted their energy allocation from maintaining health to reproduction, indicating that investment into reproduction carries significant health costs.

Collaboration between a Child Telephone Helpline and Sexual and Reproductive Health and Rights Organisations in Senegal: Lessons Learned

ERIC Educational Resources Information Center

Flink, Ilse Johanna Elisabeth; Mbaye, Solange Marie Odile; Diouf, Simon Richard Baye; Baumgartner, Sophie; Okur, Pinar

2018-01-01

This study identifies lessons learned from a collaboration between a child telephone helpline and sexual and reproductive health and rights (SRHR) organisations in Senegal established in the context of an SRHR programme for young people. We assessed how helpline operators are equipped to address sexual health and rights issues with young people,…

[Influencing factors for reproductive health of female workers in petrochemical industry].

PubMed

Kou, Z X; Wang, S L; Chen, Z L; He, Y H; Yu, W L; Mei, L Y; Zhang, H D

2018-02-20

Objective: To investigate the reproductive health status of female workers in petrochemical industry, and to provide a reference for improving reproductive health status and developing preventive and control measures for female workers in petrochemical industry. Methods: A face-to-face questionnaire survey was performed from January to October, 2016. The Questionnaire on Women's Reproductive Health was used to investigate the reproductive health of female workers in petrochemical industry. The multivariate logistic regression model was used to identify the influencing factors for reproductive health of female workers in petrochemical industry. Results: Among the 7485 female workers, 1 268 (40.9%) had abnormal menstrual period, 1 437 (46.4%) had abnormal menstrual volume, 177 (28.5%) had hyperplasia of mammary glands, and 1 807 (24.6%) had gynecological inflammation. The reproductive system diseases in female workers in petrochemical industry were associated with the factors including age, marital status, education level, unhealthy living habits, abortion, overtime work, work shift, workload, video operation, occupational exposure, positive events, and negative events, and among these factors, negative events (odds ratio[ OR ]= 1.856) , unhealthy living habits ( OR =1.542) , and positive events ( OR =1.516) had greater impact on reproductive system diseases. Conclusion: Many chemical substances in the occupational environment of petrochemical industry can cause damage to the reproductive system, which not only affects the health of the female workers, but also poses potential threats to the health of their offspring. Occupational exposure, unhealthy living habits, overtime work, and work shift have great influence on reproductive system diseases in female workers.

"Siempre me critican": barriers to reproductive health in Ocotal, Nicaragua.

PubMed

Luffy, Samantha M; Evans, Dabney P; Rochat, Roger W

2015-05-01

To identify perceived barriers to accessing reproductive health care according to the women of Ocotal, Nicaragua; describe their understanding of their reproductive rights; and document their opinions about Nicaragua's total ban on abortion. From May to June 2014, three focus group discussions were held in Spanish with 17 women from two different neighborhoods (barrios) in the city of Ocotal, Nicaragua. A semi-structured discussion guide with open-ended questions was employed to elucidate local perspectives regarding the focus group discussions themes. Serious obstacles including 1) violence against women, 2) machismo, 3) criticism from others, and 4) lack of communication and education limit women's ability to make their own reproductive health decisions. Women had a pervasive lack of knowledge about reproductive rights and the international human rights documents that define them. In addition, due to religious and cultural ideologies, most women supported the country's total ban on abortion in most circumstances, with the possible exception of rape. Both men and women in Ocotal should be encouraged to participate in community-level programs designed to reduce the impact of the following obstacles to receiving reproductive health care: 1) violence against women and machismo; 2) insufficient, non-standardized sexual education and information about reproductive rights; and 3) poor communication within families and the community at large. Any future public health campaigns to address women's reproductive health needs in Ocotal should implement these types of programs, at the neighborhood level, to reduce stigma surrounding sexual health and activity.

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

Methodological issues in studies of air pollution and reproductive health.

PubMed

Woodruff, Tracey J; Parker, Jennifer D; Darrow, Lyndsey A; Slama, Rémy; Bell, Michelle L; Choi, Hyunok; Glinianaia, Svetlana; Hoggatt, Katherine J; Karr, Catherine J; Lobdell, Danelle T; Wilhelm, Michelle

2009-04-01

In the past decade there have been an increasing number of scientific studies describing possible effects of air pollution on perinatal health. These papers have mostly focused on commonly monitored air pollutants, primarily ozone (O(3)), particulate matter (PM), sulfur dioxide (SO(2)), carbon monoxide (CO), and nitrogen dioxide (NO(2)), and various indices of perinatal health, including fetal growth, pregnancy duration, and infant mortality. While most published studies have found some marker of air pollution related to some types of perinatal outcomes, variability exists in the nature of the pollutants and outcomes associated. Synthesis of the findings has been difficult for various reasons, including differences in study design and analysis. A workshop was held in September 2007 to discuss methodological differences in the published studies as a basis for understanding differences in study findings and to identify priorities for future research, including novel approaches for existing data. Four broad topic areas were considered: confounding and effect modification, spatial and temporal exposure variations, vulnerable windows of exposure, and multiple pollutants. Here we present a synopsis of the methodological issues and challenges in each area and make recommendations for future study. Two key recommendations include: (1) parallel analyses of existing data sets using a standardized methodological approach to disentangle true differences in associations from methodological differences among studies; and (2) identification of animal studies to inform important mechanistic research gaps. This work is of critical public health importance because of widespread exposure and because perinatal outcomes are important markers of future child and adult health.

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

Reproductive health care strategy -- a gender-sensitive approach to family welfare.

PubMed

Anita

1996-01-01

The author advocates a reproductive health care strategy to revitalize India's family welfare program. A major shift in focus is needed in population policy and programs to incorporate a gender-sensitive approach. That shift should help to clear the path toward improved health status for women and female children. Consensus reached at the UN's 1994 International Conference on Population and Development supported a change in population and development policies, affording women's empowerment, gender equality, and equity greater priority for a meaningful policy of human-centered sustainable development. Reproductive health care, reproductive health in practice, the quality of care in reproductive health, gender equality as a human right, and empowering women are discussed.

Health issues in adolescents' Internet use - benefits and risks.

PubMed

Hardoff, D

2013-09-01

The Internet has turned during the past decade into a major information resource in various domains of life and a communication venue among adolescents who seek health information via the net. The increasing availability of computers in homes, as well as wireless Internet access, means that adolescents today can go online anywhere, at any time. The media are not the leading cause of any major health problem, but they do contribute significantly to a variety of adolescent health problems, including aggressive behavior, sexual activity, drug use, obesity, sleep disorders, eating disorders, depression, suicide and self harm. This paper focuses on 3 major health issues in adolescents' Internet use: Body image and eating behaviors; sexuality and reproductive health behaviors; and self harm and suicidal behavior. This paper also demonstrates Internet venues where reliable health information is provided to young people by health professionals. Health professionals need to recognize the hazards of adolescents Internet use, and to address potential Internet abuse when encountering adolescents in clinical settings.

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.

Public health issues.

PubMed

Ward, R D

1992-04-01

In a recent MSMS survey, MSMS members ranked public health as one the top five issues of major concern to Michigan physicians. Tobacco use, chronic illness, and HIV-infected health care workers comprise some of the major public health issues facing physicians and patients in Michigan. Following is a brief examination of each of these issues. Also included is a brief discussion of medical doctors as public health directors. Should all public health directors be medical doctors? This question is addressed in this cover story.

'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.

Male Reproductive Health After Childhood, Adolescent, and Young Adult Cancers: A Report From the Children's Oncology Group

PubMed Central

Kenney, Lisa B.; Cohen, Laurie E.; Shnorhavorian, Margarett; Metzger, Monika L.; Lockart, Barbara; Hijiya, Nobuko; Duffey-Lind, Eileen; Constine, Louis; Green, Daniel; Meacham, Lillian

2012-01-01

The majority of children, adolescents, and young adults diagnosed with cancer will become long-term survivors. Although cancer therapy is associated with many adverse effects, one of the primary concerns of young male cancer survivors is reproductive health. Future fertility is often the focus of concern; however, it must be recognized that all aspects of male health, including pubertal development, testosterone production, and sexual function, can be impaired by cancer therapy. Although pretreatment strategies to preserve reproductive health have been beneficial to some male patients, many survivors remain at risk for long-term reproductive complications. Understanding risk factors and monitoring the reproductive health of young male survivors are important aspects of follow-up care. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) were created by the COG to provide recommendations for follow-up care of survivors at risk for long-term complications. The male health task force of the COG-LTFU Guidelines, composed of pediatric oncologists, endocrinologists, nurse practitioners, a urologist, and a radiation oncologist, is responsible for updating the COG-LTFU Guidelines every 2 years based on literature review and expert consensus. This review summarizes current task force recommendations for the assessment and management of male reproductive complications after treatment for childhood, adolescent, and young adult cancers. Issues related to male health that are being investigated, but currently not included in the COG-LTFU Guidelines, are also discussed. Ongoing investigation will inform future COG-LTFU Guideline recommendations for follow-up care to improve health and quality of life for male survivors. PMID:22649147

Sustainability and factors affecting the success of community-based reproductive health programs in rural northwest Ethiopia.

PubMed

Argaw, Daniel; Fanthahun, Mesganaw; Berhane, Yemane

2007-08-01

arious Community-Based Reproductive Health interventions were initiated in many developing countries but their effectiveness has not been evaluated as much as needed. A comparative cross sectional study was carried out in February 2002 among women who participated in community based reproductive health interventions in South Gondar zone, Ethiopia. The study was conducted in eight kebeles taking successful and weak program areas for comparison. Both quantitative and qualitative methods were used for data collection. The qualitative method included key informants interview, and Focus Group Discussions with Community-based reproductive health agents (CBRHAs). A multistage sampling technique was employed to select 792 study subjects for the quantitative part of the study. Awareness of the presence of the CBRHA in the locality, participation in selection of the agents, acceptance of the agent, and evertalking to CBRHA about reproductive health issues were significantly higher in successful than in weak program areas [OR(95% CI) = 2.32 (1.74, 3.08), 3.28 (1.22, 9.27), 6.65 (3.59, 12.43), and 5.05 (3.22, 7.96), respectively]. In multiple logistic regression analysis awareness of presence of CBRHA in the village, acceptance of the CBRHA, and having had discussion with CBRHA maintained significant associations with type of community-based reproductive health program (successful/weak). Focus Group Discussions and Key Informant Interviews revealed better involvement of community leaders and health workers in the process of selecting and supervising CBRHA in successful areas compared to weak areas. The sustainability score of the Community-Based Reproductive Health Program (CBRHP) graded by the program coordinators was 2.92 out of 5. Acceptance of the CBRHAs, communication of the agents with community members, level of Support to the agents, better involvement of community representatives in the selection process were found to be the major factors affecting CBRHP. Overall

Evaluation of school-based reproductive health education program for adolescent girls.

PubMed

Golbasi, Zehra; Taskin, Lale

2009-01-01

To evaluate the effectiveness of school-based reproductive health education for adolescent girls on the reproductive knowledge level of the girls. This research was carried out as a quasi-experimental study at two vocational girls high schools, one of which was used as the study school and the other as the control school. The study group (97 students) consisted of three classes representing every grade. The control group consisted of students selected likewise (92 students). Reproductive health education was given to students in the study group for 10 weeks; the control group was not subjected to any educational program. The impact of the program was evaluated with reproductive health knowledge test designed for this study. A pretest evaluated baseline knowledge, and a posttest measured the gain in knowledge. Baseline knowledge score of students in study and control group were similar and low (p > 0.05). We found that the reproductive health knowledge level of students in the study group increased significantly after the program of education. Post-test knowledge scores (75.03 +/- 13.82) of the students in the study group were higher than those of the control group (36.65 +/- 14.17). The results showed students' low baseline knowledge and a good ability to learn. A school-based reproductive health education is needed to promote knowledge and prevention in reproductive health among teenagers.

Latino community health workers and the promotion of sexual and reproductive health.

PubMed

Lechuga, Julia; Garcia, Dina; Owczarzak, Jill; Barker, Maria; Benson, Meghan

2015-05-01

Community health worker (CHW) programs have existed for over 50 years across the world. However, only recently has research evidence documented their effectiveness. Research is still needed to identify issues related to implementation and sustainability of CHW programs. This article explores the role and challenges of U.S. Latino CHWs trained to deliver a comprehensive sexual and reproductive health educational intervention to Latino families. We conducted a semistructured interview with a purposive convenience sample of 19 CHWs. Findings suggest that CHWs occupy roles that go beyond those they were trained for. CHWs serve not only as educators but also as providers of social support, facilitators of access to resources, patient navigators, and civil rights advocates. Lack of clarity of the role of a CHW influenced perceptions of adequacy of compensation, training, and integration into the agency that trained them. Policy facilitating the standardization of the CHW occupational category and role expectations is imperative to ensure successful implementation and sustainability of U.S. CHW programs. © 2015 Society for Public Health Education.

Improving reproductive health in rural China through participatory planning.

PubMed

Kaufman, Joan; Liu, Yunguo; Fang, Jing

2012-01-01

China's new health reform initiative aims to provide quality accessible health care to all, including remote rural populations, by 2020. Public health insurance coverage for the rural poor has increased, but rural women have fared worse because of lower status and lack of voice in shaping the services they need. Use of prenatal care, safe delivery and reproductive tract infections (RTIs) services is inadequate and service seeking for health problems remains lower for men. We present findings from a study of gender and health equity in rural China from 2002 to 2008 and offer recommendations from over a decade of applied research on reproductive health in rural China. Three studies, conducted in poor counties between 1994 and 2008, identified problems in access and pilot tested interventions and mechanisms to increase women's participation in health planning. They were done in conjunction with a World Bank programme and the global Gender and Health Equity Network (GHEN). Reproductive health service-seeking improved and the study interventions increased local government commitment to providing such services through new health insurance mechanisms. Findings from the studies were summarised into recommendations on gender and health for inclusion in new health reform efforts.

IPPF focuses on advocacy. Advocacy for reproductive health: worldwide.

PubMed

Puri, S; Ketting, E

1996-01-01

The International Planned Parenthood Federation has been advocating human rights since its establishment in 1952. Since the adoption of its global strategic plan, Vision 2000, it has dealt with advocacy in a more systematic manner. Advocacy aims to gain broader support for a cause. In family planning and reproductive health, advocacy is important in counteracting conservative opposition movements. Its most effective tool is high-quality information and services for meeting people's needs. Its target groups are women's groups, youth organizations, parliamentarians, media representatives, and religious leaders. Information, education, and communication (IEC) campaigns differ from advocacy, because the latter is deliberately persuasive and campaign-oriented. An Advocacy Working Group was convened by IPPF and an Advocacy Guide was produced in 1995. Advocacy is needed for the promotion of sexual and reproductive health in the face of opposition from traditional and cultural forces represented by small, vocal, well-financed and organized groups. In 1984 they succeeded in halting funding for IPPF by the United States. This made IPPF resolute in strategic planning and setting goals as contained in Vision 2000. The goals include advocacy for family planning, the prevention of unsafe abortion, women's empowerment, the involvement of youth, the responsibility of men for family life, and the improvement of the status of the female child. The IPPF's 1985 Central Council discussed new initiatives and an Issues Manual was published. The 1989 Members' Assembly held a seminar on critical issues in advocating family planning. A further 1993 resolution urged support for advocacy initiatives. A Public Response Guide was published in 1991 and Language Guidelines were also produced for correct family planning terminology. In addition, an Interregional Training Workshop was held in London in 1995 on the use of the Advocacy Guide. Recommendations were also submitted by participants for

Privatisation in reproductive health services in Pakistan: three case studies.

PubMed

Ravindran, T K Sundari

2010-11-01

Privatisation in Pakistan's health sector was part of the Structural Adjustment Programme that started in 1998 following the country's acute foreign exchange crisis. This paper examines three examples of privatisation which have taken place in service delivery, management and capacity-building functions in the health sector: 1) large-scale contracting out of publicly-funded health services to private, not-for-profit organisations; 2) social marketing/franchising networks providing reproductive health services; and 3) a public-private partnership involving a consortium of private players and the government of Pakistan. It assesses the extent to which these initiatives have contributed to promoting equitable access to good quality, comprehensive reproductive health services. The paper concludes that these forms of privatisation in Pakistan's health sector have at best made available a limited range of fragmented reproductive health services, often of sub-optimal quality, to a fraction of the population, with poor returns in terms of health and survival, especially for women. This analysis has exposed a deep-rooted malaise within the health system as an important contributor to this situation. Sustained investment in health system strengthening is called for, where resources from both public and private sectors are channelled towards achieving health equity, under the stewardship of the state and with active participation by and accountability to members of civil society. Copyright © 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Understanding young bisexual women's sexual, reproductive and mental health through syndemic theory.

PubMed

Flanders, Corey E; Gos, Giselle; Dobinson, Cheryl; Logie, Carmen H

2016-03-16

We sought to understand how young bisexual women in Toronto perceive their sexual and reproductive health needs, the challenges to achieving those needs, and the factors contributing both positively and negatively to their sexual and reproductive health. We conducted a community-based research project that included an advisory committee of young bisexual women, academic partners, and a community health centre. Four 2-hour focus group sessions were conducted with a total of 35 participants. Data were analyzed through a constructivist grounded theory approach using Nvivo software. Participants' discussion of their sexual and reproductive health indicated that they perceived social marginalization, particularly biphobia and monosexism, as a significant challenge to their health. Participants also discussed their sexual, reproductive and mental health as interconnected. Young bisexual women in this study perceived their sexual, reproductive and mental health as interconnected and negatively influenced by social marginalization. This perception is in line with syndemic research that illustrates the interrelationship between psychosocial and sexual health. Researchers should further explore the utility of syndemic theory in understanding the complexity of young bisexual women's health.

A cross-sectional study to explore postgraduate students' understanding of and beliefs about sexual and reproductive health in a public university, Malaysia.

PubMed

Soleymani, Shahla; Abdul Rahman, Hejar; Lekhraj, Rampal; Mohd Zulkefli, Nor Afiah; Matinnia, Nasrin

2015-08-29

The main sexual and reproductive health issues among young people are premarital sexual intercourse, unwanted pregnancies, unsafe abortions and sexually transmitted diseases including Human Immunodeficiency Virus. The aim of this study was to determine the knowledge related to sexual and reproductive health among Malaysian postgraduate students in a public university in Malaysia. A cross-sectional study was carried out among postgraduate students by systematic random sampling technique. A pre-tested self administered questionnaire was used to collect the data. Out of 434 respondents, the majority of students were female (78.6 %) and single (78.3 %). The overall mean age of respondents was 27.0 ranging from 20 to 46 years of age. The main sources of information for sexual and reproductive health awareness were the internet (78.6 %) and newspaper (61.8 %). The majority (97.9 %) of the students knew that AIDS is a sexually transmitted disease. Most of them believed that the spread of sexually transmitted diseases was through shaking hands (92.1 %). Use of condoms was perceived to be the best way to avoid sexually transmitted diseases (88.4 %). Sexual and reproductive health knowledge was significantly associated with the students' age, marital status and faculty. The socio-demographic factors and current educational status accounted for a significant 9 % of the variability in sexual and reproductive health knowledge, f (7, 426) = 11, p <0.001. The postgraduate students' level of knowledge on sexual and reproductive health was not satisfactory. Sexual and reproductive health knowledge was associated with the students' marital status and faculty. Intervention programs related to sexual and reproductive health are recommended.

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.

Indigenous peoples of North America: environmental exposures and reproductive justice.

PubMed

Hoover, Elizabeth; Cook, Katsi; Plain, Ron; Sanchez, Kathy; Waghiyi, Vi; Miller, Pamela; Dufault, Renee; Sislin, Caitlin; Carpenter, David O

2012-12-01

Indigenous American communities face disproportionate health burdens and environmental health risks compared with the average North American population. These health impacts are issues of both environmental and reproductive justice. In this commentary, we review five indigenous communities in various stages of environmental health research and discuss the intersection of environmental health and reproductive justice issues in these communities as well as the limitations of legal recourse. The health disparities impacting life expectancy and reproductive capabilities in indigenous communities are due to a combination of social, economic, and environmental factors. The system of federal environmental and Indian law is insufficient to protect indigenous communities from environmental contamination. Many communities are interested in developing appropriate research partnerships in order to discern the full impact of environmental contamination and prevent further damage. Continued research involving collaborative partnerships among scientific researchers, community members, and health care providers is needed to determine the impacts of this contamination and to develop approaches for remediation and policy interventions.

Indigenous Peoples of North America: Environmental Exposures and Reproductive Justice

PubMed Central

Cook, Katsi; Plain, Ron; Sanchez, Kathy; Waghiyi, Vi; Miller, Pamela; Dufault, Renee; Sislin, Caitlin; Carpenter, David O.

2012-01-01

Background: Indigenous American communities face disproportionate health burdens and environmental health risks compared with the average North American population. These health impacts are issues of both environmental and reproductive justice. Objectives: In this commentary, we review five indigenous communities in various stages of environmental health research and discuss the intersection of environmental health and reproductive justice issues in these communities as well as the limitations of legal recourse. Discussion: The health disparities impacting life expectancy and reproductive capabilities in indigenous communities are due to a combination of social, economic, and environmental factors. The system of federal environmental and Indian law is insufficient to protect indigenous communities from environmental contamination. Many communities are interested in developing appropriate research partnerships in order to discern the full impact of environmental contamination and prevent further damage. Conclusions: Continued research involving collaborative partnerships among scientific researchers, community members, and health care providers is needed to determine the impacts of this contamination and to develop approaches for remediation and policy interventions. PMID:22899635

Sexuality and reproductive issues in children with myelomeningocele.

PubMed

Joyner, B D; McLorie, G A; Khoury, A E

1998-02-01

Recent advancements in surgical and medical therapies have improved the life expectancy of children with myelomeningocele. Yet, there has been a contrasting lack of improvement with regards to sexual function and reproductive issues that continue to infantilize this population. This article identifies five major risk factors that contribute to these delays which invariably lead to irreversible emotional trauma if they are not addressed early in childhood. Adequate psychosexual education of myelomeningocele patients and their families is a tremendous societal challenge. But, only with education will there be trends away from policies of isolation to those that reinforce community integration of the physically disabled.

Gender relations and women's reproductive health in South Sudan

PubMed Central

Kane, Sumit; Rial, Matilda; Matere, Anthony; Dieleman, Marjolein; Broerse, Jacqueline E.W.; Kok, Maryse

2016-01-01

Background In South Sudan, women disproportionately bear the burden of morbidity and mortality related to sexual and reproductive health, with a maternal mortality ratio of 789 deaths per 100,000 live births. Design A qualitative study was conducted to analyze how gendered social relations among the Fertit people affect women's ability to exercise control over their reproductive lives and thereby their sexual and reproductive health. Transcripts of 5 focus group discussions and 44 semi-structured interviews conducted with purposefully selected community members and health personnel were analyzed using Connell's relational theory of gender. Results Women across all age groups report that they have little choice but to meet the childbearing demands of husbands and their families. Women, both young and old, and also elders, are frustrated about how men and society are letting them down and how they are left to bear the reproductive burden. The poverty and chronic insecurity in South Sudan mean that many men have few sources of pride and achievement; conformity and complicity with the hegemonic practices accord both security and a sense of belonging and privilege to men, often at the expense of women's reproductive health. Conclusions Inequalities in the domestic, social, and economic spheres intersect to create social situations wherein Fertit women's agency in the reproductive realm is constrained. In South Sudan, as long as economic and social opportunities for women remain restricted, and as long as insecurity and uncertainty remain, many women will have little choice but to resort to having many children to safeguard their fragile present and future. Unless structural measures are taken to address these inequalities, there is a risk of both a widening of existing health inequalities and the emergence of new inequalities. PMID:27900934

Gender relations and women's reproductive health in South Sudan.

PubMed

Kane, Sumit; Rial, Matilda; Matere, Anthony; Dieleman, Marjolein; Broerse, Jacqueline E W; Kok, Maryse

2016-01-01

In South Sudan, women disproportionately bear the burden of morbidity and mortality related to sexual and reproductive health, with a maternal mortality ratio of 789 deaths per 100,000 live births. A qualitative study was conducted to analyze how gendered social relations among the Fertit people affect women's ability to exercise control over their reproductive lives and thereby their sexual and reproductive health. Transcripts of 5 focus group discussions and 44 semi-structured interviews conducted with purposefully selected community members and health personnel were analyzed using Connell's relational theory of gender. Women across all age groups report that they have little choice but to meet the childbearing demands of husbands and their families. Women, both young and old, and also elders, are frustrated about how men and society are letting them down and how they are left to bear the reproductive burden. The poverty and chronic insecurity in South Sudan mean that many men have few sources of pride and achievement; conformity and complicity with the hegemonic practices accord both security and a sense of belonging and privilege to men, often at the expense of women's reproductive health. Inequalities in the domestic, social, and economic spheres intersect to create social situations wherein Fertit women's agency in the reproductive realm is constrained. In South Sudan, as long as economic and social opportunities for women remain restricted, and as long as insecurity and uncertainty remain, many women will have little choice but to resort to having many children to safeguard their fragile present and future. Unless structural measures are taken to address these inequalities, there is a risk of both a widening of existing health inequalities and the emergence of new inequalities.

Do family-planning workers in China support provision of sexual and reproductive health services to unmarried young people?

