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: ...
Wayal, Sonali; Cowan, Frances; Warner, Pamela; Copas, Andrew; Mabey, David; Shahmanesh, Maryam
In India, female sex workers (FSWs), suffer from high HIV prevalence and abortions. Contraceptive use among general population women is well understood. However, FSWs contraceptives practices and reproductive health needs are under-researched. We investigated contraceptive practices among HIV-positive and negative FSWs in Goa, India and explored its association with socio-demographic and sex work related factors. Cross-sectional study using respondent driven sampling recruited 326 FSWs. They completed an interviewer-administered questionnaire and were screened for STI/HIV. Multivariable logistic regression was used to explore factors associated with sterilisation relative to no contraception. HIV prevalence was high (26%). Of the 59 FSWs planning pregnancy, 33% were HIV-positive and 5-7% had Gonorrhoea, Chlamydia and Trichomonas. 25% and 65% of FSWs screened-positive for Syphilis and Herpes simplex virus type 2 antibodies respectively. Among the 260 FSWs analysed for contraceptive use, 39% did not use contraceptives, and 26% had experienced abortion. Half the FSWs had undergone sterilisation, and only 5% used condoms for contraception. Among HIV-positive FSWs, 45% did not use contraceptives. Sterilisation was independently associated with older age, illiteracy, having an intimate non-paying male partner, having children and financial autonomy. Exposure to National AIDS Control Organisation's HIV-prevention interventions was reported by 34% FSWs and was not significantly associated with contraceptive use (adjusted odds ratio 1.4, 95% CI 0.7 to 2.9). HIV-prevention interventions should promote contraception, especially among young and HIV-positive FSWs. Integrating HIV treatment and care services with HIV-prevention interventions is vital to avert HIV-positive births.
Oza, Karishma K; Silverman, Jay G; Bojorquez, Ietza; Strathdee, Steffanie A; Goldenberg, Shira M
To explore experiences during childhood and adolescence that influenced reproductive and sexual health among women who had entered the sex industry in adolescence. A qualitative study was conducted using information provided by 25 female sex workers (FSWs) from Tijuana, Mexico, who reported entering the sex industry when younger than 18 years. In-depth, semi-structured interviews were conducted with all participants between January 31, 2011, and July 8, 2011. Four interrelated themes that shaped health experiences-early sexual abuse, early illicit drug use, ongoing violence, and limited access to reproductive and sexual health care-were identified. Participants reporting these experiences were at risk of unintended teenaged pregnancy, spontaneous abortion or stillbirth, and untreated sexually transmitted infections. Programs and policies that address social, structural, and individual vulnerabilities during adolescence and adulthood are required to promote reproductive and sexual health among FSWs in Tijuana, Mexico. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Dantas, T A; Cancian, G; Neodini, D N R; Mano, D R S; Capucho, C; Predes, F S; Pulz, R Barbieri; Pigoso, A A; Dolder, H; Severi-Aguiar, G D C
Ametryn is an herbicide used to control broadleaf and grass weeds and its acute and chronic toxicity is expected to be low. Since toxicological data on ametryn is scarce, the aim of this study was to evaluate rat reproductive toxicity. Thirty-six adult male Wistar rats (90 days) were divided into three groups: Co (control) and T1 and T2 exposed to 15 and 30 mg/kg/day of ametryn, respectively, for 56 days. Testicular analysis demonstrated that ametryn decreased sperm number per testis, daily sperm production, and Leydig cell number in both treated groups, although little perceptible morphological change has been observed in seminiferous tubule structure. Lipid peroxidation was higher in group T2, catalase activity decreased in T1 group, superoxide dismutase activity diminished, and a smaller number of sulphydryl groups of total proteins were verified in both exposed groups, suggesting oxidative stress. These results showed negative ametryn influence on the testes and can compromise animal reproductive performance and survival.
