Franchising Reproductive Health Services

Science.gov (United States)

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

Safe Abortion and the Global Political Economy of Reproductive Rights

OpenAIRE

Barbara B Crane

2005-01-01

Sexual and Reproductive Health and Rights (SRHR) advocates are joining the call for global economic justice, while drawing attention to the neglect of SRHR in the Millennium Development Goals. At the same time, abortion and other core SRHR issues are coming to the fore in specialized and influential arenas concerned with HIV/AIDS, maternal and child health, humanitarian response, and human rights. A strategic response is required from the SRHR movement. Development (2005) 48, 85–91. doi:10.10...

Credit where credit is due: Pakistan's role in reducing the global burden of reproductive, maternal, newborn, and child health (RMNCH).

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Ghaffar, Abdul; Qazi, Shamim; Shah, Iqbal

2015-11-25

Factors contributing to Pakistan's poor progress in reducing reproductive, maternal, newborn, and child health (RMNCH) include its low level of female literacy, gender inequity, political challenges, and extremism along with its associated relentless violence; further, less than 1% of Pakistan's GDP is allocated to the health sector. However, despite these disadvantages, Pakistani researchers have been able to achieve positive contributions towards RMNCH-related global knowledge and evidence base, in some cases leading to the formulation of WHO guidelines, for which they should feel proud. Nevertheless, in order to improve the health of its own women and children, greater investments in human and health resources are required to facilitate the generation and use of policy-relevant knowledge. To accomplish this, fair incentives for research production need to be introduced, policy and decision-makers' capacity to demand and use evidence needs to be increased, and strong support from development partners and the global health community must be secured.

African Journal of Reproductive Health

African Journals Online (AJOL)

African Journal of Reproductive Health (AJRH) is published by the Women's Health and ... review articles, short reports and commentaries on reproductive health in Africa. ... Social norms and adolescents' sexual health: an introduction for ...

Patterns of globalized reproduction: Egg cells regulation in Israel and Austria.

Science.gov (United States)

Shalev, Carmel; Werner-Felmayer, Gabriele

2012-04-18

Since the successful introduction of in vitro fertilization in 1978, medically assisted reproduction (MAR) has proliferated in multiple clinical innovations. Consequently, egg cells have become an object of demand for both infertility treatment and stem cell research, and this raises complex legal, ethical, social and economic issues.In this paper we compare how the procurement and use of human egg cells is regulated in two countries: Israel and Austria. Israel is known for its scientific leadership, generous public funding, high utilization and liberal regulation of assisted reproductive technology (ART). Austria lies at the other extreme of the regulatory spectrum in terms of restrictions on reproductive interventions.In both countries, however, there is a constant increase in the use of the technology, and recent legal developments make egg cells more accessible. Also, in both countries the scarcity of egg cells in concert with the rising demand for donations has led to the emergence of cross-border markets and global 'reproductive tourism' practices. In Israel, in particular, a scandal known as the 'eggs affair' was followed by regulation that allowed egg cell donations from outside the country under certain conditions.Cross-border markets are developed by medical entrepreneurs, driven by global economic gaps, made possible by trans-national regulatory lacunae and find expression as consumer demand. The transnational practice of egg cell donations indicates the emergence of a global public health issue, but there is a general lack of medical and epidemiological data on its efficacy and safety. We conclude that there is need for harmonisation of domestic laws and formulation of new instruments for international governance.

Patterns of globalized reproduction: Egg cells regulation in Israel and Austria

Directory of Open Access Journals (Sweden)

Shalev Carmel

2012-04-01

Full Text Available Abstract Since the successful introduction of in vitro fertilization in 1978, medically assisted reproduction (MAR has proliferated in multiple clinical innovations. Consequently, egg cells have become an object of demand for both infertility treatment and stem cell research, and this raises complex legal, ethical, social and economic issues. In this paper we compare how the procurement and use of human egg cells is regulated in two countries: Israel and Austria. Israel is known for its scientific leadership, generous public funding, high utilization and liberal regulation of assisted reproductive technology (ART. Austria lies at the other extreme of the regulatory spectrum in terms of restrictions on reproductive interventions. In both countries, however, there is a constant increase in the use of the technology, and recent legal developments make egg cells more accessible. Also, in both countries the scarcity of egg cells in concert with the rising demand for donations has led to the emergence of cross-border markets and global 'reproductive tourism' practices. In Israel, in particular, a scandal known as the 'eggs affair' was followed by regulation that allowed egg cell donations from outside the country under certain conditions. Cross-border markets are developed by medical entrepreneurs, driven by global economic gaps, made possible by trans-national regulatory lacunae and find expression as consumer demand. The transnational practice of egg cell donations indicates the emergence of a global public health issue, but there is a general lack of medical and epidemiological data on its efficacy and safety. We conclude that there is need for harmonisation of domestic laws and formulation of new instruments for international governance.

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

Science.gov (United States)

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.

Male reproductive health and yoga

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Pallav Sengupta

2013-01-01

Full Text Available 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.

History, Structure and Agency in Global Health Governance; Comment on “Global Health Governance Challenges 2016 – Are We Ready?”

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Stephen Gill

2017-04-01

Full Text Available Ilona Kickbusch’s thought provoking editorial is criticized in this commentary, partly because she fails to refer to previous critical work on the global conditions and policies that sustain inequality, poverty, poor health and damage to the biosphere and, as a result, she misreads global power and elides consideration of the fundamental historical structures of political and material power that shape agency in global health governance. We also doubt that global health can be improved through structures and processes of multilateralism that are premised on the continued reproduction of the ecologically myopic and socially unsustainable market civilization model of capitalist development that currently prevails in the world economy. This model drives net financial flows from poor to rich countries and from the poor to the affluent and super wealthy individuals. By contrast, we suggest that significant progress in global health requires a profound and socially just restructuring of global power, greater global solidarity and the “development of sustainability.”

A New Gilded Age, and What It Means for Global Health Comment on "Global Health Governance Challenges 2016 - Are We Ready?"

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Schrecker, Ted

2016-08-17

New contours of global inequality present new challenges for global health, and require that we consider new kinds of health issues as global. I provide a number of illustrations, arguing the need for a political science of health that goes beyond conventional preoccupations with formal institutional and inter-state interactions and takes into account how globalization has affected the health policy landscape and restructured the distribution of economic and political power not only among countries, but also within them. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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

Science.gov (United States)

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

Marxist Perspectives on the Global Enclosures of Social Reproduction

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Friederike Beier

2018-05-01

Full Text Available Women’s unpaid care and domestic work is gaining relevance in policy-making as well as in academia. Feminist scholars and activists have lobbied successfully for the integration of unpaid care and domestic work into the Sustainable Development Goals (Goal 5.4 of the United Nations in the hope for greater recognition of women’s contribution to the economy. Policy documents about social reproduction highlight women’s disproportionate share of reproductive activities as an obstacle to women’s economic empowerment and as a relic of ‘traditional’ gender roles. Social reproduction is thereby not understood as a merit in itself, but as an obstacle to women’s participation in paid labour. Policy implications will enable certain empowerment effects for some women, but at the same time promote the increasing privatization and commodification of reproductive work across the globe. Rising inequalities between the Global North and South and between women along the categories of class and race will be one major result. To theoretically explain such contradictory effects of the recognition of social reproduction, I use the concept of ‘enclosures’ based on Marx’ ‘primitive accumulation’. Feminist scholars use the concept to explain how unpaid care and housework is commodified or de-commodified to integrate women into the paid labour force or to reduce the costs of social reproduction according to the needs of the economy. The sudden interest in unpaid care and domestic work e.g. in the Sustainable Development Goals can therefore be seen as process of double enclosure, which integrates women into the paid labour force, but also sets the grounds for the further commodification of domestic and care work. This paper aims to critically discuss the sudden interest in unpaid domestic and care work and its contradictory effects from a Marxist feminist perspective and reflects on feminist strategies and movements in global governance. After

State Support: A Prerequisite for Global Health Network Effectiveness Comment on "Four Challenges that Global Health Networks Face".

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Marten, Robert; Smith, Richard D

2017-07-24

Shiffman recently summarized lessons for network effectiveness from an impressive collection of case-studies. However, in common with most global health governance analysis in recent years, Shiffman underplays the important role of states in these global networks. As the body which decides and signs international agreements, often provides the resourcing, and is responsible for implementing initiatives all contributing to the prioritization of certain issues over others, state recognition and support is a prerequisite to enabling and determining global health networks' success. The role of states deserves greater attention, analysis and consideration. We reflect upon the underappreciated role of the state within the current discourse on global health. We present the tobacco case study to illustrate the decisive role of states in determining progress for global health networks, and highlight how states use a legitimacy loop to gain legitimacy from and provide legitimacy to global health networks. Moving forward in assessing global health networks' effectiveness, further investigating state support as a determinant of success will be critical. Understanding how global health networks and states interact and evolve to shape and support their respective interests should be a focus for future research. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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

Science.gov (United States)

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

Sexual behaviour, contraceptive practice and reproductive health ...

African Journals Online (AJOL)

Conclusion: The gaps in reproductive health knowledge, negative attitudes, high prevalence of risky sexual activity and poor reproductive health care seeking behaviour call for mounting of educational intervention programmes and development of youth-friendly reproductive health services on campus. KEY WORDS: ...

Beyond reproduction: women's health in today's developing world.

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Raymond, Susan U; Greenberg, Henry M; Leeder, Stephen R

2005-10-01

The concept of women's health is tethered strongly to reproductive health. At present, international attention and resources are focused on obstetric events and, recently, HIV/AIDS because of the significance of these problems in the least developed nations. This limited concept of women's health, however, is decreasingly relevant to the global community, and needs to be revisited in the light of decreasing fertility and increasing life expectancy in many countries where it was previously applicable. It should be expanded to embrace the full spectrum of health experienced by women, and preventive and remedial approaches to the major conditions that afflict women. Allocation of health service resources should be aligned with the epidemiological realities of these threats to women's health. Cause of death data for women aged 15-34 years and 35-44 years were examined for nine less developed countries. Deaths associated with pregnancy and child birth, and HIV were compared with deaths due to three chronic disease categories (cancer, cardiovascular disease, and diabetes). The women's health research literature for developing countries appearing in the American Journal of Public Health and British Medical Journal was also examined. In seven out of the nine countries, among women aged 15-34 years, chronic diseases caused over 20% of deaths, while reproductive causes and HIV together accounted for approximately 10% of deaths, in all countries except in India. Among women aged 35-44 years, in all but India, chronic diseases accounted for over four times the deaths attributable to reproductive causes and HIV. The causes of death were not related to the level of development in these countries as measured by GNI PPP. Papers pertaining to women's health published in public health and medical research journals focused principally on reproduction. Extending the definition of women's health to include a concern for chronic diseases is critical if the needs of women in less

Scientific Knowledge Dissemination and Reproductive Health ...

African Journals Online (AJOL)

USER

AJRH and Reproductive Health Promotion in Africa ... First, Africa is the only major region of the world with ... Women's Health and Action Research Centre .... 1. Okonofua FE, ed. Confronting the challenge of reproductive health in Africa. 2014 ...

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

Science.gov (United States)

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.

Where the lay and the technical meet: Using an anthropology of interfaces to explain persistent reproductive health disparities in West Africa.

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Jaffré, Yannick; Suh, Siri

2016-05-01

Despite impressive global investment in reproductive health programs in West Africa, maternal mortality remains unacceptably high and obstetric care is often inadequate. Fertility is among the highest in the world, while contraceptive prevalence remains among the lowest. This paper explores the social and technical dimensions of this situation. We argue that effective reproductive health programs require analyzing the interfaces between technical programs and the social logics and behaviors of health professionals and client populations. Significant gaps between health programs' goals and the behaviors of patients and health care professionals have been observed. While public health projects aim to manage reproduction, sexuality, fertility, and professional practices are regulated socially. Such projects may target technical practices, but access to care is greatly influenced by social norms and ethics. This paper shows how an empirical anthropology that investigates the social and technical interfaces of reproduction can contribute to improved global health. Copyright © 2016 Elsevier Ltd. All rights reserved.

Gender and Women's Reproductive Health

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Aygul Akyuz

2010-08-01

Full Text Available AIM: According to the “rights to equality” in reproductive and sexual rights, “no persons should be discriminated against their sexual and reproductive lives, in their access to health care and/or services on the grounds of race, sex, sexual orientation, marital status, family position, age, language, religion, political, or other opinion; national or social origin, property, birth, or other status” In this context, health professionals devoted to reproductive health are responsible for the provision of services to individuals equally and should maintain equality rights. The aim of this study is to determine the effects of gender on the reproductive health of women and utilization of reproductive health services. METHODS: The study population consisted of 250 married women at their reproductive ages of 15 to 49, who applied to the obstetrics and gynecology service of a university hospital and a gynecology clinic of a training hospital dedicated to obstetrics and gynecology between 1 February 2007 and 30 April 2007. The data collection form was developed by researchers after evaluation of the relevant literature which relevance of gender discrimination could show where the questions. RESULTS: 52% of Women’ have graduated from primary school. Education levels of women with men (her husband between level of education is statistically significant difference, and women were receive less education than men (her husband (²=34.231, p<0.001. The study was determined that women who received training secondary school and above, worked and decision maker to domestic that they get prenatal care of a high percentage and deliver their babies in the hospital with the aid of a health care professional, and they go to medical center from gynecological problems and they need to obtain permission from their husbands in order to seek aid at a medical center of a low percentage (p<0.05. CONCLUSION: Women's reproductive health, gender discrimination status

Contraceptive prevalence, reproductive health and our common future.

Science.gov (United States)

Diczfalusy, E

1991-03-01

The 1980s will go into history as a decade of lost opportunities to increase contraceptive prevalence and improve reproductive health worldwide. As the decade closes, 500 million couples still have no access to fertility regulation, there are 30-50 million induced abortions each year, 15 million infant and child deaths (30% of all deaths worldwide), an estimated 250 million new cases of sexually transmitted diseases and 60-80 million infertile couples. One of the major problems is that many policy makers are still unimpressed with the global demographic reality. World population was less than 300 million 1991 years ago. It took some 1500 years to double this number by the time of the voyages of Columbus to America. The first billion was reached at the beginning of the last century and the second in the lifetime of the author, in 1927. Then it took less than 50 years to double this number to 4 billion by 1976. Global population is 5.3 billion today. In view of such figures, it is understandable that, historically, it was this demographic concern that in the 1960s persuaded many governments to support family planning programmes. During the subsequent decades, it was gradually recognized by developing country governments that family planning lowers infant, child and maternal mortality and morbidity and reduces the number of illegal abortions and their health hazards. Today, 52 developing country governments support family planning programmes for the demographic rationale, but 65 for the reproductive health and human rights rationale. Where do we go from here? That will mainly depend on the number of years it will take to reach replacement level of fertility (around 2.1 children per couple) worldwide. If the level is reached in 2010 (the low projection of the United Nations), global population will stabilize by the end of the 21st century at 8 billion; if it is reached in 2035 (medium projection), population will stabilize around 10 billion; however, if it is reached

Reproductive tourism and the quest for global gender justice.

Science.gov (United States)

Donchin, Anne

2010-09-01

Reproductive tourism is a manifestation of a larger, more inclusive trend toward globalization of capitalist cultural and material economies. This paper discusses the development of cross-border assisted reproduction within the globalized economy, transnational and local structural processes that influence the trade, social relations intersecting it, and implications for the healthcare systems affected. I focus on prevailing gender structures embedded in the cross-border trade and their intersection with other social and economic structures that reflect and impact globalization. I apply a social connection model of responsibility for unjust outcomes and consider strategies to counter structural injustices embedded in this industry. The concluding section discusses policy reforms and proposals for collaborative action to preclude further injustices and extend full human rights to all.

Towards comprehensive women's healthcare in sub-Saharan Africa: addressing intersections between HIV, reproductive and maternal health.

Science.gov (United States)

Kendall, Tamil; Bärnighausen, Till; Fawzi, Wafaie W; Langer, Ana

2014-12-01

This themed supplement to JAIDS: Journal of Acquired Immune Deficiency Syndromes focuses on the critical intersections between HIV, reproductive, and maternal health services in the health systems of sub-Saharan Africa. The epidemiology of HIV among women of reproductive age on the sub-continent demands a holistic conceptualization and comprehensive approaches to ensure that HIV, reproductive, and maternal health are optimally addressed. Yet, in many instances, the national and global responses to these health issues remain siloed. Women's health needs and new global and national guidelines for HIV treatment raise important policy, programmatic, and operational questions regarding service integration, scale-up, and health systems functioning. In June 2013, the Maternal Health Task Force at the Harvard School of Public Health, the United States Agency for International Development, and the United States Centers for Disease Control and Prevention convened an international technical meeting of researchers, policymakers, and practitioners to discuss the existing evidence base about the interconnections between HIV, reproductive, and maternal health and identify the most important knowledge gaps and research priorities. The articles in this special issue deepen and expand on those discussions by (1) providing empirical evidence about challenges, (2) identifying how improving clinical care and models of service delivery, strengthening health systems, and addressing social dynamics can contribute to better outcomes, and (3) mapping future research directions. Together, these articles underscore that new policy frameworks and integrated approaches are necessary but not sufficient to address health system challenges. Addressing the multiple needs of women of reproductive age who are living with HIV or are at risk of acquiring HIV is a complex undertaking that requires improved access to, utilization and quality of comprehensive women's healthcare. Continued evaluation and

The impact of education and globalization on sexual and reproductive health: retrospective evidence from eastern and southern Africa.

Science.gov (United States)

Van Stam, Marie-Anne; Michielsen, Kristien; Stroeken, Koen; Zijlstra, Bonne J H

2014-01-01

The objective of this study is to qualify the relationship between sexual and reproductive health (SRH) and educational attainment in eastern and southern Africa (ESA). We hypothesize that the regional level of globalization is a moderating factor in the relationship between SRH and educational attainment. Using retrospective data from Kenya, Malawi, Tanzania, and Zambia, the associations between SRH (eight indicators), educational attainment, and globalization were examined using multilevel logistic regression analysis. It was found that the model fit for every SRH outcome indicator increased significantly after including the interaction between globalization and educational attainment, supporting the hypothesis. Depending on the level of globalization, three types of relationships between education and SRH were found: (1) for the indicators "more than four children," "intercourse before 17 years," "first child before 20 years," and "one or more child died" education is risk-decreasing, and the reduction is stronger in more globalized regions; (2) for the indicators "condom use at last intercourse" and "current contraceptive use" education is risk-decreasing, and the reduction is stronger in less globalized regions; (3) for the indicators "HIV positive" and "more than four lifetime sexual partners" education is risk increasing, but only in less globalized regions. In conclusion, these effects are related to three types of access: (1) access to services, (2) access to information, and (3) access to sexual networks. The findings highlight the relevance of globalization when analyzing the association between SRH and education, and the importance of structural factors in the development of effective SRH promotion interventions.

Knowledge Networking for Family Planning: The Potential for Virtual Communities of Practice to Move Forward the Global Reproductive Health Agenda

Directory of Open Access Journals (Sweden)

Megan O’Brien

2010-06-01

Full Text Available This paper highlights experience from five years of using virtual communication tools developed by the World Health Organization Department of Reproductive Health and Research (WHO/RHR and its partners in the Implementing Best Practices (IBP in Reproductive Health Initiative to help bridge the knowledge-to-practice gap among family planning and reproductive health professionals. It explores how communities of practice and virtual networks offer a unique low-cost way to convene public health practitioners around the world to share experiences. It offers examples of how communities of practice can contribute to the development and dissemination of evidence-based health information products, and explores the potential for online networking and collaboration to enhance and inform program design and management. The paper is intended to inform the reproductive health community, as well as others working in health and development, of the potential for using virtual communities of practice to work towards achieving common goals and provide some examples of their successful use.

Reproductive health and empowerment -- a Rajasthan perspective.

Science.gov (United States)

Pal, P; Joshi, V

1996-01-01

Reproductive health is one of the major issues of current feminist debates. The issue was brought to light because of population control policies which are being enforced through women's bodies and the spread of HIV/AIDS. In this context, women's organizations and activists are trying to focus upon the issue of reproductive health as part of the larger issue of the position of women in families, societies, and states. Policy makers and donor agencies are trying to address the problem as lack of awareness and knowledge of how to use contraceptives. The authors argue in this situation that it is important to study reproductive health relative to the status of women in society. This paper looks at the existing social construct of patriarchy and population control policies in relation to reproductive health. Women and self, the reproductive role of women, preference for male children, family planning decision making, family planning programs and reproductive health, and the Vikalp program in two districts of Rajasthan are discussed.

Social influences and reproductive health of adolescents

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Stanković Biljana

2007-01-01

Full Text Available Reproductive health represents a state of complete physical, mental and social prosperity, and not just the absence of illness or weakness, and it refers to reproductive processes, functions and systems. Adolescents, young people from the age of ten to nineteen, are yet to achieve their reproductive function, thus their reproductive health and behavior are very significant both from the individual and social standpoint. Risky behavior, which represents the main cause of diseases that young people contract most often, in the field of sexuality often lead to unplanned pregnancies and abortions, as well as diseases from sexually transmitted infections. The extensiveness can be decreased by prevention. Reproductive health promotion, as well as general health promotion, understands a social surrounding that supports healthy behavior styles. Above all, the family, schoolmates, health and school systems, mass media, without neglecting the importance of economic, social and political security in society, political and legal solutions, as well as activities of nongovernmental, religious and other organizations. Their impact, in complex interaction, directly and indirectly influence youth behavior and determine the decisions they make regarding reproductive health.

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

Science.gov (United States)

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.

Consanguinity and reproductive health among Arabs

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Al Ali Mahmoud T

2009-10-01

Full Text Available Abstract 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.

Persistent organic pollutants and male reproductive health

DEFF Research Database (Denmark)

Vested, Anne; Giwercman, Aleksander; Bonde, Jens Peter

2014-01-01

development. An extensive number of epidemiological studies have addressed the possible effects of exposure to POPs on male reproductive health, but the results are conflicting. Thus far, most studies have focused on investigating exposure and the different reproductive health outcomes during adulthood. Some...... suggested adverse effects of exposure to these compounds on human reproductive health, which, according to the endocrine disrupter hypothesis, are ascribed to the compounds' potential to interfere with endocrine signaling, especially when exposure occurs during certain phases of fetal and childhood...... studies have addressed the potential harmful effects of fetal exposure with respect to malformations at birth and/or reproductive development, whereas only a few studies have been able to evaluate whether intrauterine exposure to POPs has long-term consequences for male reproductive health with measurable...

The role of human rights litigation in improving access to reproductive health care and achieving reductions in maternal mortality.

Science.gov (United States)

Dunn, Jennifer Templeton; Lesyna, Katherine; Zaret, Anna

2017-11-08

Improving maternal health, reducing global maternal mortality, and working toward universal access to reproductive health care are global priorities for United Nations agencies, national governments, and civil society organizations. Human rights lawyers have joined this global movement, using international law and domestic constitutions to hold nations accountable for preventable maternal death and for failing to provide access to reproductive health care services. This article discusses three decisions in which international treaty bodies find the nations of Brazil and Peru responsible for violations of the Convention on the Elimination of All Forms of Discrimination Against Women and the International Covenant on Civil and Political Rights and also two domestic decisions alleging constitutional violations in India and Uganda. The authors analyze the impact of these decisions on access to maternal and other reproductive health services in Brazil, Peru, India, and Uganda and conclude that litigation is most effective when aligned with ongoing efforts by the public health community and civil society organizations. In filing these complaints and cases on behalf of individual women and their families, legal advocates highlight health system failures and challenge the historical structures and hierarchies that discriminate against and devalue women. These international and domestic decisions empower women and their communities and inspire nations and other stakeholders to commit to broader social, economic, and political change. Human rights litigation brings attention to existing public health campaigns and supports the development of local and global movements and coalitions to improve women's health.

Sexual and Reproductive Health Knowledge, Behaviour and ...

African Journals Online (AJOL)

Erah

reproductive health knowledge, sexual activities and sexuality education needs. ... Sexuality education should be provided for in-school adolescents through .... Both parents live together .... share their reproductive health ... Religious leader ..... Health of Young People: A Challenge and a. Promise. 1993. 3. World health ...

DOH to integrate reproductive health in health care delivery.

Science.gov (United States)

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.

Reproductive Investment and Health Costs in Roma Women

Directory of Open Access Journals (Sweden)

Jelena Čvorović

2017-11-01

Full Text Available In this paper, we examine whether variation in reproductive investment affects the health of Roma women using a dataset collected through original anthropological fieldwork among Roma women in Serbia. Data were collected in 2014–2016 in several Roma semi-urban settlements in central Serbia. The sample consisted of 468 Roma women, averaging 44 years of age. We collected demographic data (age, school levels, socioeconomic status, risk behaviors (smoking and alcohol consumption, marital status, and reproductive history variables (the timing of reproduction, the intensity of reproduction, reproductive effort and investment after birth, in addition to self-reported health, height, and weight. Data analyses showed that somatic, short-term costs of reproduction were revealed in this population, while evolutionary, long-term costs were unobservable—contrariwise, Roma women in poor health contributed more to the gene pool of the next generation than their healthy counterparts. Our findings appear to be consistent with simple trade-off models that suggest inverse relationships between reproductive effort and health. Thus, personal sacrifice—poor health as an outcome—seems crucial for greater reproductive success.

Global health and global health ethics

National Research Council Canada - National Science Library

Benatar, S. R; Brock, Gillian

2011-01-01

...? What are our responsibilities and how can we improve global health? Global Health and Global Health Ethics addresses these questions from the perspective of a range of disciplines, including medicine, philosophy and the social sciences...

Creating understanding of reproductive health. Exchanges.

Science.gov (United States)

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.

Social influences and reproductive health of adolescents

OpenAIRE

Stanković Biljana

2007-01-01

Reproductive health represents a state of complete physical, mental and social prosperity, and not just the absence of illness or weakness, and it refers to reproductive processes, functions and systems. Adolescents, young people from the age of ten to nineteen, are yet to achieve their reproductive function, thus their reproductive health and behavior are very significant both from the individual and social standpoint. Risky behavior, which represents the main cause of diseases that young pe...

Assisted reproductive technologies and fertility "tourism": examples from global Dubai and the Ivy League.