PubMed

Tu, Xiaowen; Cui, Nian; Lou, Chaohua; Gao, Ersheng

2004-04-01

To ascertain the perspectives of family-planning service providers in eight sites in China on the provision of sexual and reproductive health services to unmarried young people. Data were drawn from a survey of 1927 family-planning workers and 16 focus group discussions conducted in eight sites in China in 1998-99. Family-planning workers recognized the need to protect the sexual health of unmarried young people and were unambiguous about the need for government agencies to provide information and education on sexual and reproductive health to unmarried young people; however, perceptions about the appropriate age for and content of such education remained conservative. While about 70% of family-planning workers were willing to provide contraceptives to unmarried young people, and about 60% approved government provision of contraceptive services to unmarried young people, only one quarter agreed that the services could be extended to senior high schools. Family-planning workers in China are ambivalent about the provision of sexual and reproductive health services to unmarried young people, which potentially poses a significant obstacle to the adoption of safe sex behaviours by young people, as well as to the provision of sexual and reproductive health information and services to young unmarried people in China. Training programmes for family-planning workers are urgently needed to address this issue.

Attitude of parents and teachers towards adolescent reproductive and sexual health education.

PubMed

Nair, M K C; Leena, M L; Paul, Mini K; Pillai, H Vijayan; Babu, George; Russell, P S; Thankachi, Yamini

2012-01-01

To assess parents' and teachers' attitude towards Adolescent Reproductive Sexual Health Education (ARSHE). The study group consisted of a random sample of 795 parents and 115 teachers belonging to three urban schools (one boys only, one girls only and one co-education) and one co-education rural school at Thiruvananthapuram district, Kerala, where an ICMR supported ARSHE intervention programme was done subsequently. A self-administered questionnaire for parents and teachers developed by an ICMR taskforce for ARSHE programme was used to assess their opinion on the need, content and the appropriate person to provide adolescent reproductive sexual health education in a school setting. 65.2% of parents and 40.9% teachers have not discussed growth and development issues with their adolescents. Only 5.2% teachers and 1.1% parents discussed sexual aspects with adolescents. 44% of parents agreed that information on HIV/AIDS/STD should be provided. More than 50% of parents were not sure whether information on topics like masturbation, dating, safe sex, contraceptives, pregnancy, abortion and childcare should be provided to adolescents. Results pointed out the need for introducing reproductive and sexual education in the school setting. Only 1.1% of parents and 5.2% teachers actually discussed sexual aspects with adolescents which highlights the need for parent and teacher awareness programs before ARSHE is introduced in the schools.

Review of hazards to female reproductive health in veterinary practice.

PubMed

Scheftel, Joni M; Elchos, Brigid L; Rubin, Carol S; Decker, John A

2017-04-15

OBJECTIVE To review publications that address female reproductive health hazards in veterinary practice, summarize best practices to mitigate reproductive risks, and identify current knowledge gaps. DESIGN Systematized review. SAMPLE English-language articles describing chemical, biological, and physical hazards present in the veterinary workplace and associations with adverse reproductive outcomes or recommendations for minimizing risks to female reproductive health. PROCEDURES Searches of the CAB abstracts database were performed in July 2012 and in May 2015 with the following search terms: veterinarians AND occupational hazards and vets.id AND occupational hazards.sh. Searches of the PubMed database were conducted in November 2012 and in May 2015 with the following medical subject heading terms: occupational exposure AND veterinarians; anesthetics, inhalation/adverse effects AND veterinarians; risk factors AND pregnancy AND veterinarians; pregnancy outcome AND veterinarians; and animal technicians AND occupational exposure. Two additional PubMed searches were completed in January 2016 with the terms disinfectants/toxicity AND female AND fertility/drug effects and veterinarians/psychology AND stress, psychological. No date limits were applied to searches. RESULTS 4 sources supporting demographic trends in veterinary medicine and 118 resources reporting potential hazards to female reproductive health were identified. Reported hazards included exposure to anesthetic gases, radiation, antineoplastic drugs, and reproductive hormones; physically demanding work; prolonged standing; and zoonoses. CONCLUSIONS AND CLINICAL RELEVANCE Demographic information suggested that an increasing number of women of reproductive age will be exposed to chemical, biological, and physical hazards in veterinary practice. Information on reproductive health hazards and minimizing risk, with emphasis on developing a safety-focused work culture for all personnel, should be discussed starting

Review of hazards to female reproductive health in veterinary practice

PubMed Central

Scheftel, Joni M.; Elchos, Brigid L.; Rubin, Carol S.; Decker, John A.

2017-01-01

OBJECTIVE To review publications that address female reproductive health hazards in veterinary practice, summarize best practices to mitigate reproductive risks, and identify current knowledge gaps. DESIGN Systematized review. SAMPLE English-language articles describing chemical, biological, and physical hazards present in the veterinary workplace and associations with adverse reproductive outcomes or recommendations for minimizing risks to female reproductive health. PROCEDURES Searches of the CAB abstracts database were performed in July 2012 and in May 2015 with the following search terms: veterinarians AND occupational hazards and vets.id AND occupational hazards.sh. Searches of the PubMed database were conducted in November 2012 and in May 2015 with the following medical subject heading terms: occupational exposure AND veterinarians; anesthetics, inhalation/adverse effects AND veterinarians; risk factors AND pregnancy AND veterinarians; pregnancy outcome AND veterinarians; and animal technicians AND occupational exposure. Two additional PubMed searches were completed in January 2016 with the terms disinfectants/toxicity AND female AND fertility/drug effects and veterinarians/psychology AND stress, psychological. No date limits were applied to searches. RESULTS 4 sources supporting demographic trends in veterinary medicine and 118 resources reporting potential hazards to female reproductive health were identified. Reported hazards included exposure to anesthetic gases, radiation, antineoplastic drugs, and reproductive hormones; physically demanding work; prolonged standing; and zoonoses. CONCLUSIONS AND CLINICAL RELEVANCE Demographic information suggested that an increasing number of women of reproductive age will be exposed to chemical, biological, and physical hazards in veterinary practice. Information on reproductive health hazards and minimizing risk, with emphasis on developing a safety-focused work culture for all personnel, should be discussed starting

A youth-led reproductive health program in a university setting.

PubMed

Djalalinia, Shirin; Ramezani Tehrani, Fahimeh; Malekafzali, Hossein; Hashemi, Zeynab; Peykari, Niloofar

2015-01-01

Reproductive health problems affect youths in all countries. There is an urgent need to enhance youths reproductive health services to provide a healthy life for this group. In this regard, the present study aimed to evaluate the Reproductive Health Peer Education Program based on the opinion of university students. This interventional study was conducted in Qazvin University of Medical Sciences through the peer education method. The participants of this study were 24 peer educators who received training in a 40 hour peer educator training course. The peer education program was implemented in the university. In order to evaluate this community- based intervention, 329 students were selected through the stratified sampling method and their opinion was assessed. Descriptive statistical methods were used by SPSS software for data analysis. The results of the study revealed that peer education was accepted by 64.7% (n= 213) of the students, according to their opinion. The educational priorities of the students were as follows: pre-marriage counseling (78%, n= 166); STI/AIDS (17%, n= 36); and contraception (5%, n= 11). The peer education program was recognized as the most required reproductive health service in the university by 55.3% (n= 118) of the students. They believed that the most important duties of the peer educators were: education (33.5%, n= 71); counseling (30.4%, n= 65); referring to a counseling center (21.6%, n= 46) and referring to a therapeutic center (14.5%, n= 31). Also, the students stated that confidentiality (53%, n= 113), suitable communication (26%, n= 55) and sufficient knowledge (21%, n= 45) were desired characteristics for the peer educators. According to the students' opinion, peer education could provide suitable reproductive health services and could also be beneficial for reproductive health promotion and might reinforce positive behaviors in youths. Reproductive health peer- counseling is a sensitive process, and it is best to be

Experiences of girls with hearing impairment in accessing reproductive health care services in Ibadan, Nigeria.

PubMed

Arulogun, Oyedunni S; Titiloye, Musibau A; Afolabi, Nathanael B; Oyewole, Oyediran E; Nwaorgu, Onyekwere G B

2013-03-01

Delivery of health services to people with hearing impairment is poorly understood in Nigeria and limited research has been done to throw more light on the process involved. This study described experiences of 167 girls with hearing impairment in accessing reproductive health services in Ibadan using a validated questionnaire. Descriptive statistics and binary logistic regression were used to analyze the data. Almost 95.0% of respondents had ever visited health facility for reproductive health issues. Of these 6.2% and 4.6% went for treatment of STIs and pregnancy termination respectively; 36.7% were embarrassed to ask questions in the presence of an interpreter, communication (40.5%) and cost (10.8%) were key barriers to access and 85.6% would use facility if hearing impairment-friendly services are provided. Respondents who were currently working were 20 times more likely to receive services they wanted (OR = 20.29, CI = 1.05-392.16). Availability of certified interpreters and ensuring confidentiality are key to effective service delivery for the hearing impaired.

The effect of assisted reproduction treatment on mental health in fertile women.

PubMed

Zivaridelavar, Maryam; Kazemi, Ashraf; Kheirabadi, Gholam Reza

2016-01-01

The process of assisted reproductive treatment is a stressful situation in the treatment of infertile couples and it would harm the mental health of women. Fertile women who started infertility treatment due to male factor infertility have reported to experience less stress and depression than other women before the assisted reproductive process but considering the cultural and social factors and also the etiology of the assisted reproductive process, it could affect the metal health of these women. Therefore, this study was conducted to evaluate the mental health of fertile women who undergo assisted reproductive treatment due to male factor infertility. This study was a prospective study on 70 fertile women who underwent assisted reproductive treatment due to male factor infertility. The exclusion criterion was to stop super ovulation induction. To assess mental health, anxiety and depression dimensions of the general health questionnaire were used. Before starting ovulation induction and after oocyte harvesting, the general health questionnaire was filled by women who were under treatment. Data were analyzed using multi-variable linear regression, paired t-test, and Chi-square. The results showed that the mean score of depression and anxiety before ovulation induction and after oocyte harvesting were not significantly different; but the rate of mental health disorder in the depression dimension was significantly decreased after oocytes harvesting (31.7% vs. 39.7%). Also, there was a significant relation between the level of anxiety and depression before ovulation induction and after oocyte harvesting (P < 0.05). The anxiety level after oocyte harvesting had a positive and significant correlation with the economic situation (P < 0.05). This study revealed that the process of assisted reproductive treatment does not affect the mental health in fertile women independently, but these women start assisted reproductive process with high levels of depression and

Integrated Community Strategies for Linking Youth to Adolescent Reproductive Health Services: A Case Study.

PubMed

Sotolongo, Joy; House, L Duane; Swanson, Sally; Davis, Sarah E H

2017-03-01

This article describes the development and promotion of a full-service adolescent health center at a local health department intended to increase teen access to contraceptive and reproductive health care. This work was conducted as part of a multicomponent, community-based teen pregnancy prevention initiative in Gaston County, North Carolina. To increase access to adolescent reproductive health services, we implemented multiple integrated strategies: (1) building community support for adolescent reproductive health services; (2) providing technical assistance to the health department in opening the Teen Wellness Center (TWC), a teen-centered, full-service clinic; (3) strengthening referral partnerships between community organizations and clinical services; and (4) educating teens on how to access reproductive health services. Data were collected to examine the change in the number of adolescent reproductive health clients after the opening of the TWC. In the first year, the TWC was opened, 1,675 adolescent clients received reproductive health services, for a 12.5% increase compared with the prior year. The number of adolescent clients who received more than one type of reproductive health services (e.g., wellness visit and family planning services) increased by 133%. The number of adolescent clients who received family planning services increased by 3.8%. The project achieved an increase in adolescent reproductive health clients. Establishment of a teen-centered, full-service clinic and working with youth-serving agencies to increase knowledge of the clinic's services are promising approaches to increasing teen access to reproductive health care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

What women want from women's reproductive health research: a qualitative study.

PubMed

Pandey, Shilpi; Porter, Maureen; Bhattacharya, Siladitya

2015-12-01

Researchers are being urged to involve patients in the design and conduct of studies in health care with limited insight at present into their needs, abilities or interests. This is particularly true in the field of reproductive health care where many conditions such as pregnancy, menopause and fertility problems involve women who are otherwise healthy. To ascertain the feasibility of involving patients and members of the public in research on women's reproductive health care (WRH). University and tertiary care hospital in north-east Scotland; 37 women aged 18-57. Four focus groups and one individual interview were audio-recorded and verbatim transcripts analysed thematically by two researchers using a grounded theory approach. Most participants were interested in WRH, but some participated to promote a health issue of special concern to them. Priorities for research reflected women's personal concerns: endometriosis, polycystic ovary syndrome, menopause, fertility risks of delaying parenthood and early post-natal discharge from hospital. Women were initially enthusiastic about getting involved in research on WRH at the design or delivery stage, but after discussion in focus groups, some questioned their ability to do so or the time available to commit to research. None of the respondents expected payment for any involvement, believing that the experience would be rewarding enough in itself. Involving patients and public in research would include different perspectives and priorities; however, recruiting for this purpose would be challenging. © 2014 John Wiley & Sons Ltd.

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...

Understanding sexual and reproductive health needs of adolescents: evidence from a formative evaluation in Wakiso district, Uganda.

PubMed

Atuyambe, Lynn M; Kibira, Simon P S; Bukenya, Justine; Muhumuza, Christine; Apolot, Rebecca R; Mulogo, Edgar

2015-04-22

Adolescents are frequently reluctant to seek sexual and reproductive health services (SRH). In Uganda, adolescent health and development is constrained by translation of the relevant policies to practice. Recent studies done in central Uganda have shown that there is need for a critical assessment of adolescent friendly services (AFS) to gain insights on current practice and inform future interventions. This study aimed to assess the sexual reproductive health needs of the adolescents and explored their attitudes towards current services available. A qualitative study was conducted in Wakiso district, central Uganda in September 2013.Twenty focus group discussions (FGDs) stratified by gender (10 out-of-school, and 10 in-school), were purposefully sampled. We used trained research assistants (moderator and note taker) who used a pretested FGD guide translated into the local language to collect data. All discussions were audio taped, and were transcribed verbatim before analysis. Thematic areas on; adolescent health problems, adolescent SRH needs, health seeking behaviour and attitudes towards services, and preferred services were explored. Data was analysed using atlas ti version 7 software. Our results clearly show that adolescents have real SRH issues that need to be addressed. In and out-of-school adolescents had sexuality problems such as unwanted pregnancies, sexually transmitted infections (STIs), defilement, rape, substance abuse. Unique to the females was the issue of sexual advances by older men and adolescents. We further highlight RH needs which would be solved by establishing adolescent friendly clinics with standard recommended characteristics (sexuality information, friendly health providers, a range of good clinical services such as post abortion care etc.). With regard to health seeking behaviour, most adolescents do not take any action at first until disease severity increase. Adolescents in Uganda have multiple sexual and reproductive health needs

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.

Socioeconomic and Reproductive Health Outcomes of Female Genital Mutilation.

PubMed

Refaei, Mansoureh; Aghababaei, Soodabeh; Pourreza, Abolghasem; Masoumi, Seyedeh Zahra

2016-11-01

Female genital mutilation (FGM) is one of the important aspects of reproductive health. The economic, social and health consequences of FGM threaten the achievement of sustainable development goals. The purpose of this study was to assess the economic, social and reproductive health consequences of FGM from the perspective of individual, family, community and health system. In this study, we reviewed 1536 articles from 1979 to 2015. Fifty-one studies were directly related to our goal. Research papers, review articles, case studies and books on the research topic were used. The results of this review showed that most studies on FGM, have investigated health complications of FGM, and few studies have addressed its socioeconomic aspects. The complications from the FGM can impose a significant economic burden on individuals, society and health system. Social consequences of FGM are more irritating than health consequences, so to tackle this practice; its social aspects should be more emphasized. Significant short and long term consequences of FGM threaten women's reproductive health; Reproductive health is one of the essential prerequisites of sustainable development. Sustainable development will be achieved if women are healthy. This practice can threaten achieving sustainable development. In Iran, FGM is performed in some areas, but there are no official statistics about it and there has yet been no plan to deal with FGM. FGM is a form of social injustice which women suffer. Ending FGM requires a deep and long-term commitment. Knowing its consequences and its effects on individual, families, the health system and community will help supporters to continue fighting this practice. Any money spent on eliminating this harmful practice, compared with the costs of complications, would not be wasteful.  It seems that further studies are needed to assess socioeconomic effects of FGM and the relationship between type of FGM and induced complications. Such studies will help

Reproductive health knowledge, attitudes and practices of adolescents attending an obstetric unit in Georgetown, Guyana.

PubMed

Rose, Elizabeth M; Rajasingam, Daghni; Derkenne, Ruth C; Mitchell, Vivienne; Ramlall, Anita A

2016-04-01

Teenage pregnancy continues to be a serious maternal health issue globally. Problems faced by teenage mothers are biological, social, and psychological, and may include sexual coercion and violence. This study sought to explore formally the knowledge, attitudes and practices of pregnant teenagers in Georgetown, Guyana, which has one of the highest rates of teenage pregnancy in Latin America and the Caribbean. This was a cross-sectional, prospective study. After ethical approval had been granted, 50 pregnant girls attending Georgetown Public Hospital Corporation (GPHC) were interviewed during a 6-week period. Using a convenience sample approach, the principal investigator used a questionnaire to collect data. This was then analysed using Stata/SE V.9.2 and Microsoft Excel programs. As well as overall poor sexual and reproductive health knowledge and high-risk sexual health practices, our study revealed a high rate of rape and sexual coercion among the 50 girls interviewed. Almost a quarter (22%) admitted to having been raped in the past, and 80% stated a lack of power in their sexual relationships. There is a need for more targeted sexual and reproductive health services for teenagers attending GPHC, and for more research into sexual violence among this group of women. The establishment of a screening and referral system for those at risk should begin to address specific issues and optimise health outcomes for the women and their babies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Level of Young People Sexual and Reproductive Health Service Utilization and Its Associated Factors among Young People in Awabel District, Northwest Ethiopia.

PubMed

Ayehu, Atitegeb; Kassaw, Teketo; Hailu, Getachew

2016-01-01

Currently in Ethiopia, young people's sexual and reproductive health services are limited and there is a growing issue of confidentiality and affordability of these health services. Moreover, the available services provided are not sensitive to the special needs of young people. Therefore, this study was aimed to assess young people's sexual and reproductive health service utilization and its associated factors in Awabel district, Northwest Ethiopia. A community based cross-sectional study was conducted among 781 randomly selected young people using a pre-tested structured questionnaires in Awabel district, Northwest Ethiopia. Data were entered into Epi data version 3.1 and analyzed using SPSS version 16.0 software. The mean age of respondents were 17.80 (+ 2.65) years. About 41% of young people had utilized sexual and reproductive health services. Young people from families of higher family expenditure, lived with mothers, participated in peer education and lived near to a Health Center were more likely to utilize sexual and reproductive health services. Furthermore, those who had a parental discussion on sexual and reproductive health (AOR (95% C.I): 2.23 (1.43, 3.46)) and ever had sexual intercourse (AOR (95% C.I): 1.88 (1.30, 2.71)) were more likely to utilize the service than their counterparts. On the other hand, those young people lived with their father and had a primary level of educational attainment was less likely to utilize the service. Utilization of sexual and reproductive health services is low which needs a great attention where; if not intervened, young people might engage in risky sexual activities. Therefore, it needs a concerted effort from all the concerned bodies to improve their service utilization and thereby reduce the burden of young people's disease and disabilities associated with sexual and reproductive health.

Global warming and reproductive health.

PubMed

Potts, Malcolm; Henderson, Courtney E

2012-10-01

The largest absolute numbers of maternal deaths occur among the 40-50 million women who deliver annually without a skilled birth attendant. Most of these deaths occur in countries with a total fertility rate of greater than 4. The combination of global warming and rapid population growth in the Sahel and parts of the Middle East poses a serious threat to reproductive health and to food security. Poverty, lack of resources, and rapid population growth make it unlikely that most women in these countries will have access to skilled birth attendants or emergency obstetric care in the foreseeable future. Three strategies can be implemented to improve women's health and reproductive rights in high-fertility, low-resource settings: (1) make family planning accessible and remove non-evidenced-based barriers to contraception; (2) scale up community distribution of misoprostol for prevention of postpartum hemorrhage and, where it is legal, for medical abortion; and (3) eliminate child marriage and invest in girls and young women, thereby reducing early childbearing. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

ICPD beyond 2014: moving beyond missed opportunities and compromises in the fulfilment of sexual and reproductive health and rights.

PubMed

Sippel, Serra

2014-01-01

The 1994 International Conference on Population and Development (ICPD) in Cairo marked a paradigm shift that took family planning out of a population control context and into the broader context of sexual and reproductive health and rights (SRHR). While progress has been made with increased access to family planning and a decrease in maternal deaths, we have not seen practical results for the majority of women and girls worldwide, who still experience unacceptably high rates of maternal deaths, unmet contraceptive needs and HIV infections. Three of the compromises made by governments at Cairo - integration, reproductive rights and resource allocation - hindered the fulfilment of women's and girls' SRHR. The post-2015 agenda must ensure that economic development and global health interventions are linked at the national and global levels; family planning, HIV, maternal health and other reproductive health services are integrated and delivered through primary health settings; and access to safe and voluntary abortion services is recognised as a human right. Non-governmental organisations and donors must move beyond siloed issue areas to challenge governments, multilateral agencies, the financial sector and each other to ensure that the promise of SRHR is realised.

Conscientious objection to sexual and reproductive health services: international human rights standards and European law and practice.

PubMed

Zampas, Christina; Andión-Ibañez, Ximena

2012-06-01

The practice of conscientious objection often arises in the area of individuals refusing to fulfil compulsory military service requirements and is based on the right to freedom of thought, conscience and religion as protected by national, international and regional human rights law. The practice of conscientious objection also arises in the field of health care, when individual health care providers or institutions refuse to provide certain health services based on religious, moral or philosophical objections. The use of conscientious objection by health care providers to reproductive health care services, including abortion, contraceptive prescriptions, and prenatal tests, among other services is a growing phenomena throughout Europe. However, despite recent progress from the European Court of Human Rights on this issue (RR v. Poland, 2011), countries and international and regional bodies generally have failed to comprehensively and effectively regulate this practice, denying many women reproductive health care services they are legally entitled to receive. The Italian Ministry of Health reported that in 2008 nearly 70% of gynaecologists in Italy refuse to perform abortions on moral grounds. It found that between 2003 and 2007 the number of gynaecologists invoking conscientious objection in their refusal to perform an abortion rose from 58.7 percent to 69.2 percent. Italy is not alone in Europe, for example, the practice is prevalent in Poland, Slovakia, and is growing in the United Kingdom. This article outlines the international and regional human rights obligations and medical standards on this issue, and highlights some of the main gaps in these standards. It illustrates how European countries regulate or fail to regulate conscientious objection and how these regulations are working in practice, including examples of jurisprudence from national level courts and cases before the European Court of Human Rights. Finally, the article will provide recommendations

Reproductive Health-Care Utilization of Young Adults Insured as Dependents.

PubMed

Andrasfay, Theresa

2018-05-01

The common practice of sending an explanation of benefits to policyholders may inadvertently disclose sensitive services to the parents of dependents, making confidentiality a potential barrier to reproductive health care. This study compares the reproductive health-care utilization of young adult dependents and young adult policyholders using nationally representative data collected after full implementation of the Affordable Care Act. Data from 2,108 young adults aged 18-25 years in the 2015 National Health Interview Survey were analyzed. Logistic regressions predicted utilization of two preventive services (general doctor visit and flu vaccination) and four reproductive health services (HIV testing, obstetrician/gynecologist visit, hormonal contraceptive use, and Pap testing) from the insurance type of the young adult (dependent, privately insured policyholder, or Medicaid). In unadjusted analyses, young adult dependents had lower utilization of HIV tests than their peers who were privately insured or Medicaid policyholders. Young women dependents had lower utilization of Pap tests than young women on Medicaid. Once controls were included, young adult dependents did not have significantly lower odds of obtaining reproductive health care than privately insured policyholders. Dependent young men still had marginally lower odds of ever having an HIV test (adjusted odds ratio = .65, p = .08) and dependent young women still had marginally lower odds of ever having a Pap test (adjusted odds ratio = .58, p = .06) than comparable Medicaid policyholders. Despite confidentiality concerns, young adults insured as dependents have utilization of several reproductive health services similar to that of comparable young adult policyholders. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Correlation between women's sub-health and reproductive diseases with pregnancies and labors.

PubMed

Xu, Xiaojuan; Zeng, Qian; Ding, Hong; Feng, Lingyan; Deng, Linwen

2014-08-01

To investigate whether female sub-health conditions and reproductive diseases are associated with pregnancies and labors. A cross-sectional survey was performed by using a structured questionnaire. A total of 1343 women aged 35 years or younger in six urban areas of Chengdu were included in the study. According to the Screening Criteria of sub-health conditions, these women were categorized into three groups: postpartum healthy group, sub-healthy group, and reproductive disease group. Data were double-entered using EpiData and then analyzed by SPSS. Pregnancy and labor were correlated with postpartum sub-health conditions. The number of pregnancies was negatively correlated with women's postnatal health but was positively correlated with the incidence of postpartum reproductive diseases. The number of pregnancies and labors is probably an important factor leading to sub-health conditions and the occurrence of reproductive diseases in women. Avoiding or reducing unwanted pregnancies and labors, enhancing the awareness of health among childbearing-age women are effective measures for preventing sub-health conditions.

Support for School-Based Reproductive Health Services among South Carolina Voters.

ERIC Educational Resources Information Center

Lindley, Lisa L.; Reininger, Belinda M.; Saunders, Ruth P.

2001-01-01

Surveyed South Carolina registered voters regarding level of support for school-based reproductive health services. Most voters supported providing contraceptive information, counseling, and referrals to students. They were less supportive of providing students with more direct and possibly invasive reproductive health services at school. Few…

Effectiveness of a reproductive sexual health education package among school going adolescents.

PubMed

Nair, M K C; Paul, Mini K; Leena, M L; Thankachi, Yamini; George, Babu; Russell, P S; Pillai, H Vijayan

2012-01-01

To assess the effectiveness of a school based "Adolescent Reproductive Sexual Health Education (ARSHE) Package" in improving students' knowledge on reproductive sexual health matters. An ARSHE package originally developed at Child Development Centre, Kerala, modified and approved by ICMR taskforce group was administered in three urban schools (One boys only, one girls only and one co-education) and one co-education rural school at Thiruvananthapuram district, Kerala. The study sample consisted of 1,586 adolescents including 996 boys and 560 girls of class IX and XI. Pre and post intervention knowledge regarding reproductive sexual health matters was assessed using a self-administered questionnaire. In the pre-intervention period, it was observed that majority of adolescents were poorly informed about reproductive sexual health matters, particularly about contraceptives. As compared to boys, girls had much poorer knowledge about prevention of pregnancy and after intervention; there was a statistically significant increase in the knowledge in both boys and girls. Among girls percentage of poor knowledge had reduced significantly from 64.1% to 8.3% and among boys from 37.7% to 3.5%. Similarly, increase in knowledge level was also observed in various other aspects of reproductive and sexual health including, STI, HIV/AIDS and perceptions about premarital sex. The study results revealed the feasibility and effectiveness of school based reproductive and sexual health education intervention programs for adolescents.

A needs assessment on addressing environmental health issues within reproductive health service provision: Considerations for continuing education and support.

PubMed

Williamson, Linzi; Sangster, Sarah; Bayly, Melanie; Gibson, Kirstian; Lawson, Karen; Clark, Megan

2017-12-01

This needs assessment was initially undertaken to explore the beliefs and knowledge of nurses and physicians about the impact of environmental toxicants on maternal and infant health, as well as to describe current practice and needs related to addressing environmental health issues (EHI). One hundred and thirty-five nurses (n = 99) and physicians (n = 36) working in Saskatchewan completed an online survey. Survey questions were designed to determine how physicians and nurses think about and incorporate environmental health issues into their practice and means of increasing their capacity to do so. Although participants considered it important to address EHIs with patients, in actual practice they do so with only moderate frequency. Participants reported low levels of knowledge about EHIs' impact on health, and low levels of confidence discussing them with patients. Participants requested additional information on EHIs, especially in the form of online resources. The results suggests that while nurses and physicians consider EHIs important to address with patients, more education, support, and resources would increase their capacity to do so effectively. Based on the findings, considerations and recommendations for continuing education in this area have been provided.

Workplace hazards to women's reproductive health.

PubMed

Rice, Heidi Roeber; Baker, Beth A

2007-09-01

Women make up nearly half of Minnesota's workforce. Thus, many women, including those of reproductive age, are exposed to workplace hazards. These hazards may be chemical-toxicants such as heavy metals, pesticides, and endocrine disruptors; physical--the result of activities or proximity to something in the environment; or biological-infectious agents. And they are of growing concern among scientists and the public. Although data on the effect of these hazards on the reproductive health of women is limited, there is evidence indicating they ought to be of concern to women and the physicians who treat them. Clinicians are encouraged to assess women for exposure to workplace hazards and to communicate with them about whether such exposure might increase their risk for problems such as infertility, miscarriage, and preterm birth. This article highlights selected job-related hazards and offers suggestions for caring for working women of reproductive age.

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…

Reproductive health information for young women in Kazakhstan: disparities in access by channel.

PubMed

Buckley, Cynthia; Barrett, Jennifer; Adkins, Kristen

2008-01-01

This study explores young women's reliance on reproductive and sexual health information channels, examining the relationship between information sources and reproductive health knowledge. Utilizing 1995 and 1999 Kazakhstan Demographic and Health Surveys, we investigate access to reproductive health knowledge among young women (ages 15-24) during a key period in the development of wide-scale reproductive health programs in Kazakhstan. Despite reproductive health campaigns throughout the 1990s, we find consistently high proportions of young women without family planning information access. Among young women with access to information, few received information from channels most strongly linked to knowledge and behavioral changes (family and medical professionals). Mass media sources and peer information networks remained the most often utilized channels. Urban residence, non-Kazakh ethnicity, older age (20-24), and higher education significantly increased the odds of accessing family planning information among young Kazakhstani women, and these same factors were especially important in terms of the relative odds of accessing medical and parental channels. While overall contraceptive knowledge and prevalence rose in Kazakhstan during the 1990s, we find knowledge varied by the information channel accessed. Findings also indicate that young women, regardless of marital status, possessed consistently low levels of reproductive health knowledge at the decade's end.

Sexual and reproductive health communication and awareness of contraceptive methods among secondary school female students, northern Ethiopia: a cross-sectional study.

PubMed

Melaku, Yohannes Adama; Berhane, Yemane; Kinsman, John; Reda, Hailemariam Lemma

2014-03-14

Adolescent girls continue to fall victim to unintended pregnancy and its consequences, with particular problems arising in low income countries. Awareness about methods of contraception is an important step towards gaining access and using suitable contraceptive methods. However, studies assessing the relationship between sexual and reproductive health communication and awareness of contraceptive methods among secondary school female students are lacking. A cross sectional study was conducted among 807 female students in six secondary schools in Mekelle town, Ethiopia. Study participants were selected with a stratified cluster sampling technique. Data collection was carried out using a structured, self-administered questionnaire, and data entry was done using EPI Info Version 3.3.2 software. The data were then cleaned and analyzed using SPSS version 20. Bivariate and multivariate logistic regressions were used to determine factors associated with awareness of female students on methods of contraception. Of all the students, 127(15.8%) reported ever having had sex, of whom 109(85.8%) had ever used contraceptives. Twenty (16%) of the sexually active students reported having been pregnant, of whom 18(90%) terminated their pregnancies with induced abortion. Discussion on sexual and reproductive health matters with their parent/s and peer/s in the six months prior to the study was reported by 351(43.5%) and 493(61.1%) of the students respectively. 716(88%) students were aware of different methods of contraception. Discussing sexual and reproductive health issues with parents (AOR=2.56(95% CI: 1.45, 4.50)) and peers (AOR=2.46(95% CI: 1.50, 4.03)) were found to be independent predictors for contraceptive awareness among students. Discussion on sexual and reproductive health issues with family and peers has a positive effect on contraceptive awareness of students. Therefore, strategies to improve open parent-child communication, and appropriate peer-to-peer communication

ARSH 1: Reproductive and sexual health problems of adolescents and young adults: a cross sectional community survey on knowledge, attitude and practice.

PubMed

Nair, M K C; Leena, M L; Thankachi, Yamini; George, Babu; Russell, Paul Swamidhas Sudhakar

2013-11-01

To understand the problems faced and the difference in knowledge, attitude and practice of young people across the age group of 10-24 y on reproductive and sexual health issues and to get their suggestions regarding adolescent care services. This cross sectional community survey involving three districts in Kerala was conducted among adolescents and young adults of 10-24 y using a population proportion to sample size technique. The main problems faced by the young people between 10 and 24 y of age were financial, substance abuse in family, poor academic performance, difference of opinion, disease in self/family, mental problems, lack of talent, strict parents, difficulty in mingling, love failure, broken family, loneliness and problems at school/office in the descending order. As the age advances higher percentage of both boys (43.4%) and girls (61.7%) discuss reproductive sexual health issues among themselves. There was a statistically significant difference in personal hygiene practices like changing napkins/cloths more than once a day (94.3%), cleaning genital organs with soap every day (71.7%), washing after urination (69.2%), washing from front to back after defecation (62.2%) and washing hands with soap after defecation (73.2%) between 10-14, 15-19, and 20-24 y age group with higher percentages in the older groups. In order to make the service more useful, more of the older group participants suggested giving information on adolescent services to parents, adolescents and society as a whole by creating better societal acceptance and keeping confidentiality in service delivery. This study has shown an overall inadequacy in reproductive health knowledge in all age groups, but increasing knowledge gain and better attitude and practices on reproductive and sexual health as the age increases. The suggestions made by the group regarding need for adolescent reproductive sexual health (ARSH) and counseling services with privacy and confidentiality ensured, is useful

Patients' satisfaction with sexual and reproductive health services delivered in HIV clinics across European regions.

PubMed

Platteau, Tom; Müller, Matthias C; Nideröst, Sibylle; Csepe, Peter; Dedes, Nikos; Apers, Ludwig; Schrooten, Ward; Nöstlinger, Christiana

2013-09-01

Throughout Europe, differences in satisfaction with HIV-care of people living with HIV (PLHIV) persist, despite a tendency towards harmonisation of policy and management. A European sample of 1,549 PLHIV responded to an anonymous questionnaire assessing demographic background, general health, mental health, sexual health, and HIV-service provision. We compared the results across 3 regions: Western, Southern and Central/Eastern Europe. PLHIV differed in several socio-demographic variables (gender, migrant status, sexual orientation, and financial situation) as well as specific psychosocial aspects (HIV-related discrimination, satisfaction with sexual and reproductive health (SRH) services in HIV-care settings, and complaints about service provision). Using multivariate analysis, a predictive model for satisfaction with SRH services in HIV clinics was developed, resulting into region of residence, and participants' satisfaction with their own health status as significant predictors. Better integration of SRH services in HIV-care should be encouraged. Service providers should be trained and encouraged to discuss SRH issues with their patients to create a supportive environment, free of discrimination. More time should be allocated to discuss SRH issues with individual patients.

Task shifting and sharing in maternal and reproductive health in low-income countries: a narrative synthesis of current evidence.

PubMed

Dawson, Angela J; Buchan, James; Duffield, Christine; Homer, Caroline S E; Wijewardena, Kumudu

2014-05-01

Reducing maternal mortality and providing universal access to reproductive health in resource poor settings has been severely constrained by a shortage of health workers required to deliver interventions. The aim of this article is to determine evidence to optimize health worker roles through task shifting/sharing to address Millennium Development Goal 5 and reduce maternal mortality and provide universal access to reproductive health. A narrative synthesis of peer-reviewed literature from 2000 to 2011 was undertaken with retrieved documents assessed using an inclusion/exclusion criterion and quality appraisal guided by critical assessment tools. Concepts were analysed thematically. The analysis identified a focus on clinical tasks (the delivery of obstetric surgery, anaesthesia and abortion) that were shifted to and/or shared with doctors, non-physician clinicians, nurses and midwives. Findings indicate that shifting and sharing these tasks may increase access to and availability of maternal and reproductive health (MRH) services without compromising performance or patient outcomes and may be cost effective. However, a number of issues and barriers were identified with health workers calling for improved in-service training, supervision, career progression and incentive packages to better support their practice. Collaborative approaches involving community members and health workers at all levels have the potential to deliver MRH interventions effectively if accompanied by ongoing investment in the health care system.

[Study protocol on the effect of the economic crisis on mortality and reproductive health and health inequalities in Spain].

PubMed

Pérez, Glòria; Gotsens, Mercè; Palència, Laia; Marí-Dell'Olmo, Marc; Domínguez-Berjón, M Felicitas; Rodríguez-Sanz, Maica; Puig, Vanessa; Bartoll, Xavier; Gandarillas, Ana; Martín, Unai; Bacigalupe, Amaia; Díez, Elia; Ruiz, Miguel; Esnaola, Santiago; Calvo, Montserrat; Sánchez, Pablo; Luque Fernández, Miguel Ángel; Borrell, Carme

The aim is to present the protocol of the two sub-studies on the effect of the economic crisis on mortality and reproductive health and health inequalities in Spain. Substudy 1: describe the evolution of mortality and reproductive health between 1990 and 2013 through a longitudinal ecological study in the Autonomous Communities. This study will identify changes caused by the economic crisis in trends or reproductive health and mortality indicators using panel data (17 Autonomous Communities per study year) and adjusting Poisson models with random effects variance. Substudy 2: analyse inequalities by socioeconomic deprivation in mortality and reproductive health in several areas of Spain. An ecological study analysing trends in the pre-crisis (1999-2003 and 2004-2008) and crisis (2009-2013) periods will be performed. Random effects models Besag York and Mollié will be adjusted to estimate mortality indicators softened in reproductive health and census tracts. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Poor reproductive health among a group of socially damaged Middle Eastern women: a cross-sectional study.

PubMed

Mohammadi, Gohar; Amiraliakbari, Sedigheh; Ramezankhani, Ali; Majd, Hamid Alavi

2011-01-01

Despite the scope of violence against women and its importance for reproductive health, few data are available on the reproductive health issues among women having experienced violence. This study described the reproductive disorders complicating social harm among 98 socially damaged women seeking care from drop-in centers who were of Persian ancestry, able to communicate and comprehend the contents of the questionnaire, and had history of domestic violence. The questionnaire had five dimensions: demographics, reproductive health, sexual performance, sexual behavior, and violence. Reproductive health included data on gestation, unplanned pregnancy, abortion, contraception, and cervical cancer screening. Data on sexual performance was acquired via the Persian version of sexual function scale, which has been demonstrated to have acceptable external validity in Iranian population. For sexual function, data was gathered on age at first intercourse and whether a participant had ever engaged in an oral or anal sexual activity. Mean age of participants was 33.4 years. Forty-seven percent of participants were married, 34.8% were divorced, 9.8% were widowed, and 8.7% were single. Mean age at first marriage was 16.4 (4.3) years and mean age at first sexual relationship was 16 (3.9) years. Illiteracy was observed among 18.5% of participants. Elementary education was reported by 22.8%, while only 3.3% of participants reported academic studies. Fifty-five percent were unemployed and 44.6% reported to be working at the time of the study. It was observed that 72.8% of participants were inflicted physically, as well as emotionally and sexually. The violence was reported to be exerted by husband (42.6%), parents (38.4%), or both (19.0%). Among 39 participants who ran away from home, 38 participants reported to be inflicted by violence. Unwanted pregnancy was reported by 64.6% of the participants. Abortion was reported in 50.0% of participants. Contraception was completely ignored

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

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. Copyright © 2016 Cleveland Clinic.

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…

Sources of Information on HIV and Sexual and Reproductive Health for Couples Living with HIV in Rural Southern Malawi

PubMed Central

Gombachika, Belinda Chimphamba; Chirwa, Ellen; Malata, Address; Maluwa, Alfred

2013-01-01

With wider access to antiretroviral therapy, people living with HIV are reconsidering their reproductive decisions: remarrying and having children. The purpose of the paper is to explore sources of information for reproductive decision used by couples living with HIV in patrilineal and matrilineal districts of Malawi. Data were collected from forty couples from July to December 2010. Our results illuminate five specific issues: some of the informants (1) remarry after divorce/death of a spouse, (2) establish new marriage relationship with spouses living with HIV, and (3) have children hence the need for information to base their decisions. There are (4) shared and interactive couple decisions, and (5) informal networks of people living with HIV are the main sources of information. In addition, in matrilineal community, cultural practices about remarriage set up structures that constrained information availability unlike in patrilineal community where information on sexual and reproductive health, HIV, and AIDS was disseminated during remarriage counselling. However, both sources are not able to provide comprehensive information due to complexity and lack of up to date information. Therefore, health workers should, offer people living with HIV comprehensive information that takes into consideration the cultural specificity of groups, and empower already existing and accepted local structures with sexual and reproductive health, HIV, and AIDS knowledge. PMID:23662206

Feasibility and validity of using WHO adolescent job aid algorithms by health workers for reproductive morbidities among adolescent girls in rural North India.

PubMed

Archana, Siddaiah; Nongkrynh, B; Anand, K; Pandav, C S

2015-09-21

High prevalence of reproductive morbidities is seen among adolescents in India. Health workers play an important role in providing health services in the community, including the adolescent reproductive health services. A study was done to assess the feasibility of training female health workers (FHWs) in the classification and management of selected adolescent girls' reproductive health problems according to modified WHO algorithms. The study was conducted between Jan-Sept 2011 in Northern India. Thirteen FHWs were trained regarding adolescent girls' reproductive health as per WHO Adolescent Job-Aid booklet. A pre and post-test assessment of the knowledge of the FHWs was carried out. All FHWs were given five modified WHO algorithms to classify and manage common reproductive morbidities among adolescent girls. All the FHWs applied the algorithms on at least ten adolescent girls at their respective sub-centres. Simultaneously, a medical doctor independently applied the same algorithms in all girls. Classification of the condition was followed by relevant management and advice provided in the algorithm. Focus group discussion with the FHWs was carried out to receive their feedback. After training the median score of the FHWs increased from 19.2 to 25.2 (p - 0.0071). Out of 144 girls examined by the FHWs 108 were classified as true positives and 30 as true negatives and agreement as measured by kappa was 0.7 (0.5-0.9). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 94.3% (88.2-97.4), 78.9% (63.6-88.9), 92.5% (86.0-96.2), and 83.3% (68.1-92.1) respectively. A consistent and significant difference between pre and post training knowledge scores of the FHWs were observed and hence it was possible to use the modified Job Aid algorithms with ease. Limitation of this study was the munber of FHWs trained was small. Issues such as time management during routine work, timing of training, overhead cost of training etc were not

Health research needed to resolve scientific issues surrounding drinking water disinfection

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kleffman, D.

Disinfection of drinking water will most likely continue in the United States in order to prevent exposure to microbial pathogens that can cause infectious disease. However, the emergence of concerns over possible toxicological effects, including cancer, mutagenicity, cardiovascular disease, and reproductive effects, may require that the disinfection techniques used in this country be altered or changed. First, the spectrum of possible health effects and the level of risk posed by exposure to chemicals in drinking water must be determined. This will require a continuing research program to develop the scientific data necessary to resolve these issues. In this paper, themore » authors discusses the microbiological, chemical, toxicological, and epidemiological research that is needed to address these issues.« less

Gender norms as health harms: reclaiming a life course perspective on sexual and reproductive health and rights.

PubMed

Crockett, Cailin; Cooper, Bergen

2016-11-01

Despite their demographic significance and the lifetime impact of gender disparities on their health and rights, women considered older than reproductive age are excluded from most investments in global public health. While development policies linking human rights with access to sexual and reproductive healthcare have yielded progress towards improving the status of women and girls, older women have not benefited from these initiatives. Yet as women grow older, they experience a range of health conditions rooted in their reproductive biology - from ageing with fistula, to cervical and breast cancers. Current approaches to global women's health ignore these serious conditions, harming older women through the perpetuation of gender norms that construe women's health through a narrow reproductive lens. Meanwhile, older women are generally absent from global ageing discourse, which lacks a gender perspective, creating a dual invisibility as the field of global women's health presumes ageing women are accounted for. Reclaiming the sexual rights framework suggested by the International Conference on Population and Development and the Beijing Platform for Action, we call for the revision of global health policies to incorporate a life course approach to women's health as a matter of human rights. Published by Elsevier B.V.

The reproductive health needs of refugees: emerging consensus attracts predictable controversy.

PubMed

Cohen, S A

1998-10-01

According to the UN High Commissioner for Refugees, there are approximately 40 million refugees and other internally displaced people worldwide, with the overwhelming majority coming from and still living in developed countries. 80% of all refugees are estimated to be women and children. Many refugees spend months and even years in what are designed to be temporary settings where efforts are made to accommodate their basic needs such as food, clean water, shelter, security, and primary health care during emergency situations. Women refugees, however, have certain unique needs beyond what traditionally have been considered basic in relief programs. Many women in developing countries suffer considerable health risks during the best of times due to their poverty or low social status. When fleeing conflict or natural disaster, their health status is at even higher risk of being compromised by severe living conditions and the complete absence of reproductive health services. The recognition that women refugees often face serious and sometimes life-threatening reproductive health-related situations led to the development of a field manual on reproductive health for use at the local level. Planned for publication in late 1998 or early 1999, the guide will describe the goals of a minimum array of reproductive health services in the early phase of an emergency and provide direct guidance on care relating to sexual violence, STDs, family planning, adolescents' needs, and other reproductive health concerns such as female genital mutilation and treatment for septic and incomplete abortion. The manual has garnered worldwide attention and support, as well as scrutiny by abortion opponents in the US, in particular New Jersey Republican Representative Chris Smith.

Occupational reproductive health risks.

PubMed

Filkins, K; Kerr, M J

1993-01-01

The potentially harmful effects on women of certain workplace exposures are widely appreciated, and steps to control these have included legislative efforts such as right-to-know laws of well as corporate policies mandating selective restriction of fertile women, which are illegal under federal civil rights laws. This chapter reviews the various occupational health risks reproductive women face in the workplace but also considers the effects of other genetic, medical, social, infectious, and environmental factors which may be of even greater concern than most occupational factors.

Knowledge and Perceptions of Reproductive Health among Latinas

ERIC Educational Resources Information Center

Rojas-Guyler, Liliana; Price, Kimberly L. J.; Young, Kathleen; King, Keith A.

2010-01-01

Objectives: The purpose of this study was to assess potential relationships among reproductive health knowledge, preventive health behaviors, perceived severity and risk of breast cancer, cervical cancer, and sexually transmitted infections and selected demographical variables and characteristics related to acculturation among Latina immigrants.…

Folate and human reproduction.

PubMed

Tamura, Tsunenobu; Picciano, Mary Frances

2006-05-01

The influence of folate nutritional status on various pregnancy outcomes has long been recognized. Studies conducted in the 1950s and 1960s led to the recognition of prenatal folic acid supplementation as a means to prevent pregnancy-induced megaloblastic anemia. In the 1990s, the utility of periconceptional folic acid supplementation and folic acid food fortification emerged when they were proven to prevent the occurrence of neural tube defects. These distinctively different uses of folic acid may well be ranked among the most significant public health measures for the prevention of pregnancy-related disorders. Folate is now viewed not only as a nutrient needed to prevent megaloblastic anemia in pregnancy but also as a vitamin essential for reproductive health. This review focuses on the relation between various outcomes of human reproduction (ie, pregnancy, lactation, and male reproduction) and folate nutrition and metabolism, homocysteine metabolism, and polymorphisms of genes that encode folate-related enzymes or proteins, and we identify issues for future research.

Reproductive health knowledge among African American women enrolled in a clinic-based randomized controlled trial to reduce psychosocial and behavioral risk, Project DC-HOPE

PubMed Central

Backonja, Uba; Robledo, Candace A.; Wallace, Maeve E.; Flores, Katrina F.; Kiely, Michele

2016-01-01

Background Washington, D.C. has among the highest rates of sexually transmitted infections (STIs) and unintended pregnancy in the United States. Increasing women’s reproductive health knowledge may help address these reproductive health issues. This analysis assessed whether high-risk pregnant African American women in Washington, D.C. who participated in an intervention to reduce behavioral and psychosocial risks had greater reproductive health knowledge than women receiving usual care. Methods Project DC-HOPE was a randomized controlled trial that included pregnant African American women in Washington, D.C., recruited during prenatal care. Women in the intervention group were provided reproductive health education and received tailored counseling sessions to address their psychosocial and behavioral risk(s) (cigarette smoking, environmental tobacco smoke exposure, depression, and intimate partner violence). Women in the control group received usual prenatal care. Participants completed a 10-item reproductive knowledge assessment at baseline (n=1,044) and postpartum (n=830). Differences in total reproductive health knowledge scores at baseline and postpartum between groups were examined via chi-squared tests. Differences in postpartum mean total score by group were assessed via multiple linear regression. Results Women in both groups and at both time points scored approximately 50% on the knowledge assessments. At postpartum, women in the intervention group had higher total scores compared to women receiving usual care (mean 5.40 [SD 1.60] vs. 5.03 [SD 1.53] out of 10, respectively; p<0.001). Conclusions While intervention participants increased reproductive health knowledge, overall scores remained low. Development of interventions designed to impart accurate, individually tailored information to women may promote reproductive health knowledge among high-risk pregnant African American women residing in Washington, D.C. PMID:27094910

The Impact of Racism on the Sexual and Reproductive Health of African American Women

PubMed Central

Prather, Cynthia; Fuller, Taleria R.; Marshall, Khiya J.; Jeffries, William L.

2016-01-01

African American women are disproportionately affected by multiple sexual and reproductive health conditions compared with women of other races/ethnicities. Research suggests that social determinants of health, including poverty, unemployment, and limited education, contribute to health disparities. However, racism is a probable underlying determinant of these social conditions. This article uses a socioecological model to describe racism and its impact on African American women’s sexual and reproductive health. Although similar models have been used for specific infectious and chronic diseases, they have not described how the historical underpinnings of racism affect current sexual and reproductive health outcomes among African American women. We propose a socioecological model that demonstrates how social determinants grounded in racism affect individual behaviors and interpersonal relationships, which may contribute to sexual and reproductive health outcomes. This model provides a perspective to understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes. The model also presents an opportunity to increase dialog and research among public health practitioners and encourages them to consider the role of these contextual experiences and supportive data when developing prevention interventions. Considerations address the provision of opportunities to promote health equity by reducing the effects of racism and improving African American women’s sexual and reproductive health. PMID:27227533

The Impact of Racism on the Sexual and Reproductive Health of African American Women.