Science.gov (United States)

Inhorn, Marcia C; Shrivastav, Pankaj; Patrizio, Pasquale

2012-01-01

What motivates the global movements of infertile people searching for assisted reproductive technologies (ARTs)? In this article, we attempt to answer this question by exploring infertile patients' practices of so-called "fertility tourism." Based on ethnographic research carried out with nearly 300 infertile travelers in two major ART centers--one in the global hub of the United Arab Emirates and the other at a major East Coast Ivy League university--we examine a diverse set of reasons for reproductive travel. We argue that reproductive "tourism" should be reconceptualized as reproductive "exile" in that infertile couples feel barred from accessing ARTs in their home countries. Listening to reproductive travel stories is key to understanding infertile couples' transnational "quests for conception." Stories of two couples, one from Lebanon and one from Italy, demonstrate the poignancy of these quests and begin to shed light on the complex calculus of factors governing this global movement of reproductive actors.

Reproductive health of male radiographers

International Nuclear Information System (INIS)

Shakhatreh, Farouk M.

2001-01-01

To compare certain reproductive health problems reported in 2 groups of males, one of which was exposed to x-ray radiation (radiographers) and the other group that was not exposed to x-ray radiation. The reproductive health problems were miscarriage, congenital anomalies, still births and infertility. Two groups of men were selected (90 in each group). The first group consisted of radiographers and the other groups consisted of men not exposed to x-ray radiation. The 2 groups were matched for age and source. Relative risk, attributable risk percentage and level of significance were calculated. Incidence rate of reproductive health problems was increasing with the increase in duration of exposure to x-ray radiation ranging between 17% (for those exposed for 1-5 years) to 91% (for those exposed for more than 15 years). There were significant associations between exposure to radiation and miscarriage (relative risk = 1.67, attributable risk percentage = 40%), congenital anomalies (relative risk = 10, attributable risk percentage 90%), still birth (relative risk = 7, attributable risk percentage = 86%), and infertility (relative risk = 4.5, attributable risk = 78%). The incidence rates of reproductive health problems reported by male radiographers were significantly higher than that reported by the non exposed group and higher than the incidence rates reported in community-based studies in Jordan. The incidence rates of fetal death (miscarriage and stillbirth together) and infertility reported by our radiographers were higher than had been reported by the British radiographers. An immediate plan of action is needed to protect our radiographers. Further studies are needed in this field taking into account all extraneous variables that may affect the reproductive health of radiographers. (author)

Sexual and reproductive health and rights: integration as a holistic and rights-based response to HIV/AIDS.

Science.gov (United States)

Barroso, Carmen; Sippel, Serra

2011-11-01

For decades, donors, governments, and civil society have recognized the importance of sexual and reproductive health and rights (SRHR) in efforts to alleviate poverty and advance gender equality and women's rights. More recently, in the battle against HIV/AIDS--and given the unique challenges the pandemic presents for health and development--the global community has acknowledged the benefits of synergizing sexual and reproductive health and HIV/AIDS interventions. However, the United States has been slow to incorporate lessons learned from the international experience when it comes to integrating HIV/AIDS, SRHR, and gender equality in the fight against HIV/AIDS. This article highlights the importance of SRHR and lessons learned from SRHR-HIV integration to inform U.S. domestic and global AIDS strategies and interventions. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Business as Usual: A Lack of Institutional Innovation in Global Health Governance Comment on "Global Health Governance Challenges 2016 - Are We Ready?"

Science.gov (United States)

Lee, Kelley

2016-08-17

There were once again high expectations that a major global health event - the Ebola virus outbreak of 2014-2015 - would trigger meaningfully World Health Organization (WHO) reform and strengthen global health governance (GHG). Rather than a "turning point," however, the global community has gone back to business as usual. This has occurred against a backdrop of worldwide political turmoil, characterised by a growing rejection of existing political leaders and state-centric institutions. Debates about GHG so far have given insufficient attention to the need for institutional innovation. This entails rethinking the traditional bureaucratic model of postwar intergovernmental organizations which is disconnected from the transboundary, fast-paced nature of today's globalizing world. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Communication of reproductive health information to the rural girl ...

African Journals Online (AJOL)

influence their sexual behaviors and to determine the extent to which adolescents had access to sexual and reproductive health information. Methods: The case study ... with sexual reproduction health education, information and services. ..... munity health workers as their main sources of sexual and reproductive health ...

[A meta-synthesis on gender, disability and reproductive health in sub-Saharan Africa].

Science.gov (United States)

Mac-Seing, Muriel; Zarowsky, Christina

2017-01-01

Reproductive health remains a major global health issue. People with disabilities face additional discrimination and barriers to access which need to be better understood. To contribute to future interventions, we examined the intersections between gender and disability related to reproductive health in sub-Saharan Africa in the qualitative literature. We conducted a meta-synthesis, using a taxonomic analysis. An inductive and iterative approach was adopted to allow exploration of new and emergent semantic variations in themes. NVivo 11 Plus was used to code themes. Ten qualitative studies from six sub-Saharan African countries were analysed. Two main thematic areas emerged from the analysis: 1) gendered roles of people with disabilities are programmed by sociocultural normativity, including perceptions about sexuality. They are exacerbated by the hegemony of ableism and influenced by the type of reproductive health issues experienced by people with disabilities; and 2) experiences of disability in interaction with a reproductive health issue are exacerbated by the type of disability, influenced by the type of barriers to access, and perceived differently depending upon the actors involved. The intersections between gender and disability embodied by people with disabilities are multiple and complex. Not only do imposed gendered roles influence the lives of people with disabilities, but their experiences of disability are also intricately linked to gender. An intersectional analysis is proposed as a useful support to developing future perspectives.

Culture and religious beliefs in relation to reproductive health.

Science.gov (United States)

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.

Educational needs of reproductive health students: A Delphi study

OpenAIRE

N Yamani; M Shakour; S Ehsanpour

2013-01-01

Introduction: The importance of reproductive health led to establish the MSc in reproductive health program in developed country. In Iran, the program has not been offered yet. The aim of this study was to assess educational needs of MSc program in reproductive health. Methods: This research used Delphi method. Fifteen experts in reproductive health from Iran participated in this study. First, we provided a list of educational needs for every task, then experts confirmed or rejected education...

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

Science.gov (United States)

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'.

Persistent organic pollutants and male reproductive health

Directory of Open Access Journals (Sweden)

Anne Vested

2014-02-01

Full Text Available Environmental contaminants such as persistent organic pollutants (POPs are man-made bioaccumulative compounds with long half-lives that are found throughout the world as a result of heavy use in a variety of consumer products during the twentieth century. Wildlife and animal studies have long suggested adverse effects of exposure to these compounds on human reproductive health, which, according to the endocrine disrupter hypothesis, are ascribed to the compounds' potential to interfere with endocrine signaling, especially when exposure occurs during certain phases of fetal and childhood development. An extensive number of epidemiological studies have addressed the possible effects of exposure to POPs on male reproductive health, but the results are conflicting. Thus far, most studies have focused on investigating exposure and the different reproductive health outcomes during adulthood. Some studies have addressed the potential harmful effects of fetal exposure with respect to malformations at birth and/or reproductive development, whereas only a few studies have been able to evaluate whether intrauterine exposure to POPs has long-term consequences for male reproductive health with measurable effects on semen quality markers and reproductive hormone levels in adulthood. Humans are not exposed to a single compound at a time, but rather, to a variety of different substances with potential divergent hormonal effects. Hence, how to best analyze epidemiological data on combined exposures remains a significant challenge. This review on POPs will focus on current knowledge regarding the potential effects of exposure to POPs during fetal and childhood life and during adulthood on male reproductive health, including a critical revision of the endocrine disruption hypothesis, a comment on pubertal development as part of reproductive development and a comment on how to account for combined exposures in epidemiological research.

Gender issues in reproductive health: a review.

Science.gov (United States)

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

2011-01-01

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

Migration status, reproductive health knowledge and sexual ...

African Journals Online (AJOL)

Reproductive health is an essential aspect of the wellbeing of adolescents. Therefore reproductive health knowledge and sexual behaviour deservedly attract the attention of researchers, programme planners and policy implementers working with young people. Yet in Nigeria, little is known about the effect of migration ...

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

Directory of Open Access Journals (Sweden)

Mbeeli Thomas

2011-12-01

Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusion Namibia's expenditure on reproductive health is remarkable by the

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

Science.gov (United States)

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

Reproductive And Sexual Health - The Unfinished Agenda

Directory of Open Access Journals (Sweden)

V K Srivastava

2003-12-01

Full Text Available The international community for the first time during the International Conference on Population and Development in 1994 defined the Reproductive Health, not in a demographic context, but as a right and matter of choice for even individual. In the years that followed other International Conferences on women issues reinforced this consensus. The human right relevant of Reproductive Health includes : The right to life and health, The freedom to marry and determine the number, timing and spacing of children, The right to access the information, The right to discrimination and equality for men and women, The right to liberty and security of the person, including freedom from sexual violence and coercion, The right to privacy, The women all over the world have the same reproductive health needs, however, the factors like migration and urbanization that influence the involuntary movement of populations within the national frontiers render them more vulnerable, including to reproductive health problems. This increases their needs for preventive and curative care, including sendees related to safe motherhood, family planning, prevention and treatment of complicated abortions. HIV/AIDS and other sexually transmitted infections (STls. The consequences of sexual violence, traditional values, extended families, new friends and unfamiliar ways of life, inadequate reproductive health sendees etc are unusual impediments for availing the sendees.

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

NARCIS (Netherlands)

Berro Pizzarossa, Lucia; Perehudoff, Katrina

2017-01-01

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

Sexual-Reproductive Health Belief Model of college students

Directory of Open Access Journals (Sweden)

Masoomeh Simbar

2004-09-01

Full Text Available Sexual- reproductive health of youth is one of the most unknown aspects of our community, while the world, including our country is faced with the risk of AIDS spreading. The aim of this study was to describe Health Belief Model (HBM of the students about sexual-reproductive health behaviors and evaluate the ability of the model in predicting related behaviors. By using quota sampling, 1117 male and female students of Qazvin Medical Science and International universities were included in the study in 1991. A self-completed questionnaire was prepared containing close questions based on HBM components including perceived threats (susceptibility and severity of related diseases, perceived reproductive benefits and barriers and self efficacy of youth about reproductive health. A total of 645 of participants were female and 457 were male (Mean age 21.4±2.4 and 22.7±3.5, respectively. The Health Belief Model of the students showed that they perceived a moderate threat for AIDS and venereal diseases and their health outcomes. Most of them perceived the benefits of reproductive health behaviors. They believed that the ability of youth in considering reproductive health is low or moderate. However, they noted to some barriers for spreading of reproductive health in youth including inadequacy of services. Boys felt a higher level of threat for acquiring the AIDS and venereal diseases in compare to girls, but girls had a higher knowledge about these diseases and their complications. The Health Belief Model of the students with premarital intercourse behavior was not significantly different with the students without this behavior (Mann-Withney, P<0.05. Female students and the students without the history of premarital intercourse had significantly more positive attitude towards abstinence, comparing to male students and students with the history of premarital intercourse, respectively (Mann-Withney, P<0.05. Seventy five percent of students believed in

Mental and Reproductive Health Correlates of Academic Performance among Debre Berhan University Female Students, Ethiopia : The Case of Premenstrual Dysphoric Disorder

NARCIS (Netherlands)

Alemu, Sisay Mulugeta; Habtewold, Tesfa Dejenie; Haile, Yohannes Gebreegziabhere

2017-01-01

Background. Globally 3 to 8% of reproductive age women are suffering from premenstrual dysphoric disorder (PMDD). Several mental and reproductive health-related factors cause low academic achievement during university education. However, limited data exist in Ethiopia. The aim of the study was to

Advancing the right to health through global organizations: The potential role of a Framework Convention on Global Health.

Science.gov (United States)

Friedman, Eric A; Gostin, Lawrence O; Buse, Kent

2013-06-14

Organizations, partnerships, and alliances form the building blocks of global governance. Global health organizations thus have the potential to play a formative role in determining the extent to which people are able to realize their right to health. This article examines how major global health organizations, such as WHO, the Global Fund to Fight AIDS, TB and Malaria, UNAIDS, and GAVI approach human rights concerns, including equality, accountability, and inclusive participation. We argue that organizational support for the right to health must transition from ad hoc and partial to permanent and comprehensive. Drawing on the literature and our knowledge of global health organizations, we offer good practices that point to ways in which such agencies can advance the right to health, covering nine areas: 1) participation and representation in governance processes; 2) leadership and organizational ethos; 3) internal policies; 4) norm-setting and promotion; 5) organizational leadership through advocacy and communication; 6) monitoring and accountability; 7) capacity building; 8) funding policies; and 9) partnerships and engagement. In each of these areas, we offer elements of a proposed Framework Convention on Global Health (FCGH), which would commit state parties to support these standards through their board membership and other interactions with these agencies. We also explain how the FCGH could incorporate these organizations into its overall financing framework, initiate a new forum where they collaborate with each other, as well as organizations in other regimes, to advance the right to health, and ensure sufficient funding for right to health capacity building. We urge major global health organizations to follow the leadership of the UN Secretary-General and UNAIDS to champion the FCGH. It is only through a rights-based approach, enshrined in a new Convention, that we can expect to achieve health for all in our lifetimes. Copyright © 2013 Friedman, Gostin

Adolescent's perspective on reproductive health: a study from Karachi

International Nuclear Information System (INIS)

Shahid, A.; Nasim, S.; Memon, A.A.; Mustafa, M.A.

2012-01-01

Objectives: To determine the existing knowledge, attitude and behavior about reproductive and sexual health in adolescents of Karachi and seek their opinion about reproductive health education. Study type, settings and duration: A cross sectional study was conducted on adolescents (17-19 years) of both gender studying in colleges of Karachi during 2010. Subject sand Methods: Using stratified sampling procedure, a cross sectional study was carried out. After informed consent and ensuring confidentiality an anonymous quantitative questionnaire was completed to ascertain the knowledge of adolescents on reproductive health. Results: A total of 912 adolescents (470 males and 442 females) of 12 public and private sector colleges of Karachi participated in the study. Acquaintance to reproductive health was present in 75% males and 71% females and most participants confirmed discussing reproductive health issues with friends. About 81% males and 91 % females affirmed for a need for enhanced reproductive health education and awareness while over 50% of the respondents were of the opinion that the right age for reproductive health education was 16 to 18 years. Confining sexual activity to one partner and avoiding exposure to blood and needles for the prevention of AIDS was known to 38% males and 44% females but the prevention of sexually transmitted infections using condoms, was known to only 1/3 rd of the respondents. Although 70% of the respondents of both genders knew that pregnancy can be avoided but only 20% knew about contraceptives. Conclusions: Most adolescents' knew about the reproductive cycle but were not well aware of how to avoid exposures to sexually transmitted infections and pregnancies. Policy message: Reproductive health education is insufficient in adolescents should be gender specific and socio culturally sensitive. (author)

Patients' satisfaction with reproductive health services at Gogo ...

African Journals Online (AJOL)

Patient satisfaction is an individual's state of being content with the care provided in the health system. It is important for reproductive health care providers to get feedback from women regarding satisfaction with reproductive health services. There is a dearth of knowledge about patient satisfaction in Malawi. Aim

Impact of the environment on reproductive health.

Science.gov (United States)

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

Promoting health equity: WHO health inequality monitoring at global and national levels

Science.gov (United States)

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne

2015-01-01

Background Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO) has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. Objective This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. Design We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. Conclusions The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level. PMID:26387506

Promoting health equity: WHO health inequality monitoring at global and national levels.

Science.gov (United States)

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne

2015-01-01

Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO) has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level.

Promoting health equity: WHO health inequality monitoring at global and national levels

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Ahmad Reza Hosseinpoor

2015-09-01

Full Text Available Background: Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. Objective: This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. Design: We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. Conclusions: The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level.

The Kenyan national response to internationally agreed sexual and reproductive health and rights goals: a case study of three policies.

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Oronje, Rose N

2013-11-01

While priorities for, and decision-making processes on, sexual and reproductive health and rights have been determined and led mainly at the international level, conflicting power dynamics and responses at the national level in some countries have continued to pose challenges for operationalising international agreements. This paper demonstrates how these conflicts have played out in Kenya through an analysis of three policy-making processes, which led to the Adolescent Reproductive Health and Development Policy (2003), the Sexual Offences Act (2006), and the National Reproductive Health Policy (2007). The paper is based on data from a broader study on the drivers and inhibitors of sexual and reproductive health policy reform in Kenya, using a qualitative, case study design. Information was gathered through 54 semi-structured, in-depth interviews with governmental and civil society policy actors and an extensive review of policy documents and media reports. The paper shows that the transformative human rights framing of access to sexual and reproductive health, supported by both a strong global women's rights movement and progressive governmental and inter-governmental actors to defeat opposition to sexual and reproductive health and rights at the international level, has not been as influential or successful at the national level in Kenya, and has made comprehensive national reforms difficult to achieve. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Reproductive health in Romania: reversing the Ceausescu legacy.

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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.

Tracking official development assistance for reproductive health in conflict-affected countries.

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Patel, Preeti; Roberts, Bayard; Guy, Samantha; Lee-Jones, Louise; Conteh, Lesong

2009-06-09

Reproductive health needs are particularly acute in countries affected by armed conflict. Reliable information on aid investment for reproductive health in these countries is essential for improving the efficiency and effectiveness of aid. The purpose of this study was to analyse official development assistance (ODA) for reproductive health activities in conflict-affected countries from 2003 to 2006. The Creditor Reporting System and the Financial Tracking System databases were the chosen data sources for the study. ODA disbursement for reproductive health activities to 18 conflict-affected countries was analysed for 2003, 2004, 2005, and 2006. An average of US $20.8 billion in total ODA was disbursed annually to the 18 conflict-affected countries between 2003 and 2006, of which US $509.3 million (2.4%) was allocated to reproductive health. This represents an annual average of US $1.30 disbursed per capita in the 18 sampled countries for reproductive health activities. Non-conflict-affected least-developed countries received 53.3% more ODA for reproductive health activities than conflict-affected least-developed countries, despite the latter generally having greater reproductive health needs. ODA disbursed for HIV/AIDS prevention and treatment increased by 119.4% from 2003 to 2006. The ODA disbursed for other direct reproductive health activities declined by 35.9% over the same period. This study provides evidence of inequity in disbursement of reproductive health ODA between conflict-affected countries and non-conflict-affected countries, and between different reproductive health activities. These findings and the study's recommendations seek to support initiatives to make aid financing more responsive to need in the context of armed conflict.

Tracking official development assistance for reproductive health in conflict-affected countries.

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Preeti Patel

2009-06-01

Full Text Available BACKGROUND: Reproductive health needs are particularly acute in countries affected by armed conflict. Reliable information on aid investment for reproductive health in these countries is essential for improving the efficiency and effectiveness of aid. The purpose of this study was to analyse official development assistance (ODA for reproductive health activities in conflict-affected countries from 2003 to 2006. METHODS AND FINDINGS: The Creditor Reporting System and the Financial Tracking System databases were the chosen data sources for the study. ODA disbursement for reproductive health activities to 18 conflict-affected countries was analysed for 2003, 2004, 2005, and 2006. An average of US $20.8 billion in total ODA was disbursed annually to the 18 conflict-affected countries between 2003 and 2006, of which US $509.3 million (2.4% was allocated to reproductive health. This represents an annual average of US $1.30 disbursed per capita in the 18 sampled countries for reproductive health activities. Non-conflict-affected least-developed countries received 53.3% more ODA for reproductive health activities than conflict-affected least-developed countries, despite the latter generally having greater reproductive health needs. ODA disbursed for HIV/AIDS prevention and treatment increased by 119.4% from 2003 to 2006. The ODA disbursed for other direct reproductive health activities declined by 35.9% over the same period. CONCLUSIONS: This study provides evidence of inequity in disbursement of reproductive health ODA between conflict-affected countries and non-conflict-affected countries, and between different reproductive health activities. These findings and the study's recommendations seek to support initiatives to make aid financing more responsive to need in the context of armed conflict.

A call to action on women's health: putting corporate CSR standards for workplace health on the global health agenda.

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Wofford, David; MacDonald, Shawn; Rodehau, Carolyn

2016-11-04

Business operates within a Corporate Social Responsibility (CSR) system that the global health community should harness to advance women's health and related sustainable development goals for workers and communities in low- and middle-income countries. Corporations and their vast networks of supplier companies, particularly in manufacturing and agribusiness, employ millions of workers, increasingly comprised of young women, who lack access to health information, products and services. However, occupational safety and health practices focus primarily on safety issues and fail to address the health needs, including reproductive health, of women workers. CSR policy has focused on shaping corporate policies and practices related to the environment, labor, and human rights, but has also ignored the health needs of women workers. The authors present a new way for global health to understand CSR - as a set of regulatory processes governed by civil society, international institutions, business, and government that set, monitor, and enforce emerging standards related to the role of business in society. They call this the CSR system. They argue that the global health community needs to think differently about the role of corporations in public health, which has been as "partners," and that the global health practitioners should play the same advocacy role in the CSR system for corporate health policies as it does for government and international health policies.

Caregiver awareness of reproductive health issues for women with intellectual disabilities

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Lin Jin-Ding

2011-01-01

Full Text Available Abstract Background Limited attention has been paid to the issue of reproductive health as it affects women with intellectual disabilities, despite reproductive health being a vital issue in public health policy for women in the general population. This paper describes caregiver awareness of reproductive health issues relative to women with intellectual disabilities who are being cared for in welfare institutions in Taiwan. Methods The study employed a cross-sectional, questionnaire-based study which recruited 1,152 caregivers (response rate = 71.87% from 32 registered disability welfare institutions in Taiwan. We classified their understanding/awareness of reproductive health issues into four domains: menstrual (1 and menopause (2 issues, sex education (3, and reproductive health services (4. Each domain had five associated yes/no questions and the total score for the four domains was out of a maximum of 20. Data were analyzed using SPSS 15.0 software. Results We found that most of the caregivers were familiar with matters concerning sex education, menopause, and reproductive health services, but they lacked adequate understanding of issues associated with menstruation in women with ID. Many aspects of reproductive health such as "menstrual pain", "age at menarche", "masturbation", "diet during perimenopause", and "publicly available reproductive health services" were issues in which caregivers lacked adequate knowledge and required further instruction. Logistic regression analysis revealed that female caregivers with a university degree, and those who had experience assisting with reproductive health care were more inclined to have higher reproductive health awareness scores than their counterparts. Conclusions This study highlights that service providers should offer appropriate reproductive health education to institutional caregivers, and that more attention be focused on the personal experiences and concerns of intellectually disabled

Education for the protection of young people’s reproductive health

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Rašević Mirjana

2006-01-01

Full Text Available Education for the protection of reproductive health is of special importance for young people in Serbia for several reasons. The first reason is an extremely low birth rate. The second is the fact that a large part of the population suffers from serious and long-standing problems in reproductive health. The third, common to all countries passing through transition, is an increase in risk behavior among young people which threatens their reproductive health either directly or indirectly. Education for reproductive health is a long-lasting process which should be initiated at an early age and should involve all social institutions, primarily health institutions, media and schools. The school is the most important link in the chain of knowledge acquisition. Therefore during elementary education, time must be found for topics such as puberty, emotional life of young people, physiology of reproduction, adolescent pregnancy, communication skills, risk behavior, contraception, sexually transmitted diseases and the importance of family and children. Over the last few years more than thirty counseling centers for young people’s reproductive health have been set up in Serbia within health clinics. Unlike health institutions, media and schools have not yet been mobilized. Therefore it is necessary to promote the role of media and schools in the process of the protection of young people’s reproductive health. .

Impact of swine reproductive technologies on pig and global food production.

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Knox, Robert V

2014-01-01

Reproductive technologies have dramatically changed the way pigs are raised for pork production in developed and developing countries. This has involved such areas as pigs produced/sow, more consistent pig flow to market, pig growth rate and feed efficiency, carcass yield and quality, labor efficiency, and pig health. Some reproductive technologies are in widespread use for commercial pork operations [Riesenbeck, Reprod Domest Anim 46:1-3, 2011] while others are in limited use in specific segments of the industry [Knox, Reprod Domest Anim 46:4-6, 2011]. Significant changes in the efficiency of pork production have occurred as a direct result of the use of reproductive technologies that were intended to improve the transfer of genes important for food production [Gerrits et al., Theriogenology 63:283-299, 2005]. While some technologies focused on the efficiency of gene transfer, others addressed fertility and labor issues. Among livestock species, pig reproductive efficiency appears to have achieved exceptionally high rates of performance (PigCHAMP 2011) [Benchmark 2011, Ames, IA, 12-16]. From the maternal side, this includes pigs born per litter, farrowing rate, as well as litters per sow per year. On the male side, boar fertility, sperm production, and sows served per sire have improved as well [Knox et al., Theriogenology, 70:1202-1208, 2008]. These shifts in the efficiency of swine fertility have resulted in the modern pig as one of the most efficient livestock species for global food production. These reproductive changes have predominantly occurred in developed countries, but data suggests transfer and adoption of these in developing countries as well (FAO STAT 2009; FAS 2006) [World pig meat production: food and agriculture organization of the United Nations, 2009; FAS, 2006) Worldwide Pork Production, 2006]. Technological advancements in swine reproduction have had profound effects on industry structure, production, efficiency, quality, and profitability. In

Volunteerism Among Out-of-School Adolescent Reproductive Health ...

African Journals Online (AJOL)

Out-of-school peer educators [PE] are resourceful in transmitting reproductive health information but their retention remains a contentious issue. This study aimed to assess motivation and sustainability of out-of-school PEs in disseminating reproductive health information among adolescents. A structured questionnaire was ...

Ethics, health policy, and Zika: From emergency to global epidemic?

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Jamrozik, Euzebiusz; Selgelid, Michael J

2018-05-01

Zika virus was recognised in 2016 as an important vector-borne cause of congenital malformations and Guillain-Barré syndrome, during a major epidemic in Latin America, centred in Northeastern Brazil. The WHO and Pan American Health Organisation (PAHO), with partner agencies, initiated a coordinated global response including public health intervention and urgent scientific research, as well as ethical analysis as a vital element of policy design. In this paper, we summarise the major ethical issues raised during the Zika epidemic, highlighting the PAHO ethics guidance and the role of ethics in emergency responses, before turning to ethical issues that are yet to be resolved. Zika raises traditional bioethical issues related to reproduction, prenatal diagnosis of serious malformations and unjust disparities in health outcomes. But the epidemic has also highlighted important issues of growing interest in public health ethics, such as the international spread of infectious disease; the central importance of reproductive healthcare in preventing maternal and neonatal morbidity and mortality; diagnostic and reporting biases; vector control and the links between vectors, climate change, and disparities in the global burden of disease. Finally, there are controversies regarding Zika vaccine research and eventual deployment. Zika virus was a neglected disease for over 50 years before the outbreak in Brazil. As it continues to spread, public health agencies should promote gender equity and disease control efforts in Latin America, while preparing for the possibility of a global epidemic. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

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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

Forced Migration and Global Responsibility for Health Comment on "Defining and Acting on Global Health: The Case of Japan and the Refugee Crisis".

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Bozorgmehr, Kayvan; Razum, Oliver

2016-11-05

Forced migration has become a world-wide phenomenon in the past century, affecting increasing numbers of countries and people. It entails important challenges from a global health perspective. Leppold et al have critically discussed the Japanese interpretation of global responsibility for health in the context of forced migration. This commentary complements their analysis by outlining three priority areas of global health responsibility for European Union (EU) countries. We highlight important stages of the migration phases related to forced migration and propose three arguments. First, the chronic neglect of the large number of internally displaced persons (IDPs) in the discourses on the "refugee crisis" needs to be corrected in order to develop sustainable solutions with a framework of the Sustainable Development Goals (SDGs). Second, protection gaps in the global system of protection need to be effectively closed to resolve conflicts with border management and normative global health frameworks. Third, effective policies need to be developed and implemented to meet the health and humanitarian needs of forced migrants; at the same time, the solidarity crisis within the EU needs to be overcome. These stakes are high. EU countries, being committed to global health, should urgently address these areas. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Involving men in reproductive health: making the mandate a reality.

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Ndong, I; Steele, C; Mahony, E

1998-01-01

When men are provided with information about reproductive health issues, they are more likely to support their partners' family planning decisions. Such support is particularly important in cultures where women are unable to negotiate sexual relationships, and may therefore be exposing themselves to sexually transmitted diseases (STDs) and unwanted pregnancies. Good communication between partners ensures that women receive the reproductive health care they need. AVSC International developed the Men As Partners (MAP) initiative with the goals of increasing men's awareness and support of their partners' reproductive health choices; men's awareness of the need to safeguard reproductive health, especially through the prevention of STDs; and the use of contraceptive methods which require the participation and cooperation of men among couples who want to use them. In May 1997, AVSC organized the first-ever interregional workshop on men's involvement in reproductive health. More than 150 participants from 5 continents attended the event in Mombasa, Kenya, where they discussed ways to involve men in the health of their female partners. Main workshop themes were gender issues, reproductive health services for men, community outreach and workplace programs, access to services, and adolescents.

Reproductive health barriers facing men and women with disabilities ...

African Journals Online (AJOL)

Reproductive health barriers facing men and women with disabilities in Durban, South Africa. ... Gender and Behaviour ... reproductive health services is often overshadowed by negative stereotypes that are held about persons with disabilities ...

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

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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

Up dating Islamic Boarding School Santri and Reproductive Health Information

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Made Asri Budisuari

2016-06-01

Full Text Available Background: Islamic boarding school system has long story in indonesia, they covered as much 14.798 student whoare teenager between 9–15 year old. Problems encountered with adolescent sexuality and reproductive health. Methods:An explorative research implemented in 3 provinces ie East Java, Nusa Tenggara Barat (NTB, East Kalimantan and sixIslamic boarding schools. Data were collected through questionnaires about reproductive health. Results: It showed 48,5%of respondents didn’t have enough knowledge, attitudes and behavior about reproductive health, 40% of respondents knewvery little about puberty, menstruation and wet dream, 71% of respondents had little knowledge about the risk of pregnancy;49% of respondents had not enough knowledge about sexually transmited diseases. 88% respondents said that they hadfall in love, 76% of respondents had positive courtship behavior. Conclusion: The information about reproductive healthin islamic boarding school for adolescents is still in adequate and only refer to yellow book. Health worker did not provideadequqte information. We still found student who have sex while when they were engaged still datting. Suggestion: Theneed of additional and up to date reproductive health information and the risks of sexual intercourse marriage it maybedelivery on interesting media, such as one social networking. A health reproductive modules consist of scientic materialand some knowledge has to be developed and should be delivery health worker. Reproductive health syllabus and trainingfor trainers for teachers of boarding school is needed.

Measuring the Impact of the Human Rights on Health in Global Health Financing.

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Davis, Sara L M

2015-12-10

In response to new scientific developments, UNAIDS, WHO, and global health financing institutions have joined together to promote a "fast-track" global scale-up of testing and treatment programs. They have set ambitious targets toward the goal of ending the three diseases by 2030. These numerical indicators, based on infectious disease modeling, can assist in measuring countries' progressive realization of the right to health. However, they only nominally reference the catastrophic impact that human rights abuses have on access to health services; they also do not measure the positive impact provided by law reform, legal aid, and other health-related human rights programs. Drawing on experience at the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has incorporated expanded stakeholder consultation and human rights programming into its grants, the article argues that addressing human rights barriers to access is often an ad hoc activity occurring on the sidelines of a health grantmaking process that has focused on the scale-up of biomedical programs to meet global health indicators. To ensure that these biomedical programs have impact, UN agencies and health financing mechanisms must begin to more systematically and proactively integrate human rights policy and practice into their modeling and measurement tools. Copyright © 2015 Davis. 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.

Strengthening Governance in Health Systems for Reproductive ...

International Development Research Centre (IDRC) Digital Library (Canada)

Home · What we do ... As a result, Pakistan's health system has suffered and health service delivery has worsened. ... This four-year project aims to strengthen health systems governance for reproductive health and rights in Pakistan.

Global issues in women's health.

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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.

Induced Abortion and Women’s Reproductive Health in India

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Sutapa Agrawal

2013-08-01

Full Text Available Despite the intensive national campaign for safe motherhood and legalization of induced abortion (IA, morbidity from abortion has remained a serious problem for Indian women. This study examined the consequences of IA on women’s reproductive health. Analysis used data of 90,303 ever-married women age 15-49 years, included in India’s second National Family Health Survey (NFHS-2, 1998-99. Binary logistic regression methods were used to examine the consequences of IA on women’s reproductive health. Independent of other factors, the likelihood of experiencing any reproductive health problems was 1.5 times higher (OR,1.46;95%CI,1.33-1.60;P<0.001 among women who had one IA and 1.9 times higher (OR,1.85;95%CI,1.52-2.27;P<0.001 among women who had two or more IA compared to women with no history of IA. Study suggests that IA may have negative consequences for women’s reproductive health.

Induced Abortion and Women’s Reproductive Health in India

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Sutapa Agrawal

2013-01-01

Full Text Available Despite the intensive national campaign for safe motherhood and legalization of induced abortion (IA, morbidity from abortion has remained a serious problem for Indian women. This study examined the consequences of IA on women’s reproductive health. Analysis used data of 90,303 ever-married women age 15-49 years, included in India’s second National Family Health Survey (NFHS-2, 1998-99. Binary logistic regression methods were used to examine the consequences of IA on women’s reproductive health. Independent of other factors, the likelihood of experiencing any reproductive health problems was 1.5 times higher (OR,1.46;95%CI,1.33-1.60;P<0.001 among women who had one IA and 1.9 times higher (OR,1.85;95%CI,1.52-2.27;P<0.001 among women who had two or more IA compared to women with no history of IA. Study suggests that IA may have negative consequences for women’s reproductive health.

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

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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.

Reproductive health experiences of women with cardiovascular disease.

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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.

Marital violence and women's reproductive health care in Uttar Pradesh, India.

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Sudha, S; Morrison, Sharon

2011-01-01

Although the impact of marital violence on women's reproductive health is recognized globally, there is little research on how women's experience of and justification of marital violence in developing country settings is linked to sexually transmitted infection (STI) symptom reporting, and seeking care for the symptoms. This study analyzes data on 9,639 currently married women from India's 2006-2007 National Family Health Survey-3 from the Central/Northern Indian state of Uttar Pradesh. The likelihood of currently married women's reporting STIs or symptoms, and the likelihood of seeking care for these, are analyzed using multivariate logistic regression techniques. Currently married women's experience of physical, sexual, and emotional marital violence in the last 12 months was significantly associated with greater likelihood of reporting a STI or symptom (odds ratio [OR], 1.364 [95% confidence interval (CI), 1.171-1.588] for physical violence; OR, 1.649 [95% CI, 1.323-2.054] for sexual violence; OR, 1.273 [95% CI, 1.117-1.450] for emotional violence). Experience of physical violence (OR, 0.728; 95% CI, 0.533-0.994) and acceptance of any justification for physical violence (OR, 0.590; 95% CI, 0.458-0.760) were significantly associated with decreased chance of seeking care, controlling for other factors. This study suggests that experiencing marital violence may have a negative impact on multiple aspects of women's reproductive health, including increased self-report of STI symptoms. Moreover, marital physical violence and accepting justification for such violence are associated with decreased chance of seeking care. Thus, policies and programs to promote reproductive health should incorporate decreasing gender-based violence, and overcoming underlying societal gender inequality. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

New Resources on Youth Reproductive Health and HIV Prevention, 2002-2004. YouthLens on Reproductive Health and HIV/AIDS. Number 14

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Finger, William, Comp.; Tipton, Margaret, Comp.

2005-01-01

As a sequel to YouthLens No. 1, New Resources Available on Youth Reproductive Health and HIV Prevention (July 2002), this YouthLens summarizes major reports and resources that have appeared since July 2002. The resources are organized by overview reports, reproductive health resources, and HIV/AIDS resources. [YouthLens is an activity of YouthNet,…

Innovative Use of the Law to Address Complex Global Health Problems Comment on "The Legal Strength of International Health Instruments - What It Brings toGlobal Health Governance?"

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Walls, Helen L; Ooms, Gorik

2017-05-20

Addressing the increasingly globalised determinants of many important problems affecting human health is a complex task requiring collective action. We suggest that part of the solution to addressing intractable global health issues indeed lies with the role of new legal instruments in the form of globally binding treaties, as described in the recent article of Nikogosian and Kickbusch. However, in addition to the use of international law to develop new treaties, another part of the solution may lie in innovative use of existing legal instruments. A 2015 court ruling in The Hague, which ordered the Dutch government to cut greenhouse gas emissions by at least 25% within five years, complements this perspective, suggesting a way forward for addressing global health problems that critically involves civil society and innovative use of existing domestic legal instruments. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Exploring challenges of the reproductive health PhD curriculum: A qualitative research

Directory of Open Access Journals (Sweden)

Sh Kohan

2016-07-01

Full Text Available Introduction: Enhancing the quality and dynamicity of higher education programs requires continuous evaluation of curriculums. Reproductive health PhD program was established in 2006 in Iran while recommending that its curriculum be evaluated by assessing graduates’ performance in workplace and surveying students, faculty members and managers. This study aimed to explore challenges of the curriculum of reproductive health PhD program. Methods: Employing a qualitative content analysis approach and using purposive and sometimes opportunistic sampling, experiences and viewpoints of 33 graduates and students of reproductive health PhD program, educational managers and reproductive health board members about the curriculum of reproductive health PhD program were collected through individual interviews and notes in 2014-15. Data were transcribed and important expressions were coded. Classification of similar codes led to preliminary categories. Five main categories were extracted by further classifications. Results: The five main categories included inadequacy of course topics and contents, challenges of student education, failure in realizing curriculum goals, long research period, and ambiguity in graduates’ professional status were appeared; each of these included various subcategories. Conclusion: Results showed that the curriculum of reproductive health PhD program required revisions to meet the program’s mission and designing courses such as sexual health and reinforcing the clinical nature of the program were necessary. Moreover, the results emphasized that the establishment of an independent educational department of reproductive health for managing higher education affairs and greater supervision of the reproductive health board on educational affairs was necessary. Furthermore, reproductive health specialists should be employed in different positions to meet society’s reproductive health needs.

Sexual and reproductive health: a public health perspective

National Research Council Canada - National Science Library

Look, P. F. A. van; Heggenhougen, Kris; Quah, Stella R

2011-01-01

.... Major changes have taken place in the last 15 years in the way decision-makers think about the subject and the manner in which programmes deliver comprehensive sexual and reproductive health services...

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

Science.gov (United States)

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.

Science.gov (United States)

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.

Evaluation of a Reproductive Health Program to Support Married ...

African Journals Online (AJOL)

... self-esteem, reproductive health and gender through girls' groups. The husbands' program focused on non-violence, support to families, and reproductive health. Population-based surveys were undertaken among married girls, at midterm and end line. Outcomes of interest were husbands' assistance with domestic work, ...

Medicalization of global health 2: The medicalization of global mental health.

Science.gov (United States)

Clark, Jocalyn

2014-01-01

Once an orphan field, 'global mental health' now has wide acknowledgement and prominence on the global health agenda. Increased recognition draws needed attention to individual suffering and the population impacts, but medicalizing global mental health produces a narrow view of the problems and solutions. Early framing by advocates of the global mental health problem emphasised biological disease, linked psychiatry with neurology, and reinforced categories of mental health disorders. Universality of biomedical concepts across culture is assumed in the globalisation of mental health but is strongly disputed by transcultural psychiatrists and anthropologists. Global mental health movement priorities take an individualised view, emphasising treatment and scale-up and neglecting social and structural determinants of health. To meet international targets and address the problem's broad social and cultural dimensions, the global mental health movement and advocates must develop more comprehensive strategies and include more diverse perspectives.

Reproductive Health Policies in Peru: Social Reforms and Citizenship Rights

Directory of Open Access Journals (Sweden)

Stéphanie Rousseau

2007-05-01

Full Text Available The article analyzes the case of reproductive health policy-making in Peru in the context of recent social policy reforms. Health-sector reforms have only partially redressed Peruvian women’s unequal access to family planning, reproductive rights and maternal care. The main sources of inequalities are related to the segmented character of the health-care system, with the highest burden placed on the public sector. The majority of women from popular classes, who are not protected by an insurance plan, are dependent upon what and how public services are provided. Simultaneously, the continuing role of conservative sectors in public debates about reproductive health policy has a strong impact on public family planning services and other reproductive rights.

Male reproductive health and environmental xenoestrogens

DEFF Research Database (Denmark)

Toppari, J; Larsen, J C; Christiansen, Peter

1996-01-01

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......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...

Male reproductive health and environmental xenoestrogens

DEFF Research Database (Denmark)

Toppari, J; Larsen, J C; Christiansen, Peter

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...

Multipurpose prevention technologies for sexual and reproductive health: mapping global needs for introduction of new preventive products.

Science.gov (United States)

Schelar, Erin; Polis, Chelsea B; Essam, Timothy; Looker, Katharine J; Bruni, Laia; Chrisman, Cara J; Manning, Judy

2016-01-01

Worldwide, women face sexual and reproductive health (SRH) risks including unintended pregnancy and sexually transmitted infections (STIs) including HIV. Multipurpose prevention technologies (MPTs) combine protection against two or more SRH risks into one product. Male and female condoms are the only currently available MPT products, but several other forms of MPTs are in development. We examined the global distribution of selected SRH issues to determine where various risks have the greatest geographical overlap. We examined four indicators relevant to MPTs in development: HIV prevalence, herpes simplex virus type 2 prevalence (HSV-2), human papillomavirus prevalence (HPV) and the proportion of women with unmet need for modern contraception. Using ArcGIS Desktop, we mapped these indicators individually and in combination on choropleth and graduated symbol maps. We conducted a principal components analysis to reduce data and enable visual mapping of all four indicators on one graphic to identify overlap. Our findings document the greatest overlapping risks in Sub-Saharan Africa, and we specify countries in greatest need by specific MPT indication. These results can inform strategic planning for MPT introduction, market segmentation and demand generation; data limitations also highlight the need for improved (non-HIV) STI surveillance globally. MPTs are products in development with the potential to empower women to prevent two or more SRH risks. Geographic analysis of overlapping SRH risks demonstrates particularly high need in Sub-Saharan Africa. This study can help to inform strategic planning for MPT introduction, market segmentation and demand generation. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Reproductive Health Care for Women with Spina Bifida

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Amie B. Jackson

2007-01-01

Full Text Available Women with spina bifida have unique health care concerns and as the life expectancy of this population increases, they are transitioning from adolescence to womanhood and entering their reproductive years with little information about what to expect. Likewise, their health care providers do not have the benefit of evidence-based research that comprehensively addresses the issues these women may face related to reproduction or aging. Few studies have focused on the effects that spina bifida may have on these women's reproductive systems, nor has attention been paid to the effects that possible reproductive endocrine changes may have on their disability. Needless to say, concerns about sexuality, sexual function, and pregnancy are just as important to these women as they are to their able-bodied counterparts.

Conscientious objection and refusal to provide reproductive healthcare: a White Paper examining prevalence, health consequences, and policy responses.

Science.gov (United States)

Chavkin, Wendy; Leitman, Liddy; Polin, Kate

2013-12-01

Global Doctors for Choice-a transnational network of physician advocates for reproductive health and rights-began exploring the phenomenon of conscience-based refusal of reproductive healthcare as a result of increasing reports of harms worldwide. The present White Paper examines the prevalence and impact of such refusal and reviews policy efforts to balance individual conscience, autonomy in reproductive decision making, safeguards for health, and professional medical integrity. The White Paper draws on medical, public health, legal, ethical, and social science literature published between 1998 and 2013 in English, French, German, Italian, Portuguese, and Spanish. Estimates of prevalence are difficult to obtain, as there is no consensus about criteria for refuser status and no standardized definition of the practice, and the studies have sampling and other methodologic limitations. The White Paper reviews these data and offers logical frameworks to represent the possible health and health system consequences of conscience-based refusal to provide abortion; assisted reproductive technologies; contraception; treatment in cases of maternal health risk and inevitable pregnancy loss; and prenatal diagnosis. It concludes by categorizing legal, regulatory, and other policy responses to the practice. Empirical evidence is essential for varied political actors as they respond with policies or regulations to the competing concerns at stake. Further research and training in diverse geopolitical settings are required. With dual commitments toward their own conscience and their obligations to patients' health and rights, providers and professional medical/public health societies must lead attempts to respond to conscience-based refusal and to safeguard reproductive health, medical integrity, and women's lives. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

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

Science.gov (United States)

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.

Experience from a multi-country initiative to improve the monitoring of selected reproductive health indicators in Africa.

Science.gov (United States)

Barreix, Maria; Tunçalp, Özge; Mutombo, Namuunda; Adegboyega, Ayotunde A; Say, Lale

2017-05-01

Universal access to sexual and reproductive health remains part of the unfinished business of global development in Africa. To achieve it, health interventions should be monitored using programmatic indicators. WHO's Strengthening Measurement of Reproductive Health Indicators in Africa initiative, implemented in Ghana, Nigeria, Kenya, Uganda, and Zimbabwe, aimed to improve national information systems for routine monitoring of reproductive health indicators. Participating countries developed action plans employing a two-pronged strategy: (1) revising, standardizing, and harmonizing existing reproductive health indicators captured through routine information-systems; and (2) building data-collection capacity through training and supervision at select pilot sites. Country teams evaluated existing and new indicators, and outlined barriers to strengthening routine measurement. Activities included updating abortion-care guidelines (spontaneous and induced abortions), providing training on laws surrounding induced abortions, and improving feedback mechanisms. The country teams updated monitoring and evaluation frameworks, and attempted to build recording/reporting capacity in selected pilot areas. Barriers to implementing the initiative that were encountered included restrictive induced-abortion laws, staff turn-over, and administrative delays, including low capacity among healthcare staff and competing priorities for staff time. The areas identified for further improvement were up-scaling programs to a national level, creating scorecards to record data, increasing collaborations with the private sector, conducting related costing exercises, and performing ex-post evaluations. © 2017 World Health Organization; licensed by Wiley on behalf of International Federation of Gynecology and Obstetrics.

Caregiver awareness of reproductive health issues for women with intellectual disabilities

OpenAIRE

Lin, Lan-Ping; Lin, Pei-Ying; Hsu, Shang-Wei; Loh, Ching-Hui; Lin, Jin-Ding; Lai, Chia-Im; Chien, Wu-Chien; Lin, Fu-Gong

2011-01-01

Abstract Background Limited attention has been paid to the issue of reproductive health as it affects women with intellectual disabilities, despite reproductive health being a vital issue in public health policy for women in the general population. This paper describes caregiver awareness of reproductive health issues relative to women with intellectual disabilities who are being cared for in welfare institutions in Taiwan. Methods The study employed a cross-sectional, questionnaire-based stu...

Determinants of the most significant characteristics of reproductive health

Directory of Open Access Journals (Sweden)

Miljković Snežana

2010-01-01

Full Text Available Introduction. Reproductive health of women is determined by females’ demographic and socio-economic characteristics, their behavior, and the complex of environmental factors. Objective. The paper examines the predictive impact of personal and environmental characteristics, health and healthcare characteristics regarding the most important aspects of reproductive health. Methods From a sample of 2,718 women, aged 20-49 years, we collected information on various characteristics using a structured questionnaire. Based on factorial analysis (principal components method, Kaisser Varimax criterion we selected representative variables (factors, describing personal (demographic and socio-economic characteristics of women, their environment (family, household, community, health (attitudes towards health, life-style, health status, healthcare (independent and the characteristics of reproductive health (dependent variables. The predictors were analyzed by multiple regression and correlation. Results. Sexual behavior was determined by socio-economic status, personal tidiness, rest, presence of risk factor(s, health evaluation and attitude toward personal responsibility, trust in physicians etc. The predictors of contraception involved satisfaction with one’s own health, serious health problems, health evaluation. The presence and number of abortions were determined by personal psychological maturity, rest, risk factors, life-style, health evaluation and its manifestations, and the continuity and timely healthcare. The predictors of adequate protection of reproductive health involved the cultural level of the community, financial standing of the household, satisfaction with one’s own life, tidiness and rest, presence of risk factors, health evaluation, attitude towards personal responsibility, and trust in physicians. HIV control was determined by satisfaction with one’s own life, physical activity of women, presence of serious health problems, and

The Reproduction of Neoliberalism and the Global Capitalist Crisis

DEFF Research Database (Denmark)

Juego, Bonn

2012-01-01

The paper attempts to contribute to a critical reading of contemporary global political economy. It provides an analysis through an empirical exposition of the latent and manifest ways neoliberalism is being reproduced institutionally and relationally despite and because of the ongoing global...... capitalist crisis. To this end, three interrelated themes are highlighted here: first, the constitutive role and functional character of crises in the evolution of capitalism and the reproduction of its current neoliberal configuration; second, the continuity of long-held ideas of groups ranging from...... multilateral organizations to global justice movements – hence, the absence of relatively new perspectives – as evident in their respective policy prescriptions and crisis responses that effectively perpetuate the hegemony of neoliberal capitalism; and third, the emergence of the political-economic regime...

EDITORIAL REPRODUCTIVE HEALTH AWARENESS AMONG ...

African Journals Online (AJOL)

Kateee

2003-07-01

Jul 1, 2003 ... abuse and lack of access to reproductive health services. ... more than 10% of all births are to women 15 to 19 years of age(1). The high ... From a human rights ... Indian adolescents, other contextual considerations are.

Adolescent Sexual and Reproductive Health in the Niger Delta ...

African Journals Online (AJOL)

There has been an increasing awareness of the need to pay special focus on the adolescent and their sexual and reproductive health. This article reviews the sexual and reproductive health of adolescents in the Niger Delta region (NDR) of Nigeria. The objective is to bring to focus these important issues in the region.

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

Science.gov (United States)

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.

Accounting for abortion: Accomplishing transnational reproductive governance through post-abortion care in Senegal.

Science.gov (United States)

Suh, Siri

2018-06-01

Reproductive governance operates through calculating demographic statistics that offer selective truths about reproductive practices, bodies, and subjectivities. Post-abortion care, a global reproductive health intervention, represents a transnational reproductive regime that establishes motherhood as women's primary legitimate reproductive status. Drawing on ethnographic fieldwork conducted in Senegal between 2010 and 2011, I illustrate how post-abortion care accomplishes reproductive governance in a context where abortion is prohibited altogether and the US is the primary bilateral donor of population aid. Reproductive governance unfolds in hospital gynecological wards and the national health information system through the mobilization and interpretation of post-abortion care data. Although health workers search women's bodies and behavior for signs of illegal abortion, they minimize police intervention in the hospital by classifying most post-abortion care cases as miscarriage. Health authorities deploy this account of post-abortion care to align the intervention with national and global maternal health policies that valorize motherhood. Although post-abortion care offers life-saving care to women with complications of illegal abortion, it institutionalizes abortion stigma by scrutinizing women's bodies and masking induced abortion within and beyond the hospital. Post-abortion care reinforces reproductive inequities by withholding safe, affordable obstetric care from women until after they have resorted to unsafe abortion.

The global landscape of cross-border reproductive care: twenty key findings for the new millennium.

Science.gov (United States)

Inhorn, Marcia C; Patrizio, Pasquale

2012-06-01

Cross-border reproductive care (CBRC), also known as procreative tourism, fertility tourism, or reproductive tourism, is an increasing global phenomenon. This article reviews the expanding scholarly literature on CBRC, with 2010-2011 representing watershed years for CBRC scholarship and activism. Terminological debates, missing data, and lack of international monitoring plague the study of CBRC. Nonetheless, it is widely acknowledged that CBRC is a growing industry, with new global hubs, new intermediaries, new media, and new spaces of interaction. Religious bans and legal restrictions have created a patchwork of 'restrictive' and 'permissive' countries, with law evasion being a primary driver of CBRC. Yet, patient motivations for CBRC are diverse and patients' levels of satisfaction with CBRC and its outcomes are generally high. Thus, scholarly concern with CBRC as law evasion must be tempered with qualitative studies of positive patient experiences. CBRC can be considered a form of 'global gynecology' in which reproductive medicine, tourism, and commerce are converging in the second decade of the new millennium.

Reproductive health issues in rural Western Kenya

Directory of Open Access Journals (Sweden)

Ouma Peter

2008-03-01

Full Text Available Abstract Background We describe reproductive health issues among pregnant women in a rural area of Kenya with a high coverage of insecticide treated nets (ITNs and high prevalence of HIV (15%. Methods We conducted a community-based cross-sectional survey among rural pregnant women in western Kenya. A medical, obstetric and reproductive history was obtained. Blood was obtained for a malaria smear and haemoglobin level, and stool was examined for geohelminths. Height and weight were measured. Results Of 673 participants, 87% were multigravidae and 50% were in their third trimester; 41% had started antenatal clinic visits at the time of interview and 69% reported ITN-use. Malaria parasitemia and anaemia (haemoglobin Conclusion In this rural area with a high HIV prevalence, the reported use of condoms before pregnancy was extremely low. Pregnancy health was not optimal with a high prevalence of malaria, geohelminth infections, anaemia and underweight. Chances of losing a child after birth were high. Multiple interventions are needed to improve reproductive health in this area.