PubMed

Prather, Cynthia; Fuller, Taleria R; Marshall, Khiya J; Jeffries, William L

2016-07-01

African American women are disproportionately affected by multiple sexual and reproductive health conditions compared with women of other races/ethnicities. Research suggests that social determinants of health, including poverty, unemployment, and limited education, contribute to health disparities. However, racism is a probable underlying determinant of these social conditions. This article uses a socioecological model to describe racism and its impact on African American women's sexual and reproductive health. Although similar models have been used for specific infectious and chronic diseases, they have not described how the historical underpinnings of racism affect current sexual and reproductive health outcomes among African American women. We propose a socioecological model that demonstrates how social determinants grounded in racism affect individual behaviors and interpersonal relationships, which may contribute to sexual and reproductive health outcomes. This model provides a perspective to understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes. The model also presents an opportunity to increase dialog and research among public health practitioners and encourages them to consider the role of these contextual experiences and supportive data when developing prevention interventions. Considerations address the provision of opportunities to promote health equity by reducing the effects of racism and improving African American women's sexual and reproductive health.

Results of the reproductive health education program for soldiers and noncommissioned officers.

PubMed

Sevig, Umit; Yilmaz, Senay; Başer, Mürüvvet; Taşci, Sultan

2006-12-01

The Turkish Armed Forces Commando Brigade has started a continuous and systematic education program, called the Patriotic Awareness Acquirement Project (PCAP), to inform soldiers who will be demobilized. Within the PCAP, topics such as Turkish history, the Armenian question, and manners/etiquette, as well as healthy living, reproductive health, family planning, general hygiene, and sexually transmitted diseases were included. The aim of Reproductive Health Education (RHE) conducted within the PCAP is to inform male individuals about reproductive health and to increase their knowledge, awareness, and sensitivity. In the RHE, the privates were provided with information regarding male and female reproductive organs, the menstruation mechanism, pregnancy, determination of gender, fertility-infertility, and sexually transmitted diseases. After the evaluation, it was reported that the privates indicated they were satisfied with RHE, were informed, took notice of the incorrect information, and, for postmilitary life, would visit health clinics for counseling.

Gap junction connexins in female reproductive organs: implications for women's reproductive health.

PubMed

Winterhager, Elke; Kidder, Gerald M

2015-01-01

Connexins comprise a family of ~20 proteins that form intercellular membrane channels (gap junction channels) providing a direct route for metabolites and signalling molecules to pass between cells. This review provides a critical analysis of the evidence for essential roles of individual connexins in female reproductive function, highlighting implications for women's reproductive health. No systematic review has been carried out. Published literature from the past 35 years was surveyed for research related to connexin involvement in development and function of the female reproductive system. Because of the demonstrated utility of genetic manipulation for elucidating connexin functions in various organs, much of the cited information comes from research with genetically modified mice. In some cases, a distinction is drawn between connexin functions clearly related to the formation of gap junction channels and those possibly linked to non-channel roles. Based on work with mice, several connexins are known to be required for female reproductive functions. Loss of connexin43 (CX43) causes an oocyte deficiency, and follicles lacking or expressing less CX43 in granulosa cells exhibit reduced growth, impairing fertility. CX43 is also expressed in human cumulus cells and, in the context of IVF, has been correlated with pregnancy outcome, suggesting that this connexin may be a determinant of oocyte and embryo quality in women. Loss of CX37, which exclusively connects oocytes with granulosa cells in the mouse, caused oocytes to cease growing without acquiring meiotic competence. Blocking of CX26 channels in the uterine epithelium disrupted implantation whereas loss or reduction of CX43 expression in the uterine stroma impaired decidualization and vascularization in mouse and human. Several connexins are important in placentation and, in the human, CX43 is a key regulator of the fusogenic pathway from the cytotrophoblast to the syncytiotrophoblast, ensuring placental growth

Attitudes toward Abortion among Providers of Reproductive Health Care.

PubMed

Dodge, Laura E; Haider, Sadia; Hacker, Michele R

2016-01-01

Access to abortion continues to decrease in the United States. The aim of this study was to explore attitudes toward abortion among clinicians who provide reproductive health care. Clinician members of several reproductive health professional organizations completed a self-administered survey that assessed their attitudes toward abortion. A total of 278 clinicians who provided clinical reproductive health services within the United States were included. Nearly all strongly agreed that abortion should be available in cases of rape (89.6%), incest (89.2%), life endangerment (93.2%), health endangerment (91.0%), and fetal anomaly (85.9%). Although most strongly disagreed that spousal notification (81.3%) and spousal consent (86.6%) should be required for married women, fewer strongly disagreed that parental notification (57.6%) and parental consent (66.9%) should be required for minors. Respondents were generally supportive of private insurance coverage (70.1% strongly agreed) and Medicaid coverage (65.0% strongly agreed) for abortion services. Support for legal abortion and public funding of abortion were significantly associated with being female (both p ≤ .03) and having no personal religious affiliation (both p ≤ .04). Younger respondents and men were more supportive of third-party involvement and mandatory counseling (all p ≤ .02). Abortion providers were significantly more supportive of abortion access (legality of abortion, public and private funding, no third-party involvement, and no mandated counseling) than nonproviders (all p < .001). Although reproductive health care providers were generally supportive of legal abortion and funding for abortion, lower support among younger respondents may indicate future difficulties in maintaining a clinical workforce that is willing to provide abortion care. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Pubescent male students' attitudes towards menstruation in Taiwan: implications for reproductive health education and school nursing practice.

PubMed

Chang, Yu-Ting; Hayter, Mark; Lin, Mei-Ling

2012-02-01

To explore male students' attitudes towards menstruation. Menstruation is a biological event that is often surrounded by secrecy and social stigma that causes anxiety amongst many young girls. A key element of this is the attitudes of young males towards this reproductive health issue. However, the literature around what young males think and feel about menstruation is limited. Qualitative. A sample of 27 male students aged between 10-12 years participated in five focus groups. Data were then subject to a thematic analysis. Five themes emerged from the data analysis that reflected the boys' feelings, experiences and attitudes towards menstruation: 'A silent topic', 'An unimportant issue', 'Errant information about menstruation'. In addition, according to their experience, participants gradually came to see menstruation from the 'menstrual stereotype' viewpoint. In their social life, they made choices that resulted in gradually regulating their behaviour that affected their 'relationships with girls'. Young boys have misguided knowledge about menstruation and this helps to perpetuate the stigma surrounding this element of reproductive health. Boys also express a desire to learn more but are often restricted in this by home and school. School nurses are the best placed professionals to address this issue. Menstrual education with boys should take a greater prominence than it often does in sexual health education in schools. Such inclusion will provide boys with a balanced and accurate knowledge base and therefore help towards reducing the social stigma around menstruation that is often experienced by young girls. © 2011 Blackwell Publishing Ltd.

Adolescents perception of reproductive health care services in Sri Lanka

PubMed Central

Agampodi, Suneth B; Agampodi, Thilini C; UKD, Piyaseeli

2008-01-01

Background Adolescent health needs, behaviours and expectations are unique and routine health care services are not well geared to provide these services. The purpose of this study was to explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among a group of adolescents in Sri Lanka in order to improve reproductive health service delivery. Methods This qualitative study was conducted in a semi urban setting in Sri Lanka. A convenient sample of 32 adolescents between 17–19 years of age participated in four focus group discussions. Participants were selected from four midwife areas. A pre-tested focus group guide was used for data collection. Male and female facilitators conducted discussions separately with young males and females. All tape-recorded data was fully transcribed and thematic analysis was done. Results Psychological distresses due to various reasons and problems regarding menstrual cycle and masturbation were reported as the commonest health problems. Knowledge on existing services was very poor and boys were totally unaware of youth health services available through the public health system. On reproductive Health Matters, girls mainly sought help from friends whereas boys did not want to discuss their problems with anyone. Lack of availability of services was pointed out as the most important barrier in reaching the adolescent needs. Lack of access to reproductive health knowledge was an important reason for poor self-confidence among adolescents to discuss these matters. Lack of confidentiality, youth friendliness and accessibility of available services were other barriers discussed. Adolescents were happy to accept available services through public clinics and other health infrastructure for their services rather than other organizations. A demand was made for separate youth friendly services through medical practitioners. Conclusions and recommendations

Adolescents perception of reproductive health care services in Sri Lanka.

PubMed

Agampodi, Suneth B; Agampodi, Thilini C; Ukd, Piyaseeli

2008-05-03

Adolescent health needs, behaviours and expectations are unique and routine health care services are not well geared to provide these services. The purpose of this study was to explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among a group of adolescents in Sri Lanka in order to improve reproductive health service delivery. This qualitative study was conducted in a semi urban setting in Sri Lanka. A convenient sample of 32 adolescents between 17-19 years of age participated in four focus group discussions. Participants were selected from four midwife areas. A pre-tested focus group guide was used for data collection. Male and female facilitators conducted discussions separately with young males and females. All tape-recorded data was fully transcribed and thematic analysis was done. Psychological distresses due to various reasons and problems regarding menstrual cycle and masturbation were reported as the commonest health problems. Knowledge on existing services was very poor and boys were totally unaware of youth health services available through the public health system. On reproductive Health Matters, girls mainly sought help from friends whereas boys did not want to discuss their problems with anyone. Lack of availability of services was pointed out as the most important barrier in reaching the adolescent needs. Lack of access to reproductive health knowledge was an important reason for poor self-confidence among adolescents to discuss these matters. Lack of confidentiality, youth friendliness and accessibility of available services were other barriers discussed. Adolescents were happy to accept available services through public clinics and other health infrastructure for their services rather than other organizations. A demand was made for separate youth friendly services through medical practitioners. Adolescent health services are inadequate and available services

Surrogacy and women's right to health in India: issues and perspective.

PubMed

Kumar, Pawan; Inder, Deep; Sharma, Nandini

2013-01-01

The human body is a wonderful machine. The future of child birth in the form of test tube babies, surrogate motherhood through new reproductive and cloning technology will introduce undreamt of possibilities in the sexual arena. Surrogacy is a method of assisted reproduction whereby a woman agrees to become pregnant for the purpose of gestating and giving birth to a child for others to raise. In some jurisdictions the possibility of surrogacy has been allowed and the intended parents may be recognized as the legal parents from birth. Commercial surrogacy, or "Womb for rent", is a growing business in India. In our rapidly globalizing world, the growth of reproductive tourism is a fairly recent phenomenon. Surrogacy business is exploiting poor women in country like India already having with an alarmingly high maternal death rate. This paper talks about paternity issues and women's right to health in context of surrogacy. Government must seriously consider enacting a law to regulate surrogacy in India in order to protect and guide couples going in for such an option. Without a foolproof legal framework, patients will invariably be misled and the surrogates exploited.

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…

The Impact of Militarism, Patriarchy, and Culture on Israeli Women's Reproductive Health and Well-Being.

PubMed

Granek, Leeat; Nakash, Ora

2017-12-01

In this paper, we situate and frame Israeli women's reproductive health within the social, historical, political, cultural, and geographical context of Israeli women's lives. We used a theoretical review in this paper. Militarism, patriarchy, and cultural values heavily shape and influence Jewish and Arab women's access to and experience of reproductive health when it comes to the imperative to have children, pregnancy, birth, access to contraception and abortion, and other reproductive healthcare services. We discuss five main factors pertaining to Israeli women's reproductive health including (1) fertility and emphasis on reproduction; (2) infertility; (3) pregnancy, birth, and miscarriage; (4) reproductive rights including contraception and abortion; and (5) maternity leave and accessible childcare. Israel is a pro-natalist country, in which both Jewish and Arab women share many of the consequences of the social imperative to have children. Though Arab women, as part of their double minority status, are exposed to more mental health risks pre- and postpartum, the personal and public reproductive health decisions and reproductive healthcare services are largely shaped by similar social forces. These include the patriarchal and religious culture that dictates a value system that highly cherishes motherhood, and within the military political context of the on-going Israeli-Palestinian conflict and past social and political traumas. We address four major gaps that need to be addressed in order to improve Israeli women's reproductive health and well-being that include the neoliberal gap, the information gap, the reproductive health services gap, and the leadership and policy gap.

Department of Defense Birth and Infant Health Registry: select reproductive health outcomes, 2003-2014.

PubMed

Bukowinski, Anna T; Conlin, Ava Marie S; Gumbs, Gia R; Khodr, Zeina G; Chang, Richard N; Faix, Dennis J

2017-11-01

Established following a 1998 directive, the Department of Defense Birth and Infant Health Registry (Registry) team conducts surveillance of select reproductive health outcomes among military families. Data are compiled from the Military Health System Data Repository and Defense Manpower Data Center to define the Registry cohort and outcomes of interest. Outcomes are defined using ICD-9/ICD-10 and Current Procedural Terminology codes, and include: pregnancy outcomes (e.g., live births, losses), birth defects, preterm births, and male:female infant sex ratio. This report includes data from 2003-2014 on 1,304,406 infants among military families and 258,332 pregnancies among active duty women. Rates of common adverse infant and pregnancy outcomes were comparable to or lower than those in the general US population. These observations, along with prior Registry analyses, provide reassurance that military service is not independently associated with increased risks for select adverse reproductive health outcomes. The Registry's diverse research portfolio demonstrates its unique capabilities to answer a wide range of questions related to reproductive health. These data provide the military community with information to identify successes and areas for improvement in prevention and care.

Building Irish families through surrogacy: medical and judicial issues for the advanced reproductive technologies

PubMed Central

Sills, Eric Scott; Healy, Clifford M

2008-01-01

Surrogacy involves one woman (surrogate mother) carrying a child for another person/s (commissioning person/couple), based on a mutual agreement requiring the child to be handed over to the commissioning person/couple following birth. Reasons for seeking surrogacy include situations where a woman has non-functional or absent reproductive organs, or as a remedy for recurrent pregnancy loss. Additionally, surrogacy may find application in any medical context where pregnancy is contraindicated, or where a couple consisting of two males seek to become parents through oocyte donation. Gestational surrogacy is one of the main issues at the forefront of bioethics and the advanced reproductive technologies, representing an important challenge to medical law. This analysis reviews the history of surrogacy and clinical and legal issues pertaining to this branch of reproductive medicine. Interestingly, the Medical Council of Ireland does not acknowledge surrogacy in its current practice guidelines, nor is there specific legislation addressing surrogacy in Ireland at present. We therefore have developed a contract-based model for surrogacy in which, courts in Ireland may consider when confronted with a surrogacy dispute, and formulated a system to resolve any potential dispute arising from a surrogacy arrangement. While the 2005 report by the Commission on Assisted Human Reproduction (CAHR) is an expert opinion guiding the Oireachtas' development of specific legislation governing assisted human reproduction and surrogacy, our report represents independent scholarship on the contractual elements of surrogacy with particular focus on how Irish courts might decide on surrogacy matters in a modern day Ireland. This joint medico-legal collaborative also reviews the contract for services arrangement between the commissioning person/s and the surrogate, and the extent to which the contract may be enforced. PMID:18983640

Impact of reproductive health on socio-economic development: a case study of Nigeria.

PubMed

Adinma, J I B; Adinma, E D

2011-03-01

The link between reproductive health, sexual and reproductive right, and development was highlighted at the International Conference on Population and Development held in Egypt. Developmental disparities are related to socio-economic differences which have led to the identification of distinct socio-economic classifications of nations. Human development represents the socioeconomic standing of any nation, in addition to literacy status and life expectancy. Africa accounts for 25% of the world's landmass but remains the world's poorest continent. Nigeria, the most populous country in Africa, has policies and programmes geared towards the improvement of its socio-economic standing and overal development, with little positive result. Reproductive health is a panacea towards reversing the stalled socio-economic growth of Nigeria as evident from the linkage between reproductive health and development, highlighted in Millennium Development Goals 3, 4, 5 and 6. Fast tracking Nigeria's development requires implementation of reproductive health policies and programmes targeted on women and children.

Incorporating social media into practice: a blueprint for reproductive health providers.

PubMed

Omurtag, Kenan; Turek, Paul

2013-09-01

Industries are quick to adopt online applications that consumers are using to attract attention to products or services. The adoption of social media among medical professionals, although slow, is an inexorable reality particularly in reproductive health, where patients typically use online resources to pursue their health concerns. On the basis of the literature and personal experience with social media in infertility care, we provide guidance for reproductive health practitioners on how to use social media effectively.

Population and reproductive health in National Adaptation Programmes of Action (NAPAs) for climate change in Africa.

PubMed

Mutunga, Clive; Hardee, Karen

2010-12-01

This paper reviews 44 National Adaptation Programmes of Action (NAPAs) to assess the NAPA process and identify the range of interventions included in countries' priority adaptation actions and highlight how population issues and reproductive health/family planning (RH/FP) are addressed as part of the adaptation agenda. A majority of the 44 NAPAs identify rapid population growth as a key component of vulnerability to climate change impacts. However, few chose to prioritise NAPA funds for family planning/reproductive health programmes. The paper emphasizes the need to translate the recognition of population pressure as a factor related to countries' ability to adapt to climate change into relevant project activities. Such projects should include access to RH/FP, in addition to other strategies such as girls' education and women's empowerment that lead to lower fertility. Attention to population and integrated strategies should be central and aligned to longer-term national adaptation plans and strategies.

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.

[Benefit of network education to college students' knowledge about sexual and reproductive health in Ningbo city].

PubMed

Wang, Guo-yao; Ji, Yun-xin; Ding, Hui-qing; Gui, Zhong-bao; Liang, Xiao-ming; Fu, Jian-fei; Cheng, Yue

2015-12-01

To investigate how network education can improve college students' knowledge on sexual and reproductive health in Ningbo city. From December 2012 to June 2013, we conducted a questionnaire investigation among college students in Ningbo city about the effects of network education on their knowledge about sexual psychology, sexual physiology, sexual ethics, and reproductive health. A total of 7 362 college students accomplished the investigation, of whom 2 483 (42.1% males and 57.9% females) received network education, while the other 4 879 (24.1% males and 75.9% females) did not. Approximately 47.1% of the male and 28.0% of the female students acquired sexual and reproductive knowledge via network education. Reproductive health-related network education significantly enriched the students' knowledge about the reproductive system and sex, pubertal development, sexual physiology, conception and embryonic development, methods of contraception, sexual psychology, sexually transmitted diseases and their prevention, pregnancy care and eugenics, and environment- and occupation-related reproductive health (P < 0.01). It also remarkably improved their cognitive attitude towards reproductive health knowledge (P < 0.01). Those who received reproductive health-related network education showed a significantly higher rate of masturbation (P < 0.01) but markedly later time of the first masturbation (P < 0.01) than those who did not. Network education can enhance the effect of reproductive health education among college students and improve their sexual experience and health.

The Role of Gender Empowerment on Reproductive Health Outcomes in Urban Nigeria

PubMed Central

Speizer, Ilene S.; Fotso, Jean-Christophe; Akiode, Akinsewa; Saad, Abdulmumin; Calhoun, Lisa; Irani, Laili

2014-01-01

Objectives To date, limited evidence is available for urban populations in sub-Saharan Africa, specifically research into the association between urban women’s empowerment and reproductive health outcomes. The objective of this study is to investigate whether women’s empowerment in urban Nigerian settings is associated with family planning use and maternal health behaviors. Moreover, we examine whether different effects of empowerment exist by region of residence. Methods This study uses baseline household survey data from the Measurement, Learning & Evaluation Project (MLE) for the Nigerian Urban Reproductive Health Initiative (NURHI) being implemented in six major cities. We examine four dimensions of empowerment: economic freedom, attitudes towards domestic violence, partner prohibitions and decision-making. We determine if the empowerment dimensions have different effects on reproductive health outcomes by region of residence using multivariate analyses. Results Results indicate that more empowered women are more likely to use modern contraception, deliver in a health facility and have a skilled attendant at birth. These trends vary by empowerment dimension and by city/region in Nigeria. Conclusions We conclude by discussing the implications of these findings on future programs seeking to improve reproductive health outcomes in urban Nigeria and beyond. PMID:23576403

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. Copyright © 2014 Elsevier B.V. All rights reserved.

Women's Health Issues in the Space Environment

NASA Technical Reports Server (NTRS)

Jennings, Richard T.

1999-01-01

Women have been an integral part of US space crews since Sally Ride's mission in 1983, and a total of 40 women have been selected as US astronauts. The first Russian female cosmonaut flew in 1963. This presentation examines the health care and reproductive aspects of flying women in space. In addition, the reproductive implications of delaying one's childbearing for an astronaut career and the impact of new technology such as assisted reproductive techniques are examined. The reproductive outcomes of the US female astronauts who have become pregnant following space flight exposure are also presented. Since women have gained considerable operational experience on the Shuttle, Mir and during EVA, the unique operational considerations for preflight certification, menstruation control and hygiene, contraception, and urination are discussed. Medical and surgical implications for women on long-duration missions to remote locations are still evolving, and enabling technologies for health care delivery are being developed. There has been considerable progress in the development of microgravity surgical techniques, including laparoscopy, thoracoscopy, and laparotomy. The concepts of prevention of illness, conversion of surgical conditions to medically treatable conditions and surgical intervention for women on long duration space flights are considered.

Health, equity, and reproductive risks in the workplace.

PubMed

Daniels, C R; Paul, M; Rosofsky, R

1990-01-01

Potential exposure to occupational reproductive hazards raises complex questions regarding health and gender discrimination in the workplace. On the one hand, growing scientific evidence suggests that workplace exposures to either sex can cause a wide range of disorders ranging from infertility to adverse pregnancy outcomes. On the other hand, policies alleging to protect workers from reproductive risks have often reinforced gender inequalities in the workplace. This article sheds new light on this continuing debate through an examination of the policy insights suggested by a recent study of reproductive hazard policies in Massachusetts. In what ways do policies evidenced in this study reflect or differ from historical patterns of protectionism? The article presents a political-legal review of reproductive hazard policies in the workplace, then examines the policy implications of the Massachusetts study, and finally presents the prescriptions for change that are implied by both the historical and contemporary evidence.

Women's health issues with fibromyalgia syndrome.

PubMed

Shaver, Joan L F; Wilbur, Joellen; Robinson, F Patrick; Wang, Edward; Buntin, Mary S

2006-11-01

Fibromyalgia syndrome (FMS) involves multiple sensory, somatic, and cognitive symptoms that are bound to affect or be affected by physical and mental health status and behavioral components of daily life. From a telephone survey of 442 women with and 205 women without FMS as volunteers, data were compared on (1) general health status, (2) reproductive and sleep-related diagnoses, and (3) lifestyle health behaviors. All multiple or logistics regression analyses for group differences were controlled for age, body mass index (BMI), race, employment status, marital status, having a college degree, low household income, and having ever been diagnosed with depression, with a Bonferroni p value correction for multiple indicators. Accordingly, FMS negatively impacted both perceived physical and mental health status, although relatively more so for physical (p < 0.017). Women with FMS were more likely to have had reproductive health or sleep-related diagnoses, including premenstrual syndrome, dysmenorrhea, breast cysts, bladder cystitis, sleep apnea, restless leg syndrome, and abnormal leg movements (p < 0.0125). They were calculated to use less than half as many calories per week as control women (689 +/- 1293 vs. 1499 +/- 1584 kcal/week, p < 0.05) and had more sleep pattern difficulties (p < 0.0125), more negative changes in sexual function (greater odds for 5 of 10 indicators at p < 0.005), and lower alcohol use (odds ratio = 0.39, p < 0.05). Patients with FMS deserve careful assessment for reproductive conditions and sleep-related functional disorders. Besides more research into mechanisms underlying symptoms, intervention testing specifically to alleviate sleep problems, low physical activity levels, and sexual dysfunction should be paramount.

Impact of stress on female reproductive health disorders: Possible beneficial effects of shatavari (Asparagus racemosus).

PubMed

Pandey, Ajai K; Gupta, Anumegha; Tiwari, Meenakshi; Prasad, Shilpa; Pandey, Ashutosh N; Yadav, Pramod K; Sharma, Alka; Sahu, Kankshi; Asrafuzzaman, Syed; Vengayil, Doyil T; Shrivastav, Tulsidas G; Chaube, Shail K

2018-07-01

Stress is deeply rooted in the society and women are frequently exposed to psychological, physical and physiological stressors. Psychological stress disturbs reproductive health by inducing generation of reactive oxygen species (ROS) and thereby oxidative stress (OS). The increased OS may affect physiology of ovary, oocyte quality and cause female reproductive health disorders. To overcome stress-mediated reproductive health disorders in women, shatavari (Asparagus racemosus) is frequently recommended in Ayurvedic system of medicine. Although shatavari is one of the major health tonics and most popular rasayana drugs to treat reproductive ailments of women, underlying mechanism of shatavari action at the level of ovary remains poorly understood. Based on the existing studies, we propose that shatavari may improve female reproductive health complications including hormonal imbalance, polycystic ovarian syndrome (PCOS), follicular growth and development, oocyte quality and infertility possibly by reducing OS level and increasing antioxidants level in the body. Further studies are required to elucidate the mechanism of shatavari actions at the level of ovary and oocyte that directly impacts the reproductive health of women. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Measuring reproductive health: review of community-based approaches to assessing morbidity.

PubMed Central

Sadana, R.

2000-01-01

This article begins by reviewing selected past approaches to estimating the prevalence of a range of morbidities through the use of household or community-based interview surveys in developed and developing countries. Subsequently, it reviews epidemiological studies that have used a range of methods to estimate the prevalence of reproductive morbidities. A detailed review of recent community or hospital based health interview validation studies that compare self-reported, clinical and laboratory measures is presented. Studies from Bangladesh, Bolivia, China, Egypt, India, Indonesia, Nigeria, Philippines and Turkey provide empirical evidence that self-reported morbidity and observed morbidity measure different phenomena and therefore different aspects of reproductive health and illness. Rather than estimating the prevalence of morbidity, interview-based surveys may provide useful information about the disability or burden associated with reproductive health and illness. PMID:10859858

Herbal Therapies and Social-Health Policies: Indigenous Ati Negrito Women's Dilemma and Reproductive Healthcare Transitions in the Philippines.