From Millennium Development Goals to post-2015 sustainable development: sexual and reproductive health and rights in an evolving aid environment.

Science.gov (United States)

Hill, Peter S; Huntington, Dale; Dodd, Rebecca; Buttsworth, Michael

2013-11-01

Using research from country case studies, this paper offers insights into the range of institutional and structural changes in development assistance between 2005 and 2011, and their impact on the inclusion of a sexual and reproductive health and rights agenda in national planning environments. At a global level during this period, donors supported more integrative modalities of aid - sector wide approaches, poverty reduction strategy papers, direct budgetary support - with greater use of economic frameworks in decision-making. The Millennium Development Goals brought heightened attention to maternal mortality, but at the expense of a broader sexual and reproductive health and rights agenda. Advocacy at the national planning level was not well linked to programme implementation; health officials were disadvantaged in economic arguments, and lacked financial and budgetary controls to ensure a connection between advocacy and action. With increasing competency in higher level planning processes, health officials are now refocusing the post-2015 development goals. If sexual and reproductive health and rights is to claim engagement across all its multiple elements, advocates need to link them to the key themes of sustainable development: inequalities in gender, education, growth and population, but also to urbanisation, migration, women in employment and climate change. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Differentials in reproductive and child health status in India

Directory of Open Access Journals (Sweden)

Nikhilesh Parchure

2011-12-01

Full Text Available

Background: Inequalities in reproductive and child health (RCH exist, in general, in different regions of India. The present study aims to investigate the current status of RCH and examine the factors responsible for it in different parts of India.

Methods: This study utilized data obtained from two Indian studies – (i National Family Health Survey – 3 (NFHS- 2005-06 and (ii District Level Household Survey (DLHS – 2002-04. Reproductive Health Index was computed on the basis of five variables such as total fertility rate, infant mortality rate, birth order, delivery care and female educational attainment.

Results: In terms of reproductive and child health, a wide range of variation exists in India in its different regions. The study reveals that among Indian states, 13 states have an index value less than the national average. On the basis of the reproductive health index, the Indian states can be divided into three categories, namely; progressive states, semi progressive states and backward states.

Conclusions: The interstate differences in healthcare utilization are partly due to variations in the implementation of maternal health care programs as well as differences in availability of and accessibility to healthcare between Indian states.

Global Health Security

Centers for Disease Control (CDC) Podcasts

2017-09-21

Dr. Jordan Tappero, a CDC senior advisor on global health, discusses the state of global health security.  Created: 9/21/2017 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Center for Global Health (CGH).   Date Released: 9/21/2017.

Educational Needs of Adult Men regarding Sexual and Reproductive Health in Ahvaz, Iran

Directory of Open Access Journals (Sweden)

Marjan Hajizadeh

2015-06-01

Full Text Available Background & aim: Men’s sexual and reproductive health is one of the most important public health issues. However, less attention has been paid to this matter, compared to women’s health issues. The aim of this study was to evaluate the educational needs of men regarding sexual and reproductive health in Ahvaz, Iran. Methods:This descriptive study was performed on 1,068 adult men (aged 20-60 years, selected via random cluster sampling in Ahvaz city in 2014. In order to determine the educational needs of men regarding sexual and reproductive health, a questionnaire consisting of three major sections (i.e., demographic data, sexual and reproductive health needs, and men’s attitudes was designed. The validity of the questionnaire was determined by content and face validity. Its reliability was assessed by internal consistency (α=85% and test-retest. For data analysis, descriptive statistics, t-test and ANOVA were performed, using SPSS version 19. Results: The majority of men (75.1% had poor knowledge and a moderate attitude (67.3% towards sexual and reproductive health. The three most important educational needs of men regarding sexual and reproductive health were cancers of male reproductive system (83.8%, sexually transmitted diseases (STD/HIV (77.4% and religious attitudes toward sex (77%, respectively. Friends were the most important source of information in all aspects of sexual and reproductive health, while men preferred to receive information from a male physician or counselor. According to the results, men were dissatisfied with the amount of information they received about sexual and reproductive health. Conclusion: Based on the findings, men felt the need for sexual and reproductive health education; these needs were influenced by social and demographic factors, except marital status. If health policymakers pay attention to these educational needs, it is possible to implement suitable programs for improving men's sexual health and

Rethinking reproductive "tourism" as reproductive "exile".

Science.gov (United States)

Inhorn, Marcia C; Patrizio, Pasquale

2009-09-01

Whereas reproductive "tourism" implies leisure travel, reproductive "exile" bespeaks the numerous difficulties and constraints faced by infertile patients who are "forced" to travel globally for assisted reproduction. Given this reality, it is time to rethink the language of "reproductive tourism," replacing it with more accurate and patient-centered terms.

Review Article Conscientious Objection and Reproductive Health ...

African Journals Online (AJOL)

However conscientious objection amongst the available few is a hitherto undocumented potential factor influencing access to health care in SSA. Provision of certain reproductive health services goes counter to some individual's religious and moral beliefs and practices. Health providers sometimes refuse to participate in or ...

Decisions and dilemmas--reproductive health needs assessment for adolescent girls in Samoa.

Science.gov (United States)

Lata, Shareen

2003-09-01

This study gathered baseline data on reproductive health information and service needs of adolescent girls aged between 16 to 19 years in Samoa. The opinions and attitudes of these girls towards the provision of reproductive health services, and the health services available in Samoa were investigated using qualitative and quantitative research methods. Self-administered, semi-structured questionnaires were used with the adolescent girls, and semi-structured interview schedules were used with key informants from health services and the hospitality and entertainment industries. Access to age-specific education, information and health services were identified as reproductive health needs for Samoan adolescent girls. Promotion and encouragement of condom use by sexually active adolescents was also identified as a need. Including biological and psychosocial aspects of reproductive health in the school curriculum may improve knowledge. Reproductive health education involves all strata of society, such as governments, churches, communities, and families, with each playing a vital role. No stratum should be wholly responsible for addressing adolescent reproductive health. Any Samoan initiative on reproductive health may be evaluated against the data from this study. This study featured both selection bias and measurement bias. Sex is not openly discussed in Samoan society and could have led to participants not responding to certain questions or providing responses that they deemed socially desirable. These biases may have distorted results. Convenient population sampling method used may have led to mis-reporting of results in some adolescent groups.

Evaluation of a Sexual and Reproductive Health Education ...

African Journals Online (AJOL)

AJRH Managing Editor

Faculty of Health, Sports and Social Work, Research Centre Mental Health Nursing, Inholland ... Evaluation research concerning the impact of sexual and reproductive health (SRH) ..... awareness of the existence of HIV, pregnancy and.

Introduction to Reproduction: Online Education for the Millennial Learner.

Science.gov (United States)

Castle, Megan; Kick, Laura; Haseley, Heather; Wallach, Harlan; Woodruff, Teresa K

2016-07-01

Despite staggering rates of sexually transmitted infections and unplanned pregnancies, reproductive health education is not yet standardized across secondary or postsecondary curricula. The Women's Health Research Institute and Northwestern University Information Technology created Introduction to Reproduction, a massive open online course to encourage global students to learn the biological foundations of reproductive health. This digital education experience appeals to the Millennial learner and offers unique opportunities to explore topics in reproductive biology via lectures, animations, and three-dimensional anatomical illustrations. Data were collected anonymously from de-identified learners who elected to self-report on their experiences while completing the course as well as through Coursera datasets. Northwestern University's Institutional Review Board classified this research project as an exempt status due to the de-identified nature of the collected data. Participants from 47 countries report on reproductive health content knowledge, past reproductive health education, and level of engagement with the topic. These data indicate that the Introduction to Reproduction course has a meaningful impact on its participants and presents the information in a concise and accessible format. Distribution of this course to a wider audience is the goal for the program and important to the field of reproductive health. © 2016 by the Society for the Study of Reproduction, Inc.

Global crop exposure to critical high temperatures in the reproductive period: historical trends and future projections

International Nuclear Information System (INIS)

Gourdji, Sharon M; Sibley, Adam M; Lobell, David B

2013-01-01

Long-term warming trends across the globe have shifted the distribution of temperature variability, such that what was once classified as extreme heat relative to local mean conditions has become more common. This is also true for agricultural regions, where exposure to extreme heat, particularly during key growth phases such as the reproductive period, can severely damage crop production in ways that are not captured by most crop models. Here, we analyze exposure of crops to physiologically critical temperatures in the reproductive stage (T crit ), across the global harvested areas of maize, rice, soybean and wheat. Trends for the 1980–2011 period show a relatively weak correspondence (r = 0.19) between mean growing season temperature and T crit exposure trends, emphasizing the importance of separate analyses for T crit . Increasing T crit exposure in the past few decades is apparent for wheat in Central and South Asia and South America, and for maize in many diverse locations across the globe. Maize had the highest percentage (15%) of global harvested area exposed to at least five reproductive days over T crit in the 2000s, although this value is somewhat sensitive to the exact temperature used for the threshold. While there was relatively little sustained exposure to reproductive days over T crit for the other crops in the past few decades, all show increases with future warming. Using projections from climate models we estimate that by the 2030s, 31, 16, and 11% respectively of maize, rice, and wheat global harvested area will be exposed to at least five reproductive days over T crit in a typical year, with soybean much less affected. Both maize and rice exhibit non-linear increases with time, with total area exposed for rice projected to grow from 8% in the 2000s to 27% by the 2050s, and maize from 15 to 44% over the same period. While faster development should lead to earlier flowering, which would reduce reproductive extreme heat exposure for wheat on a

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

Directory of Open Access Journals (Sweden)

Namasivayam A

2012-07-01

Full Text Available Amrita Namasivayam,1 Donatus C Osuorah,2 Rahman Syed,3 Diddy Antai3,41Department of Public Health, Division of Global Health (IHCAR, Karolinska Institute, Stockholm, Sweden; 2Department of Pediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra, Nigeria; 3Department of Public Health, Division of Social Medicine, Karolinska Institute, Stockholm, Sweden; 4Division of Global Health and Inequalities, The Angels Trust, Abuja, NigeriaBackground: The role of gender inequities in explaining women's access to reproductive health care was examined in four countries (two sub-Saharan African and two South Asian countries. The extent of gender inequities varies across and within countries, and is rooted in the different cultural practices and gender norms within these different countries, and differences in the status and autonomy of women.Methods: Demographic and Health Survey data from women aged 15–49 years within these countries were analyzed with multivariate logistic regression analysis to examine the role of multidimensional characteristics of gender inequities, operationalized as access to skilled antenatal care, tetanus toxoid injection during pregnancy, and access to skilled antenatal care.Results: Significant associations were found between several dimensions of gender inequities (with the exception of decision-making autonomy and reported use of maternal reproductive health care services. Several pathways of influence between the outcome and exposure variables were also identified.Conclusion: Dimensions of gender inequities (with the exception of decision-making autonomy differentially influenced woman's use of reproductive health care services, thus highlighting the urgent need for concerted and sustained efforts to change these harmful traditional values if several of these countries are to meet Millennium Development Goal-5.Keywords: women, gender inequities, reproductive health care, Namibia, Kenya, Nepal, India

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

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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.

Science.gov (United States)

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.

[Gender inequality and reproductive health: a perspective for the program].

Science.gov (United States)

Szasz, I

1993-01-01

Research on the influence of the social, economic, and cultural context on reproductive health is just beginning in Mexico. Because health risks and damage appear to be associated with living conditions of the population, the mechanisms through which social inequality affects reproductive health should be analyzed. Gender inequality is of particular importance to the study of reproductive health. The construction of feminine identity, centered on motherhood and the ability to relate to others, has decisive consequences for self-esteem, social valuation, and the capacity of women to make decisions and act in their own self interest. The obstacles that women face in making decisions about sexuality and reproduction have psychological, affective, and health costs. Women living in contexts of limited female autonomy are often pressured into early pregnancy and union and to having large families. The need to satisfy expectations for their gender and social position, fear of being devalued or abandoned, and the desire to cement affective relationships may restrict their capacity to exercise their sexuality with autonomy and to separate it from procreation. The low rates of use of contraceptives by men and the almost exclusive focus on women of contraceptive technologies and programs also reflect the inequality of the sexes. The lesser access to resources and exercise of power by women in the household may lead to nutritional disadvantages, and societal standards that tolerate extramarital sexual activity for men but not for women leave women vulnerable to sexually transmitted diseases. The health effects of gender inequalities are magnified by poverty and other forms of social disadvantage. The Program of Reproductive Health and Society aims to contribute to improved reproductive health in the Mexican population through study of the consequences of social and gender inequality.

How economic empowerment reduces women's reproductive health vulnerability in Tanzania

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Westeneng, J.; D'Exelle, B.S.H.

2015-01-01

This article uses data from Northern Tanzania to analyse how economic empowerment helps women reduce their reproductive health (RH) vulnerability. It analyses the effect of women's employment and economic contribution to their household on health care use at three phases in the reproductive cycle:

Gender relations and women's reproductive health in South Sudan

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Sumit Kane

2016-11-01

Full Text Available 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.

Gender relations and women's reproductive health in South Sudan

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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

Integrating reproductive and child health and HIV services in Tanzania

African Journals Online (AJOL)

Integrating reproductive and child health and HIV services in Tanzania: Implication to policy, systems and services. ... Experts around the world recognize the central role of Sexual and Reproductive Health (SRH) services in preventing HIV infection. Evidence suggests that improving access to contraception for women to ...

Making sense of the global health crisis: policy narratives, conflict, and global health governance.

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Ney, Steven

2012-04-01

Health has become a policy issue of global concern. Worried that the unstructured, polycentric, and pluralist nature of global health governance is undermining the ability to serve emergent global public health interests, some commentators are calling for a more systematic institutional response to the "global health crisis." Yet global health is a complex and uncertain policy issue. This article uses narrative analysis to explore how actors deal with these complexities and how uncertainties affect global health governance. By comparing three narratives in terms of their basic assumptions, the way they define problems as well as the solutions they propose, the analysis shows how the unstructured pluralism of global health policy making creates a wide scope of policy conflict over the global health crisis. This wide scope of conflict enables effective policy-oriented learning about global health issues. The article also shows how exclusionary patterns of cooperation and competition are emerging in health policy making at the global level. These patterns threaten effective learning by risking both polarization of the policy debate and unanticipated consequences of health policy. Avoiding these pitfalls, the analysis suggests, means creating global health governance regimes that promote openness and responsiveness in deliberation about the global health crisis.

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

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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.

CHALLENGES IN REPRODUCTIVE HEALTH CARE OF ADOLESCENTS IN SLOVENIA

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Bojana Pinter

2018-02-01

Full Text Available Background: Slovenia is one of the most successful European countries in the prevention of adolescent pregnancy and the country with a relative early sexual engagement of adolescents. Every year new generations of adolescents are entering puberty, thus reproductive health care of adolescents should be our continuous priority. Methods: The most important challenges in reproductive health care of adolescents in Slovenia are early sexual engagement of adolescents, low double method use at sexual intercourse and inadequate detection of sexually transmitted infections. Possible responses should be found on a micro-level of physician (recognition of a new role of physician, promotion of ABC ap- proach and on a macro-level of society (development of national strategy of reproductive health care, introduction of systematic sexuality education in the schools. Conclusions: Challenges in reproductive health care of adolescents are several and possible responses are integral. A response on challenges demand that every physician recognizes his/her new role and develops his/her competency. Responses on challenges will be feasible with inter- connection of physicians with other physicians and professionals and with collaboration of profession and politics.

Review of hazards to female reproductive health in veterinary practice.

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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

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

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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

The new global health.

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De Cock, Kevin M; Simone, Patricia M; Davison, Veronica; Slutsker, Laurence

2013-08-01

Global health reflects the realities of globalization, including worldwide dissemination of infectious and noninfectious public health risks. Global health architecture is complex and better coordination is needed between multiple organizations. Three overlapping themes determine global health action and prioritization: development, security, and public health. These themes play out against a background of demographic change, socioeconomic development, and urbanization. Infectious diseases remain critical factors, but are no longer the major cause of global illness and death. Traditional indicators of public health, such as maternal and infant mortality rates no longer describe the health status of whole societies; this change highlights the need for investment in vital registration and disease-specific reporting. Noncommunicable diseases, injuries, and mental health will require greater attention from the world in the future. The new global health requires broader engagement by health organizations and all countries for the objectives of health equity, access, and coverage as priorities beyond the Millennium Development Goals are set.

Tracking official development assistance for reproductive health in conflict-affected countries: 2002-2011.

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Patel, P; Dahab, M; Tanabe, M; Murphy, A; Ettema, L; Guy, S; Roberts, B

2016-09-01

To provide information on trends on official development assistance (ODA) disbursement patterns for reproductive health activities in 18 conflict-affected countries. Secondary data analysis. 18 conflict-affected countries and 36 non-conflict-affected countries. The Creditor Reporting System (CRS) database was analyzed for ODA disbursement for direct and indirect reproductive health activities to 18 conflict-affected countries (2002-2011). A comparative analysis was also made with 36 non-conflict-affected counties in the same 'least-developed' income category. Multivariate regression analyses examined associations between conflict status and reproductive health ODA and between reproductive needs and ODA disbursements. Patterns of ODA disbursements (constant U.S. dollars) for reproductive health activities. The average annual ODA disbursed for reproductive health to 18 conflict-affected countries from 2002 to 2011 was US$ 1.93 per person per year. There was an increase of 298% in ODA for reproductive health activities to the conflict-affected countries between 2002 and 2011; 56% of this increase was due to increases in HIV/AIDS funding. The average annual per capita reproductive health ODA disbursed to least-developed non-conflict-affected countries was 57% higher than to least-developed conflict-affected countries. Regression analyses confirmed disparities in ODA to and between conflict-affected countries. Despite increases in ODA for reproductive health for conflict-affected countries (albeit largely for HIV/AIDS activities), considerable disparities remains. Study tracking 10 years of aid for reproductive aid shows major disparities for conflict-affected countries. © 2016 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

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

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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 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 anxiety. Therefore, prior to the assisted reproductive treatment mental health consultation is needed.

Catalyzing a Reproductive Health and Social Justice Movement.

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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.

Global health governance as shared health governance.

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Ruger, Jennifer Prah

2012-07-01

With the exception of key 'proven successes' in global health, the current regime of global health governance can be understood as transnational and national actors pursuing their own interests under a rational actor model of international cooperation, which fails to provide sufficient justification for an obligation to assist in meeting the health needs of others. An ethical commitment to providing all with the ability to be healthy is required. This article develops select components of an alternative model of shared health governance (SHG), which aims to provide a 'road map,' 'focal points' and 'the glue' among various global health actors to better effectuate cooperation on universal ethical principles for an alternative global health equilibrium. Key features of SHG include public moral norms as shared authoritative standards; ethical commitments, shared goals and role allocation; shared sovereignty and constitutional commitments; legitimacy and accountability; country-level attention to international health relations. A framework of social agreement based on 'overlapping consensus' is contrasted against one based on self-interested political bargaining. A global health constitution delineating duties and obligations of global health actors and a global institute of health and medicine for holding actors responsible are proposed. Indicators for empirical assessment of select SHG principles are described. Global health actors, including states, must work together to correct and avert global health injustices through a framework of SHG based on shared ethical commitments.

Global health justice and governance.

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Ruger, Jennifer Prah

2012-01-01

While there is a growing body of work on moral issues and global governance in the fields of global justice and international relations, little work has connected principles of global health justice with those of global health governance for a theory of global health. Such a theory would enable analysis and evaluation of the current global health system and would ethically and empirically ground proposals for reforming it to more closely align with moral values. Global health governance has been framed as an issue of national security, human security, human rights, and global public goods. The global health governance literature is essentially untethered to a theorized framework to illuminate or evaluate governance. This article ties global health justice and ethics to principles for governing the global health realm, developing a theoretical framework for global and domestic institutions and actors.

Accessing adolescent sexual and reproductive health services ...

African Journals Online (AJOL)

Adolescent sexual and reproductive health access continues to dominate the development agenda since the historic 1994 Cairo Conference and becomes a huge public health concern for the increasing diverse of undocumented adolescents who have become an important component as irregular migration patterns and ...

CRITICAL WINDOWS FOR REPRODUCTIVE HEALTH IN CHILDREN AND ADOLESCENTS

Science.gov (United States)

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...

Global Oral Health Inequalities

Science.gov (United States)

Garcia, I.; Tabak, L.A.

2011-01-01

Despite impressive worldwide improvements in oral health, inequalities in oral health status among and within countries remain a daunting public health challenge. Oral health inequalities arise from a complex web of health determinants, including social, behavioral, economic, genetic, environmental, and health system factors. Eliminating these inequalities cannot be accomplished in isolation of oral health from overall health, or without recognizing that oral health is influenced at multiple individual, family, community, and health systems levels. For several reasons, this is an opportune time for global efforts targeted at reducing oral health inequalities. Global health is increasingly viewed not just as a humanitarian obligation, but also as a vehicle for health diplomacy and part of the broader mission to reduce poverty, build stronger economies, and strengthen global security. Despite the global economic recession, there are trends that portend well for support of global health efforts: increased globalization of research and development, growing investment from private philanthropy, an absolute growth of spending in research and innovation, and an enhanced interest in global health among young people. More systematic and far-reaching efforts will be required to address oral health inequalities through the engagement of oral health funders and sponsors of research, with partners from multiple public and private sectors. The oral health community must be “at the table” with other health disciplines and create opportunities for eliminating inequalities through collaborations that can harness both the intellectual and financial resources of multiple sectors and institutions. PMID:21490232

A 'mystery client' evaluation of adolescent sexual and reproductive health services in health facilities from two regions in Tanzania.

Directory of Open Access Journals (Sweden)

Zaina Mchome

Full Text Available Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning. The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed.

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

Science.gov (United States)

Behrman, Julia Andrea; Weitzman, Abigail

2016-03-01

This article explores the effects of the 2010 Haiti earthquake on women's reproductive health, using geocoded data from the 2005 and 2012 Haiti Demographic and Health Surveys. We use geographic variation in the destructiveness of the earthquake to conduct a difference-in-difference analysis. Results indicate that heightened earthquake intensity reduced use of injectables-the most widely used modern contraceptive method in Haiti-and increased current pregnancy and current unwanted pregnancy. Analysis of impact pathways suggests that severe earthquake intensity significantly increased women's unmet need for family planning and reduced their access to condoms. The earthquake also affected other factors that influence reproductive health, including women's ability to negotiate condom use in their partnerships. Our findings highlight how disruptions to health care services following a natural disaster can have negative consequences for women's reproductive health. © 2016 The Population Council, Inc.

Towards Transnational Feminisms. Some reflections and concerns in relation to the globalization of reproductive technologies

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Gupta, J.A.

2006-01-01

This article discusses the emergence of the concept of ‘transnational feminisms’ as a differentiated notion from ‘global sisterhood’ within feminist postcolonial criticism. This is done in order to examine its usefulness for interrogating the globalization of reproductive technologies and women’s

Global Health in the Anthropocene: Moving Beyond Resilience and Capitalism Comment on "Health Promotion in an Age of Normative Equity and Rampant Inequality".

Science.gov (United States)

van de Pas, Remco

2016-12-24

There has been much reflection on the need for a new understanding of global health and the urgency of a paradigm shift to address global health issues. A crucial question is whether this is still possible in current modes of global governance based on capitalist values. Four reflections are provided. (1) Ecological -centered values must become central in any future global health framework. (2) The objectives of 'sustainability' and 'economic growth' present a profound contradiction. (3) The resilience discourse maintains a gridlock in the functioning of the global health system. (4) The legitimacy of multi-stakeholder governance arrangements in global health requires urgent attention. A dual track approach is suggested. It must be aimed to transform capitalism into something better for global health while in parallel there is an urgent need to imagine a future and pathways to a different world order rooted in the principles of social justice, protecting the commons and a central role for the preservation of ecology. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The future of global health education: training for equity in global health

Directory of Open Access Journals (Sweden)

Lisa V. Adams

2016-11-01

Full Text Available Abstract Background Among academic institutions in the United States, interest in global health has grown substantially: by the number of students seeking global health opportunities at all stages of training, and by the increase in institutional partnerships and newly established centers, institutes, and initiatives to house global health programs at undergraduate, public health and medical schools. Witnessing this remarkable growth should compel health educators to question whether the training and guidance that we provide to students today is appropriate, and whether it will be applicable in the next decade and beyond. Given that “global health” did not exist as an academic discipline in the United States 20 years ago, what can we expect it will look like 20 years from now and how can we prepare for that future? Discussion Most clinicians and trainees today recognize the importance of true partnership and capacity building in both directions for successful international collaborations. The challenge is in the execution of these practices. There are projects around the world where this is occurring and equitable partnerships have been established. Based on our experience and observations of the current landscape of academic global health, we share a perspective on principles of engagement, highlighting instances where partnerships have thrived, and examples of where we, as a global community, have fallen short. Conclusions As the world moves beyond the charity model of global health (and its colonial roots, it is evident that the issue underlying ethical global health practice is partnership and the pursuit of health equity. Thus, achieving equity in global health education and practice ought to be central to our mission as educators and advisors when preparing trainees for careers in this field. Seeking to eliminate health inequities wherever they are ingrained will reveal the injustices around the globe and in our own cities and

Observations on reproductive health programs in the Baltic States

DEFF Research Database (Denmark)

Lazarus, Jeff; Nadisauskiene, R J; Liljestrand, J

2004-01-01

Public attention in Sweden has been drawn to three neighboring states that recently joined the European Union: Estonia, Latvia, and Lithuania. At this historic moment, it seems instructive to look at how the rapidly reformed health sectors of these ex-Soviet republics are responding to the vision...... of reproductive health articulated in Cairo 10 years ago. Reproductive health and rights have improved in these states in spite of recent reforms often acting to oppose improvement. Reforms such as the introduction of family medicine need continued adjustment, especially regarding antenatal care. One special...

Promotion of adolescent reproductive health and healthy living. Malaysia.

Science.gov (United States)

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.