PubMed

Ong, Homervergel G; Kim, Young-Dong

2015-01-01

The high maternal mortality in the Philippines in the past decades prompted intervention strategies to curb unwanted deaths of mothers and improve health and social conditions of women. Such introductions however have begun to challenge traditional reproductive health practices creating confusion among practitioners and incipient transitions in healthcare. Our aim in this study was to document the herbal therapies practiced by indigenous Ati Negrito women and discuss the implications of social and conventional healthcare intervention programs on reproductive healthcare traditions by conducting semistructured interviews. Fidelity Level index was used to determine culturally important plants (i.e., the most preferred). Review of related studies on most preferred plants and therapies was further carried out to provide information regarding their safety/efficacy (or otherwise). Determination of informants' traditional medicinal knowledge was done using Mann-Whitney U and Kruskal-Wallis tests. A total of 49 medicinal plants used in treating female reproductive health-related syndromes across four categories were recorded. Significant differences in traditional medicinal knowledge were recorded when informants were grouped according to age, education, and number of children. Issues discussed in this research could hopefully raise awareness on changes in healthcare practices in indigenous cultures and on medical safety especially when traditional and conventional medications interact.

Herbal Therapies and Social-Health Policies: Indigenous Ati Negrito Women's Dilemma and Reproductive Healthcare Transitions in the Philippines

PubMed Central

Ong, Homervergel G.; Kim, Young-Dong

2015-01-01

The high maternal mortality in the Philippines in the past decades prompted intervention strategies to curb unwanted deaths of mothers and improve health and social conditions of women. Such introductions however have begun to challenge traditional reproductive health practices creating confusion among practitioners and incipient transitions in healthcare. Our aim in this study was to document the herbal therapies practiced by indigenous Ati Negrito women and discuss the implications of social and conventional healthcare intervention programs on reproductive healthcare traditions by conducting semistructured interviews. Fidelity Level index was used to determine culturally important plants (i.e., the most preferred). Review of related studies on most preferred plants and therapies was further carried out to provide information regarding their safety/efficacy (or otherwise). Determination of informants' traditional medicinal knowledge was done using Mann-Whitney U and Kruskal-Wallis tests. A total of 49 medicinal plants used in treating female reproductive health-related syndromes across four categories were recorded. Significant differences in traditional medicinal knowledge were recorded when informants were grouped according to age, education, and number of children. Issues discussed in this research could hopefully raise awareness on changes in healthcare practices in indigenous cultures and on medical safety especially when traditional and conventional medications interact. PMID:26345471

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. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Reproductive issues in patients undergoing Hematopoietic Stem Cell Transplantation: an update.

PubMed

Guida, Maurizio; Castaldi, Maria Antonietta; Rosamilio, Rosa; Giudice, Valentina; Orio, Francesco; Selleri, Carmine

2016-11-01

In 1963 George Mathé announced to the world that he had cured a patient of leukaemia by means of a bone-marrow transplant. Since than much progress has been made and nowadays Hematopoietic Stem Cell Transplantation (HSCT) is considered the most effective treatment of numerous severe haematological diseases. Gynaecological complications in HSCT women represent a serious concern for these patients, but often underestimated by clinicians in the view of Overall Survival. The main gynaecological complications of HSCT are represented by: premature ovarian failure (POF), thrombocytopenia-associated menorrhagia, genital symptoms or sexual problems in course of chronic GVHD (cGVHD), osteoporosis, secondary solid tumours due to immunosuppressive drugs to treat cGVHD and severity of cGVHD, and fertility and pregnancy issues. In particular fertility-related issues are always more relevant for patients, whose life expectation is constantly growing up after HSCT.Thus, taking care of a patient undergoing HSCT should primarily include gynaecological evaluation, even before conditioning regimen or chemotherapy for the underlying malignancy, as, in our opinion, it is of great importance to ensure a complete diagnostic work-up and intervention options to guarantee maximum reproductive health and a better quality of life in HSCT women.The present review aims at describing principal features of the aforementioned gynaecological complications of HSCT, and to define, on the basis of current international literature, a specific protocol for the prevention, diagnosis, management and follow-up of gynaecological complications of both autologous and heterologous transplantation, before and after the procedure.

Attitudes toward comparative effectiveness research and patient engagement among reproductive health clinicians.

PubMed

Kohn, Julia; Unger, Zoe; Dolatshahi, Jennifer; Simons, Hannah; Rein, Alison

2017-06-01

To assess reproductive health clinicians' knowledge of and attitudes toward comparative effectiveness research (CER), patient-centered outcomes research (PCOR) and patient engagement in research. Web-based survey of reproductive health clinicians. Among 103 responding clinicians, familiarity with CER and PCOR was moderate (35 and 44%, respectively). Once definitions were provided, most respondents agreed with the potential positive impacts of CER and patient engagement (65-87%), the importance of PCOR (95-99%) and that their patients might be interested in engaging in research as more than subjects (93%). We found positive attitudes toward PCOR and CER, and a range of experiences with patient engagement in research. There may be untapped potential for PCOR and CER in the reproductive health field.

Using human rights for sexual and reproductive health: improving legal and regulatory frameworks

PubMed Central

Kismodi, Eszter; Hilber, Adriane Martin; Lincetto, Ornella; Stahlhofer, Marcus; Gruskin, Sofia

2010-01-01

Abstract This paper describes the development of a tool that uses human rights concepts and methods to improve relevant laws, regulations and policies related to sexual and reproductive health. This tool aims to improve awareness and understanding of States’ human rights obligations. It includes a method for systematically examining the status of vulnerable groups, involving non-health sectors, fostering a genuine process of civil society participation and developing recommendations to address regulatory and policy barriers to sexual and reproductive health with a clear assignment of responsibility. Strong leadership from the ministry of health, with support from the World Health Organization or other international partners, and the serious engagement of all involved in this process can strengthen the links between human rights and sexual and reproductive health, and contribute to national achievement of the highest attainable standard of health. PMID:20616975

[Impact of sexual and reproductive health theme insertion in the undergraduate medical].

PubMed

de Medeiros, Robinson Dias; de Azevedo, George Dantas; Maranhão, Técia Maria de Oliveira; Gonçalves, Ana Katherine; Barros, Yasha Emerenciano; de Araújo, Ana Cristina Pinheiro Fernandes; Lima, Stênia Lins Leão

2014-03-01

To evaluate the impact of sexual and reproductive health theme insertion in the undergraduate medical curriculum at a Brazilian public university. We developed an instrument for cognitive assessment in sexual and reproductive health based on the subjects addressed in the optional curriculum component Reproductive Health, resulting in an objective multiple choice test containing 27 items. The selected topics were: human, sexual and reproductive rights (HSRR), sexuality, institutional violence, gender, sexual violence, conception, contraception, abortion/legal interruption of pregnancy, maternal mortality and sexually transmitted infections (STIs) - HIV/AIDS. The subjects were grouped into three dimensions of knowledge: HSRR, legal/institutional and biomedical. Two multivariate models were adjusted in the analysis of covariance. The study included 183 students, 127 of the group who took the elective curriculum course reproductive health (RH Group) and 56 who did not (Non-RH Group). Ninety-six students (52.5%) were males and 87 (47.5%) were females. Mean age was 24.7±1.9 years for the RH Group and 24.4±2.6 for the Non-RH Group. The average performance of the SR Group was higher than that of Non-RH subjects regarding the following subjects: HSRR, sexuality, institutional violence, sexual violence, abortion/legal interruption, and STDs - HIV/AIDS. There was no gender difference in performance, except for the theme maternal mortality, in which males scored worse than females (6.9±0.2 and 7.8±0.2, respectively; p<0.05). The participation of students in the elective curriculum component Reproductive Health was associated with better performance in some dimensions of cognitive assessment, suggesting a positive impact of this initiative on general medical education.

Reproductive choice in Islam: gender and state in Iran and Tunisia.

PubMed

Obermeyer, C M

1994-01-01

This report examines the extent to which reproductive choice is compatible with Islamic principles. It presents the argument that the impact of Islam on reproductive choice is largely a function of the political context in which gender issues are defined. Indicators of reproductive health in countries of the Middle East are reviewed and the way these relate to constraints on reproductive choice is assessed. The examples of Tunisia and Iran are used to illustrate the way in which Islam is invoked to legitimate conflicting positions concerning women and their reproductive options.

Leveraging Social Networks to Support Reproductive Health and Economic Wellbeing among Guatemalan Maya Women

ERIC Educational Resources Information Center

Prescott, Alexandra S.; Luippold-Roge, Genevieve P.; Gurman, Tilly A.

2016-01-01

Objective: Maya women in Guatemala are disproportionately affected by poverty and negative reproductive health outcomes. Although social networks are valued in many Indigenous cultures, few studies have explored whether health education programmes can leverage these networks to improve reproductive health and economic wellbeing. Design: This…

Reproductive Health Education Model in Early Childhood through Education Film "Damar Wulan"

ERIC Educational Resources Information Center

Zahrulianingdyah, Atiek

2015-01-01

Reproductive health education for early childhood it has been the time to teach, because the demand of the changing times and will affect the child's life when he/she is a teenager. During this time, the reproductive health education, which is in it there is sex education, considered taboo among some communities. They argue that the reproductive…

Essential learning tools for continuing medical education for physicians, geneticists, nurses, allied health professionals, mental health professionals, business administration professionals, and reproductive endocrinology and infertility (REI) fellows: the Midwest Reproductive Symposium International.

PubMed

Collins, Gretchen G; Jeelani, Roohi; Beltsos, Angeline; Kearns, William G

2018-04-01

Essential learning tools for continuing medical education are a challenge in today's rapidly evolving field of reproductive medicine. The Midwest Reproductive Symposium International (MRSi) is a yearly conference held in Chicago, IL. The conference is targeted toward physicians, geneticists, nurses, allied health professionals, mental health professionals, business administration professionals, and reproductive endocrinology and infertility (REI) fellows engaged in the practice of reproductive medicine. In addition to the scientific conference agenda, there are specific sessions for nurses, mental health professionals, and REI fellows. Unique to the MRSi conference, there is also a separate "Business Minds" session to provide education on business acumen as it is an important element to running a department, division, or private clinic.

Ten years of democracy in South Africa: documenting transformation in reproductive health policy and status.

PubMed

Cooper, Diane; Morroni, Chelsea; Orner, Phyllis; Moodley, Jennifer; Harries, Jane; Cullingworth, Lee; Hoffman, Margaret

2004-11-01

The advent of democracy in South Africa in 1994 created a unique opportunity for new lows and policies to be passed. Today, a decade later, South African reproductive health policies and the laws that underwrite them are among the most progressive and comprehensive in the world in terms of the recognition that they give to human rights, including sexual and reproductive rights. This paper documents the changes in health policy and services that have occurred, focusing particularly on key areas of sexual and reproductive health: contraception, maternal health, termination of pregnancy, cervical and breast cancer, gender-based and sexual violence, HIV/AIDS and sexually transmitted infections and infertility. Despite important advances, significant changes in women's reproductive health status are difficult to discern, given the relatively short period of time and the multitude of complex factors that influence health, especially inequalities in socio-economic and gender status. Gaps remain in the implementation of reproductive health policies and in service delivery that need to be addressed in order for meaningful improvements in women's reproductive health status to be achieved. Civil society has played a major role in securing these legislative and policy changes, and health activist groups continue to pressure the government to introduce further changes in policy and service delivery, especially in the area of HIV/AIDS.

Assessing the quality of reproductive health services in Egypt via exit interviews.

PubMed

Zaky, Hassan H M; Khattab, Hind A S; Galal, Dina

2007-05-01

This study assesses the quality of reproductive health services using client satisfaction exit interviews among three groups of primary health care units run by the Ministry of Health and Population of Egypt. Each group applied a different model of intervention. The Ministry will use the results in assessing its reproductive health component in the health sector reform program, and benefits from the strengths of other models of intervention. The sample was selected in two stages. First, a stratified random sampling procedure was used to select the health units. Then the sample of female clients in each health unit was selected using the systematic random approach, whereby one in every two women visiting the unit was approached. All women in the sample coming for reproductive health services were included in the analysis. The results showed that reproductive health beneficiaries at the units implementing the new health sector reform program were more satisfied with the quality of services. Still there were various areas where clients showed significant dissatisfaction, such as waiting time, interior furnishings, cleanliness of the units and consultation time. The study showed that the staff of these units did not provide a conductive social environment as other interventions did. A significant proportion of women expressed their intention to go to private physicians owing to their flexible working hours and variety specializations. Beneficiaries were generally more satisfied with the quality of health services after attending the reformed units than the other types of units, but the generalization did not fully apply. Areas of weakness are identified.

Dimensions of gender relations and reproductive health inequity perceived by female undergraduate students in the Mekong Delta of Vietnam: a qualitative exploration.

PubMed

Bui, Thanh Cong; Markham, Christine M; Ross, Michael W; Williams, Mark L; Beasley, R Palmer; Tran, Ly T H; Nguyen, Huong T H; Le, Thach Ngoc

2012-10-24

Increasing evidence indicates that gender equity has a significant influence on women's health; yet few culturally specific indicators of gender relations exist which are applicable to health. This study explores dimensions of gender relations perceived by female undergraduate students in southern Vietnamese culture, and qualitatively examines how this perceived gender inequity may influence females' sexual or reproductive health. Sixty-two female undergraduate students from two universities participated in eight focus group discussions to talk about their perspectives regarding national and local gender equity issues. Although overall gender gaps in the Mekong Delta were perceived to have decreased in comparison to previous times, several specific dimensions of gender relations were emergent in students' discussions. Perceived dimensions of gender relations were comparable to theoretical structures of the Theory of Gender and Power, and to findings from several reports describing the actual inferiority of women. Allocation of housework and social paid work represented salient dimensions of labor. The most salient dimension of power related to women in positions of authority. Salient dimensions of cathexis related to son preference, women's vulnerability to blame or criticism, and double standards or expectations. Findings also suggested that gender inequity potentially influenced women's sexual and reproductive health as regards to health information seeking, gynecological care access, contraceptive use responsibility, and child bearing. Further investigations of the associations between gender relations and different women's sexual and reproductive health outcomes in this region are needed. It may be important to address gender relations as a distal determinant in health interventions in order to promote gender-based equity in sexual and reproductive health.

Quality of care in reproductive health programmes: monitoring and evaluation of quality improvement.

PubMed

Kwast, B E

1998-12-01

As 200 million women become pregnant every year, at least 30 million will develop life-threatening complications requiring emergency treatment at any level of society where they live. But it is a basic human right that pregnancy be made safe for all women as complications are mostly unpredictable. This requires reproductive health programmes which are responsive to women's and their families' needs and expectations on the one hand and enhancement of community participation, high quality obstetric services, and both provider collaboration and satisfaction on the other. Monitoring and evaluation of these facets need to be an integral part of any safe motherhood programme, not only to assess progress, but also to use this information for subsequent planning and implementation cycles of national programmes. Lessons learned from ten years' implementation of Safe Motherhood programmes indicate that process and outcome indicators are more feasible for short-term evaluation purposes than impact indicators, such as maternal mortality reduction. The former are described in this paper with relevant country examples. This is the third, and last, article in a series on quality of care in reproductive health programmes. The first (Kwast 1998a) contains an overview of concepts, assessments, barriers and improvements of quality of care. The second (Kwast 1998b) addresses education issues for quality improvement.

Inhalation anesthetics and the reproductive risk associated with occupational exposure among women working in veterinary anesthesia.

PubMed

Allweiler, Sandra I; Kogan, Lori R

2013-05-01

To investigate reproductive health issues for women working in veterinary anesthesia compared with those working in veterinary critical care. Reproductive health issues were classified as time to conceive, fertility treatment, miscarriage, and children with birth defects. Questionnaire-based survey. A survey was designed to assess the reproductive health of female personnel working in veterinary anesthesia. To account for other job related factors that might impact reproductive health (i.e. stress, heavy lifting, long working hours and varying schedules), women working in veterinary critical care were used as a comparison group. There were 295 respondents including, (209 faculty and staff working in veterinary anesthesia and 86 in veterinary critical care). There were no statistical differences in length of time to conceive, number of couples receiving fertility treatment, miscarriages, and children with birth defects between the two groups. This study did not show a statistically significant difference in reproductive risk for women working in veterinary anesthesia when compared to women working in veterinary critical care. Overall the incidence for reproductive health problems is similar to the risk for the general population of females in North America. © 2013 The Authors. Veterinary Anaesthesia and Analgesia © 2013 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

Women's well-being and reproductive health in Indian mining community: need for empowerment.

PubMed

D'Souza, Melba Sheila; Karkada, Subrahmanya Nairy; Somayaji, Ganesha; Venkatesaperumal, Ramesh

2013-04-19

This paper is a qualitative study of women's well-being and reproductive health status among married women in mining communities in India. An exploratory qualitative research design was conducted using purposive sampling among 40 selected married women in a rural Indian mining community. Ethical permission was obtained from Goa University. A semi-structured indepth interview guide was used to gather women's experiences and perceptions regarding well-being and reproductive health in 2010. These interviews were audiotaped, transcribed, verified, coded and then analyzed using qualitative content analysis. Early marriage, increased fertility, less birth intervals, son preference and lack of decision-making regarding reproductive health choices were found to affect women's reproductive health. Domestic violence, gender preference, husbands drinking behaviors, and low spousal communication were common experiences considered by women as factors leading to poor quality of marital relationship. Four main themes in confronting women's well-being are poor literacy and mobility, low employment and income generating opportunities, poor reproductive health choices and preferences and poor quality of martial relationships and communication. These determinants of physical, psychological and cultural well-being should be an essential part of nursing assessment in the primary care settings for informed actions. Nursing interventions should be directed towards participatory approach, informed decision making and empowering women towards better health and well-being in the mining community.

Reproductive Issues in Women with Turner Syndrome.

PubMed

Folsom, Lisal J; Fuqua, John S

2015-12-01

Turner syndrome is one of the most common chromosomal abnormalities affecting female infants. The severity of clinical manifestations varies and it affects multiple organ systems. Women with Turner syndrome have a 3-fold increase in mortality, which becomes even more pronounced in pregnancy. Reproductive options include adoption or surrogacy, assisted reproductive techniques, and in rare cases spontaneous pregnancy. Risks for women with Turner syndrome during pregnancy include aortic disorders, hepatic disease, thyroid disease, type 2 diabetes, and cesarean section delivery. Providers must be familiar with the risks and recommendations in caring for women with Turner syndrome of reproductive age. Copyright © 2015 Elsevier Inc. All rights reserved.

Reproductive rights and options available to women infected with HIV in Ghana: perspectives of service providers from three Ghanaian health facilities.

PubMed

Laar, Amos Kankponang

2013-03-15

Owing to improved management of HIV and its associated opportunistic infections, many HIV-positive persons of reproductive age are choosing to exercise their right of parenthood. This study explored the knowledge of health workers from two Ghanaian districts on the reproductive rights and options available to HIV-positive women who wish to conceive. Facility-based cross-sectional in design, the study involved the entire population of nurse counselors (32) and medical officers (3) who provide counseling and testing services to clients infected with HIV. Both structured and in-depth interviews were conducted after informed consent. Two main perspectives were revealed. There was an overwhelmingly high level of approbation by the providers on HIV-positive women's right to reproduction (94.3%). At the same time, the providers demonstrated a lack of knowledge regarding the various reproductive options available to women infected with HIV. Site of facility, and being younger were associated with practices that violated client's right to contraceptive counseling (p < 0.05) in each case. Some of the providers openly expressed their inability to give qualified guidance to HIV-positive women on the various reproductive options. Taken together, these findings suggest that many HIV-positive clients do not receive comprehensive information about their reproductive options. These findings highlight some of the problems that service providers face as HIV counselors. Both service providers and policy makers need to recognize these realities and incorporate reproductive health issues of HIV-persons into the existing guidelines.

Pupils' Perceptions of Sex and Reproductive Health Education in Primary Schools in Tanzania: A Phenomenological Study

ERIC Educational Resources Information Center

Kapinga, Orestes Silverius; Hyera, Daniel Frans

2015-01-01

This study explored pupils' perceptions of sex and reproductive health education in primary schools in Tanzania. Specifically, the study aimed at (i) exploring pupils' views on sex and reproductive health education in primary schools; (ii) determining opinions on the appropriateness of sex and reproductive health education for pupils in primary…

Tales from the "hood:" placing reproductive health communication between African American fathers and children in context.

PubMed

Ohalete, Nnenna; Georges, Jane; Doswell, Willa

2010-01-01

To evaluate reproductive health communication between African American fathers and their children. In this qualitative ethnographic study, data were collected through tape-recorded individual interviews about the content and timing of reproductive health communication, the reproductive health values fathers intended to impart to their children, and their comfort level in doing so. A total sample of 19 African-American fathers participated. Data were coded according to the qualitative analytic principles established by Miles and Huberman (1994), and analyzed using manifest and latent content analysis approaches. Although 10 fathers reported feeling uncomfortable having these conversations, 18 reported having reproductive health communication with their children, and most encouraged their sons and daughters to delay sex until adulthood. These conversations were primarily driven by the fear of HIV/AIDS and the negative consequences of sex; however, some conversations were inappropriate for developmental age. African-American fathers may benefit from education to help them have age appropriate reproductive health communication with their children. Registered Nurses and Nurse Practitioners are well positioned to educate African American adolescents and their fathers on reproductive health. Future dyadic African American father-child studies are needed to explore more fully African-American children's perceptions of reproductive health communication and the effect on delaying sex.

Contraceptive prevalence, reproductive health, and international morality.

PubMed

Diczfalusy, E

1992-04-01

This article is a transcript of the 58th Joseph Price Oration, delivered by Egon Diczfalusy (MD, PhD) at the 10th Annual Meeting of the American Gynecological and Obstetrical Society, held in Carlsbad, California on September 5-7, 1991. In his speech, Diczfalusy discussed the international community's moral obligation to promoting reproductive health, which hinges primarily on contraceptive prevalence. WHO figures indicate that 85% of the world's births, 95% of the world's infant deaths, and 99% of the world's maternal deaths take place in developing countries. While a women in a developed country has a 1 in 1750 chance of dying from pregnancy-related causes, the risk is 1 in 24 for a woman in Africa. The goals of reproductive health are well-known: reducing the unmet need for family planning, increasing family planning services and methods; lessening maternal, infant, and child mortality and morbidity; and reducing the prevalence of STDs. An investment of $2/capita would eliminate most maternal deaths in the developing world. An additional $2/capita spending increase in developing countries would also immunize all children, eradicate polio, and provide the drugs necessary to cure all cases of diarrheal disease, acute respiratory infection tuberculosis, malaria, schistosomiasis, and STDs. But the most important element with respect to reproductive health is increasing contraceptive prevalence. Over the next decade, yearly world population increments will approach 97 million. 94% of this growth will take place in developing countries. As Diczfalusy explains, the technology and resources to solve these problems exists. At bottom, the obstacle to overcoming the problems is the lack of political will.

Adolescent pregnancies in the Amazon Basin of Ecuador: a rights and gender approach to adolescents' sexual and reproductive health

PubMed Central

Goicolea, Isabel

2010-01-01

In the Andean region of Latin America over one million adolescent girls get pregnant every year. Adolescent pregnancy (AP) has been associated with adverse health and social outcomes, but it has also been favorably viewed as a pathway to adulthood. AP can also be conceptualized as a marker of inequity, since it disproportionately affects girls from the poorest households and those who have not been able to attend school. Using results from a study carried out in the Amazon Basin of Ecuador, this paper explores APs and adolescents' sexual and reproductive health from a rights and gender approach. The paper points out the main features of a rights and gender approach, and how it can be applied to explore APs. Afterward it describes the methodologies (quantitative and qualitative) and main results of the study, framing the findings within the rights and gender approach. Finally, some implications that could be generalizable to global reserach on APs are highlighted. The application of the rights and gender framework to explore APs contributes to a more integral view of the issue. The rights and gender framework stresses the importance of the interaction between rights-holders and duty-bearers on the realization of sexual and reproductive rights, and acknowledges the importance of gender–power relations on sexual and reproductive decisions. A rights and gender approach could lead to more integral and constructive interventions, and it could also be useful when exploring other sexual and reproductive health matters. PMID:20596248

Adolescent pregnancies in the Amazon Basin of Ecuador: a rights and gender approach to adolescents' sexual and reproductive health.

PubMed

Goicolea, Isabel

2010-06-24

In the Andean region of Latin America over one million adolescent girls get pregnant every year. Adolescent pregnancy (AP) has been associated with adverse health and social outcomes, but it has also been favorably viewed as a pathway to adulthood. AP can also be conceptualized as a marker of inequity, since it disproportionately affects girls from the poorest households and those who have not been able to attend school.Using results from a study carried out in the Amazon Basin of Ecuador, this paper explores APs and adolescents' sexual and reproductive health from a rights and gender approach. The paper points out the main features of a rights and gender approach, and how it can be applied to explore APs. Afterward it describes the methodologies (quantitative and qualitative) and main results of the study, framing the findings within the rights and gender approach. Finally, some implications that could be generalizable to global reserach on APs are highlighted.The application of the rights and gender framework to explore APs contributes to a more integral view of the issue. The rights and gender framework stresses the importance of the interaction between rights-holders and duty-bearers on the realization of sexual and reproductive rights, and acknowledges the importance of gender-power relations on sexual and reproductive decisions. A rights and gender approach could lead to more integral and constructive interventions, and it could also be useful when exploring other sexual and reproductive health matters.