Science.gov (United States)

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

Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century.

Science.gov (United States)

Inhorn, Marcia C; Patrizio, Pasquale

2015-01-01

Infertility is estimated to affect as many as 186 million people worldwide. Although male infertility contributes to more than half of all cases of global childlessness, infertility remains a woman's social burden. Unfortunately, areas of the world with the highest rates of infertility are often those with poor access to assisted reproductive techniques (ARTs). In such settings, women may be abandoned to their childless destinies. However, emerging data suggest that making ART accessible and affordable is an important gender intervention. To that end, this article presents an overview of what we know about global infertility, ART and changing gender relations, posing five key questions: (i) why is infertility an ongoing global reproductive health problem? (ii) What are the gender effects of infertility, and are they changing over time? (iii) What do we know about the globalization of ART to resource-poor settings? (iv) How are new global initiatives attempting to improve access to IVF? (v) Finally, what can be done to overcome infertility, help the infertile and enhance low-cost IVF (LCIVF) activism? An exhaustive literature review using MEDLINE, Google Scholar and the keyword search function provided through the Yale University Library (i.e. which scans multiple databases simultaneously) identified 103 peer-reviewed journal articles and 37 monographs, chapters and reports from the years 2000-2014 in the areas of: (i) infertility demography, (ii) ART in low-resource settings, (iii) gender and infertility in low-resource settings and (iv) the rise of LCIVF initiatives. International Federation of Fertility Societies Surveillance reports were particularly helpful in identifying important global trends in IVF clinic distribution between 2002 and 2010. Additionally, a series of articles published by scholars who are tracking global cross-border reproductive care (CBRC) trends, as well as others who are involved in the growing LCIVF movement, were invaluable. Recent

Globalization and gametes: reproductive 'tourism,' Islamic bioethics, and Middle Eastern modernity.

Science.gov (United States)

Inhorn, Marcia C

2011-04-01

'Reproductive tourism' has been defined as the search for assisted reproductive technologies (ARTs) and human gametes (eggs, sperm, embryos) across national and international borders. This article conceptualizes reproductive tourism within 'global reproscapes,' which involve the circulation of actors, technologies, money, media, ideas, and human gametes, all moving in complicated manners across geographical landscapes. Focusing on the Muslim countries of the Middle East, the article explores the Islamic 'local moral worlds' informing the movements of Middle Eastern infertile couples. The ban on third-party gamete donation in Sunni Muslim-majority countries and the recent allowance of donor technologies in the Shia Muslim-majority countries of Iran and Lebanon have led to significant movements of infertile couples across Middle Eastern national borders. In the new millennium, Iran is leading the way into this 'brave new world' of high-tech, third-party assisted conception, with Islamic bioethical discourses being used to justify various forms of technological assistance. Although the Middle East is rarely regarded in this way, it is a key site for understanding the intersection of technoscience, religious morality, and modernity, all of which are deeply implicated in the new world of reproductive tourism.

Moral development and reproductive health decisions.

Science.gov (United States)

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.

Pesantren dan Upaya Pendidikan Kesehatan Reproduksi Remaja (Pesantren and Adolescent Reproductive Health Education Effort

Directory of Open Access Journals (Sweden)

Setia Pranata

2014-04-01

Full Text Available Background: Although there was Pesantren Health Post, but the promotion and education of reproductive health did notproceed well. Students at the Pesantren are mostly teenagers, therefore sexuality and reproduction problems in pesantrenhad become potential threats. This study described there productive health education in pesantren, that focused on theeducation system, material, and factors supporting and inhibiting reproductive health education efforts. Methods: This was a qualitative study. The data were collected by means of purposive sampling. The study was conducted at two pesantrens in Sampang, Balikpapan and West Lombok regencies. Data were collected by indepth interviews to managers, teachers and students. Results: This study indicated that reproductive education was not something new to the pesantren. The Classic Buku Kuning had been the reference of reproductive education among santri. The kyai used bandongan teaching methods which tend to be monologue. Further more this method did not employ evaluation system. The large number of santri, the high commitment and responsibility of the manager of pesantren, and the availibility of 24 hours assistance were factors that supported reproductive health education in pesantren. The inhibiting factors were limited understanding of reproductive health issues, lack of transparency of the pesantren community regarding issues that were considered taboo, and limitations of supporting infrastructure. Another aspect was the lack of external support that were relevance to the issue of adolescent reproductive health services. Recomendations: It is recommended to enrich the materials on reproductive health education in pesantren,

Peopling Global Health

Directory of Open Access Journals (Sweden)

João Biehl

2014-06-01

Full Text Available The field of Global Health brings together a vastly diverse array of actors working to address pressing health issues worldwide with unprecedented financial and technological resources and informed by various agendas. While Global Health initiatives are booming and displacing earlier framings of the field (such as tropical medicine or international health, critical analyses of the social, political, and economic processes associated with this expanding field — an “open source anarchy” on the ground — are still few and far between. In this essay, we contend that, among the powerful players of Global Health, the supposed beneficiaries of interventions are generally lost from view and appear as having little to say or nothing to contribute. We make the case for a more comprehensive and people-centered approach and demonstrate the crucial role of ethnography as an empirical lantern in Global Health. By shifting the emphasis from diseases to people and environments, and from trickle-down access to equality, we have the opportunity to set a humane agenda that both realistically confronts challenges and expands our vision of the future of global communities.

SEXUAL AND REPRODUCTIVE HEALTH IN ACCRA, GHANA

African Journals Online (AJOL)

David Ofori-Adjei

2012-06-01

Jun 1, 2012 ... sexual and reproductive ill health; one in ten women reported menstrual irregularities and almost one quarter ... and fertility from the Women's Health Study of Accra. II (WHSA-II) survey conducted in 2008-9. ..... breast exams (46%), nutrition education (29%) and. HIV tests (25%) were the most commonly ...

Reproductive Health Needs Assessment of Girl and Boy Teenagers

Directory of Open Access Journals (Sweden)

M Shakour

2016-11-01

Full Text Available Background & aim: Reproductive health of puberty is very important in the cycle of Life. Adolescence is a very important period of time in cycle of life and it is followed by physical, psychological and social changes. Therefore the aim of this study was needs assessment of reproductive health for adolescence as a first and principal step in curriculum planning for health services. Methods: This study was qualitative like the most needs assessments and the method was content analysis. Data gathering was done by semi structured interview. We used two focus groups (7and 10persons for needs assessment of reproductive health between girls, and personal interview with 10 boys. We did content analysis and then extracted the main themes and sub themes. Results: Adolescent girls had diverse needs in four groups: experiences related to menstruation and hygiene, social needs, sexual needs and psychological needs. Also adolescent boys had three groups of needs like physical changes, psychological and sexual needs. In physical needs group they had some needs like no knowledge of symptoms of adolescence, no knowledge of hygiene related to puberty. In psychological needs group they had some needs like feeling depression and in sexual needs group they had some needs like tendency to make contacts with girls, no knowledge of communication with people with different sex. Conclusion: Education and the systematic planning in reproductive health matters are necessary for parents, teachers and adolescents, and they are known as the prior needs.

Development and Psychometric Assessment of the Measure of Globalization Influence on Health Risk (MGIHR) Among Mexican Women with Breast Cancer.

Science.gov (United States)

Nodora, Jesse N; Carvajal, Scott C; Robles-Garcia, Rebeca; Agraz, Francisco Páez; Daneri-Navarro, Adrian; Meza-Montenegro, Maria Mercedes; Gutierrez-Millan, Luis Enrique; Martinez, Maria Elena

2015-08-01

Lacking in the literature are data addressing the extent to which changes in reproductive and lifestyle factors predispose women in developing nations to higher breast cancer rates, and the degree to which these are due to globalization influences. This article describes the development and psychometric assessment of an instrument intended to measure global, predominantly U.S., influences on breast cancer risk profile among women residing in Mexico. Using investigator consensus and a focus group methodology, the Measure of Globalization Influence on Health Risk (MGIHR) was developed and completed by 341 women. Psychometric analysis support the use of an 11-item Consumerism and Modernity scale and 7-item Reproductive Control and Gender Role scale. The MGIHR is a valid and reliable instrument for understanding changing lifestyle and reproductive factors for breast cancer risk and may provide a more complete understanding of breast cancer development and needed interventions.

Mapping the global health employment market: an analysis of global health jobs.

Science.gov (United States)

Keralis, Jessica M; Riggin-Pathak, Brianne L; Majeski, Theresa; Pathak, Bogdan A; Foggia, Janine; Cullinen, Kathleen M; Rajagopal, Abbhirami; West, Heidi S

2018-02-27

The number of university global health training programs has grown in recent years. However, there is little research on the needs of the global health profession. We therefore set out to characterize the global health employment market by analyzing global health job vacancies. We collected data from advertised, paid positions posted to web-based job boards, email listservs, and global health organization websites from November 2015 to May 2016. Data on requirements for education, language proficiency, technical expertise, physical location, and experience level were analyzed for all vacancies. Descriptive statistics were calculated for the aforementioned job characteristics. Associations between technical specialty area and requirements for non-English language proficiency and overseas experience were calculated using Chi-square statistics. A qualitative thematic analysis was performed on a subset of vacancies. We analyzed the data from 1007 global health job vacancies from 127 employers. Among private and non-profit sector vacancies, 40% (n = 354) were for technical or subject matter experts, 20% (n = 177) for program directors, and 16% (n = 139) for managers, compared to 9.8% (n = 87) for entry-level and 13.6% (n = 120) for mid-level positions. The most common technical focus area was program or project management, followed by HIV/AIDS and quantitative analysis. Thematic analysis demonstrated a common emphasis on program operations, relations, design and planning, communication, and management. Our analysis shows a demand for candidates with several years of experience with global health programs, particularly program managers/directors and technical experts, with very few entry-level positions accessible to recent graduates of global health training programs. It is unlikely that global health training programs equip graduates to be competitive for the majority of positions that are currently available in this field.

Male reproductive health and environmental xenoestrogens

DEFF Research Database (Denmark)

Toppari, J.; Larsen, John Christian; Christiansen, Pia

1996-01-01

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...

Global health research needs global networking

NARCIS (Netherlands)

Ignaciuk, A.; Leemans, R.

2012-01-01

To meet the challenges arising from global environmental change on human health, co-developing common approaches and new alliances of science and society are necessary. The first steps towards defining cross-cutting, health-environment issues were developed by the Global Environmental Change and

Tracking official development assistance for reproductive health in conflict-affected countries.

OpenAIRE

Patel, P; Roberts, B; Guy, S; Lee-Jones, L; Conteh, L

2009-01-01

Editors' Summary Background Reproductive health concerns the bodily functions and systems that are involved in conceiving and bearing offspring. A reproductively healthy person is able to have a responsible, satisfying and safe sex life and to reproduce if and when they chose to do so. More specifically, to ensure their reproductive health, both men and women need access to safe and effective birth control methods, they need to know how to avoid sexually transmitted diseases (including HIV/AI...

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

Science.gov (United States)

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.

spatio-temporal analysis of reproductive health indicators in nigeria

African Journals Online (AJOL)

userpc

attempts to analyze few indicators that directly and indirectly influence the state of reproductive health in ... health in Nigeria. Secondary data sources from Nigeria's Demographic and Health Survey ..... women and deny them their fundamental.

The Legal Strength of International Health Instruments - What It Brings to Global Health Governance?

Science.gov (United States)

Nikogosian, Haik; Kickbusch, Ilona

2016-09-04

Public health instruments have been under constant development and renewal for decades. International legal instruments, with their binding character and strength, have a special place in this development. The start of the 21st century saw, in particular, the birth of the first World Health Organization (WHO)-era health treaties - the WHO Framework Convention on Tobacco Control (WHO FCTC) and its first Protocol. The authors analyze the potential impact of these instruments on global health governance and public health, beyond the traditional view of their impact on tobacco control. Overall, the very fact that globally binding treaties in modern-era health were feasible has accelerated the debate and expectations for an expanded role of international legal regimes in public health. The impact of treaties has also been notable in global health architecture as the novel instruments required novel institutions to govern their implementation. The legal power of the WHO FCTC has enabled rapid adoption of further instruments to promote its implementation, thus, enhancing the international instrumentarium for health, and it has also prompted stronger role for national legislation on health. Notably, the Convention has elevated several traditionally challenging public health features to the level of international legal obligations. It has also revealed how the legal power of the international health instrument can be utilized in safeguarding the interests of health in the face of competing agendas and legal disputes at both the domestic and international levels. Lastly, the legal power of health instruments is associated with their potential impact not only on health but also beyond; the recently adopted Protocol to Eliminate Illicit Trade in Tobacco Products may best exemplify this matter. The first treaty experiences of the 21st century may provide important lessons for the role of legal instruments in addressing the unfolding challenges in global health. © 2016 The

Title: Gender analysis of sexual and reproductive health information ...

African Journals Online (AJOL)

manda

women bear a greater burden of reproductive mortality and morbidity as they shoulder the physical ... Simonelli et al (2002), evaluating sexual and reproductive health education and services for ... Service providers and student leaders formed one group. Students ... Muhimbili is also a teaching hospital for MUHAS and the.

Accessing Sexual and Reproductive Health Information and ...

African Journals Online (AJOL)

Accessing Sexual and Reproductive Health Information and Services: A Mixed Methods Study of Young ... PROMOTING ACCESS TO AFRICAN RESEARCH ... and services in Soweto, South Africa using quantitative and qualitative methods.

extramarital affair as correlate of reproductive health and home

African Journals Online (AJOL)

Mugumbate

health and home instability among couples in Ibadan, Nigeria. Descriptive survey ... importance of reproductive health education and home stability to health and general ..... extramarital affair in Nepal due to economic factors such as foreign ...

Reproductive health in women with serious mental illnesses.

Science.gov (United States)

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.

Global health and foreign policy.

Science.gov (United States)

Feldbaum, Harley; Lee, Kelley; Michaud, Joshua

2010-01-01

Health has long been intertwined with the foreign policies of states. In recent years, however, global health issues have risen to the highest levels of international politics and have become accepted as legitimate issues in foreign policy. This elevated political priority is in many ways a welcome development for proponents of global health, and it has resulted in increased funding for and attention to select global health issues. However, there has been less examination of the tensions that characterize the relationship between global health and foreign policy and of the potential effects of linking global health efforts with the foreign-policy interests of states. In this paper, the authors review the relationship between global health and foreign policy by examining the roles of health across 4 major components of foreign policy: aid, trade, diplomacy, and national security. For each of these aspects of foreign policy, the authors review current and historical issues and discuss how foreign-policy interests have aided or impeded global health efforts. The increasing relevance of global health to foreign policy holds both opportunities and dangers for global efforts to improve health.

Global Health and Foreign Policy

Science.gov (United States)

Feldbaum, Harley; Lee, Kelley; Michaud, Joshua

2010-01-01

Health has long been intertwined with the foreign policies of states. In recent years, however, global health issues have risen to the highest levels of international politics and have become accepted as legitimate issues in foreign policy. This elevated political priority is in many ways a welcome development for proponents of global health, and it has resulted in increased funding for and attention to select global health issues. However, there has been less examination of the tensions that characterize the relationship between global health and foreign policy and of the potential effects of linking global health efforts with the foreign-policy interests of states. In this paper, the authors review the relationship between global health and foreign policy by examining the roles of health across 4 major components of foreign policy: aid, trade, diplomacy, and national security. For each of these aspects of foreign policy, the authors review current and historical issues and discuss how foreign-policy interests have aided or impeded global health efforts. The increasing relevance of global health to foreign policy holds both opportunities and dangers for global efforts to improve health. PMID:20423936

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

Science.gov (United States)

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…

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

Science.gov (United States)

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.

Male reproductive health and environmental xenoestrogens

DEFF Research Database (Denmark)

Toppari, J; Larsen, J C; Christiansen, Peter

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 cr...

Reproductive health and the environment: Counseling patients about risks.

Science.gov (United States)

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.

Addressing gender inequalities to improve the sexual and reproductive health and wellbeing of women living with HIV.

Science.gov (United States)

Amin, Avni

2015-01-01

Globally, women constitute 50% of all persons living with HIV. Gender inequalities are a key driver of women's vulnerabilities to HIV. This paper looks at how these structural factors shape specific behaviours and outcomes related to the sexual and reproductive health of women living with HIV. There are several pathways by which gender inequalities shape the sexual and reproductive health and wellbeing of women living with HIV. First, gender norms that privilege men's control over women and violence against women inhibit women's ability to practice safer sex, make reproductive decisions based on their own fertility preferences and disclose their HIV status. Second, women's lack of property and inheritance rights and limited access to formal employment makes them disproportionately vulnerable to food insecurity and its consequences. This includes compromising their adherence to antiretroviral therapy and increasing their vulnerability to transactional sex. Third, with respect to stigma and discrimination, women are more likely to be blamed for bringing HIV into the family, as they are often tested before men. In several settings, healthcare providers violate the reproductive rights of women living with HIV in relation to family planning and in denying them care. Lastly, a number of countries have laws that criminalize HIV transmission, which specifically impact women living with HIV who may be reluctant to disclose because of fears of violence and other negative consequences. Addressing gender inequalities is central to improving the sexual and reproductive health outcomes and more broadly the wellbeing of women living with HIV. Programmes that go beyond a narrow biomedical/clinical approach and address the social and structural context of women's lives can also maximize the benefits of HIV prevention, treatment, care and support.

Transforming global health with mobile technologies and social enterprises: global health and innovation conference.

Science.gov (United States)

Kayingo, Gerald

2012-09-01

More than 2,000 people convened for the ninth annual Global Health and Innovation Conference at Yale University on April 21-22, 2012. Participants discussed the latest innovations, ideas in development, lessons learned, opportunities and challenges in global health activities. Several themes emerged, including the important role of frontline workers, strengthening health systems, leveraging social media, and sustainable and impact-driven philanthropy. Overall, the major outcome of the conference was the increased awareness of the potential of mobile technologies and social enterprises in transforming global health. Experts warned that donations and technological advances alone will not transform global health unless there are strong functioning health infrastructures and improved workforce. It was noted that there is a critical need for an integrated systems approach to global health problems and a need for scaling up promising pilot projects. Lack of funding, accountability, and sustainability were identified as major challenges in global health.

[Women's health and reproductive rights. Meeting in Brasilia].

Science.gov (United States)

1991-01-01

The Latin American and Caribbean Seminar on Women's Health and Reproductive Rights was held in Brasilia on November 13-14, 1991. The seminar manifesto reproduced here cities the many ways in which women in the region are oppressed by poverty and social injustice, and points to Cuba as a country where health and reproductive rights are respected. Latin American has been oppressed for 500 years. Its population still experiences misery, poverty, and deprivation of human rights and an equitable quality of life. The poor, especially women and children, are being decimated by endemic disease, mass sterilization, sexual and racial discrimination, and expropriation of liberty and the freedom to make choices concerning their own countries and bodies. The situation has resulted from the neoliberal policies of the latin American governments with the exception of Cuba. The international policy has called for renunciation of national sovereignty and submission to imperialist policy. social programs have suffered particularly. Women in Latin American are not considered 1st class in all stages of their lives. The Seminar of Women's Health and Reproductive Rights signals the urgent need to improve the situation through measures to mobilize society in defence of health and reproductive rights. High indices of maternal mortality caused largely by illegal abortion, premature births and perinatal deaths, lack of prenatal care, malnutrition, generalized violence, prostitution of minors and adolescents, psychic disturbances from limitations and deformations in the exercise of sexuality, lack of choice of contraceptive methods, surgical sterilization at a young age, excess numbers of cesareans, high-technology medical interventions motivated by economic interest, lack of sex education, and shortcomings of preventive health policies and basic public services are among the problems affecting Latin American women. Cuba is hailed as a country where women can freely choose abortion, and where

Investigating Health Belief model component about sexual and reproductive health in college female students

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Akram Aslani

2016-05-01

Full Text Available Background and objective: One of the critical steps in providing social and family health by concentrating on women's health is expanding sexual and reproductive health and addressing it in various aspects of the national and international level. Therefore in this study the goal is analyzing the components of the health belief model about sexual and reproductive health of female students of University of Medical Sciences of Shahroud. Methods: The present study is a cross-sectional analysis which conducted by participation of 397 female students of University of Medical Sciences of Shahroud in 2014. The data collecting tool was a questionnaire that was consisted of demographic information, knowledge and structures of health belief model. The data was analyzed by SPSS software and t-test and chi-square test. Results: The results showed that students had high self-efficacy (17.7 ± 2 in reproductive health care but the rate of their perceived barriers (3.02± 1.37 that was reported was almost high. Also there was a direct relation between demographic variable of age and the knowledge of students. The average score of students' awareness of sexually transmitted disease that was obtained was 9.97 ± 2.62. There was no significant relationship between age, marital status and their study major with structures of health belief model about sexually transmitted diseases and AIDS and its preventive behaviors. Conclusion: The findings of this study show that the self-efficacy of students about preventive behaviors of unwanted pregnancy and sexually transmitted diseases and AIDS is high. In other hand the average of perceived barriers in students is relatively high. Considering the findings it is recommended that sexual and reproductive health programs should be applied in order to reduce the barriers and to further increase the ability of young people. Paper Type: Research Article.

Tracking Global Fund HIV/AIDS resources used for sexual and reproductive health service integration: case study from Ethiopia.

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Mookherji, Sangeeta; Ski, Samantha; Huntington, Dale

2015-05-27

The Global Fund to Fight AIDS, Tuberculosis & Malaria (GF) strives for high value for money, encouraging countries to integrate synergistic services and systems strengthening to maximize investments. The GF needs to show how, and how much, its grants support more than just HIV/AIDS, TB and malaria. Sexual and Reproductive Health (SRH) has been part of HIV/AIDS grants since 2007. Previous studies showed the GF PBF system does not allow resource tracking for SRH integration within HIV/AIDS grants. We present findings from a resource tracking case study using primary data collected at country level. Ethiopia was the study site. We reviewed data from four HIV/AIDS grants from January 2009-June 2011 and categorized SDAs and activities as directly, indirectly, or not related to SRH integration. Data included: GF PBF data; financial, performance, in-depth interview and facility observation data from Ethiopia. All HIV/AIDS grants in Ethiopia support SRH integration activities (12-100%). Using activities within SDAs, expenditures directly supporting SRH integration increased from 25% to 66% for the largest HIV/AIDS grant, and from 21% to 34% for the smaller PMTCT-focused grant. Using SDAs to categorize expenditures underestimated direct investments in SRH integration; activity-based categorization is more accurate. The important finding is that primary data collection could not resolve the limitations in using GF GPR data for resource tracking. The remedy is to require existing activity-based budgets and expenditure reports as part of PBF reporting requirements, and make them available in the grant portfolio database. The GF should do this quickly, as it is a serious shortfall in the GF guiding principle of transparency. Showing high value for money is important for maximizing impact and replenishments. The Global Fund should routinely track HIV/AIDs grant expenditures to disease control, service integration, and overall health systems strengthening. The current PBF system

Teachers' Perspectives on Sexual and Reproductive Health ...

African Journals Online (AJOL)

AJRH Managing Editor

In-School Adolescent Reproductive Health in Nigeria ... recognized, little is known on the kind of involvements desired by teachers and their perceptions of handling students' ... Majority was not willing or comfortable in personal counseling of.

Occupational reproductive health risks.

Science.gov (United States)

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.

Early Menarche as an Alternative Reproductive Tactic in Human Females: An Evolutionary Approach to Reproductive Health Issues

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Meghan T. Gillette

2012-12-01

Full Text Available The age at which a female reaches sexual maturity is critical in determining her future reproductive health and success. Thus, a worldwide decline in menarcheal age (timing of first menstrual period may have serious long-term consequences. Early menarcheal timing (first menstrual period before age 12 can have a negative effect on fecundity, as well as the quality and quantity of offspring, and may consequently influence population growth or decline. In this paper, we apply an evolutionary framework to modern human health, and assess both proximate and ultimate consequences of declining menarcheal age. Examination of human reproductive health within an evolutionary framework is innovative and essential, because it illuminates the ultimate consequences of a declining age of menarche and facilitates new ways of thinking about the long-term and intergenerational transmission of health and disease; thus, an evolutionary framework lends itself to innovative public health and policy programs. In this paper, we examine whether or not early menarche is an alternative reproductive tactic that modern human females employ in response to a stressful environment, and whether or not early menarche is ultimately beneficial.

The effectiveness of social marketing in global health: a systematic review.

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Firestone, Rebecca; Rowe, Cassandra J; Modi, Shilpa N; Sievers, Dana

2017-02-01

Social marketing is a commonly used strategy in global health. Social marketing programmes may sell subsidized products through commercial sector outlets, distribute appropriately priced products, deliver health services through social franchises and promote behaviours not dependent upon a product or service. We aimed to review evidence of the effectiveness of social marketing in low- and middle-income countries, focusing on major areas of investment in global health: HIV, reproductive health, child survival, malaria and tuberculosis. We searched PubMed, PsycInfo and ProQuest, using search terms linking social marketing and health outcomes for studies published from 1995 to 2013. Eligible studies used experimental or quasi-experimental designs to measure outcomes of behavioural factors, health behaviours and/or health outcomes in each health area. Studies were analysed by effect estimates and for application of social marketing benchmark criteria. After reviewing 18 974 records, 125 studies met inclusion criteria. Across health areas, 81 studies reported on changes in behavioural factors, 97 studies reported on changes in behaviour and 42 studies reported on health outcomes. The greatest number of studies focused on HIV outcomes (n = 45) and took place in sub-Saharan Africa (n = 67). Most studies used quasi-experimental designs and reported mixed results. Child survival had proportionately the greatest number of studies using experimental designs, reporting health outcomes, and reporting positive, statistically significant results. Most programmes used a range of methods to promote behaviour change. Programmes with positive, statistically significant findings were more likely to apply audience insights and cost-benefit analyses to motivate behaviour change. Key evidence gaps were found in voluntary medical male circumcision and childhood pneumonia. Social marketing can influence health behaviours and health outcomes in global health; however evaluations

Reorienting adolescent sexual and reproductive health research : Reflections from an international conference

NARCIS (Netherlands)

Michielsen, Kristien; De Meyer, Sara; Ivanova, Olena; Anderson, Ragnar; Decat, Peter; Herbiet, Céline; Kabiru, Caroline W.; Ketting, Evert; Lees, James; Moreau, Caroline; Tolman, Deborah L.; Vega, Bernardo; Verhetsel, Elizabeth; Chandra-Mouli, Venkatraman; Vanwesenbeeck, W.M.A.