Skirting the issue: women and international health in historical perspective.

PubMed Central

Birn, A E

1999-01-01

Over the last decades women have become central to international health efforts, but most international health agencies continue to focus narrowly on the maternal and reproductive aspects of women's health. This article explores the origins of this paradigm as demonstrated in the emergence of women's health in the Rockefeller Foundation's public health programs in Mexico in the 1920s and 1930s. These efforts bore a significant reproductive imprint; women dispensed and received services oriented to maternal and childbearing roles. Women's health and social advocacy movements in Mexico and the United States partially shaped this interest. Even more important, the emphasis on women in the Rockefeller programs proved an expedient approach to the Foundation's underlying goals: promoting bacteriologically based public health to the government, medical personnel, business interests, and peasants; helping legitimize the Mexican state; and transforming Mexico into a good political and commercial neighbor. The article concludes by showing the limits to the maternal and reproductive health model currently advocated by most donor agencies, which continue to skirt--or sidestep--major concerns that are integral to the health of women. Images p400-a p401-a p402-a p403-a PMID:10076494

The Efficiency of Reproduction Health Education Given to Adolescents during the Postpartum Period.

PubMed

Topatan, Serap; Demirci, Nurdan

2015-10-01

Our research, partly experimental and partly prospective, was conducted for the purpose of evaluating the efficiency of reproductive health education given to adolescents during the postpartum period. The study comprised with 120 adolescents aged 15 to 19 (60 experimental group, 60 control group). Follow-up was conducted every 3 months for a total of 12 months, and the study concluded with 55 individuals from the experimental group and 46 individuals from the control group having participated fully, for the full 12 months. At the end of the research, it was found that the reproductive health knowledge of the experimental (103.10 ± 11.43) and control (99.15 ± 9.53) groups were similar before education. A statistically significant difference was also found between the total points for the scale determining the reproductive health of the experimental and control groups before and after education (P < .001). The socio-demographic variables affecting the total points for the scale determining the reproductive health-protective behavior of women were evaluated by multiple regression analysis; the most effective variables were found to be age and educational status. A statistically significant difference was also found between the total points for the family planning behavior scale of the experimental and control groups before and after education (P < .001). From this, it was understood that reproductive health education given during the postpartum and follow-up periods has a positive effect on adolescents' developing reproductive health behaviors and on creating knowledge and awareness related to family planning behavior. But there needs to be follow-up and supporting specific for adolescents in the current health system. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Conservative litigation against sexual and reproductive health policies in Argentina.

PubMed

Peñas Defago, María Angélica; Morán Faúndes, José Manuel

2014-11-01

In Argentina, campaigns for the recognition of sexual and reproductive rights have sparked opposition through litigation in which the dynamics of legal action have come from self-proclaimed "pro-life" NGOs, particularly since 1998, when the conservative NGO Portal de Belén successfully achieved the banning of emergency contraception through the courts. The activities of these groups, acting as a "civil arm" of religion, are focused primarily on obstructing access to legally permissible abortions and bringing about the withdrawal of a number of recognized public policies on sexual and reproductive health, particularly the 2002 National Programme for Sexual Health and Responsible Procreation. This paper analyzes the litigation strategies of these conservative NGOs and how their use of the courts in Argentina has changed over the years. It gives examples of efforts in local courts to block individual young women from accessing legal abortion following rape, despite a ruling by the National Supreme Court of Justice in 2012 that no judicial permission is required. In spite of major advances, the renewed influence of the Catholic hierarchy in the Argentine political scene with the accession of the new Pope poses challenges to the work by feminists and women's movements to extend and consolidate sexual and reproductive rights. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Reproductive health care and family planning among women in Nepal.

PubMed

Liu, Marisa; Nagarajan, Neeraja; Ranjit, Anju; Gupta, Shailvi; Shrestha, Sunil; Kushner, Adam L; Nwomeh, Benedict C; Groen, Reinou S

2016-07-01

To describe findings from a validated survey examining access to care, contraceptive needs, access to surgical care, menstruation-related healthcare needs, and barriers to receiving reproductive health care in Nepal. An analysis was undertaken using data obtained through a two-part population-based, cross-sectional, cluster-randomized survey corroborated by a visual physical examination performed nationwide between May 25 and June 12, 2014. Women aged 12-50years were included. The odds of delivering exclusively in a health facility, having a cesarean delivery, and using contraception were modeled using logistic regression. Overall, 876 female interviewees were of reproductive age (12-50years). Only 237 (27.1%) women were using contraception. Maternal education was the strongest predictor of delivering exclusively in a healthcare facility (odds ratio [OR] 7.57, 95% confidence interval [CI] 4.48-12.79; P<0.001). The odds of having a cesarean delivery were doubled by urban living (OR 2.20, 95% CI 1.09-4.13; P<0.001). On multivariable analysis, a predictor of using contraception was a history of having given birth (OR 9.61, 95% CI 4.62-20.01; P<0.001). In Nepal, reproductive healthcare disparities for women are manifold. Education for women appears to be a significant determinant of accessing reproductive health care. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Effects of Reproductive Health Education on Knowledge and Attitudes Among Female Adolescents in Saudi Arabia.

PubMed

Tork, Hanan Mohamed Mohamed; Al Hosis, Khalid Fahad

2015-09-01

For many girls, the onset of puberty that occurs during adolescence marks a time of heightened vulnerability to early pregnancy, with its attendant complications and heightened risk of maternal mortality. National and international forums have recognized the need to address these problems through reproductive health education. This article assesses the reproductive-health-related knowledge and attitudes of female adolescents aged between 14 and 19 years. In addition, the authors assess the effectiveness of a reproductive health education program in improving the related knowledge of female adolescents. The study was conducted on female students in three secondary schools and in the preparatory year at Qassim University (N = 309). A 59-item structured questionnaire was used to test the knowledge and attitudes of all participants regarding reproductive health before and after the intervention program. Data collection was carried out between September and November 2012. A significant increase for the total sample in knowledge regarding puberty and menstruation was observed (p < .001) postintervention. Differences in overall knowledge regarding pregnancy and antenatal care were statistically significant. Knowledge regarding contraceptive intrauterine devices improved from 27.2% preintervention to 67.6% postintervention. This study clearly showed that the reproductive health education program improves knowledge among adolescent girls regarding reproductive health.

ARSH 4: Parental understanding of adolescent issues: parent-adolescent dyad agreement.

PubMed

Nair, M K C; Thankachi, Yamini; Leena, M L; George, Babu; Russell, Paul Swamidhas Sudhakar

2013-11-01

To elicit areas of discordance between the parent-adolescent dyad with regard to reproductive sexual health issues using the same questions to both and to elicit the gender sensitivity of the parents. This study was conducted using similar questions for both adolescents and young adults and their parents in three districts of Kerala. Data analysis was done comparing unmarried adolescents and young adults' response to reproductive and sexual health issues and the parental agreement status with their ward's responses. There were a total of 3,625 parent-unmarried young adults dyads. Parental attitudinal difference towards their sons and daughters on selected parenting issues was observed. With regard to the following reproductive and sexual health problems, (i) knew about menstruation before menarche (64.1%), (ii) got information on hygiene practices from home (80.8%), (iii) have menstrual problems (66.4%), agreement with adolescent response was high, whereas with regard to (i) anxious about adolescent physical and mental changes (29.2%), (ii) received information on reproductive sexual health (RSH) from mother (26.7%), (iii) do not have any abnormal vaginal discharge (46.7%), (iv) parents taken precautions to prevent sexual abuse (17.5%), (v) have been sexually abused (15.6%), agreement with unmarried young adults' response was low and all these differences were statistically significant. The results of 3,625 parent-unmarried adolescents and young adults dyad data showed poor agreement on vital issues like sexual abuse apart from gender inequality favouring sons.

A reproductive health survey of rural women in Hebei.

PubMed

Wang, J

1998-12-01

This article presents the findings of a 1995 family planning survey conducted among 657 women aged 18-49 years in rural areas of Tangshan City, Zhoushou City, and Xingtai City in Hebei province, Northern China. 620 were married, 37 were single, and 6 were widowed. 85.8% of married rural women used a contraceptive method (female sterilization or IUD). There were 1219 pregnancies, 230 abortions, 31 miscarriages, and 3 stillbirths. 68.1% received prenatal check-ups at hospitals and health centers. 47.4% received prenatal care during the first trimester of pregnancy. 76.1% received check-ups at township health centers. Women were aware of the need for sound personal hygiene, sanitary napkins, and avoidance of heavy manual work during menstruation. 45.1% had less than 5 years of education; 51.8% had 6-10 years of education; and 3.1% had over 10 years of education. About 54% delivered at home. Home deliveries were due to lack of transportation, high expenses, and other reasons. Deliveries were attended by a doctor or midwife. Postpartum home visits were not assured. 32.4% had routine gynecological check-ups. 48.1% had never received gynecological services. 51.6% of married women had 2 children; 16.9% had more. The author recommended improved socioeconomic and cultural conditions, a women-centered reproductive health security system integrated with education, and legislative change. Reproductive health education should be integrated into family planning programs and include health awareness and more education. Men should participate in programs and share more responsibility for reproduction. Services should improve in quality.

Steps through the revision process of reproductive health sections of ICD-11.

PubMed

Chou, Doris; Tunçalp, Özge; Hotamisligil, Selen; Norman, Jane; Say, Lale; Volkmer, Björn; Pattinson, Bob; Rooney, Cleo; Serour, Gamal; de Mouzon, Jacques; Gardosi, Jason; Thueroff, Joachim; Mark, Morgan; D'Hooghe, Thomas

2012-01-01

In 2007, the WHO initiated an organizational structure for the 11th revision of the International Classification of Diseases (ICD). Effective deployment of ICD-derived tools facilitates the use and collection of health information in a variety of resource settings, promoting quantitatively informed decisions. They also facilitate comparison of disease incidence and outcomes between different countries and different health care systems around the world. The Department of Reproductive Health and Research (RHR) coordinates the revision of chapters 14 (diseases of the genitourinary system), 15 (pregnancy, childbirth, and puerperium), and 16 (conditions originating in the perinatal period). RHR convened a technical advisory group (TAG), the Genito-Urinary Reproductive Medicine (GURM) TAG, for the ICD revision. The TAG's work reflects the collective understanding of sexual and reproductive health and is now available for review within the ICD-11 revision process. Copyright © 2012 S. Karger AG, Basel.

Right to sexual and reproductive health in new population policies of Iran.

PubMed

Kokabisaghi, Fatemeh

2017-05-01

Sexual and reproductive health services in Iran are influenced by population policies. Willingness of Iranian policy makers to control the population's growth rate resulted in the provision of countrywide family planning services and contraceptives from 1990 to 2013. Now policy makers favour population growth because of a statistically significant decline in the fertility rate and ageing of the population. New population policies contain incentives for higher fertility and limitations on family planning services. Some elements of these policies contradict standards of international human rights treaties including prohibition against retrogressive measures and limitations on sexual and reproductive health services. These policies may jeopardize individual and public health. Iran should immediately revoke these laws and policies and progressively improve people's enjoyment of their right to sexual and reproductive health. The country's population policies should focus on encouraging people to have higher fertility by providing financial and social support to parents and future children.

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

PubMed

Kurth, Elisabeth; Jaeger, Fabienne N; Zemp, Elisabeth; Tschudin, Sibil; Bischoff, Alexander

2010-11-01

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. 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. 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. Health policies for asylum seekers need to be designed to assure

Reproductive health services in Malawi: an evaluation of a quality improvement intervention.

PubMed

Rawlins, Barbara J; Kim, Young-Mi; Rozario, Aleisha M; Bazant, Eva; Rashidi, Tambudzai; Bandazi, Sheila N; Kachale, Fannie; Sanghvi, Harshad; Noh, Jin Won

2013-01-01

this study was to evaluate the impact of a quality improvement initiative in Malawi on reproductive health service quality and related outcomes. (1) post-only quasi-experimental design comparing observed service quality at intervention and comparison health facilities, and (2) a time-series analysis of service statistics. sixteen of Malawi's 23 district hospitals, half of which had implemented the Performance and Quality Improvement (PQI) intervention for reproductive health at the time of the study. a total of 98 reproductive health-care providers (mostly nurse-midwives) and 139 patients seeking family planning (FP), antenatal care (ANC), labour and delivery (L&D), or postnatal care (PNC) services. health facility teams implemented a performance and quality improvement (PQI) intervention over a 3-year period. Following an external observational assessment of service quality at baseline, facility teams analysed performance gaps, designed and implemented interventions to address weaknesses, and conducted quarterly internal assessments to assess progress. Facilities qualified for national recognition by complying with at least 80% of reproductive health clinical standards during an external verification assessment. key measures include facility readiness to provide quality care, observed health-care provider adherence to clinical performance standards during service delivery, and trends in service utilisation. intervention facilities were more likely than comparison facilities to have the needed infrastructure, equipment, supplies, and systems in place to offer reproductive health services. Observed quality of care was significantly higher at intervention than comparison facilities for PNC and FP. Compared with other providers, those at intervention facilities scored significantly higher on client assessment and diagnosis in three service areas, on clinical management and procedures in two service areas, and on counselling in one service area. Service statistics

Health issues of female foreign domestic workers: a systematic review of the scientific and gray literature.

PubMed

Malhotra, Rahul; Arambepola, Chandima; Tarun, Samiksha; de Silva, Vijitha; Kishore, Jugal; Østbye, Truls

2013-01-01

Although the number of female foreign domestic workers (FDWs) is increasing worldwide, little is known about their health issues. To systematically review the literature on health issues of female FDWs to ascertain the problems studied, identify limitations, and suggest future research and policy implications. A systematic database (PubMed, EBSCO Host, and Google Scholar) and bibliographic search identified the English-language scientific and gray literature published during 1990-2012 addressing health issues of female FDWs living with the family of the employer, using qualitative and/or quantitative research methods. Studies in which female FDWs constituted less than half of the participants were excluded. The health issues studied and identified were adverse work conditions and associated health problems (such as physical, verbal, and sexual abuse at the workplace, caregiving tasks associated with musculoskeletal strain, and chemical exposure associated with respiratory difficulty), mental health (psychotic, neurotic, and mood disorders), infectious diseases (most of the studies were on intestinal parasitic infections), and health knowledge/attitudes/practices (most of the studies were in context of sexual and reproductive health). Most of the studies were medical record reviews or questionnaire-based surveys utilizing convenience sampling or qualitative interviews/focus group discussions. Female FDWs face numerous health problems. Studies on representative, possibly longitudinal, samples of female FDWs focusing on specific health conditions are needed to better understand the epidemiology of such conditions. Concerted efforts through the governments of both labor-sending and host countries are required to improve the health, work conditions, and safety of this vulnerable group of women.

Sexual and reproductive issues and inflammatory bowel disease: a neglected topic in men.

PubMed

Allocca, Mariangela; Gilardi, Daniela; Fiorino, Gionata; Furfaro, Federica; Peyrin-Biroulet, Laurent; Danese, Silvio

2018-03-01

There has been considerable literature on sexual issues in women with inflammatory bowel disease (IBD), but relatively little attention has been paid to these aspects in men. To review the available literature and to provide the best management of sexual and reproductive issues in male patients with IBD. The scientific literature on sexual and reproductive issues in men with IBD was reviewed. Several factors, including surgical and medication treatments, disease activity, lifestyle, and psychological factors, may play a role in the development of infertility and sexual dysfunction and may negatively impact pregnancy outcomes. Proctocolectomy with ileal pouch-anal anastomosis increases the risk of erectile and ejaculatory dysfunction by up to 26%. A treatment with sildenafil can be effective. Sperm banking should be advised to young men with IBD before surgery. Both sulfasalazine and methotrexate may be responsible for reversible sexual dysfunction and infertility. Furthermore, sulfasalazine should be switched to mesalazine at least 4 months before conception because of a higher risk of congenital malformations in pregnancies fathered by men treated with this drug. Psychotropic drugs, frequently used in IBD, may cause sexual dysfunction up to 80%. Last but not the least, voluntary childlessness occurs frequently, mainly because of concerns about medication safety in pregnancy and fear of transmitting disease. Accurate counseling, and where necessary, psychological support can decrease any misperceptions and fears. Close collaboration between the gastroenterologist and the patient is recommended for the best management of these relevant, neglected aspects in men with IBD.

An international comparison of women's health issues in the Philippines, Thailand, Malaysia, Canada, Hong Kong, and Singapore: the CIDA-SEAGEP Study.

PubMed

Choi, Bernard C K

2004-11-19

This was an international study of women's health issues, based on an Official Study Tour in Southeast Asia (the Philippines, Thailand, Malaysia, Hong Kong, and Singapore) and Canada. The objectives of the study were to identify and compare current gaps in surveillance, research, and programs and policies, and to predict trends of women's health issues in developing countries based on the experience of developed countries. Key informant interviews (senior government officials, university researchers, and local experts), self-administered questionnaires, courtesy calls, and literature searches were used to collect data. The participating countries identified women's health as an important issue, especially for reproductive health (developing countries) and senior's health (developed countries). Cancer, lack of physical activity, high blood pressure, diabetes, poverty, social support, caring role for family, and informing, educating, and empowering people about women's health issues were the main concerns. Based on this study, 17 recommendations were made on surveillance, research, and programs and policies. A number of forthcoming changes in women''s health patterns in developing countries were also predicted.

Workshop on promotion of reproductive health and family planning held.

PubMed

1997-09-01

Two reproductive health advocacy networks have been established in two districts in eastern Africa to help promote family planning and reproductive health among the people in this area. The districts are the Suhum-Kraboa-Coaltar and the New Juaben Municipality. To enhance the performance of the network, a 4-day workshop was held at Koforidua for the members to prepare an action plan for their advocacy and map out areas of collaboration between the public and the private sector group. The workshop, organized by the Futures Group International based in the US with support from the USAID, was attended by 30 participants from nongovernmental organizations and public offices. In an address, Ms. Patience Adow, the Regional Minister observed that through the idea of family planning has been promoted in the country over the past two decades, the country continues to experience a population growth rate of about 2.8%. She expressed the hope that the workshop will equip the participants with the relevant skills to develop and implement their advocacy strategy effectively. Dr. J. E. Taylor, Medical Administrator of the Koforidua Central Hospital, who chaired the function in a bid to improve the health of women and the quality of life of the people. The Ministry of Health as part of its medium term strategic plan has developed the national reproductive health and service policy.

Applying human rights to improve access to reproductive health services.

PubMed

Shaw, Dorothy; Cook, Rebecca J

2012-10-01

Universal access to reproductive health is a target of Millennium Development Goal (MDG) 5B, and along with MDG 5A to reduce maternal mortality by three-quarters, progress is currently too slow for most countries to achieve these targets by 2015. Critical to success are increased and sustainable numbers of skilled healthcare workers and financing of essential medicines by governments, who have made political commitments in United Nations forums to renew their efforts to reduce maternal mortality. National essential medicine lists are not reflective of medicines available free or at cost in facilities or in the community. The WHO Essential Medicines List indicates medicines required for maternal and newborn health including the full range of contraceptives and emergency contraception, but there is no consistent monitoring of implementation of national lists through procurement and supply even for basic essential drugs. Health advocates are using human rights mechanisms to ensure governments honor their legal commitments to ensure access to services essential for reproductive health. Maternal mortality is recognized as a human rights violation by the United Nations and constitutional and human rights are being used, and could be used more effectively, to improve maternity services and to ensure access to drugs essential for reproductive health. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Sexual and Reproductive Health Behaviors of California Community College Students

ERIC Educational Resources Information Center

Trieu, Sang Leng; Bratton, Sally; Marshak, Helen Hopp

2011-01-01

Objective: To explore the sexual and reproductive health behaviors of students from 13 community college campuses in California. Participants: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). Methods: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was…

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. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Ethical issues in newer assisted reproductive technologies: A view from Nigeria.

PubMed

Fadare, J O; Adeniyi, A A

2015-12-01

Infertility is a prevalent condition in many developing countries with significant physical and psychosocial implications. The aim of this study is to discuss briefly the ethics of newer assisted reproductive technology (ART) with special emphasis on the peculiarities in Nigeria. MEDLINE and Google Scholar were searched for English-language articles from January 1990 to July 2014 using the search terms "ethics of ART AND Nigeria," "ethical issues in in vitro fertilization AND Nigeria." Using the above search phrases, a total of 43 articles were retrieved out of which only 5 dealt specifically with the subject matter. The core ethical issues found in the reviewed literature are listed in [Table 1]. Inequitable access to ART due to its high cost, lack of regulatory body, safety of the procedure, and fate of the embryos were the main themes identified from the papers. Surrogacy, sex selection, and gamete donation were additional relevant ethical issues. There is an urgent need for stakeholders in developing countries to formulate cultural and context-specific guidelines to help address some of these ethical dilemmas.

The Core Competencies for Adolescent Sexual and Reproductive Health

ERIC Educational Resources Information Center

Elfers, John; Carlton, Lidia; Gibson, Paul; Puffer, Maryjane; Smith, Sharla; Todd, Kay

2014-01-01

The Adolescent Sexual Health Work Group commissioned the development of core competencies that define the knowledge, skills, and attitudes necessary for all providers of adolescent sexual and reproductive health. This article describes the background and rationale for this set of competencies, the history and use of competencies, and the process…

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…

Helping public sector health systems innovate: the strategic approach to strengthening reproductive health policies and programs.

PubMed

Fajans, Peter; Simmons, Ruth; Ghiron, Laura

2006-03-01

Public sector health systems that provide services to poor and marginalized populations in developing countries face great challenges. Change associated with health sector reform and structural adjustment often leaves these already-strained institutions with fewer resources and insufficient capacity to relieve health burdens. The Strategic Approach to Strengthening Reproductive Health Policies and Programs is a methodological innovation developed by the World Health Organization and its partners to help countries identify and prioritize their reproductive health service needs, test appropriate interventions, and scale up successful innovations to a subnational or national level. The participatory, interdisciplinary, and country-owned process can set in motion much-needed change. We describe key features of this approach, provide illustrations from country experiences, and use insights from the diffusion of innovation literature to explain the approach's dissemination and sustainability.

Dimensions of gender relations and reproductive health inequity perceived by female undergraduate students in the Mekong Delta of Vietnam: a qualitative exploration

PubMed Central

2012-01-01

Introduction Increasing evidence indicates that gender equity has a significant influence on women’s health; yet few culturally specific indicators of gender relations exist which are applicable to health. This study explores dimensions of gender relations perceived by female undergraduate students in southern Vietnamese culture, and qualitatively examines how this perceived gender inequity may influence females’ sexual or reproductive health. Methods Sixty-two female undergraduate students from two universities participated in eight focus group discussions to talk about their perspectives regarding national and local gender equity issues. Results Although overall gender gaps in the Mekong Delta were perceived to have decreased in comparison to previous times, several specific dimensions of gender relations were emergent in students’ discussions. Perceived dimensions of gender relations were comparable to theoretical structures of the Theory of Gender and Power, and to findings from several reports describing the actual inferiority of women. Allocation of housework and social paid work represented salient dimensions of labor. The most salient dimension of power related to women in positions of authority. Salient dimensions of cathexis related to son preference, women’s vulnerability to blame or criticism, and double standards or expectations. Findings also suggested that gender inequity potentially influenced women’s sexual and reproductive health as regards to health information seeking, gynecological care access, contraceptive use responsibility, and child bearing. Conclusion Further investigations of the associations between gender relations and different women’s sexual and reproductive health outcomes in this region are needed. It may be important to address gender relations as a distal determinant in health interventions in order to promote gender-based equity in sexual and reproductive health. PMID:23095733

Reproduction Symposium: developmental programming of reproductive and metabolic health.

PubMed

Padmanabhan, V; Veiga-Lopez, A

2014-08-01

Inappropriate programming of the reproductive system by developmental exposure to excess steroid hormones is of concern. Sheep are well suited for investigating developmental origin of reproductive and metabolic disorders. The developmental time line of female sheep (approximately 5 mo gestation and approximately 7 mo to puberty) is ideal for conducting sequential studies of the progression of metabolic and/or reproductive disruption from the developmental insult to manifestation of adult consequences. Major benefits of using sheep include knowledge of established critical periods to target adult defects, a rich understanding of reproductive neuroendocrine regulation, availability of noninvasive approaches to monitor follicular dynamics, established surgical approaches to obtain hypophyseal portal blood for measurement of hypothalamic hormones, and the ability to perform studies in natural setting thereby keeping behavioral interactions intact. Of importance is the ability to chronically instrument fetus and mother for determining early endocrine perturbations. Prenatal exposure of the female to excess testosterone (T) leads to an array of adult reproductive disorders that include LH excess, functional hyperandrogenism, neuroendocrine defects, multifollicular ovarian morphology, and corpus luteum dysfunction culminating in early reproductive failure. At the neuroendocrine level, all 3 feedback systems are compromised. At the pituitary level, gonadotrope (LH secretion) sensitivity to GnRH is increased. Multifollicular ovarian morphology stems from persistence of follicles as well as enhanced follicular recruitment. These defects culminate in progressive loss of cyclicity and reduced fecundity. Prenatal T excess also leads to fetal growth retardation, an early marker of adult reproductive and metabolic diseases, insulin resistance, hypertension, and behavioral deficits. Collectively, the reproductive and metabolic deficits of prenatal T-treated sheep provide proof of

[Reproductive health: a contribution to the evaluation of a virtual library].