2016-01-01

On December 4th 2014, the International Centre for Reproductive Health (ICRH) at Ghent University organized an international conference on adolescent sexual and reproductive health (ASRH) and well-being. This viewpoint highlights two key messages of the conference - 1) ASRH promotion is broadening

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

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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.

Science.gov (United States)

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.

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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.

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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

Teachers' Perspectives on Sexual and Reproductive Health ...

African Journals Online (AJOL)

AJRH Managing Editor

While school-based sexual and reproductive health interventions for in-school adolescents is widely recognized .... selection of the schools in Ile-Ife and Ilesa through .... abortion, which had led to deaths of some female ..... Indian journal of.

Adolescents perception of reproductive health care services in Sri Lanka

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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

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Agampodi Thilini C

2008-05-01

Full Text Available Abstract 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

Adolescents perception of reproductive health care services in Sri Lanka.

Science.gov (United States)

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

76 FR 70462 - Advisory Committee for Reproductive Health Drugs; Notice of Meeting

Science.gov (United States)

2011-11-14

...] Advisory Committee for Reproductive Health Drugs; Notice of Meeting AGENCY: Food and Drug Administration... Committee for Reproductive Health Drugs. General Function of the Committee: To provide advice and... be limited. If the number of registrants requesting to speak is greater than can be reasonably...

78 FR 734 - Advisory Committee for Reproductive Health Drugs; Notice of Meeting

Science.gov (United States)

2013-01-04

...] Advisory Committee for Reproductive Health Drugs; Notice of Meeting AGENCY: Food and Drug Administration... Committee for Reproductive Health Drugs. General Function of the Committee: To provide advice and... limited. If the number of registrants requesting to speak is greater than can be reasonably accommodated...

Defining global neuroendocrine gene expression patterns associated with reproductive seasonality in fish.

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Dapeng Zhang

Full Text Available BACKGROUND: Many vertebrates, including the goldfish, exhibit seasonal reproductive rhythms, which are a result of interactions between external environmental stimuli and internal endocrine systems in the hypothalamo-pituitary-gonadal axis. While it is long believed that differential expression of neuroendocrine genes contributes to establishing seasonal reproductive rhythms, no systems-level investigation has yet been conducted. METHODOLOGY/PRINCIPAL FINDINGS: In the present study, by analyzing multiple female goldfish brain microarray datasets, we have characterized global gene expression patterns for a seasonal cycle. A core set of genes (873 genes in the hypothalamus were identified to be differentially expressed between May, August and December, which correspond to physiologically distinct stages that are sexually mature (prespawning, sexual regression, and early gonadal redevelopment, respectively. Expression changes of these genes are also shared by another brain region, the telencephalon, as revealed by multivariate analysis. More importantly, by examining one dataset obtained from fish in October who were kept under long-daylength photoperiod (16 h typical of the springtime breeding season (May, we observed that the expression of identified genes appears regulated by photoperiod, a major factor controlling vertebrate reproductive cyclicity. Gene ontology analysis revealed that hormone genes and genes functionally involved in G-protein coupled receptor signaling pathway and transmission of nerve impulses are significantly enriched in an expression pattern, whose transition is located between prespawning and sexually regressed stages. The existence of seasonal expression patterns was verified for several genes including isotocin, ependymin II, GABA(A gamma2 receptor, calmodulin, and aromatase b by independent samplings of goldfish brains from six seasonal time points and real-time PCR assays. CONCLUSIONS/SIGNIFICANCE: Using both

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

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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.

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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.

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

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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.

Conscientious Objection and Reproductive Health Service Delivery ...

African Journals Online (AJOL)

HP

Lack of access to quality reproductive health services is the main contributor to the high maternal mortality and morbidity in ... such services to clients/patients on moral and/or religious grounds. While the ..... The internal morality of medicine:.

Medicalization of global health 1: has the global health agenda become too medicalized?

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Clark, Jocalyn

2014-01-01

Medicalization analyses have roots in sociology and have critical usefulness for understanding contemporary health issues including the 'post-2015 global health agenda'. Medicalization is more complex than just 'disease mongering'--it is a process and not only an outcome; has both positive and negative elements; can be partial rather than complete; and is often sought or challenged by patients or others in the health field. It is understood to be expanding rather than contracting, plays out at the level of interaction or of definitions and agenda-setting, and is said to be largely harmful and costly to individuals and societies. Medicalization of global health issues would overemphasise the role of health care to health; define and frame issues in relation to disease, treatment strategies, and individual behaviour; promote the role of medical professionals and models of care; find support in industry or other advocates of technologies and pharmaceuticals; and discount social contexts, causes, and solutions. In subsequent articles, three case studies are explored, which critically examine predominant issues on the global health agenda: global mental health, non-communicable disease, and universal health coverage. A medicalization lens helps uncover areas where the global health agenda and its framing of problems are shifted toward medical and technical solutions, neglecting necessary social, community, or political action.

Use of Reproductive Health Information among University Undergraduates in Ogun State, Nigeria

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Samuel Olu Adeyoyin

2017-09-01

Full Text Available Young adults bear a higher risk of reproductive health problems than adults. Cases of unwanted pregnancies and their attendant complications reportedly rank among the highest in Africa. This study therefore investigates reproductive health and use of health information among university undergraduates in Nigeria. Correlational research design was adopted using descriptive survey method. Questionnaire was designed and used as survey instrument. The study used 25% of 6,978 undergraduate students from government and private universities in Abeokuta, Ogun State between 16-24 years old from each of the 35 departments that made up 8 colleges in the two universities. A total number of 1,745 copies of questionnaire were administered to the respondents out of which 1,500 copies were filled completely and retrieved making the response rate to be 86.95%. The findings of this study show that friends, parents and relatives were the closest sources of health information the respondents have used for reproductive health purposes. Utilisation of health information through information resources was effective. The study also concludes that cultural value, level of education and unfriendly attitude of health officials were parts of the major problems confronting effective utilization of reproductive health information among young adults in Nigeria.

Impacts of globalization in health.

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Ioannou, Andriani; Mechili, Aggelos; Kolokathi, Aikaterini; Diomidous, Marianna

2013-01-01

Globalization is the process of international integration arising from the interchange of world views, products, ideas, and other aspects of culture. Globalization describes the interplay of macro-social forces across cultures. The purpose of this study is a systematic review of the bibliography on the impacts of globalization in health. The consequences of globalization on health present a twofold dimension, on the one hand affects the health of the population and on the other hand organization and functioning of health systems. As a result of globalization, there has been an undeniable economic development and technological progress to support the level of health around the world, improving the health status of certain populations with a beneficial increase in life expectancy. In many aspects globalization is good but there are many problems too.

Mental and Reproductive Health Correlates of Academic Performance among Debre Berhan University Female Students, Ethiopia: The Case of Premenstrual Dysphoric Disorder.

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Alemu, Sisay Mulugeta; Habtewold, Tesfa Dejenie; Haile, Yohannes Gebreegziabhere

2017-01-01

Globally 3 to 8% of reproductive age women are suffering from premenstrual dysphoric disorder (PMDD). Several mental and reproductive health-related factors cause low academic achievement during university education. However, limited data exist in Ethiopia. The aim of the study was to investigate mental and reproductive health correlates of academic performance. Institution based cross-sectional study was conducted with 667 Debre Berhan University female students from April to June 2015. Academic performance was the outcome variable. Mental and reproductive health characteristics were explanatory variables. Two-way analysis of variance (ANOVA) test of association was applied to examine group difference in academic performance. Among 529 students who participated, 49.3% reported mild premenstrual syndrome (PMS), 36.9% reported moderate/severe PMS, and 13.8% fulfilled PMDD diagnostic criteria. The ANOVA test of association revealed that there was no significant difference in academic performance between students with different level of PMS experience ( F -statistic = 0.08, p value = 0.93). Nevertheless, there was a significant difference in academic performance between students with different length of menses ( F -statistic = 5.15, p value = 0.006). There was no significant association between PMS experience and academic performance, but on the other hand, the length of menses significantly associated with academic performance.

Global Health Solidarity.

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West-Oram, Peter G N; Buyx, Alena

2017-07-01

For much of the 20th century, vulnerability to deprivations of health has often been defined by geographical and economic factors. Those in wealthy, usually 'Northern' and 'Western', parts of the world have benefited from infrastructures, and accidents of geography and climate, which insulate them from many serious threats to health. Conversely, poorer people are typically exposed to more threats to health, and have lesser access to the infrastructures needed to safeguard them against the worst consequences of such exposure. However, in recent years the increasingly globalized nature of the world's economy, society and culture, combined with anthropogenic climate change and the evolution of antibiotic resistance, has begun to shift the boundaries that previously defined the categories of person threatened by many exogenous threats to health. In doing so, these factors expose both new and forgotten similarities between persons, and highlight the need for global cooperative responses to the existential threats posed by climate change and the evolution of antimicrobial resistance. In this article, we argue that these emerging health threats, in demonstrating the similarities that exist between even distant persons, provides a catalyst for global solidarity, which justifies, and provides motivation for, the establishment of solidaristic, cooperative global health infrastructures.

Reproductive Health Aid : A Delicate Balancing Act

NARCIS (Netherlands)

van Dalen, H.P.; Micevska Scharf, M.

2011-01-01

In this contribution the authors show that development assistance targeting reproductive health overwhelmingly concentrates on HIV/AIDS at the expense of family planning elements. Data on financial contributions disbursed by governments and private foundations are used as collected by the Resource

Reproductive health problems and health seeking behavior of female sex workers in Sabon Gari Local Government Area, Zaria, Nigeria

Directory of Open Access Journals (Sweden)

L O Omokanye

2014-01-01

Full Text Available Background: The sexual and reproductive health needs of sex workers have been neglected both in research and public health interventions. Among the reasons for this are the condemnation, stigma and ambiguous legal status of sex work in Nigeria. This study was aimed at determining the reproductive health problems and health-seeking behavior of brothel-based female sex workers (FSW. Materials and Methods: This cross-sectional study was conducted among brothel-based FSW in Sabon-Gari Local Government in Zaria, Nigeria between 1 st January 2011 and 31 st June 2011. A total of 208 FSW were randomly selected and information was obtained with the use of the semi-structured questionnaire. Data entry was done with the help of structured codes in Microsoft Excel. Descriptive analysis was carried out using the statistical package (SSPS 16-University of Bristol. Results: Majority 90.7% of the respondents had experienced reproductive morbidity in the last 3 months. Frequently experienced symptoms were vaginal discharge (63.8%, acute lower abdominal pain (57.5%, menstrual irregularities (37% and genital ulcer (32.3%. Genital tear occurred in only 25 (9.8% respondents. Furthermore, 178 (63.6% had a termination of unwanted pregnancies. Most (32.3% sought care for their reproductive health problems from chemist shops; followed by the private hospitals in 23.6% of respondents. Others took self-medication for their ailments. Post-treatment success was the most frequently mentioned reason for the choice of place of treatment, followed by finance. Conclusion: The most commonly reported reproductive health problem among FSW was vaginal discharge and many of them have poor health seeking behavior. Health promotion and client sensitive health care services specifically targeting FSW should be developed, packaged and delivered to improve reproductive health of FSW. There should be concerted efforts by the government and other stakeholders in reproductive health to

Promoting Global Health

Directory of Open Access Journals (Sweden)

Margaret A. Winker, MD

2015-11-01

Full Text Available The Editor-in-Chief of the International Journal of MCH and AIDS (IJMA is a member of the World Association of Medical Editors (WAME. The Editorial Board of IJMA believes it is important that the statement on promoting global health and this accompanying editorial is brought to the attention of our readers. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

Health, equity, and reproductive risks in the workplace.

Science.gov (United States)

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.

Biological control of vaginosis to improve reproductive health

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P Mastromarino

2014-01-01

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

Effectiveness of the Sexual Health/Reproductive Health Education Given to Turkey Adolescents Who Use Alcohol or Substance.

Science.gov (United States)

Ataman, Hacer; Kömürcü, Nuran

The research was conducted experimentally to evaluate the effectiveness of the sexual health/reproductive health (SH/RH) education given to Turkish adolescents who use alcohol or illicit substances. The population was adolescents who use alcohol and substances and were inpatients at the Child and Adolescent Substance Addiction Research, Treatment and Education Center. The adolescents were grouped into the following three groups: Group 1 (control group), Group 2 (those who have received training once), and Group 3 (those who have received training twice). Data were collected between September 2011 and December 2012 using the forms Self-Introduction and Information on Sexual Health-Reproductive Health and Information on Sexual Health-Reproductive Health Education Modules. Upon studying the total SH/RH test scores of the groups individually, a statistically significant difference was observed in the scores of Groups 2 and 3 (p education in a repetitive manner for prevention of risky sexual behavior.

Where theory and practice of global health intersect: the developmental history of a Canadian global health initiative.

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Daibes, Ibrahim; Sridharan, Sanjeev

2014-01-01

This paper examines the scope of practice of global health, drawing on the practical experience of a global health initiative of the Government of Canada--the Teasdale-Corti Global Health Research Partnership Program. A number of challenges in the practical application of theoretical definitions and understandings of global health are addressed. These challenges are grouped under five areas that form essential characteristics of global health: equity and egalitarian North-South partnerships, interdisciplinary scope, focus on upstream determinants of health, global conceptualization, and global health as an area of both research and practice. Information in this paper is based on the results of an external evaluation of the program, which involved analysis of project proposals and technical reports, surveys with grantees and interviews with grantees and program designers, as well as case studies of three projects and a review of relevant literature. The philosophy and recent definitions of global health represent a significant and important departure from the international health paradigm. However, the practical applicability of this maturing area of research and practice still faces significant systemic and structural impediments that, if not acknowledged and addressed, will continue to undermine the development of global health as an effective means to addressing health inequities globally and to better understanding, and acting upon, upstream determinants of health toward health for all. While it strives to redress global inequities, global health continues to be a construct that is promoted, studied, and dictated mostly by Northern institutions and scholars. Until practical mechanisms are put in place for truly egalitarian partnerships between North and South for both the study and practice of global health, the emerging philosophy of global health cannot be effectively put into practice.

Reproductive health knowledge, beliefs and determinants of ...

African Journals Online (AJOL)

Conclusion: Though respondents were knowledgeable about benefits of family planning, there is the need for continuous education of women about reproductive health issues and integration of men's participation in family planning programme to increase utilization of family planning services in Ibadan, Nigeria.

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

Science.gov (United States)

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.

[Global health: a Latin American vision].

Science.gov (United States)

Franco-Giraldo, Álvaro

2016-02-01

This article presents a Latin American vision of global health from a counterhegemonic perspective, applicable to various countries of the world in similar circumstances. It begins by reviewing several concepts and trends in global health and outlining the differences between conventional public health, international health, and global health, but without seeing them as antagonistic, instead situating them in a model that is based on global health and also includes the other two disciplines. It is understood that global factors influenced earlier theories, schemes, and models of classic international health. The article emphasizes the importance of several aspects of world-geopolitics and economic globalization that impose constraints on world health; it also underscores the theory of social and environmental determinants of the health-disease spectrum, which have impacts beyond those of epidemiologic risk factors. The suggested approach is based on cosmopolitanism and holism: global philosophical and political currents that allow for a better interpretation of world phenomena and are more relevant because they give rise to lines of action. Structurally, the theoretical foundations of global health are presented in three analytical areas: global justice and equity, governance and the supranational protection of rights, and holism and a new global consciousness. The article concludes by underscoring the need to construct an approach to the existence and praxis of global public health that is based on the Latin American perspective, an approach that highlights grassroots social movements as an alternative way to secure a new order and global awareness of rights and to redefine the architecture of global health governance.

Examining the global health arena: strengths and weaknesses of a convention approach to global health challenges.

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Haffeld, Just Balstad; Siem, Harald; Røttingen, John-Arne

2010-01-01

The article comprises a conceptual framework to analyze the strengths and weaknesses of a global health convention. The analyses are inspired by Lawrence Gostin's suggested Framework Convention on Global Health. The analytical model takes a starting-point in events tentatively following a logic sequence: Input (global health funding), Processes (coordination, cooperation, accountability, allocation of aid), Output (definition of basic survival needs), Outcome (access to health services), and Impact (health for all). It then examines to what degree binding international regulations can create order in such a sequence of events. We conclude that a global health convention could be an appropriate instrument to deal with some of the problems of global health. We also show that some of the tasks preceding a convention approach might be to muster international support for supra-national health regulations, negotiate compromises between existing stakeholders in the global health arena, and to utilize WHO as a platform for further discussions on a global health convention. © 2010 American Society of Law, Medicine & Ethics, Inc.

Reproductive tract infections in northern Vietnam: health providers' diagnostic dilemmas

DEFF Research Database (Denmark)

Nguyen, My Hu'o'ng; Gammeltoft, Tine; Christoffersen, Sarah Vigh

2010-01-01

Research was conducted on reproductive tract infections among women obtaining induced abortions at Ph[image omitted]-[image omitted] hospital in Haiphong City, a major maternity hospital in northern Vietnam. The research aimed to explore how clinicians and lab-technicians diagnose reproductive...... tract infections and the difficulties they experience in establishing exact diagnoses. A combination of both quantitative and qualitative research methodologies was employed. The quantitative research involved 748 abortion-seeking women; the qualitative research was conducted with 10 doctors and 10 lab......-technicians providing reproductive health services. A marked tendency was observed among both clinicians and lab-technicians to overdiagnose reproductive tract infections and to prescribe antibiotics routinely. Social, cultural, and clinical factors associated with the tendency to overdiagnose reproductive tract...

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

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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.

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

Directory of Open Access Journals (Sweden)

Isabel Goicolea

2010-06-01

Full Text Available 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.

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

Science.gov (United States)

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

Will the struggle for health equity and social justice be best served by a Framework Convention on Global Health?

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Haynes, Leigh; Legge, David; London, Leslie; McCoy, David; Sanders, David; Schuftan, Claudio

2013-06-14

The idea of a Framework Convention for Global Health (FCGH), using the treaty-making powers of the World Health Organization (WHO), has been promoted as an opportunity to advance global health equity and the right to health. The idea has promise, but needs more thought regarding risks, obstacles, and strategies. The reform of global health governance must be based on a robust analysis of the political economy out of which the drivers of inequality and the denial of the right to health arise. Some of the published commentary has focused on using the proposed FCGH to institutionalize a paradigm change regarding international aid for health care, i.e., reconceptualizing such aid as obligatory, based on human solidarity rather than strategic considerations, based on global stability and national security. We warn against limiting the project to questions of inter-governmental financial transfers because of the risk of neglecting the underlying structural determinants of health injustice. Such neglect would help to legitimize an unjust and unsustainable global economic regime. We raise further questions about the strategic logic informing any campaign for a FCGH. The governments of the United States and Europe have put considerable effort into weakening WHO through tight donor controls, and it would require heavy pressure to persuade them to sign on to a FCGH. Generating such pressure would require strong popular mobilization around the local and diverse priorities of different communities across the globe, and recognition of a common need for effective regulation at the global level. We argue for a broad-based campaign from which the need for more effective global health regulation (and a FCGH) would emerge as a common theme arising from myriad more specific claims. This type of campaign would respond to local needs, and would also be understood within a global, political, and economic perspective. Copyright © 2013 Haynes, Legge, McCoy, Sanders, Schuftan. This is an

Community-based study of reproductive tract infections among women of the reproductive age group in the urban health training centre area in Hubli, Karnataka

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Sangeetha S Balamurugan

2012-01-01

Full Text Available Background: Reproductive tract infections (RTIs is a global health problem including both sexually transmitted infections (STIs and non-sexually transmitted infections (non-STIs of the reproductive tract. RTI/STI is an important concern, as it possess risk for human immunodeficiency virus transmission. Hence a community study was done in Hubli, in terms of active search of the cases based on the symptoms, clinical examination, and feasible laboratory tests along with providing treatment, counseling, and follow-up. Objectives: The objective was to know the prevalence of RTIs among the reproductive age group women and the socio-demographic factors influencing the occurrence of the disease. Materials and Methods: A cross-sectional study was done using a simple random sampling technique to select households. A pretested structured pro forma was used to collect data on RTIs from 656 women of 15-45 years, residing in the field practice area. This was followed by clinical examination and collection of samples for laboratory tests in Urban Health Training Centre, attached to Karnataka Institute of Medical Sciences, Hubli. Results: The prevalence of RTIs among the reproductive age group women was 40.4% based on their symptoms, with majority having abnormal vaginal discharge. The prevalence of RTIs based on clinical finding was 37.4% with majority having vaginitis. The laboratory test revealed a prevalence of 34.3% with majority having Candidiasis. The influence of socio-demographic factors like increased parity, poor socio-economic conditions, poor menstrual hygiene, illiteracy has its direct effect on occurrence of RTI in the community. Conclusion: This depicts that whereever possible, clinical and laboratory findings should support self-reported morbidity to know the exact prevalence of any disease in the community.

Integration of sexual and reproductive health in the medical curriculum in Pakistan

International Nuclear Information System (INIS)

Afsar, H.A.; Sohani, S.; Younas, M.; Mohammad, S.

2006-01-01

Objective: To assess the knowledge of medical practitioners regarding management of selected reproductive tract infections, diagnosis of sexual dysfunction and identification of sexual abuse and to assess the attitudes and practices of health care providers regarding sexual and reproductive rights in order to recommend areas that need to be incorporated in a sexual and reproductive health curriculum. Design: A cross-sectional survey. Place and Duration of Study: From March to August 2003 in the District Turbat of Balochistan, Pakistan. Subject and Methods: Selected indicators of knowledge, attitudes and practices regarding sexual and reproductive health of primary care physicians were assessed using a pre-tested questionnaire and formal informal interviews. Variables were identified from the literature and previous in-depth interviews, and then formulated into respective questions. A Lichert scale marked from 1 to 5 was used for categorizing responses into agreed, neutral and disagreed. Descriptive statistics were computed using SPSS version 10 for windows. Qualitative interviews were translated and transcribed and analyzed according to pre-judged and emerging themes. Results: Out of 45 physicians interviewed, nearly half scored less than 50% in the knowledge section. Attitudes and practices assessed suggested a tendency to be judgmental, gender/rights discriminatory and with little provision for enabling clients to make their own decisions, so essential for quality sexual health service provision. Conclusion: Keeping in view the importance of the sexual health issues and a lack of ability of health care providers to handle it effectively, deficient areas of sexual health must be integrated into the medical curriculum. Medical educators have the responsibility to train physicians and other health professionals in the core competencies to improve the sexual and reproductive health of their communities. (author)

Endocrine-disrupting chemicals and male reproductive health: a review

Directory of Open Access Journals (Sweden)

Damjan Balabanič

2018-03-01

Full Text Available Balanced functioning of the endocrine system is essential for preservation of human species by providing normal growth and development, reproduction, and normal functioning of all other organ systems. In the last decades, emerging area of interest is the impact of environmental exposures to human health. Important environmental pollutants are endocrine-disrupting che- micals (EDCs, which can have adverse e ects on the living organism due to their interference with the endocrine system. The group of known EDCs embraces ubiquitous synthetic substan- ces used as industrial lubricants and solvents, with their by-products, incomplete combustion remains, pharmaceuticals and personal care products, pesticides and plasticizers. Natural com- pounds such as genistein, a phytoestrogen, and heavy metals can also have endocrine e ects. Endocrine disruption is a serious public health problem. EDCs among other health problems ge- nerate reproductive disorders in males, such as decreases in sperm count and quality, increases in testicular germ cell numbers, prostate and breast cancers, cryptorchidism and hypospadias, impaired fertility, and infertility. This paper critically reviews the current knowledge of the impa- ct of EDCs on reproductive disorders in human males.

Reproductive health in young male adults with chronic diseases in childhood.

Science.gov (United States)

De Sanctis, Vincenzo; Soliman, Ashraf; Mohamed, Yassin

2013-01-01

The Centres for Disease Control and Prevention have defined a chronic diseases as an "illnesses that are prolonged, do not resolve spontaneously, and are rarely cured completely". Approximately 20% of all children have a chronic illness and 65% of them the illness is severe enough to interfere with daily activities. Failure of pubertal growth, delay or absence of sexual development, infertility and sexual dysfunction due to hypogonadism and defective spermatogenesis are well recognized disturbances among adolescents and young male adult patients with chronic diseases. The causes are multifactorial and can be due to disease itself, associated complications or drugs. Haemoglobinopathies, endocrine disorders, gastrointestinal and renal diseases are some examples that frequently cause some degree of disability. Infertility affects the future quality of life of these patients and is a predictor of stress in current and future relationships. Health care providers often neglect the reproductive health of chronically ill adolescents and young adults, although many studies indicate that they are sexually active and interested in knowing about their future fertility. This review article provides an overview of the literature concerning the impact of some chronic diseases in adolescents and young adults on reproductive health but will not address patients with cancer because it has been tackled adequately in the literature.MEDLINE database search of English-language medical journal articles published between 1975 and 2012 for papers related to reproductive health in adolescents and young adults with chronic diseases since childhood was done. Several Authors, recommend that all young adult patients with severe/prolonged chronic disease in childhood should be offered reproductive health care in a specialized center with appropriate expertise, involving a multidisciplinary team, including endocrinologists, andrologists, geneticists, psychologists, urologists and specialist

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

Science.gov (United States)

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

Global health: governance and policy development.

Science.gov (United States)

Kelley, Patrick W

2011-06-01

Global health policy is now being influenced by an ever-increasing number of nonstate and non-intergovernmental actors to include influential foundations, multinational corporations, multi-sectoral partnerships, and civil society organizations. This article reviews how globalization is a key driver for the ongoing evolution of global health governance. It describes the massive increases in bilateral and multilateral investments in global health and it highlights the current global and US architecture for performing global health programs. The article closes describing some of the challenges and prospects that characterize global health governance today. Copyright © 2011 Elsevier Inc. All rights reserved.

Reproductive intentions and use of reproductive health care among female survivors of childhood cancer.

Science.gov (United States)

van Dijk, M; van den Berg, M H; Overbeek, A; Lambalk, C B; van den Heuvel-Eibrink, M M; Tissing, W J; Kremer, L C; van der Pal, H J; Loonen, J J; Versluys, B; Bresters, D; Kaspers, G J L; van Leeuwen, F E; van Dulmen-den Broeder, E

2018-06-01

Do female childhood cancer survivors (CCSs) express a decreased desire to have children and do they use reproductive health care more often compared to women without a history of cancer? Overall, no difference was found in the desire to have children between CCSs and controls, whereas CCSs consult a fertility specialist more often, at a younger age, and sooner after their first attempt at conceiving. Female CCSs may face a shorter than anticipated reproductive window as a result of their cancer treatment. Little is known about their desire to have children and use of reproductive health care, especially in relation to their former cancer treatment. This study is part of the DCOG LATER-VEVO study, a nationwide retrospective cohort study on female fertility in Dutch CCSs. In total, 1749 CCSs and 1673 controls were invited for the study. Data collection took place between January 2008 and May 2014. Data on the desire to have children and use of reproductive health care were collected by questionnaire. The control group consisted of sisters from CCSs and females from the general population. In total, 1106 (63%) CCSs and 818 (49%) controls completed the questionnaire. Overall, no difference was found in the desire to have children between CCSs and controls (86% and 89%, respectively). However, survivors of a CNS tumour were less likely to desire children and CCSs without biological children at time of study were more likely to report that their desire to have children was unfulfilled because of medical reasons (9%), compared to controls (1%). In total, 12% of CCSs ever consulted a fertility specialist compared to 10% of controls (OR = 1.7, 95% CI: 1.3-2.4). Mean (SD) age at time of their first visit was 27.7 (4.4) years for CCSs and 29.9 (3.9) years for controls (P self-report and may therefore be subject to recall bias. Decisions about parenthood affect all CCSs. It's important to evaluate reproductive intentions and function timely after cancer treatment, so CCSs can

Attitude of Lithuanian residents to confidentiality of adolescent sexual and reproductive health care

DEFF Research Database (Denmark)

Jaruseviciene, Lina; Lazarus, Jeff; Zaborskis, Apolinaras

2011-01-01

To assess the attitudes of Lithuanian residents towards the protection of confidentiality in the sexual and reproductive health care of adolescents.......To assess the attitudes of Lithuanian residents towards the protection of confidentiality in the sexual and reproductive health care of adolescents....

Vitamin E as an Antioxidant in Female Reproductive Health

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Siti Syairah Mohd Mutalip

2018-01-01

Full Text Available Vitamin E was first discovered in 1922 as a substance necessary for reproduction. Following this discovery, vitamin E was extensively studied, and it has become widely known as a powerful lipid-soluble antioxidant. There has been increasing interest in the role of vitamin E as an antioxidant, as it has been discovered to lower body cholesterol levels and act as an anticancer agent. Numerous studies have reported that vitamin E exhibits anti-proliferative, anti-survival, pro-apoptotic, and anti-angiogenic effects in cancer, as well as anti-inflammatory activities. There are various reports on the benefits of vitamin E on health in general. However, despite it being initially discovered as a vitamin necessary for reproduction, to date, studies relating to its effects in this area are lacking. Hence, this paper was written with the intention of providing a review of the known roles of vitamin E as an antioxidant in female reproductive health.

Effects of global warming on fish reproductive endocrine axis, with special emphasis in pejerrey Odontesthes bonariensis.

Science.gov (United States)

Miranda, Leandro Andrés; Chalde, Tomás; Elisio, Mariano; Strüssmann, Carlos Augusto

2013-10-01

The ongoing of global warming trend has led to an increase in temperature of several water bodies. Reproduction in fish, compared with other physiological processes, only occurs in a bounded temperature range; therefore, small changes in water temperature could significantly affect this process. This review provides evidence that fish reproduction may be directly affected by further global warming and that abnormal high water temperature impairs the expression of important genes throughout the brain-pituitary-gonad axis. In all fishes studied, gonads seem to be the organ more readily damaged by heat treatments through the inhibition of the gene expression and subsequent synthesis of different gonadal steroidogenic enzymes. In view of the feedback role of sex steroids upon the synthesis and release of GnRH and GtHs in fish, it is possible that the inhibition observed at brain and pituitary levels in treated fish is consequence of the sharp decrease in plasma steroids levels. Results of in vitro studies on the inhibition of pejerrey gonad aromatase expression by high temperature corroborate that ovary functions are directly disrupted by high temperature independently of the brain-pituitary axis. For the reproductive responses obtained in laboratory fish studies, it is plausible to predict changes in the timing and magnitude of reproductive activity or even the total failure of spawning season may occur in warm years, reducing annual reproductive output and affecting future populations. Copyright © 2013 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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…

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.

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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.

Reproductive Health Knowledge And Practices Among Junior ...

African Journals Online (AJOL)

Methods: A cross sectional survey of the reproductive health knowledge and practices of 412 junior secondary school pupils from 12 schools in Enugu State, Nigeria was undertaken using a uniform set of structured self-administered questionnaire. Results: The results revealed that while the pupils demonstrated fair ...

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

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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.

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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.

Women's television watching and reproductive health behavior in Bangladesh

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Mizanur Rahman

2017-12-01

Full Text Available Bangladesh has made significant social, economic, and health progress in recent decades, yet many reproductive health indicators remain weak. Access to television (TV is increasing rapidly and provides a potential mechanism for influencing health behavior. We present a conceptual framework for the influence of different types of TV exposure on individual’s aspirations and health behavior through the mechanisms of observational learning and ideational change. We analyze data from two large national surveys conducted in 2010 and 2011 to examine the association between women’s TV watching and five reproductive health behaviors controlling for the effects of observed confounders. We find that TV watchers are significantly more likely to desire fewer children, are more likely to use contraceptives, and are less likely to have a birth in the two years before the survey. They are more likely to seek at least four antenatal care visits and to utilize a skilled birth attendant. Consequently, continued increase in the reach of TV and associated growth in TV viewing is potentially an important driver of health behaviors in the country.

Health promotion in globalization

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Álvaro Franco-Giraldo

2012-10-01

Full Text Available Objective: to unravel some theoretical and factual elements required to implement more effective health promotion strategies and practices in the field of health services whilst following the great challenges that globalization has imposed on the health systems, which are inevitably expressed in the local context (glocalization. Methodology: a narrative review taking into account the concepts of globalization and health promotion in relation to health determinants. The authors approach some courses of action and strategies for health promotion based on the social principles and universal values that guide health promotion, health service reorientation and primary healthcare, empowerment, social participation, and inter-sectoral and social mobilization. Discussion: the discussion focuses on the redirection of health promotion services in relation to the wave of health reforms that has spread throughout the world under the neoliberal rule. The author also discusses health promotion, its ineffectiveness, and the quest for renewal. Likewise, the author sets priorities for health promotion in relation to social determinants. Conclusion: the current global order, in terms of international relations, is not consistent with the ethical principles of health promotion. In this paper, the author advocates for the implementation of actions to change the social and physical life conditions of people based on changes in the use of power in society and the appropriate practice of politics in the context of globalization in order to achieve the effectiveness of the actions of health promotion.

Polycentrism in Global Health Governance Scholarship; Comment on “Four Challenges That Global Health Networks Face”

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Jale Tosun

2018-01-01

Full Text Available Drawing on an in-depth analysis of eight global health networks, a recent essay in this journal argued that global health networks face four challenges to their effectiveness: problem definition, positioning, coalition-building, and governance. While sharing the argument of the essay concerned, in this commentary, we argue that these analytical concepts can be used to explicate a concept that has implicitly been used in global health governance scholarship for quite a few years. While already prominent in the discussion of climate change governance, for instance, global health governance scholarship could make progress by looking at global health governance as being polycentric. Concisely, polycentric forms of governance mix scales, mechanisms, and actors. Drawing on the essay, we propose a polycentric approach to the study of global health governance that incorporates coalitionbuilding tactics, internal governance and global political priority as explanatory factors.

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

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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…

Ethical concerns for maternal surrogacy and reproductive tourism.

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Deonandan, Raywat; Green, Samantha; van Beinum, Amanda

2012-12-01

Reproductive medical tourism is by some accounts a multibillion dollar industry globally. The seeking by clients in high income nations of surrogate mothers in low income nations, particularly India, presents a set of largely unexamined ethical challenges. In this paper, eight such challenges are elucidated to spur discussion and eventual policy development towards protecting the rights and health of vulnerable women of the Global South.

A global public health imperative

African Journals Online (AJOL)

MESKE

Actions towards closing the health equity gap: A global public health imperative. Tewabech ... global health development. With only two ... of himself and of his family; including food, clothing .... impact on health equity and in the end issued the.

A cross sectional study on reproductive health disorders in dairy cattle in Sudan

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Amira Mohamed Elhassan

2015-06-01

Full Text Available A cross sectional survey was carried out in dairy farms in four States of Sudan to determine prevalence of reproductive health disorders that affect dairy cattle industries in the country. A total of 575 adult female cows in dairy farms located in Khartoum, Gezira, Sennar, and White Nile States were investigated using questionnaire survey and face-to-face interviews with the owners. The results indicated that 24.4% of the animals were affected with one or more reproductive health disorders. Abortion (57.1% represented the major health problem affecting calf yield, followed by infertility (34.3% and neonatal death (8.6%. Other health problems included stillbirth, vaginitis and retained placenta, anomalies, metritis and repeat breeder. Most of the abortion cases were detected during third trimester (76.25% followed by first (12.5% and second (11.25% trimesters. Finally, countrywide investigations of reproductive disorders and increasing awareness to the owners are recommended for designing successful control strategies of reproductive disorders in Sudan.

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

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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.

Writing for Justice: A qualitative Analysis of Ugandan Media Coverage of Women’s Reproductive Health.

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Anholt, Rosanne

2015-01-01

Introduction: Women in Uganda encounter considerable challenges to the realisation of their reproductive health rights. Mass media play a significant role in shaping a society’s understanding of their health and perception on health rights. This study explored how women’s reproductive health is

From conceptual pluralism to practical agreement on policy: global responsibility for global health.

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Ruger, Jennifer Prah; Hammonds, Rachel; Ooms, Gorik; Barry, Donna; Chapman, Audrey; Van Damme, Wim

2015-10-28

As the human cost of the global economic crisis becomes apparent the ongoing discussions surrounding the post-2015 global development framework continue at a frenzied pace. Given the scale and scope of increased globalization moving forward in a post-Millennium Development Goals era, to protect and realize health equity for all people, has never been more challenging or more important. The unprecedented nature of global interdependence underscores the importance of proposing policy solutions that advance realizing global responsibility for global health. This article argues for advancing global responsibility for global health through the creation of a Global Fund for Health. It suggests harnessing the power of the exceptional response to the combined epidemics of AIDS, TB and Malaria, embodied in the Global Fund to Fight AIDS, Tuberculosis and Malaria, to realize an expanded, reconceptualized Global Fund for Health. However this proposal creates both an analytical quandary embedded in conceptual pluralism and a practical dilemma for the scope and raison d'etre of a new Global Fund for Health. To address these issues we offer a logical framework for moving from conceptual pluralism in the theories supporting global responsibility for health to practical agreement on policy to realize this end. We examine how the innovations flowing from this exceptional response can be coupled with recent ideas and concepts, for example a global social protection floor, a Global Health Constitution or a Framework Convention for Global Health, that share the global responsibility logic that underpins a Global Fund for Health. The 2014 Lancet Commission on Global Governance for Health Report asks whether a single global health protection fund would be better for global health than the current patchwork of global and national social transfers. We concur with this suggestion and argue that there is much room for practical agreement on a Global Fund for Health that moves from the

Female genital mutilation: psychological and reproductive health ...

African Journals Online (AJOL)

The study examined the reproductive health and psychological effects of female genital mutilation, in one traditional area in the Upper East region (i.e. Kayoro Traditional Area) of Ghana. The results of the study revealed that, the practice of FGM actually affects the physical (deforming the female genitalia), psychological (the ...

Conservative litigation against sexual and reproductive health policies in Argentina.

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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.

Polycentrism in Global Health Governance Scholarship

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Tosun, Jale

2018-01-01

Drawing on an in-depth analysis of eight global health networks, a recent essay in this journal argued that global health networks face four challenges to their effectiveness: problem definition, positioning, coalition-building, and governance. While sharing the argument of the essay concerned, in this commentary, we argue that these analytical concepts can be used to explicate a concept that has implicitly been used in global health governance scholarship for quite a few years. While already prominent in the discussion of climate change governance, for instance, global health governance scholarship could make progress by looking at global health governance as being polycentric. Concisely, polycentric forms of governance mix scales, mechanisms, and actors. Drawing on the essay, we propose a polycentric approach to the study of global health governance that incorporates coalitionbuilding tactics, internal governance and global political priority as explanatory factors. PMID:29325406

Changes in male reproductive health and effects of endocrine disruptors in Scandinavian countries

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Toppari Jorma

2002-01-01

Full Text Available Male reproductive health has deteriorated in many ways during the last decades. The incidence of testicular cancer has rapidly increased in Europe and European-derived populations. Sperm concentrations have declined and sperm motility and morphology have worsened in many areas. Both adverse trends have been shown to be associated with year of birth. Older birth cohorts have better reproductive health than the younger generations. Incidences of cryptorchidism and hypospadias have also increased according to several studies. The reasons for secular trends are unknown, but the rapid pace of the change points to environmental causes. Endocrine disrupting chemicals have been hypothesized to influence male reproductive health.

Accessing Sexual and Reproductive Health Information and Services

African Journals Online (AJOL)

AJRH Managing Editor

... Women's Access to SRH. African Journal of Reproductive Health March 2015; 19 (1): 73 ... Mixed Methods Study of Young Women's Needs and Experiences in Soweto,. South Africa. 1,2* ...... 04-164-020) (pp. i–91). Washington, DC: The.

Towards the promotion of reproductive health of the young

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Stanković Biljana

2007-01-01

Full Text Available Premature sexual activity of the young, before reaching physical and psycho-social maturity, brings along the risk of jeopardizing their reproductive health, mostly because it can lead to sexually transmitted infections or pregnancy, which is mostly unwanted in adolescence. The starting assumption of the promotion of reproductive health of the young is understanding and acceptance of their sexuality and relevant needs in social environment in which they live. Primarily in the family, the media, healthcare institutions and school. During the period of childhood and youth, school possesses the unique possibility to enable a large number of young people to acquire knowledge and skills related to sexuality and reproductive health and shape their values, attitudes and beliefs. The complexity of the process of making the decision about becoming sexually active, as well as the space for action towards its postponement to older age, are also indicated by the results of the research conducted in Belgrade, on the sample of one hundred and eleven female adolescents aged fourteen to twenty, who became sexually active at the age sixteen and earlier. These are primarily those results which refer to the meaning of love and sex in their value system, motives, feelings and attitudes related to becoming sexually active.

Reproductive technologies as social innovations in the system of public health

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Raisa Viktorovna Nifantova

2014-09-01

Full Text Available The article is devoted to such important problem as Russians’ reproductive health worsening that defines health of posterity and viability of generations, and appreciably impacts on the birth rate. Statistics of contraception among women of reproductive age, statistics of induced abortions occurrence, statistics of primary, and secondary infertility are investigated. Data of Public Opinion Foundation on problems of child-free marriages and reproductive rights of citizens are given. Results of medical, scientific centers about additional reproductive technologies practice such as in vitro fertilization (EKO, surrogate motherhood, etc. are shown. The importance of state support of these technologies and liberalization of legal control of the realization of a desire to be parents as the most important tool of demographic policy is emphasized. The questions of raising the public importance of family planning, sex education, family and moral values among young formation, healthy lifestyle, responsible motherhood and paternity are explored in the article.

Reproductive Health Needs Among Substance Use Disorder Treatment Clients.

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Terplan, Mishka; Lawental, Maayan; Connah, Melanie Bryant; Martin, Caitlin Eileen

2016-01-01

Individuals with substance use disorders (SUDs) have unique reproductive health needs. The aim of this study was to evaluate these needs and assess the acceptability of family planning service delivery of SUD treatment clients. Reproductive health needs of drug treatment clients were assessed using a cross-sectional anonymous survey in 4 treatment sites in Baltimore City, MD. Surveys were distributed by staff. Contraceptives assessed included sterilization, intrauterine devices, implants, injections, pills, patches, rings, condoms, spermicide, withdrawal, and the rhythm method. Results are stratified by sex and between those using and not using highly effective contraceptive methods. A total of 115 women and 95 men completed the survey (80% younger than 50 years), with 39% of women and 54% of men reporting using condoms, but only 24% of women and 26% of men reporting consistent use. All other methods were used by less than 12% of the sample. Only 20% of sexually active women reported using a highly reliable form of contraception and only 53% were using any form of contraception at all. Contraceptive use correlated inversely with age, but did not correlate with having had sexually transmitted infection testing or other preventive health services. Although more than 90% of participants had access to health care services in the past 3 years, 25% of women and 33% of men reported difficulty accessing health care providers. The majority of respondents said they would likely use family planning services if available at their SUD treatment (83% of women and 58% of men). Men and women in SUD treatment have unmet reproductive health needs. As SUD treatment moves toward greater integration, the programmatic inclusion of family planning services should be considered.

A reproductive health survey of rural women in Hebei.

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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.

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

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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

Introduction to Global Health Promotion.

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Torres, Jennifer

2017-03-01

Global health education is becoming increasingly prominent in universities throughout the country especially in programs focused on health and behavioral sciences, law, economics, and political science. Introduction to Global Health Promotion is a book that can be used by both instructors and students in the field of global health. The book provides theories and models, human rights, and technology relevant to the field. In addition the book is designed to share best evidence for promoting health and reducing morbidity and mortality in a variety of areas. The book can be used by health educators, public health practitioners, professors, and students as a resource for research and practice in the field of health promotion and disease prevention.

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

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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 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 women from slum areas depended on the government facilities for reproductive health services. Our findings suggest that significant differences in reproductive health outcomes exist among women from slum and non-slum communities in India. Efforts to progress towards the health MDGs and other national or international health targets may not be achieved without a focus on the

The growing impact of globalization for health and public health practice.

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Labonté, Ronald; Mohindra, Katia; Schrecker, Ted

2011-01-01

In recent decades, public health policy and practice have been increasingly challenged by globalization, even as global financing for health has increased dramatically. This article discusses globalization and its health challenges from a vantage of political science, emphasizing increased global flows (of pathogens, information, trade, finance, and people) as driving, and driven by, global market integration. This integration requires a shift in public health thinking from a singular focus on international health (the higher disease burden in poor countries) to a more nuanced analysis of global health (in which health risks in both poor and rich countries are seen as having inherently global causes and consequences). Several globalization-related pathways to health exist, two key ones of which are described: globalized diseases and economic vulnerabilities. The article concludes with a call for national governments, especially those of wealthier nations, to take greater account of global health and its social determinants in all their foreign policies.

Applying human rights to improve access to reproductive health services.

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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.

Global constitutionalism, applied to global health governance: uncovering legitimacy deficits and suggesting remedies.

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Ooms, Gorik; Hammonds, Rachel

2016-12-03

Global constitutionalism is a way of looking at the world, at global rules and how they are made, as if there was a global constitution, empowering global institutions to act as a global government, setting rules which bind all states and people. This essay employs global constitutionalism to examine how and why global health governance, as currently structured, has struggled to advance the right to health, a fundamental human rights obligation enshrined in the International Covenant on Economic, Social and Cultural Rights. It first examines the core structure of the global health governance architecture, and its evolution since the Second World War. Second, it identifies the main constitutionalist principles that are relevant for a global constitutionalism assessment of the core structure of the global health governance architecture. Finally, it applies these constitutionalist principles to assess the core structure of the global health governance architecture. Leading global health institutions are structurally skewed to preserve high incomes countries' disproportionate influence on transnational rule-making authority, and tend to prioritise infectious disease control over the comprehensive realisation of the right to health. A Framework Convention on Global Health could create a classic division of powers in global health governance, with WHO as the law-making power in global health governance, a global fund for health as the executive power, and the International Court of Justice as the judiciary power.

Reducing stigma in reproductive health.

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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.

Global health education in Swedish medical schools.

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Ehn, S; Agardh, A; Holmer, H; Krantz, G; Hagander, L

2015-11-01

Global health education is increasingly acknowledged as an opportunity for medical schools to prepare future practitioners for the broad health challenges of our time. The purpose of this study was to describe the evolution of global health education in Swedish medical schools and to assess students' perceived needs for such education. Data on global health education were collected from all medical faculties in Sweden for the years 2000-2013. In addition, 76% (439/577) of all Swedish medical students in their final semester answered a structured questionnaire. Global health education is offered at four of Sweden's seven medical schools, and most medical students have had no global health education. Medical students in their final semester consider themselves to lack knowledge and skills in areas such as the global burden of disease (51%), social determinants of health (52%), culture and health (60%), climate and health (62%), health promotion and disease prevention (66%), strategies for equal access to health care (69%) and global health care systems (72%). A significant association was found between self-assessed competence and the amount of global health education received (pcurriculum. Most Swedish medical students have had no global health education as part of their medical school curriculum. Expanded education in global health is sought after by medical students and could strengthen the professional development of future medical doctors in a wide range of topics important for practitioners in the global world of the twenty-first century. © 2015 the Nordic Societies of Public Health.

The Core Competencies for Adolescent Sexual and Reproductive Health

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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…

Measuring reproductive tourism through an analysis of Indian ART clinic Websites

Directory of Open Access Journals (Sweden)

Deonandan R

2012-09-01

Full Text Available Raywat Deonandan, Mirhad Loncar, Prinon Rahman, Sabrina OmarInterdisciplinary School of Health Sciences, University of Ottawa, Ottawa, CanadaObjectives: India is fast becoming the most prominent player in the global industry of reproductive tourism, in which infertile people cross international borders to seek assisted reproduction technologies. This study was conducted to better understand the extent and manner in which Indian clinics seek foreign clients.Methods: A systematic search of official Indian assisted reproduction technologies clinic Websites was undertaken, and instances noted where foreign clients were overtly targeted, and where maternal surrogacy was overtly offered.Results: A total of 159 clinics with Web addresses were identified, though only 78 had functioning Websites. All were published in English, with the majority clustered in the states of Maharashtra (14 and Gujarat (9. Of the 78 functioning Websites, 53 (68% featured some mention of maternal surrogacy services, and 42 (54% made overt overtures to foreign clients. Qualitative appeals to foreigners included instructions for international adoption, visa application, and the legal parental disposition of the surrogate. All Maharashtran clinic Websites that mentioned surrogacy also overtly featured reproductive tourism. Preimplantation diagnosis services were not offered disproportionately by clinics mentioning reproductive tourism.Conclusions: Based upon clinic online profiles, reproductive tourism comprises a substantial fraction of India’s assisted reproduction technologies clinics’ business focus, clustering around its most tourist-friendly locales, and surrogacy may be a strong motivator for international clientele.Keywords: assisted reproduction, global health, social media, marketing, development, IVF, surrogacy, PGD

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

Science.gov (United States)

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.

Reproduction Symposium: developmental programming of reproductive and metabolic health.

Science.gov (United States)

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].

Science.gov (United States)

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.

Global Health Governance at a Crossroads.

Science.gov (United States)

Ng, Nora Y; Ruger, Jennifer Prah

2011-06-21

This review takes stock of the global health governance (GHG) literature. We address the transition from international health governance (IHG) to global health governance, identify major actors, and explain some challenges and successes in GHG. We analyze the framing of health as national security, human security, human rights, and global public good, and the implications of these various frames. We also establish and examine from the literature GHG's major themes and issues, which include: 1) persistent GHG problems; 2) different approaches to tackling health challenges (vertical, horizontal, and diagonal); 3) health's multisectoral connections; 4) neoliberalism and the global economy; 5) the framing of health (e.g. as a security issue, as a foreign policy issue, as a human rights issue, and as a global public good); 6) global health inequalities; 7) local and country ownership and capacity; 8) international law in GHG; and 9) research gaps in GHG. We find that decades-old challenges in GHG persist and GHG needs a new way forward. A framework called shared health governance offers promise.

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

Science.gov (United States)

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 college students and improve their sexual experience and health.

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

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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 education program improves knowledge among adolescent girls regarding reproductive health.

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

Science.gov (United States)

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.

The estimate reproductive health status of populations exposured in low doses in result of Chernobyl disaster

International Nuclear Information System (INIS)

Ljaginskaja, A.M.; Izhewskij, P.W.; Golovko, O.V.

1996-01-01

In general the results achieved show that in the population living on the territories contaminated with radionuclides the most distinct negative dynamic of reproductive health than in the control areas is observed dourly the post-accidental period. The highest intensively of the negative dynamic and for certain the lower (than in the control) absolute indices of the reproductive health are revealed in the population living on the territory with 137 Cs contamination from 5 Ci/km 2 to 15 Ci/km 2 Under the equal conditions of 137 Cs contamination of soil the most distinct decrease of indices of the reproductive health was revealed in the areas with the most original level of the reproductive health that witness about the important role of the original level of the reproductive health in forming the effects of the exposure of the population. In the structure of the chosen indices of the reproductive health the loading place according to the intensively of the negative dynamic takes the indices characterising UPO and the status of the newborns, that is the indices reflecting the somatic stochastic effects of radiation influence. (author)

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

Science.gov (United States)

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.

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

Science.gov (United States)

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/

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

Science.gov (United States)

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.

Science.gov (United States)

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.

Future-proofing global health: Governance of priorities.

Science.gov (United States)

Bennett, Belinda; Cohen, I Glenn; Davies, Sara E; Gostin, Lawrence O; Hill, Peter S; Mankad, Aditi; Phelan, Alexandra L

2018-05-01

The year 2015 was a significant anniversary for global health: 15 years since the adoption of the Millennium Development Goals and the creation of the Global Alliance for Vaccines and Immunization, followed two years later by the Global Fund to Fight AIDS, TB and Malaria. 2015 was also the 10-year anniversary of the adoption of the International Health Regulations (May 2005) and the formal entering into force of the Framework Convention on the Tobacco Control (February 2005). The anniversary of these frameworks and institutions illustrates the growth and contribution of 'global' health diplomacy. Each initiative has also revealed on-going issues with compliance, sustainable funding and equitable attention in global health governance. In this paper, we present four thematic challenges that will continue to challenge prioritisation within global health governance into the future unless addressed: framing and prioritising within global health governance; identifying stakeholders of the global health community; understanding the relationship between health and behaviour; and the role of governance and regulation in supporting global health.

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

Science.gov (United States)

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.

Humanity and Justice in Global Health: Problems with Venkatapuram's Justification of the Global Health Duty.