PubMed

Alvarez, Maria do Carmo Avamilano; Cuenca, Angela Maria Belloni; Noronha, Daisy Pires; Schor, Néia

2007-10-01

Virtual libraries have been implemented in an attempt to organize scientific information found in the Internet, including the Biblioteca Virtual de Saúde Reprodutiva (BVSR), or Virtual Library on Reproductive Health. The aim is to provide quality information to researchers in the reproductive health field. The current study evaluates the use of the BVSR, emphasizing the users' expectations, difficulties, and suggestions. The study adopted a qualitative methodology. The focus group technique was applied to Internet chat groups through which reproductive health researchers communicated. Users expressed their expectations regarding information, highlighting the lack of time and the need to quickly obtain precise data. Use of virtual libraries for research increases where there is more trust in the institutions responsible for maintaining them. Researchers suggested the following: greater dissemination of the BVSR, publication of an electronic newsletter, and creation of a communications channel between the BVSR and users in order to foster intelligent collective communication.

Rapid qualitative review of ethical issues surrounding healthcare for pregnant women or women of reproductive age in epidemic outbreaks

PubMed Central

2018-01-01

This article describes, categorizes, and discusses the results of a rapid literature review aiming to provide an overview of the ethical issues and corresponding solutions surrounding pregnancies in epidemic outbreaks. The review was commissioned by the World Health Organization to inform responses to the Zika outbreak that began in 2015. Due to the urgency of the response efforts that needed to be informed by the literature search, a rapid qualitative review of the literature published in PubMed was conducted. The search and analysis were based on the operationalization of 3 key concepts: ethics, pregnancy, and epidemic outbreak. Ethical issues and solutions were interpreted within a principlist framework. The data were analyzed using qualitative content analysis. The search identified 259 publications, of which the full text of 23 papers was read. Of those, 20 papers contained a substantive part devoted to the topic of interest and were therefore analyzed further. We clustered the ethical issues and solutions around 4 themes: uncertainty, harms, autonomy/liberty, and effectiveness. Recognition of the identified ethical issues and corresponding solutions can inform and improve response efforts, public health planning, policies, and decision-making, as well as the activities of medical staff and counselors who practice before, during, or after an epidemic outbreak that affects pregnant women or those of reproductive age. The rapid review format proved to be useful despite its limited data basis and expedited review process. PMID:29370682

Rapid qualitative review of ethical issues surrounding healthcare for pregnant women or women of reproductive age in epidemic outbreaks.

PubMed

Hummel, Patrik; Saxena, Abha; Klingler, Corinna

2018-01-01

This article describes, categorizes, and discusses the results of a rapid literature review aiming to provide an overview of the ethical issues and corresponding solutions surrounding pregnancies in epidemic outbreaks. The review was commissioned by the World Health Organization to inform responses to the Zika outbreak that began in 2015. Due to the urgency of the response efforts that needed to be informed by the literature search, a rapid qualitative review of the literature published in PubMed was conducted. The search and analysis were based on the operationalization of 3 key concepts: ethics, pregnancy, and epidemic outbreak. Ethical issues and solutions were interpreted within a principlist framework. The data were analyzed using qualitative content analysis. The search identified 259 publications, of which the full text of 23 papers was read. Of those, 20 papers contained a substantive part devoted to the topic of interest and were therefore analyzed further. We clustered the ethical issues and solutions around 4 themes: uncertainty, harms, autonomy/liberty, and effectiveness. Recognition of the identified ethical issues and corresponding solutions can inform and improve response efforts, public health planning, policies, and decision-making, as well as the activities of medical staff and counselors who practice before, during, or after an epidemic outbreak that affects pregnant women or those of reproductive age. The rapid review format proved to be useful despite its limited data basis and expedited review process.

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

Health Promotion and Preventive Contents Performed During Reproduction System Learning; Observation in Senior High School

NASA Astrophysics Data System (ADS)

Yuniarti, E.; Fadilah, M.; Darussyamsu, R.; Nurhayati, N.

2018-04-01

The higher numbers of cases around sexual behavioral deviance on adolescence are significantly related to their knowledge level about the health of the reproduction system. Thus, teenagers, especially school-aged, have to receive the complete information which emphasizes on recognize promotion and prevention knowledge. This article aims to describe information about health promotion and prevention, which delivered by the teacher in Senior High School learning process on topic reproduction system. The data gained through focused observation using observation sheet and camera recorder. Further, data analyzed descriptively. The result show promotion and preventive approach have been inadequately presented. There are two reasons. Firstly, the promotion and preventive value are not technically requested in the final assessment. The second, the explanation tend to refer to consequences existed in the term of the social and religious norm rather than a scientific basis. It can be concluded suggestion to promote health reproduction and prevent the risk of health reproduction need to be implemented more practice with a scientific explanation which is included in a specific program for adolescence reproductive health improvement.

Occupational Therapy and Sexual and Reproductive Health Promotion in Adolescence: A Case Study.

PubMed

Gontijo, Daniela Tavares; de Sena e Vasconcelos, Anna Carolina; Monteiro, Rosana Juliet Silva; Facundes, Vera Lúcia Dutra; Trajano, Maria de Fátima Cordeiro; de Lima, Luciane Soares

2016-03-01

Occupational therapy can contribute to sexual and reproductive health through health education. The purpose of this study was to describe an occupational therapy intervention aimed at sexual and reproductive health promotion in adolescents. Fifty-eight adolescents were involved in the study, before, during and after the interventions. Educative activities such as puzzles, storytelling, mime and board games were used, which occupational therapy faculty and students had constructed. The games were employed as mediators for gaining knowledge in sexual and reproductive health. Outcome was measured using a questionnaire, audio recordings and field diaries. The data were analysed by descriptive statistics and thematic content analysis. The results showed the adolescents' increased knowledge of sexual and reproductive health information immediately after the intervention. The thematic analysis was grouped into three categories: the adolescents' initial expectations regarding the project, reflections on the process experienced during the interventions and use of educational games by occupational therapists. The importance of rapport and dialogue was highlighted in the construction of interventions based on participatory methods. The absence of a longitudinal follow-up is a limitation in this study. Further research is important to systematically assess sexual health promotion strategies in adolescence. Copyright © 2015 John Wiley & Sons, Ltd.

Empowerment of Adolescent Girls for Sexual and Reproductive Health Care: A Qualitative Study.

PubMed

Alimoradi, Zainab; Kariman, Nourossadat; Simbar, Masoumeh; Ahmadi, Fazlollah

2017-12-01

Adolescent girls should be empowered to acquire the ability to take care of their sexual and reproductive health. The present study aimed to improve the understanding of the factors affecting the empowerment of Iranian adolescent girls in terms of taking care of their sexual and reproductive health (e.g. pubertal and menstrual health, preventing high risk sexual behaviors, treatment seeking for sexual and reproductive complaints such as dysmenorrhea, genitalia infection). The present qualitative study was performed using conventional content analysis method. Eight key informants were purposively selected and interviewed. Data collection was performed through unstructured and in-depth interviews. The qualitative content was analyzed simultaneously with data collection based on Graneheim and Lundman method using MAXQDA 2010 software. Data analysis led to the emergence of the main theme of empowerment for care with four classes of reinforcing the foundations of sexual and reproductive health, providing services in health system, reinforcing educational institutions, and consolidating the interaction between adolescent and family, as well as thirteen sub-classes. Results of the present study showed the need for inter-sectional interaction and collaboration among authorities of health systems, education systems, and policymaking institutions to achieve a model for empowering adolescent girls via a multi-level and comprehensive approach.

Reproductive rights and options available to women infected with HIV in Ghana: perspectives of service providers from three Ghanaian health facilities

PubMed Central

2013-01-01

Background Owing to improved management of HIV and its associated opportunistic infections, many HIV-positive persons of reproductive age are choosing to exercise their right of parenthood. This study explored the knowledge of health workers from two Ghanaian districts on the reproductive rights and options available to HIV-positive women who wish to conceive. Methods Facility-based cross-sectional in design, the study involved the entire population of nurse counselors (32) and medical officers (3) who provide counseling and testing services to clients infected with HIV. Both structured and in-depth interviews were conducted after informed consent. Results Two main perspectives were revealed. There was an overwhelmingly high level of approbation by the providers on HIV-positive women’s right to reproduction (94.3%). At the same time, the providers demonstrated a lack of knowledge regarding the various reproductive options available to women infected with HIV. Site of facility, and being younger were associated with practices that violated client’s right to contraceptive counseling (p < 0.05) in each case. Some of the providers openly expressed their inability to give qualified guidance to HIV-positive women on the various reproductive options. Conclusions Taken together, these findings suggest that many HIV-positive clients do not receive comprehensive information about their reproductive options. These findings highlight some of the problems that service providers face as HIV counselors. Both service providers and policy makers need to recognize these realities and incorporate reproductive health issues of HIV-persons into the existing guidelines. PMID:23496943

Genital Tract Infections, Bacterial Vaginosis, HIV, and Reproductive Health Issues among Lima-Based Clandestine Female Sex Workers

PubMed Central

Perla, M. E.; Ghee, Annette E.; Sánchez, Sixto; McClelland, R. Scott; Fitzpatrick, Annette L.; Suárez-Ognio, Luis; Lama, Javier R.; Sánchez, Jorge

2012-01-01

Sociodemographic and behavioral characteristics of 212 Peruvian female sex workers (FSWs) were analyzed. The association between genital tract infections (GTIs) and risk factors by multivariate analysis was evaluated. Eighty-eight percent of FSWs were diagnosed with at least one GTI (HSV-2 80.1%, BV 44.8%, candidiasis 9.9%, syphilis seropositivity 9.4%, Trichomonas vaginalis 2.4%, HIV seropositivity 2.4%). Reported condom use with clients was nearly universal (98.3%), but infrequent with husband/regular partners (7.3%). In multivariate analysis BV was negatively associated with more consistent condom use (PRR = 0.63, 95% CI, 0.42–0.96). Many had not visited a Sexually Transmitted Infection (STI) clinic or been tested for HIV in the past year (40.6%, 47.1%, resp.). Nonclient contraceptive use was low (57%) and induced abortion was common (68%). High GTI burden and abortions suggest that a services-access gap persists among marginalized FSWs. Continued health outreach programs and integrating family planning and reproductive health services into existing STI clinic services are recommended. PMID:22811592

Consanguinity and reproductive health among Arabs.

PubMed

Tadmouri, Ghazi O; Nair, Pratibha; Obeid, Tasneem; Al Ali, Mahmoud T; Al Khaja, Najib; Hamamy, Hanan A

2009-10-08

Consanguineous marriages have been practiced since the early existence of modern humans. Until now consanguinity is widely practiced in several global communities with variable rates depending on religion, culture, and geography. Arab populations have a long tradition of consanguinity due to socio-cultural factors. Many Arab countries display some of the highest rates of consanguineous marriages in the world, and specifically first cousin marriages which may reach 25-30% of all marriages. In some countries like Qatar, Yemen, and UAE, consanguinity rates are increasing in the current generation. Research among Arabs and worldwide has indicated that consanguinity could have an effect on some reproductive health parameters such as postnatal mortality and rates of congenital malformations. The association of consanguinity with other reproductive health parameters, such as fertility and fetal wastage, is controversial. The main impact of consanguinity, however, is an increase in the rate of homozygotes for autosomal recessive genetic disorders. Worldwide, known dominant disorders are more numerous than known recessive disorders. However, data on genetic disorders in Arab populations as extracted from the Catalogue of Transmission Genetics in Arabs (CTGA) database indicate a relative abundance of recessive disorders in the region that is clearly associated with the practice of consanguinity.

Consanguinity and reproductive health among Arabs

PubMed Central

Tadmouri, Ghazi O; Nair, Pratibha; Obeid, Tasneem; Al Ali, Mahmoud T; Al Khaja, Najib; Hamamy, Hanan A

2009-01-01

Consanguineous marriages have been practiced since the early existence of modern humans. Until now consanguinity is widely practiced in several global communities with variable rates depending on religion, culture, and geography. Arab populations have a long tradition of consanguinity due to socio-cultural factors. Many Arab countries display some of the highest rates of consanguineous marriages in the world, and specifically first cousin marriages which may reach 25-30% of all marriages. In some countries like Qatar, Yemen, and UAE, consanguinity rates are increasing in the current generation. Research among Arabs and worldwide has indicated that consanguinity could have an effect on some reproductive health parameters such as postnatal mortality and rates of congenital malformations. The association of consanguinity with other reproductive health parameters, such as fertility and fetal wastage, is controversial. The main impact of consanguinity, however, is an increase in the rate of homozygotes for autosomal recessive genetic disorders. Worldwide, known dominant disorders are more numerous than known recessive disorders. However, data on genetic disorders in Arab populations as extracted from the Catalogue of Transmission Genetics in Arabs (CTGA) database indicate a relative abundance of recessive disorders in the region that is clearly associated with the practice of consanguinity. PMID:19811666

Operationalising sexual and reproductive health and rights in sub-Saharan Africa: constraints, dilemmas and strategies

PubMed Central

2011-01-01

Background The continued poor sexual and reproductive health (SRH) outcomes in sub-Saharan Africa highlight the difficulties in reforming policies and laws, and implementing effective programmes. This paper uses one international and two national case studies to reflect on the challenges, dilemmas and strategies used in operationalising sexual and reproductive health and rights (SRHR) in different African contexts. Methods The international case study focuses on the progress made by African countries in implementing the African Union’s Maputo Plan of Action (for the Operationalisation of the Continental Policy Framework for Sexual and Reproductive Health and Rights) and the experiences of state and non-state stakeholders in this process. The case was developed from an evaluation report of the progress made by nine African countries in implementing the Plan of Action, qualitative interviews exploring stakeholders’ experiences and perceptions of the operationalisation of the plan (carried out as part of the evaluation) in Botswana and Nigeria, and authors’ reflections. The first national case study explores the processes involved in influencing Ghana’s Domestic Violence Act passed in 2007; developed from a review of scientific papers and organisational publications on the processes involved in influencing the Act, qualitative interview data and authors’ reflections. The second national case study examines the experiences with introducing the 2006 Sexual Offences Act in Kenya, and it is developed from organisational publications on the processes of enacting the Act and a review of media reports on the debates and passing of the Act. Results Based on the three cases, we argue that prohibitive laws and governments’ reluctance to institute and implement comprehensive rights approaches to SRH, lack of political leadership and commitment to funding SRHR policies and programmes, and dominant negative cultural framing of women’s issues present the major

Women’s well-being and reproductive health in Indian mining community: need for empowerment

PubMed Central

2013-01-01

This paper is a qualitative study of women’s well-being and reproductive health status among married women in mining communities in India. An exploratory qualitative research design was conducted using purposive sampling among 40 selected married women in a rural Indian mining community. Ethical permission was obtained from Goa University. A semi-structured indepth interview guide was used to gather women’s experiences and perceptions regarding well-being and reproductive health in 2010. These interviews were audiotaped, transcribed, verified, coded and then analyzed using qualitative content analysis. Early marriage, increased fertility, less birth intervals, son preference and lack of decision-making regarding reproductive health choices were found to affect women’s reproductive health. Domestic violence, gender preference, husbands drinking behaviors, and low spousal communication were common experiences considered by women as factors leading to poor quality of marital relationship. Four main themes in confronting women’s well-being are poor literacy and mobility, low employment and income generating opportunities, poor reproductive health choices and preferences and poor quality of martial relationships and communication. These determinants of physical, psychological and cultural well-being should be an essential part of nursing assessment in the primary care settings for informed actions. Nursing interventions should be directed towards participatory approach, informed decision making and empowering women towards better health and well-being in the mining community. PMID:23602071

Assessment of reproductive health and violence against women among displaced Syrians in Lebanon.

PubMed

Reese Masterson, Amelia; Usta, Jinan; Gupta, Jhumka; Ettinger, Adrienne S

2014-02-20

The current conflict in Syria continues to displace thousands to neighboring countries, including Lebanon. Information is needed to provide adequate health and related services particularly to women in this displaced population. We conducted a needs assessment in Lebanon (June-August 2012), administering a cross-sectional survey in six health clinics. Information was collected on reproductive and general health status, conflict violence, stress, and help-seeking behaviors of displaced Syrian women. Bivariate and multivariate analyses were conducted to examine associations between exposure to conflict violence, stress, and reproductive health outcomes. We interviewed 452 Syrian refugee women ages 18-45 who had been in Lebanon for an average of 5.1 (± 3.7) months. Reported gynecologic conditions were common, including: menstrual irregularity, 53.5%; severe pelvic pain, 51.6%; and reproductive tract infections, 53.3%. Among the pregnancy subset (n = 74), 39.5% of currently pregnant women experienced complications and 36.8% of those who completed pregnancies experienced delivery/abortion complications. Adverse birth outcomes included: low birthweight, 10.5%; preterm delivery, 26.5%; and infant mortality, 2.9%. Of women who experienced conflict-related violence (30.8%) and non-partner sexual violence (3.1%), the majority did not seek medical care (64.6%). Conflict violence and stress score was significantly associated with reported gynecologic conditions, and stress score was found to mediate the relationship between exposure to conflict violence and self-rated health. This study contributes to the understanding of experience of conflict violence among women, stress, and reproductive health needs. Findings demonstrate the need for better targeting of reproductive health services in refugee settings, as well as referral to psychosocial services for survivors of violence.

Assessing public and private sector contributions in reproductive health financing and utilization for six sub-Saharan African countries.

PubMed

Nguyen, Ha; Snider, Jeremy; Ravishankar, Nirmala; Magvanjav, Oyunbileg

2011-05-01

The present study provides evidence to support enhanced attention to reproductive health and comprehensive measures to increase access to quality reproductive health services. We compare and contrast the financing and utilization of reproductive health services in six sub-Saharan African countries using data from National Health Accounts and Demographic and Health Surveys. Spending on reproductive health in 2006 ranged from US$4 per woman of reproductive age in Ethiopia to US$17 in Uganda. These are below the necessary level for assuring adequate services given that an internationally recommended spending level for family planning alone was US$16 for 2006. Moreover, reproductive health spending shows signs of decline in tandem with insufficient improvement in service utilization. Public providers played a predominant role in antenatal and delivery care for institutional births, but home deliveries with unqualified attendants dominated. The private sector was a major supplier of condoms, oral pills and IUDs. Private clinics, pharmacies and drug vendors were important sources of STI treatment. The findings highlight the need to commit greatly increased funding for reproductive health services as well as more policy attention to the contribution of public, private and informal providers and the role of collaboration among them to expand access to services for under-served populations. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

The role of parliamentarians in promoting sexual and reproductive health and rights.

PubMed

McCafferty, Christine

2009-08-01

Parliamentarians are central to the full implementation of the International Conference on Population and Development Programme of Action (ICPD PoA). We promote, review, and adopt sexual and reproductive health and rights (SRHR) legislation, including budget appropriations. Parliamentarians also approve policies formulated by government and endorse resolutions and statements in support of SRHR. All Party Parliamentary Groups on Population, Development, and Reproductive Health have now been established in nearly 100 countries to promote the ICPD PoA. Examples are given of successful SRHR parliamentary advocacy in the UK, Europe, and internationally. The biggest constraint to achieving universal access to reproductive health services by 2015 (the new MDG 5 target) remains ideological-driven campaigns across Europe and the USA. Politicians must be brave and speak out against misinformation or ill-informed and ideological-driven campaigns that mitigate the promotion of women's SRHR.

Improving maternal, newborn and women's reproductive health in crisis settings

PubMed Central

Chi, Primus Che; Urdal, Henrik; Umeora, Odidika Uj; Sundby, Johanne; Spiegel, Paul; Devane, Declan

2015-01-01

This is the protocol for a review and there is no abstract. The objectives are as follows: To identify, synthesise and evaluate the effects of health system and other interventions aimed at improving maternal, newborn and women's reproductive health in crisis settings.

Striking a balance: conscientious objection and reproductive health care from the Colombian perspective.

PubMed

Cabal, Luisa; Olaya, Monica Arango; Robledo, Valentina Montoya

2014-12-11

Conscientious Objection or conscientious refusal (CO) in access to reproductive health care is at the center of current legal debates worldwide. In countries such as the US and the UK, constitutional dilemmas surrounding CO in the context of reproductive health services reveal inadequate policy frameworks for balancing CO rights with women's rights to access contraception and abortion. The Colombian Constitutional Court's holistic jurisprudence regarding CO standards has applied international human rights norms so as to not only protect women's reproductive rights as fundamental rights, but to also introduce clear limits for the exercise of CO in health care settings. This paper reviews Latin American lines of regulation in Argentina, Uruguay, and Mexico City to argue that the Colombian Court's jurisprudence offers a strong guidance for future comprehensive policy approaches that aim to effectively balance tensions between CO and women's reproductive rights. Copyright © 2014 Cabal, Olaya, Robledo. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Religion, Poverty, and Politics: Their Impact on Women's Reproductive Health Outcomes.

PubMed

Kimball, Richard; Wissner, Michael

2015-01-01

This study sought to explore the relationship(s) between U.S. states of selected social determinants of health (SDH) and three women's reproductive health outcomes including abortion, teen births, and infant mortality rates (IMR). The data from multiple population surveys were used to establish on a state-by-state basis, the interactions between selected SDH (religion, voting patterns, child poverty, and GINI) and their policy effects on three women's reproductive health outcomes (abortion, teen births, and IMRs) using publicly available national databases. Child poverty rates and the GINI coefficient were analyzed. Religiosity information was obtained from the Pew Forum's surveys. Voting results were collected from the 2008 congressional and presidential races and were used as proxy measures for conservative- versus liberal-leaning policies and policy makers. Using multiple regression analysis, higher IMRs were associated with higher religiosity scores. Lower abortion rates were associated with voting conservatively and higher income inequality. Higher teen birth rates were associated with higher child poverty rates and voting conservatively. This study shows that selected SDH may have substantial impacts on women's reproductive health outcomes at the state level. Significant inequalities exist between liberal and conservative states that affect women's health outcomes. © 2015 Wiley Periodicals, Inc.

Sexual and reproductive health and rights in the post-2015 development agenda.

PubMed

Sen, Gita

2014-01-01

Women's health is currently shaped by the confluence of two important policy trends - the evolution of health system reform policies and from the early 1990s onwards, a strong articulation of a human rights-based approach to health that has emphasised laws and policies to advance gender equality and sexual and reproductive health and rights (SRHR). The drive for sexual and reproductive rights represents an inclusive trend towards human rights to health that goes beyond the right to health services, directing attention to girls' and women's rights to bodily autonomy, integrity and choice in relation to sexuality and reproduction. Such an expanded concept of the right to health is essential if laws, policies and programmes are to respect, protect and fulfil the health of girls and women. However, this expanded understanding has been ghettoised from the more mainstream debates on the right to health and was only partially included in the Millennium Development Goals. The paper argues in favour of a twofold approach in placing SRHR effectively in the context of the post-2015 development agenda: first, firmly ground it in an inclusive approach to the right to health; and second, drawing on two decades of national-level implementation, propose a forward-looking agenda focusing on quality, equality and accountability in policies and in programmes. This can build on good practice while addressing critical challenges central to the development framework itself.

Evaluation of Female Youth Educational Needs about Reproductive Health in Non-Medical Students in the City of Qom.

PubMed

Bazarganipour, Fatemeh; Foroozanfard, Fatemeh; Taghavi, Seyed Abdolvahab; Hekmatzadeh, Fatemeh; Sarviye, Malihe; Hosseini, Nazafarin

2013-06-01

To evaluate reproductive health education which is essential to the prevention of sexual risk behavior and its associated adverse outcomes of unwanted pregnancy, AIDS and other sexually transmitted disease in adolescents. Little is known about youth educational needs about reproductive health in Iran. The aim of this study is evaluation of female youth educational needs about reproductive health in non-medical universities in the city of Qom, north central of Iran. The study was descriptive-analytical type conducted in nine non-medical universities (400 students). A questionnaire was constructed to meet the purpose of the study based on similar studies of knowledge and attitude in different countries, yet it was modified according to Iranian culture and social norms. The findings showed that a majority of participants have moderate knowledge about all components of reproductive health. Approximately, one - third of the participants reported difficulties to discuss about sexual health with mothers. The most of the participants believed insufficient female youth reproductive health services and low knowledge about reproductive health were the main barriers for female youth reproductive health aims. The participants in this study are representatives of an important subgroup in Iran in order to evaluate female youth reproductive health educational needs. The study identified many misconception and negative attitude that need to be addressed. A health education program through parents, peers, mass media campaign and more comprehensive family planning curriculum in universities are recommended to overcome misconception and spread awareness.

How prepared are young, rural women in India to address their sexual and reproductive health needs? a cross-sectional assessment of youth in Jharkhand.