Science.gov (United States)

Kollar, Eszter; Laukötter, Sebastian; Buyx, Alena

2016-01-01

One of the most ambitious and sophisticated recent approaches to provide a theory of global health justice is Sridhar Venkatapuram's recent work. In this commentary, we first outline the core idea of Venkatapuram's approach to global health justice. We then argue that one of the most important elements of the account, Venkatapuram's basis of global health duties, is either too weak or assumed implicitly without a robust justification. The more explicit grounding of the duty to protect and promote health capabilities is based on Martha Nussbaum's version of the capability approach. We argue that this foundation gives rise to humanitarian duties rather than duties of justice proper. Venkatapuram's second argument from the social determinants of health thesis is instead a stronger candidate for grounding duties of justice. However, as a justificatory argument, it is only alluded to and has not yet been spelled out sufficiently. We offer plausible justificatory steps to fill this gap and draw some implications for global health action. We believe this both strengthens Venkatapuram's approach and serves to broaden the basis for future action in the area of global health. © 2016 John Wiley & Sons Ltd.

Framing health and foreign policy: lessons for global health diplomacy.

Science.gov (United States)

Labonté, Ronald; Gagnon, Michelle L

2010-08-22

Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation in health. In this paper we review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualized. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the 'high politics' of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional 'low politics' of foreign policy, are present in discourse but do

Framing health and foreign policy: lessons for global health diplomacy

Directory of Open Access Journals (Sweden)

Labonté Ronald

2010-08-01

Full Text Available Abstract Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation in health. In this paper we review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualized. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the 'high politics' of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional 'low politics' of foreign policy, are

Global Health in Radiation Oncology

DEFF Research Database (Denmark)

Rodin, Danielle; Yap, Mei Ling; Grover, Surbhi

2017-01-01

programs. However, formalized training and career promotion tracks in global health within radiation oncology have been slow to emerge, thereby limiting the sustained involvement of students and faculty, and restricting opportunities for leadership in this space. We examine here potential structures...... and benefits of formalized global health training in radiation oncology. We explore how defining specific competencies in this area can help trainees and practitioners integrate their activities in global health within their existing roles as clinicians, educators, or scientists. This would also help create...... and funding models might be used to further develop and expand radiation oncology services globally....

Human rights and reproductive health: political realities and pragmatic choices for married adolescent women living in urban slums, Bangladesh.

Science.gov (United States)

Rashid, Sabina Faiz

2011-12-16

In Bangladesh, particularly in urban slums, married adolescent women's human rights to life, health, and reproductive and sexual health remain adversely affected because of the structural inequalities and political economic, social and cultural conditions which shape how rights are understood, negotiated and lived. The focus of the research and methods was anthropological. An initial survey of 153 married adolescent women was carried out and from this group, 50 in-depth interviews were conducted with selected participants and, from the in-depth interviews, a further eight case studies of women and their families were selected for in-depth repeated interviews and case histories. This paper speaks of the unanticipated complexities when writing on reproductive rights for poor adolescent women living in the slums, where the discourses on 'universal human rights' are often removed from the reality of adolescent women's everyday lives. Married adolescent women and their families remain extremely vulnerable in the unpredictable, crime-prone and insecure urban slum landscape because of their age, gender and poverty. Adolescent women's understanding of their rights such as the decision to marry early, have children, terminate pregnancies and engage in risky sexual behaviour, are different from the widely accepted discourse on rights globally, which assumes a particular kind of individual thinking and discourse on rights and a certain autonomy women have over their bodies and their lives. This does not necessarily exist in urban slum populations. The lived experiences and decisions made pertaining to sexual and reproductive health and 'rights' exercised by married adolescent women, their families and slum communities, allow us to reflect on the disconnect between the international legal human rights frameworks as applied to sexual and reproductive health rights, and how these are played out on the ground. These notions are far more complex in environments where married

Global solidarity, migration and global health inequity.

Science.gov (United States)

Eckenwiler, Lisa; Straehle, Christine; Chung, Ryoa

2012-09-01

The grounds for global solidarity have been theorized and conceptualized in recent years, and many have argued that we need a global concept of solidarity. But the question remains: what can motivate efforts of the international community and nation-states? Our focus is the grounding of solidarity with respect to global inequities in health. We explore what considerations could motivate acts of global solidarity in the specific context of health migration, and sketch briefly what form this kind of solidarity could take. First, we argue that the only plausible conceptualization of persons highlights their interdependence. We draw upon a conception of persons as 'ecological subjects' and from there illustrate what such a conception implies with the example of nurses migrating from low and middle-income countries to more affluent ones. Next, we address potential critics who might counter any such understanding of current international politics with a reference to real-politik and the insights of realist international political theory. We argue that national governments--while not always or even often motivated by moral reasons alone--may nevertheless be motivated to acts of global solidarity by prudential arguments. Solidarity then need not be, as many argue, a function of charitable inclination, or emergent from an acknowledgment of injustice suffered, but may in fact serve national and transnational interests. We conclude on a positive note: global solidarity may be conceptualized to helpfully address global health inequity, to the extent that personal and transnational interdependence are enough to motivate national governments into action. © 2012 Blackwell Publishing Ltd.

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

Science.gov (United States)

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.

Science.gov (United States)

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.

Early smoking initiation, sexual behavior and reproductive health - a large population-based study of Nordic women

DEFF Research Database (Denmark)

Hansen, Bo Terning; Kjaer, Susanne Krüger; Plum, Christian Edinger Munk

2010-01-01

To investigate associations between early smoking initiation, risk-taking behavior and reproductive health.......To investigate associations between early smoking initiation, risk-taking behavior and reproductive health....

Comprehensive adolescent health programs that include sexual and reproductive health services: a systematic review.

Science.gov (United States)

Kågesten, Anna; Parekh, Jenita; Tunçalp, Ozge; Turke, Shani; Blum, Robert William

2014-12-01

We systematically reviewed peer-reviewed and gray literature on comprehensive adolescent health (CAH) programs (1998-2013), including sexual and reproductive health services. We screened 36 119 records and extracted articles using predefined criteria. We synthesized data into descriptive characteristics and assessed quality by evidence level. We extracted data on 46 programs, of which 19 were defined as comprehensive. Ten met all inclusion criteria. Most were US based; others were implemented in Egypt, Ethiopia, and Mexico. Three programs displayed rigorous evidence; 5 had strong and 2 had modest evidence. Those with rigorous or strong evidence directly or indirectly influenced adolescent sexual and reproductive health. The long-term impact of many CAH programs cannot be proven because of insufficient evaluations. Evaluation approaches that take into account the complex operating conditions of many programs are needed to better understand mechanisms behind program effects.

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

Science.gov (United States)

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.

Science.gov (United States)

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.

Globalisation and global health governance: implications for public health.

Science.gov (United States)

Kruk, Margaret E

2012-01-01

Globalisation is a defining economic and social trend of the past several decades. Globalisation affects health directly and indirectly and creates economic and health disparities within and across countries. The political response to address these disparities, exemplified by the Millennium Development Goals, has put pressure on the global community to redress massive inequities in health and other determinants of human capability across countries. This, in turn, has accelerated a transformation in the architecture of global health governance. The entrance of new actors, such as private foundations and multi-stakeholder initiatives, contributed to a doubling of funds for global health between 2000 and 2010. Today the governance of public health is in flux, with diminished leadership from multilateral institutions, such as the WHO, and poor coherence in policy and programming that undermines the potential for sustainable health gains. These trends pose new challenges and opportunities for global public health, which is centrally concerned with identifying and addressing threats to the health of vulnerable populations worldwide.

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

Science.gov (United States)

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.

Sexual and reproductive health issues facing Southeast Asian beer promoters: a qualitative pilot study.

Science.gov (United States)

Webber, Gail C; Spitzer, Denise L

2010-07-01

In Southeast Asia, hundreds of thousands of young rural women migrate from their villages to the larger cities in search of work. Many find employment with beer companies or in the clubs where beer is sold, promoting the sale of beer. Previous research suggests these young migrants are in a highly vulnerable position. This paper will describe the findings of an October 2009 meeting to develop a research agenda on the sexual and reproductive health of beer promoters and a subsequent pilot study of focus groups with beer promoters to review this agenda. Participants of the research meeting representing beer promoters, academics, non-governmental organizations (NGOs), government and the beer industry from Cambodia, Thailand, Laos, and Vietnam collaborated in the development of three key research themes. The themes were verified in focus group discussions with beer promoters organized by local research partners in all four countries. The focus group participants were asked what they felt were the key sexual and reproductive health issues facing them in a non-directive and unstructured manner, and then asked to comment more specifically on the research priorities developed at the meeting. The focus groups were recorded digitally, transcribed, and translated into English. The data were analyzed by coding for common themes and then developing matrices to compare themes between groups. The participants of the meeting identified three key research themes: occupational health (including harassment and violence, working conditions, and fair pay), gender and social norms (focusing on the impact of power relations between the genders on women's health), and reproductive health (knowledge and access to reproductive health care services). The participants in the focus groups in all four countries agreed that these were key priorities for them, though the emphasis on the most important issues varied between groups of women. Sexual harassment in the workplace and challenges in

Sexual and reproductive health issues facing Southeast Asian beer promoters: a qualitative pilot study

Directory of Open Access Journals (Sweden)

Spitzer Denise L

2010-07-01

Full Text Available Abstract Background In Southeast Asia, hundreds of thousands of young rural women migrate from their villages to the larger cities in search of work. Many find employment with beer companies or in the clubs where beer is sold, promoting the sale of beer. Previous research suggests these young migrants are in a highly vulnerable position. This paper will describe the findings of an October 2009 meeting to develop a research agenda on the sexual and reproductive health of beer promoters and a subsequent pilot study of focus groups with beer promoters to review this agenda. Methods Participants of the research meeting representing beer promoters, academics, non-governmental organizations (NGOs, government and the beer industry from Cambodia, Thailand, Laos, and Vietnam collaborated in the development of three key research themes. The themes were verified in focus group discussions with beer promoters organized by local research partners in all four countries. The focus group participants were asked what they felt were the key sexual and reproductive health issues facing them in a non-directive and unstructured manner, and then asked to comment more specifically on the research priorities developed at the meeting. The focus groups were recorded digitally, transcribed, and translated into English. The data were analyzed by coding for common themes and then developing matrices to compare themes between groups. Results The participants of the meeting identified three key research themes: occupational health (including harassment and violence, working conditions, and fair pay, gender and social norms (focusing on the impact of power relations between the genders on women's health, and reproductive health (knowledge and access to reproductive health care services. The participants in the focus groups in all four countries agreed that these were key priorities for them, though the emphasis on the most important issues varied between groups of women

Strategic Implications of Global Health

National Research Council Canada - National Science Library

Monaghan, Karen

2008-01-01

"Strategic Implications of Global Health" responds to a request from the Undersecretary of State for Democratization and Global Affairs for an intelligence assessment on the connections between health and U.S. national interests...

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

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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.

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

Science.gov (United States)

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 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.

WHO FCTC as a Pioneering and Learning Instrument Comment on "The Legal Strength of International Health Instruments - What It Brings to Global Health Governance?"

Science.gov (United States)

Puska, Pekka

2017-05-23

The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) is a unique global health instrument, since it is in the health field the only instrument that is international law. After the 10 years of its existence an Independent Expert Group assessed the impact of the FCTC using all available data and visiting a number of countries interviewing different stakeholders. It is quite clear that the Treaty has acted as a strong catalyst and framework for national actions and that remarkable progress in global tobacco control can be seen. At the same time FCTC has moved tobacco control in countries from a pure health issue to a legal responsibility of the whole government, and on the international level created stronger interagency collaboration. The assessment also showed the many challenges. The spread of tobacco use, as well as of other risk lifestyles, is related to globalization. FCTC is a pioneering example of global action to counteract the negative social consequences of globalization. A convention is not an easy instrument, but the FCTC has undoubtedly sparked thinking and development of other stronger public health instruments and of needed governance structures. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reproductive, maternal, newborn, and child health in Pakistan: challenges and opportunities.

Science.gov (United States)

Bhutta, Zulfiqar A; Hafeez, Assad; Rizvi, Arjumand; Ali, Nabeela; Khan, Amanullah; Ahmad, Faatehuddin; Bhutta, Shereen; Hazir, Tabish; Zaidi, Anita; Jafarey, Sadequa N

2013-06-22

Globally, Pakistan has the third highest burden of maternal, fetal, and child mortality. It has made slow progress in achieving the Millennium Development Goals (MDGs) 4 and 5 and in addressing common social determinants of health. The country also has huge challenges of political fragility, complex security issues, and natural disasters. We undertook an in-depth analysis of Pakistan's progress towards MDGs 4 and 5 and the principal determinants of health in relation to reproductive, maternal, newborn, and child health and nutrition. We reviewed progress in relation to new and existing public sector programmes and the challenges posed by devolution in Pakistan. Notwithstanding the urgent need to tackle social determinants such as girls' education, empowerment, and nutrition in Pakistan, we assessed the effect of systematically increasing coverage of various evidence-based interventions on populations at risk (by residence or poverty indices). We specifically focused on scaling up interventions using delivery platforms to reach poor and rural populations through community-based strategies. Our model indicates that with successful implementation of these strategies, 58% of an estimated 367,900 deaths (15,900 maternal, 169,000 newborn, 183,000 child deaths) and 49% of an estimated 180,000 stillbirths could be prevented in 2015. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

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.

Science.gov (United States)

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.

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

OpenAIRE

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

2016-01-01

Introduction: 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 h...

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

Science.gov (United States)

Larrañaga, Isabel; Martín, Unai; Bacigalupe, Amaia

2014-06-01

Sexual and reproductive health (SRH) is protected by the public authorities to ensure that people enjoy a free, satisfying, and safe sexual life. Despite the approval of the National Sexual and Reproductive Health Strategy in 2011, the progress achieved may be jeopardized by recent proposals for legislative changes affecting this area (abortion Law and 16/2012 Law) and by the impact of the current economic crisis. This article aims to describe the current situation of sexual and reproductive health in the Spanish population and to identify the potential impact of the economic crisis. To this end, we used the following information sources: the National Sexual Health Survey, the DAPHNE surveys, births and fetal deaths statistics from the Spanish National Institute of Statistics, the Registry of Voluntary Pregnancy Interruptions, reports from the National Epidemiology Center, and the National AIDS Registry. Sexual health and the availability of information are rated as good by the Spanish population. Among young people, schools and health services have become less important as information sources and the internet has become more important. Since the beginning of the crisis, contraceptive use and fertility have declined and maternity has been delayed. The economic crisis seems to have affected some indicators of sexual and reproductive health. However, the potential effects on other indicators should continue to be monitored because insufficient time may have passed for accurate determination of the full effect of the crisis. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

The macroeconomic environment and sexual and reproductive health: a review of trends over the last 30 years.

Science.gov (United States)

Fonn, Sharon; Sundari Ravindran, T K

2011-11-01

The social services provided in any country are determined by resource allocation. How money is spent, the way in which programmes are organised, and the services that are prioritised can have important implications for health, including the sexual and reproductive health of men and women. Choices in how resources are allocated are influenced by a number of factors. Covering the years from the late 1970s to the current time, this article reviews the contexts that have influenced the provision of sexual and reproductive health services and provides examples of instances where decisions about resource allocation are not evidence-based. The role of donors in determining how services are provided and their lack of accountability is discussed. We conclude that sexual and reproductive health and rights activists need to engage with and take into account the macroeconomic environment in their efforts to improve sexual and reproductive health outcomes. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Time to go global: a consultation on global health competencies for postgraduate doctors

Science.gov (United States)

Walpole, Sarah C.; Shortall, Clare; van Schalkwyk, May CI; Merriel, Abi; Ellis, Jayne; Obolensky, Lucy; Casanova Dias, Marisa; Watson, Jessica; Brown, Colin S.; Hall, Jennifer; Pettigrew, Luisa M.; Allen, Steve

2016-01-01

Background Globalisation is having profound impacts on health and healthcare. We solicited the views of a wide range of stakeholders in order to develop core global health competencies for postgraduate doctors. Methods Published literature and existing curricula informed writing of seven global health competencies for consultation. A modified policy Delphi involved an online survey and face-to-face and telephone interviews over three rounds. Results Over 250 stakeholders participated, including doctors, other health professionals, policymakers and members of the public from all continents of the world. Participants indicated that global health competence is essential for postgraduate doctors and other health professionals. Concerns were expressed about overburdening curricula and identifying what is ‘essential’ for whom. Conflicting perspectives emerged about the importance and relevance of different global health topics. Five core competencies were developed: (1) diversity, human rights and ethics; (2) environmental, social and economic determinants of health; (3) global epidemiology; (4) global health governance; and (5) health systems and health professionals. Conclusions Global health can bring important perspectives to postgraduate curricula, enhancing the ability of doctors to provide quality care. These global health competencies require tailoring to meet different trainees' needs and facilitate their incorporation into curricula. Healthcare and global health are ever-changing; therefore, the competencies will need to be regularly reviewed and updated. PMID:27241136

The impact of husbands' gender equity awareness on wives' reproductive health in rural areas of China.

Science.gov (United States)

Ying, Cui; Li, Yang; Hui, Han

2011-02-01

The aim of this study was to investigate the effect of husbands' gender equity awareness on wives' reproductive health in rural areas of China. A qualitative study of 1919 wives aged from 18 to 69 years and their husbands was conducted in rural China. Data were collected through 3838 structured interviews. We quantified "belief in gender equity" based on responses to 7 specific statements and graded the responses according to a system scoring the strength of the overall belief (a total score 19 or higher, strong; 15-18, moderate; and 14 or less, weak). Data were recorded by bi-input with EpiData 3.1 after being carefully checked. χ(2) tests and logistic regression were performed in this study. Only 20.0% of the husbands demonstrated strong convictions about gender equity. Husbands' gender equity awareness is related to wives' receiving any prenatal care, the number of prenatal visits to a healthcare provider, having a hospital delivery of a newborn, and having gynecological examination one time per year. Raising husbands' gender awareness on wives' reproductive health and reducing female illiteracy were very necessary. The whole community should participate actively in the progress of reproductive health promotion. China's Health System requires an integration of its various sectors, including family planning, maternal and child care in resource sharing, and service delivery. Obstetricians & gynecologists. After completing this CME activity, physicians should be better able to evaluate the impact of husbands' gender equity awareness on wives' reproductive health in rural areas of China; assess how raising husbands' gender awareness on wives' reproductive health and reducing female illiteracy will improve wives' reproductive health; and analyze how China's Health System can integrate its various sectors, including family planning, maternal, and childcare in resource sharing, and service delivery, to improve wives' reproductive health.

Zika and Reproductive Rights in Brazil: Challenge to the Right to Health.

Science.gov (United States)

Valente, Pablo K

2017-09-01

The Zika virus epidemic rapidly spread across Brazil and Latin America, gaining international attention because of the causal relationship between Zika and birth defects. The high number of cases in Brazil has been attributed to a failure of the state to contain the epidemic and protect the affected people, especially women. Therefore, the public health crisis created by Zika exposed a stark conflict between Brazil's constitutional right to health and the long-standing violation of reproductive rights in the country. Although health is considered to be a right of all in Brazil, women struggle with barriers to reproductive services and lack of access to safe and legal abortions. In response to the epidemic, women's rights advocates have filed a lawsuit with Brazil's supreme court that requires the decriminalization of abortion upon the diagnosis of Zika virus. However, the selective decriminalization of abortion may lead to negative social consequences and further stigmatization of people with disabilities. A solution to the reproductive health crisis in Brazil must reconcile women's right to choose and the rights of people with disabilities.

The Cairo conference and the assertion of sexual and reproductive rights a basis for sexual and reproductive health

OpenAIRE

Galdos Silva, Susana; Movimiento Manuela Ramos. Lima, Perú. Universidad Peruana Cayetano Heredia. Lima, Perú. Licenciada en educación, máster en salud pública, sexualidad y ciencias, MPH in Sexuality and Family Science.

2014-01-01

The article focuses on the International Conference on Population and Development held in El Cairo, Egypt, in 1994. The Conference addressed issues related to sexual and reproductive rights, actions to be adopted to improve the situation of young girls, the status of women, the situation of adolescents and gender equality as basic components to improve the sexual and reproductive health of the population. The concluding recommendations in this conference constitute the action program. This do...

Framing global health: the governance challenge.

Science.gov (United States)

McInnes, Colin; Kamradt-Scott, Adam; Lee, Kelley; Reubi, David; Roemer-Mahler, Anne; Rushton, Simon; Williams, Owain David; Woodling, Marie

2012-01-01

With the emergence of global health comes governance challenges which are equally global in nature. This article identifies some of the initial limitations in analyses of global health governance (GHG) before discussing the focus of this special supplement: the framing of global health issues and the manner in which this impacts upon GHG. Whilst not denying the importance of material factors (such as resources and institutional competencies), the article identifies how issues can be framed in different ways, thereby creating particular pathways of response which in turn affect the potential for and nature of GHG. It also identifies and discusses the key frames operating in global health: evidence-based medicine, human rights, security, economics and development.

Global surrogacy practices

OpenAIRE

Darnovsky, M.; Beeson, D.

2014-01-01

This report summarises discussions of participants in Thematic Area 5 (Global Surrogacy Practices) of the International Forum on Intercountry Adoption and Global Surrogacy held in August 2014. The Forum brought together advocates of women’s health, children’s rights and human rights; scholars from a range of disciplines; social workers; and legal and policy analysts with expertise in third-party reproduction and/or adoption. To the best of our knowledge, this was the first major convening of ...

Global surrogacy practices

OpenAIRE

Darnovsky, Marcy; Beeson, Diane; Cheney, Kristen

2014-01-01

textabstractThis report summarises discussions of participants in Thematic Area 5 (Global Surrogacy Practices) of the International Forum on Intercountry Adoption and Global Surrogacy held in August 2014. The Forum brought together advocates of women’s health, children’s rights and human rights; scholars from a range of disciplines; social workers; and legal and policy analysts with expertise in third-party reproduction and/or adoption. To the best of our knowledge, this was the first major c...

Who Carries the Burden of Reproductive Health and AIDS Programs? - Evidence from OECD Donor Countries

NARCIS (Netherlands)

H.P. van Dalen (Hendrik)

2006-01-01

textabstractThis paper tries to establish who carries the burden in supporting reproductive health and AIDS programs worldwide. The 1994 International Conference of Population and Development (ICPD) in Cairo established goals for the expansion of assistance in matters of reproductive health and

Non-communicable diseases and global health governance: enhancing global processes to improve health development.

Science.gov (United States)

Magnusson, Roger S

2007-05-22

This paper assesses progress in the development of a global framework for responding to non-communicable diseases, as reflected in the policies and initiatives of the World Health Organization (WHO), World Bank and the UN: the institutions most capable of shaping a coherent global policy. Responding to the global burden of chronic disease requires a strategic assessment of the global processes that are likely to be most effective in generating commitment to policy change at country level, and in influencing industry behaviour. WHO has adopted a legal process with tobacco (the WHO Framework Convention on Tobacco Control), but a non-legal, advocacy-based approach with diet and physical activity (the Global Strategy on Diet, Physical Activity and Health). The paper assesses the merits of the Millennium Development Goals (MDGs) and the FCTC as distinct global processes for advancing health development, before considering what lessons might be learned for enhancing the implementation of the Global Strategy on Diet. While global partnerships, economic incentives, and international legal instruments could each contribute to a more effective global response to chronic diseases, the paper makes a special case for the development of international legal standards in select areas of diet and nutrition, as a strategy for ensuring that the health of future generations does not become dependent on corporate charity and voluntary commitments. A broader frame of reference for lifestyle-related chronic diseases is needed: one that draws together WHO's work in tobacco, nutrition and physical activity, and that envisages selective use of international legal obligations, non-binding recommendations, advocacy and policy advice as tools of choice for promoting different elements of the strategy.

Non-communicable diseases and global health governance: enhancing global processes to improve health development

Directory of Open Access Journals (Sweden)

Magnusson Roger S

2007-05-01

Full Text Available Abstract This paper assesses progress in the development of a global framework for responding to non-communicable diseases, as reflected in the policies and initiatives of the World Health Organization (WHO, World Bank and the UN: the institutions most capable of shaping a coherent global policy. Responding to the global burden of chronic disease requires a strategic assessment of the global processes that are likely to be most effective in generating commitment to policy change at country level, and in influencing industry behaviour. WHO has adopted a legal process with tobacco (the WHO Framework Convention on Tobacco Control, but a non-legal, advocacy-based approach with diet and physical activity (the Global Strategy on Diet, Physical Activity and Health. The paper assesses the merits of the Millennium Development Goals (MDGs and the FCTC as distinct global processes for advancing health development, before considering what lessons might be learned for enhancing the implementation of the Global Strategy on Diet. While global partnerships, economic incentives, and international legal instruments could each contribute to a more effective global response to chronic diseases, the paper makes a special case for the development of international legal standards in select areas of diet and nutrition, as a strategy for ensuring that the health of future generations does not become dependent on corporate charity and voluntary commitments. A broader frame of reference for lifestyle-related chronic diseases is needed: one that draws together WHO's work in tobacco, nutrition and physical activity, and that envisages selective use of international legal obligations, non-binding recommendations, advocacy and policy advice as tools of choice for promoting different elements of the strategy.

Increasing women in leadership in global health.

Science.gov (United States)

Downs, Jennifer A; Reif, Lindsey K; Hokororo, Adolfine; Fitzgerald, Daniel W

2014-08-01

Globally, women experience a disproportionate burden of disease and death due to inequities in access to basic health care, nutrition, and education. In the face of this disparity, it is striking that leadership in the field of global health is highly skewed towards men and that global health organizations neglect the issue of gender equality in their own leadership. Randomized trials demonstrate that women in leadership positions in governmental organizations implement different policies than men and that these policies are more supportive of women and children. Other studies show that proactive interventions to increase the proportion of women in leadership positions within businesses or government can be successful. Therefore, the authors assert that increasing female leadership in global health is both feasible and a fundamental step towards addressing the problem of women's health. In this Perspective, the authors contrast the high proportion of young female trainees who are interested in academic global health early in their careers with the low numbers of women successfully rising to global health leadership roles. The authors subsequently explore reasons for female attrition from the field of global health and offer practical strategies for closing the gender gap in global health leadership. The authors propose solutions aimed to promote female leaders from both resource-wealthy and resource-poor countries, including leadership training grants, mentorship from female leaders in global professions, strengthening health education in resource-poor countries, research-enabling grants, and altering institutional policies to support women choosing a global health career path.