PubMed

Banerjee, Sushanta K; Andersen, Kathryn L; Warvadekar, Janardan; Aich, Paramita; Rawat, Amit; Upadhyay, Bimla

2015-10-17

Young, rural Indian women lack sexual and reproductive health (SRH) information and agency and are at risk of negative sexual and reproductive health outcomes. Youth-focused interventions have been shown to improve agency and self-efficacy of young women to make decisions regarding their sexual and reproductive health. The objectives of this study were to assess young women's sexual and reproductive health knowledge; describe their health-seeking behaviors; describe young women's experiences with sexual and reproductive health issues, including unwanted pregnancy and abortion; and identify sources of information, including media sources. A cross-sectional survey with a representative sample of 1381 married and unmarried women young women (15-24 years) from three rural community development blocks in Jharkhand, India was conducted in 2012. Participants were asked a series of questions related to their SRH knowledge and behavior, as well as questions related to their agency in several domains related to self-efficacy and decision-making. Linear regression was used to assess factors associated with greater or less individual agency and to determine differences in SRH knowledge and behavior between married and unmarried women. Despite national policies, participants married young (mean 15.7 years) and bore children early (53 % with first birth by 17 years). Women achieved low composite scores on knowledge around sex and pregnancy, contraception, and abortion knowledge. Around 3 % of married young women reported experiencing induced abortion; 92 % of these women used private or illegal providers. Married and unmarried women also had limited agency in decision-making, freedom of mobility, self-efficacy, and financial resources. Most of the women in the sample received SRH information by word of mouth. Lack of knowledge about sexual and reproductive health in this context indicates that young rural Indian women would benefit from a youth-friendly SRH intervention to

Reproductive health, population growth, economic development and environmental change.

PubMed

Lincoln, D W

1993-01-01

World population will increase by 1000 million, or by 20%, within 10 years. Ninety-five per cent of this increase will occur in the South, in areas that are already economically, environmentally and politically fragile. Morbidity and mortality associated with reproduction will be greater in the current decade than in any period in human history. Annually, 40-60 million pregnancies will be terminated and 5-10 million children will die within one year of birth. AIDS-related infections, e.g. tuberculosis, will undermine health care in Africa (and elsewhere) and in places AIDS-related deaths will decimate the work-force. The growth in population and associated morbidity will inhibit global economic development and spawn new problems. The key issues are migration, the spread of disease, the supply of water and the degradation of land, and fiscal policies with respect to family planning, pharmaceuticals and Third-World debt. Full education, particularly of women, and more effective family planning in the South have the power to unlock the problem. Failure will see the developed countries, with their 800 million population, swamped by the health, economic and environmental problems of the South, with its projected population of 5400 million people for the year 2000.

The Experience of Young Women Living in a Prostitution Area in Maintaining Their Reproductive Health.

PubMed

Dovis, Vonyca; Setyowati; Kurniawati, Wiwit

Young women face a difficult situation when they live in a prostitution area or red light district. A phenomenological approach was applied to explore the experiences in maintaining reproductive health of 10 young women living in the prostitution area in Lampung, one of the provinces in Sumatra. Thematic content analysis found 7 themes including: (1) The participants' perception of prostitution as a place of naughty women and free sexual activity that can transmit STDs and influence adolescent psychology; (2) The ways the participants kept their reproductive organs healthy were through maintaining friendships, maintaining personal hygiene, avoiding free sexual activity, eating healthy food, and having routine medical checkups; (3) Information support was gained from family, health workers, media, and teachers; (4) Emotional support from family and friends; (5) Barriers to maintaining good health were inaccessible health facilities and an underfunded health service; (6) The needs of the participants were reproductive health services and clean environment; (7) The participants hoped for health education and intensive health services with friendly nurses. The results of this research illustrate that there is a need for socializing intensive ways to maintain reproductive health, especially in a risky environment.

Reproductive Health Decision-Making in Perinatally HIV-Infected Adolescents and Young Adults

PubMed Central

Wiener, Lori; Zadeh, Sima; Albright, Jamie; Mellins, Claude Ann; Mancilla, Michael; Tepper, Vicki; Trexler, Connie; Purdy, Julia; Osherow, Janet; Lovelace, Susan; Kapetanovic, Suad

2013-01-01

With widespread access to antiretroviral therapy in the United States, many perinatally HIV-infected (PHIV+) children are surviving into adolescence and adulthood, becoming sexually active and making decisions about their reproductive health. The literature focusing on the reproductive decisions of individuals behaviorally infected with HIV can serve as a springboard for understanding the decision-making process of PHIV+ youth. Yet, there are many differences that critically distinguish reproductive health and related decision-making of PHIV+ youth. Given the potential public health implications of their reproductive decisions, better understanding of factors influencing the decision-making process is needed to help inform the development of salient treatment and prevention interventions. To begin addressing this understudied area, a “think tank” session, comprised of clinicians, medical providers, and researchers with expertise in the area of adolescent HIV, was held in Bethesda, MD, on September 21, 2011. The focus was to explore what is known about factors that influence the reproductive decision-making of PHIV+ adolescents and young adults, determine what important data are needed in order to develop appropriate intervention for PHIV+ youth having children, and to recommend future directions for the field in terms of designing and carrying out collaborative studies. In this report, we summarize the findings from this meeting. The paper is organized around the key themes that emerged, including utilizing a developmental perspective to create an operational definition of reproductive decision-making, integration of psychosocial services with medical management, and how to design future research studies. Case examples are presented and model program components proposed. PMID:22736033

Reproductive health decision-making in perinatally HIV-infected adolescents and young adults.

PubMed

Fair, Cynthia; Wiener, Lori; Zadeh, Sima; Albright, Jamie; Mellins, Claude Ann; Mancilla, Michael; Tepper, Vicki; Trexler, Connie; Purdy, Julia; Osherow, Janet; Lovelace, Susan; Kapetanovic, Suad

2013-07-01

With widespread access to antiretroviral therapy in the United States, many perinatally HIV-infected (PHIV+) children are surviving into adolescence and adulthood, becoming sexually active and making decisions about their reproductive health. The literature focusing on the reproductive decisions of individuals behaviorally infected with HIV can serve as a springboard for understanding the decision-making process of PHIV+ youth. Yet, there are many differences that critically distinguish reproductive health and related decision-making of PHIV+ youth. Given the potential public health implications of their reproductive decisions, better understanding of factors influencing the decision-making process is needed to help inform the development of salient treatment and prevention interventions. To begin addressing this understudied area, a "think tank" session, comprised of clinicians, medical providers, and researchers with expertise in the area of adolescent HIV, was held in Bethesda, MD, on September 21, 2011. The focus was to explore what is known about factors that influence the reproductive decision-making of PHIV+ adolescents and young adults, determine what important data are needed in order to develop appropriate intervention for PHIV+ youth having children, and to recommend future directions for the field in terms of designing and carrying out collaborative studies. In this report, we summarize the findings from this meeting. The paper is organized around the key themes that emerged, including utilizing a developmental perspective to create an operational definition of reproductive decision-making, integration of psychosocial services with medical management, and how to design future research studies. Case examples are presented and model program components proposed.

Chornobyl and reproductive health of a female rural population (an epidemiological study).

PubMed

Kundiev, Y I; Chernyuk, V I; Karakashyan, A N; Martynovskaya, T Y

2013-01-01

To study the combined effect of radioactive and chemical factors on the reproductive health of a female rural population residing and working on territories contaminated after the Chornobyl accident. The sociological questioning and gynecological examination of 1850 women have been made including the evaluation of 29520 medical reports of deliveries, 19502 medical reports of newborns, 1694 medical reports of women with spontaneous abortions as well as the state of menstrual function in 480 girls-adolescents residing on the contaminated territories. The radioactive contamination of the studied territories as well as the total effective dose of radiation for the population was evaluated by the results of the general dosimetric dose established for settlements of Ukraine. Factors of the work environment (noise, microclimate, dust, bacterial air pollution, work intensity and strain) were studied by the common hygienic methods and assessed by the criteria of the "Hygienic Classification of Work..." # 4137-86. The residues of pesticides, their isomers and products of transformation in biological fluids (blood, breast milk, cord blood) were assayed by gas-liquid chromatography method and electron capture detector with the device "Kristallux 4000" and the model M-3700. Correlative, regression, and discriminative analyses were used for mathematical processing of the data. It is proved that the reproductive health of rural women has become significantly worse after the Chornobyl accident, the most expressed disorders are seen in young women aged under 30. Worsening of reproductive health is found being the result of a combined effect of factors of radioactive and nonradioactive nature, specific for territories of residence, occupational activity and style of life. In particular, the effect of pesticides at the background of the radioactive contamination is likely to be an additional risk factor of disorders of the reproductive health of women. According to the biomonitoring

Are social franchises contributing to universal access to reproductive health services in low-income countries?

PubMed

Sundari Ravindran, T K; Fonn, Sharon

2011-11-01

A social franchise in health is a network of for-profit private health practitioners linked through contracts to provide socially beneficial services under a common brand. The early 21st century has seen considerable donor enthusiasm for promoting social franchises for the provision of reproductive health services. Based on a compendium of descriptive information on 45 clinical social franchises, located in 27 countries of Africa, Asia and Latin America, this paper examines their contribution to universal access to comprehensive reproductive health services. It finds that these franchises have not widened the range of reproductive health services, but have mainly focused on contraceptive services, and to a lesser extent, maternal health care and abortion. In many instances, coverage had not been extended to new areas. Measures taken to ensure sustainability ran counter to the objective of access for low-income groups. In almost two-thirds of the franchises, the full cost of all services had to be paid out of pocket and was unaffordable for low-income women. While standards and protocols for quality assurance were in place in all franchises, evidence on adherence to these was limited. Informal interviews with patients indicated satisfaction with services. However, factors such as difficulties in recruiting franchisees and significant attrition, franchisees' inability to attend training programmes, use of lay health workers to deliver services without support or supervision, and logistical problems with applying quality assurance tools, all raise concerns. The contribution of social franchises to universal access to reproductive health services appears to be uncertain. Continued investment in them for the provision of reproductive health services does not appear to be justified until and unless further evidence of their value is forthcoming. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Midwives as drivers of reproductive health commodity security in Kaduna State, Nigeria

PubMed Central

Alayande, Audu; Mamman-Daura, Fatima; Adedeji, Olanike; Muhammad, Ado Zakari

2016-01-01

Abstract Objectives: The significant improvement in the contraceptive prevalence rate in Kaduna State, Nigeria, from 8.4% in 2008 to 18.5% in 2013 is a notable achievement. This article analyses the role of midwives as drivers of reproductive health commodity security (RHCS) and their impact on contraceptive use in Kaduna State. Methods: The United Nations Population Fund (UNFPA) supported the bimonthly review resupply meetings facilitated by midwives at State and local government area (LGA) levels. The midwives deliver contraception to the LGAs for onward distribution to 6974 of the 25,000 health facilities across the country according to usage data from the previous 2 months. They also collect requisition, issue and resupply form data from the previous 2 months. Results: The active participation of midwives at the bimonthly meetings improved data timeliness by 23% and data completeness by 50% in 1 year. Only one health facility ran out of intrauterine devices and only 17% reported running out of female condoms. The total number of contraceptives issued increased from 31,866 in 2012 to 177,828 in 2013, resulting in a couple–year protection increase from 3408 in 2012 to 102,207 in 2013. Conclusions: Creation of increased demand and engagement of midwives in providing family planning services, especially long-acting contraceptive methods, coupled with the removal of cost to the user and the strengthening of the supply chain have been major factors in more than doubling the contraceptive prevalence rate. PMID:26909871

HIV treatment and reproductive health in the health system in Burkina Faso: resource allocation and the need for integration.

PubMed

Windisch, Ricarda; de Savigny, Don; Onadja, Geneviève; Somda, Antoine; Wyss, Kaspar; Sié, Ali; Kouyaté, Bocar

2011-11-01

Organizational changes, increased funding and the demands of HIV antiretroviral (ARV) treatment create particular challenges for governance in the health sector. We assess resource allocation, policy making and integration of the national responses to ARV provision and reproductive health in Burkina Faso, using national and district budgets related to disease burden, policy documents, organizational structures, and coordination and implementation processes. ARV provision represents the concept of a "crisis scenario", in which reforms are pushed due to a perception of urgent need, whereas the national reproductive health programme, which is older and more integrated, represents a "politics-as-usual scenario". Findings show that the early years of the national response to HIV and AIDS were characterized by new institutions with overlapping functions, and failure to integrate with and strengthen existing structures. National and district budget allocations for HIV compared to other interventions were disproportionately high when assessed against burden of disease. Strategic documents for ARV provision were relatively less developed and referred to, compared to those of the Ministry of Health Directorates for HIV and for Family Health and district health planning teams for reproductive health services. Imbalances and new structures potentially trigger important adverse effects which are difficult to remedy and likely to increase due to the dynamics they create. It therefore becomes crucial, from the outset, to integrate HIV/AIDS funding and responses into health systems. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Quantified sex: a critical analysis of sexual and reproductive self-tracking using apps.

PubMed

Lupton, Deborah

2015-01-01

Digital health technologies are playing an increasingly important role in healthcare, health education and voluntary self-surveillance, self-quantification and self-care practices. This paper presents a critical analysis of one digital health device: computer apps used to self-track features of users' sexual and reproductive activities and functions. After a review of the content of such apps available in the Apple App Store and Google Play™ store, some of their sociocultural, ethical and political implications are discussed. These include the role played by these apps in participatory surveillance, their configuration of sexuality and reproduction, the valorising of the quantification of the body in the context of neoliberalism and self-responsibility, and issues concerning privacy, data security and the use of the data collected by these apps. It is suggested that such apps represent sexuality and reproduction in certain defined and limited ways that work to perpetuate normative stereotypes and assumptions about women and men as sexual and reproductive subjects. Furthermore there are significant ethical and privacy implications emerging from the use of these apps and the data they produce. The paper ends with suggestions concerning the 'queering' of such technologies in response to these issues.

Women's reproductive health in slum populations in India: evidence from NFHS-3.

PubMed

Hazarika, Indrajit

2010-03-01

The urban population in India is one of the largest in the world. Its unprecedented growth has resulted in a large section of the population living in abject poverty in overcrowded slums. There have been limited efforts to capture the health of people in urban slums. In the present study, we have used data collected during the National Family Health Survey-3 to provide a national representation of women's reproductive health in the slum population in India. We examined a sample of 4,827 women in the age group of 15-49 years to assess the association of the variable slum with selected reproductive health services. We have also tried to identify the sociodemographic factors that influence the utilization of these services among women in the slum communities. All analyses were stratified by slum/non-slum residence, and multivariate logistic regression was used to analyze the strength of association between key reproductive health services and relevant sociodemographic factors. We found that less than half of the women from the slum areas were currently using any contraceptive methods, and discontinuation rate was higher among these women. Sterilization was the most common method of contraception (25%). Use of contraceptives depended on the age, level of education, parity, and the knowledge of contraceptive methods (p < 0.05). There were significant differences in the two populations based on the timing and frequency of antenatal visits. The probability of ANC visits depended significantly on the level of education and economic status (p < 0.05). We found that among slum women, the proportion of deliveries conducted by skilled attendants was low, and the percentage of home deliveries was high. The use of skilled delivery care was found to be significantly associated with age, level of education, economic status, parity, and prior antenatal visits (p < 0.05). We found that women from slum areas depended on the government facilities for reproductive health services. Our

Changes in the selected reproductive health indicators among married women of reproductive age in low performing areas of Bangladesh: findings from an evaluation study

PubMed Central

2014-01-01

Background Three-year duration Demand-Based Reproductive Commodity Project (DBRHCP) was launched in three low performing areas: rural Nabiganj (population 323,357), Raipur (population 260,983) and urban slum in Dhaka (population 141,912). Objectives: Assessing changes in knowledge among married women of reproductive age on selected reproductive health issues and to explore their service utilization patterns over the project period in selected low performing areas of Bangladesh. Methods The study adopted a pre- posts design. In the project areas, the entire chain of service provision were modified through the interventions under the DBRHCP, including training of the providers, enhanced behavioral change communication activities, follow-up and counseling, record keeping, reporting and monitoring, as well as improvement in logistics and supplies. Peer promoters were established as linkages between clients and service providers. All households were enlisted. Baseline and end line surveys were done using representative simple random sampling method, capturing changes over one year intervention period. Descriptive analysis was done using SPSS package, version 10. Proportional tests using Stata, version 8 were done to assess changes from baseline to end line. Results The overall contraceptive prevalence was markedly different in the three study areas but significantly increased in both Dhaka urban slums and Nabiganj. In the rural areas, a higher proportion of the women in endline compared to baseline obtained contraceptive methods from the public sectors. Irrespective of study sites, significantly higher proportion of women received ANC (Antenatal Care) and PNC (Post natal care) in endline compared to baseline. In all study sites higher proportions of women were aware of maternal complications at endline. Services were obtained from qualified persons for reported symptoms of sexually transmitted infections by a higher proportion of women at endline compared to baseline

Reproductive Issues in Women with Turner Syndrome

PubMed Central

Folsom, Lisal J.; Fuqua, John S.

2016-01-01

Synopsis Turner syndrome is one of the most common chromosomal abnormalities affecting female infants. The severity of clinical manifestations generally varies and affects multiple organ systems. Women with Turner syndrome have a threefold increase in mortality, which becomes even more pronounced in pregnancy. There are several reproductive options available for women with Turner syndrome, including adoption or surrogacy, assisted reproductive techniques, and in rare cases spontaneous pregnancy. There are well-documented risks for women with Turner syndrome during pregnancy, including specific risks of aortic pathology, hepatic disease, thyroid disease, type 2 diabetes, and Cesarean section delivery. Several professional societies have published guidelines to aid in the care of women with Turner syndrome prior to and during pregnancy. It is important for providers who care for these women to be familiar with the specific risks and recommendations in caring for women with Turner syndrome of reproductive age. PMID:26568488

Women's autonomy and reproductive health care utilisation: empirical evidence from Tajikistan.

PubMed

Kamiya, Yusuke

2011-10-01

Women's autonomy is widely considered to be a key to improving maternal health in developing countries, whereas there is no consistent empirical evidence to support this claim. This paper examines whether or not and how women's autonomy within the household affects the use of reproductive health care, using a household survey data from Tajikistan. Estimation is performed by the bivariate probit model whereby woman's use of health services and the level of women's autonomy are recursively and simultaneously determined. The data is from a sample of women aged 15-49 from the Tajikistan Living Standard Measurement Survey 2007. Women's autonomy as measured by women's decision-making on household financial matters increase the likelihood that a woman receives antenatal and delivery care, whilst it has a negative effect on the probability of attending to four or more antenatal consultations. The hypothesis that women's autonomy and reproductive health care utilisation are independently determined is rejected for most of the estimation specifications, indicating the importance of taking into account the endogenous nature of women's autonomy when assessing its effect on health care use. The empirical results reconfirm the assertion that women's status within the household is closely linked to reproductive health care utilisation in developing countries. Policymakers therefore need not only to implement not only direct health interventions but also to focus on broader social policies which address women's empowerment. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Reproduction and the new man.

PubMed

James, D; Russell, G

1987-08-01

Changing attitudes, especially by men, towards interpersonal relationships, including commitment in sexuality, has shifted the concern about reproductive issues towards men. Traditionally reproductive issues have been predominantly the concern of women, for instance male participation in contraception is traditionally about 15%, but a new man has begun to emerge that is interested in the male role in contraception, abortion and pregnancy. This work is an attempt to analyze some issues surrounding reproductive issues from the male perspective of increased mutual responsibility in sexuality. Suggestions are made that link attitudes to sexual relationships and reproduction as well as child care and support. It is assumed for the purposes of this paper that all sexual relationships that produce a child involved conception which automatically tie in contraception and abortion. This work confines itself to discussions of heterosexual relationships but recognizes that the issues of homosexual and bi-sexual relationships does have merit and weight in these issues.

Reproductive health service utilization and associated factors: the case of north Shewa zone youth, Amhara region, Ethiopia

PubMed Central

Negash, Wassie; Dessalegn, Muluken; Yitayew, Berhanu; Demsie, Mohammed; Wagnew, Maereg; Nyagero, Josephat

2016-01-01

Introduction Many youth are less informed, less experienced and less comfortable in utilizing reproductive health services. In the Sub-Saharan region the adolescents account for a higher proportion of new HIV infections and unmet need for reproductive health (RH) services. This study assessed reproductive health service utilization and associated factors among the youth in Amhara Region, Ethiopia. Methods A community based cross-sectional study was conducted from June 15-July 30, 2014. Three hundred ninety one youth were selected by systematic random sampling technique and interviewed using structured questionnaire. Data were anlyzed using SPSS windows version 20. Multiple logistic regression was done to control potential confounding variables. P-values <0.05 were considered statistically significant. Results Three hundred and nighty one in-school and out-of-school youth were interviewed; 256 (65.5%) participants were in school and 209 (53.5%) were males. Almost all respondents (93.9%) had heard about reproductive health services and a third 129 (33%) had ever practiced sexual intercourse and 54.7% of them had utilized at least one reproductive health services. Never had sexual intercourse (AOR=3.693, 95%CI: 1.266, 10.775), families that asked their children about friends (parental monitoring) (AOR=1.892, 95%CI: 1.026, 3.491), know where service provided (AOR=3.273, 95%CI: 1.158, 9.247), youths who reads newspaper readers (AOR=3.787, 95%CI: 1.849were independent predictors of youth reproductive service utilization at 95 % CI and p-value <0.05%. Conclusion Even though the youth have information about reproductive health services, youth reproductive health services utilization is very low. Therefore, building life skill, facilitating parent to child communication, establishing and strengthening of youth centres and increasing awareness for youth about those services are important steps to improve adolescents' reproductive health (RH) service utilization. PMID

Reproductive health service utilization and associated factors: the case of north Shewa zone youth, Amhara region, Ethiopia.

PubMed

Negash, Wassie; Dessalegn, Muluken; Yitayew, Berhanu; Demsie, Mohammed; Wagnew, Maereg; Nyagero, Josephat

2016-01-01

Many youth are less informed, less experienced and less comfortable in utilizing reproductive health services. In the Sub-Saharan region the adolescents account for a higher proportion of new HIV infections and unmet need for reproductive health (RH) services. This study assessed reproductive health service utilization and associated factors among the youth in Amhara Region, Ethiopia. A community based cross-sectional study was conducted from June 15-July 30, 2014. Three hundred ninety one youth were selected by systematic random sampling technique and interviewed using structured questionnaire. Data were anlyzed using SPSS windows version 20. Multiple logistic regression was done to control potential confounding variables. P-values <0.05 were considered statistically significant. Three hundred and nighty one in-school and out-of-school youth were interviewed; 256 (65.5%) participants were in school and 209 (53.5%) were males. Almost all respondents (93.9%) had heard about reproductive health services and a third 129 (33%) had ever practiced sexual intercourse and 54.7% of them had utilized at least one reproductive health services. Never had sexual intercourse (AOR=3.693, 95%CI: 1.266, 10.775), families that asked their children about friends (parental monitoring) (AOR=1.892, 95%CI: 1.026, 3.491), know where service provided (AOR=3.273, 95%CI: 1.158, 9.247), youths who reads newspaper readers (AOR=3.787, 95%CI: 1.849were independent predictors of youth reproductive service utilization at 95 % CI and p-value <0.05%. Even though the youth have information about reproductive health services, youth reproductive health services utilization is very low. Therefore, building life skill, facilitating parent to child communication, establishing and strengthening of youth centres and increasing awareness for youth about those services are important steps to improve adolescents' reproductive health (RH) service utilization.

Assessment of reproductive health and violence against women among displaced Syrians in Lebanon

PubMed Central

2014-01-01

Background The current conflict in Syria continues to displace thousands to neighboring countries, including Lebanon. Information is needed to provide adequate health and related services particularly to women in this displaced population. Methods We conducted a needs assessment in Lebanon (June-August 2012), administering a cross-sectional survey in six health clinics. Information was collected on reproductive and general health status, conflict violence, stress, and help-seeking behaviors of displaced Syrian women. Bivariate and multivariate analyses were conducted to examine associations between exposure to conflict violence, stress, and reproductive health outcomes. Results We interviewed 452 Syrian refugee women ages 18–45 who had been in Lebanon for an average of 5.1 (± 3.7) months. Reported gynecologic conditions were common, including: menstrual irregularity, 53.5%; severe pelvic pain, 51.6%; and reproductive tract infections, 53.3%. Among the pregnancy subset (n = 74), 39.5% of currently pregnant women experienced complications and 36.8% of those who completed pregnancies experienced delivery/abortion complications. Adverse birth outcomes included: low birthweight, 10.5%; preterm delivery, 26.5%; and infant mortality, 2.9%. Of women who experienced conflict-related violence (30.8%) and non-partner sexual violence (3.1%), the majority did not seek medical care (64.6%). Conflict violence and stress score was significantly associated with reported gynecologic conditions, and stress score was found to mediate the relationship between exposure to conflict violence and self-rated health. Conclusions This study contributes to the understanding of experience of conflict violence among women, stress, and reproductive health needs. Findings demonstrate the need for better targeting of reproductive health services in refugee settings, as well as referral to psychosocial services for survivors of violence. PMID:24552142

Towards gender-sensitivity: the Philippine POPCOM experience. How sensitive to gender issues are our family planning personnel?

PubMed

Danguilan, M

1995-04-01

The Philippine Commission on Population (POPCOM) sets and coordinates the country's population policy. POPCOM launched Gender I in early 1994 in the attempt to find out how aware and sensitive its board of commissioners, staff, and the provincial and city population officers were on gender and population issues. The assessment covered the respondents' gender relations at the workplace; gender, work, and family responsibilities; job satisfaction; their perceptions about gender-related issues in reproductive health; personal sex attitudes; and general perceptions on gender issues. The project also explored respondents' knowledge and perceptions on population growth and structure; population information generation and use; quality of life; reproductive health; law, ethics, and policy; and men's and women's roles. Having completed the institutional assessment, POPCOM has now implemented the Gender II project designed to strengthen the formulation, coordination, and implementation of gender-aware population and reproductive health policies and programs. Project activities include policy review and framework development, capability building through gender and reproductive health training and information management, and special research projects.

[Sexual and reproductive health and the economic crisis in Spain. SESPAS report 2014].