Stephenson, Rob; Tsui, Amy Ong; Sulzbach, Sara; Bardsley, Phil; Bekele, Getachew; Giday, Tilahun; Ahmed, Rehana; Gopalkrishnan, Gopi; Feyesitan, Bamikale
Networks of franchised health establishments, providing a standardized set of services, are being implemented in developing countries. This article examines associations between franchise membership and family planning and reproductive health outcomes for both the member provider and the client. Regression models are fitted examining associations between franchise membership and family planning and reproductive health outcomes at the service provider and client levels in three settings. Franchising has a positive association with both general and family planning client volumes, and the number of family planning brands available. Similar associations with franchise membership are not found for reproductive health service outcomes. In some settings, client satisfaction is higher at franchised than other types of health establishments, although the association between franchise membership and client outcomes varies across the settings. Franchise membership has apparent benefits for both the provider and the client, providing an opportunity to expand access to reproductive health services, although greater attention is needed to shift the focus from family planning to a broader reproductive health context.
Stephenson, Rob; Tsui, Amy Ong; Sulzbach, Sara; Bardsley, Phil; Bekele, Getachew; Giday, Tilahun; Ahmed, Rehana; Gopalkrishnan, Gopi; Feyesitan, Bamikale
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
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 ...
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 ...
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
Filkins, K; Kerr, M J
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.
Pillai, Vijayan Kumara; Gupta, Rashmi
Background: Research on reproductive health in developing countries focuses mostly on the role of economic development on various components of reproductive health. Cross-sectional and empirical research studies in particular on the effects of non-economic factors such as reproductive rights remain few and far between. Objective: This study investigates the influence of two components of an empowerment strategy, gender equality, and reproductive rights on women’s reproductive health in develo...
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.
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.
Vijayan K. Pillai
Full Text Available Research on reproductive health in developing countries focuses mostly on the role of economic development on various components of reproductive health. Cross-sectional and empirical research studies in particular on the effects of non-economic factors such as reproductive rights remain few and far between.This study investigates the influence of two components of an empowerment strategy, gender equality, and reproductive rights on women's reproductive health in developing countries. The empowerment strategy for improving reproductive health is theoretically situated on a number of background factors such as economic and social development.Cross-national socioeconomic and demographic data from a number of international organizations on 142 developing countries are used to test a model of reproductive rights and reproductive health.The findings suggest that both economic and democratic development have significant positive effects on levels of gender equality. The level of social development plays a prominent role in promoting reproductive rights. It is found that reproductive rights channel the influences of social structural factors and gender equality on reproductive health.
Pillai, Vijayan K; Gupta, Rashmi
Research on reproductive health in developing countries focuses mostly on the role of economic development on various components of reproductive health. Cross-sectional and empirical research studies in particular on the effects of non-economic factors such as reproductive rights remain few and far between. This study investigates the influence of two components of an empowerment strategy, gender equality, and reproductive rights on women's reproductive health in developing countries. The empowerment strategy for improving reproductive health is theoretically situated on a number of background factors such as economic and social development. Cross-national socioeconomic and demographic data from a number of international organizations on 142 developing countries are used to test a model of reproductive rights and reproductive health. The findings suggest that both economic and democratic development have significant positive effects on levels of gender equality. The level of social development plays a prominent role in promoting reproductive rights. It is found that reproductive rights channel the influences of social structural factors and gender equality on reproductive health.
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 ...
Shakhatreh, Farouk M.
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)
Beginning in the mid-1800s, the American Medical Association, antiobscenity crusaders, and even women's groups supported criminalization of abortion. By 1900, it was illegal nationwide. In the late 1960s, women, physicians, and states began questioning abortion laws, since many women had unsafe, often fatal, illegal abortions. By 1973, 4 states had legalized abortion and 15 other states had liberalized abortion laws. A mid-1960 study showed that private patients comprised about 95% of all elective abortions. Poor clinic patients did not have the power to convince 3 physicians to support their request for an abortion. IN 1965, the Supreme Court agreed that a Connecticut Planned Parenthood Affiliate had the right to distribute contraceptives. The 1973 Roe v. Wade Court decision advanced this decision, by confirming a woman's right to abortion during the first 2 semesters of pregnancy. In 1976, the US Congress passed the Hyde amendment forbidding federal funding (e.g., Medicaid) for abortions except to save a mother. 2 1980 Supreme Court decisions supported the Hyde amendment. The Hyde amendment and these court decisions showed discrimination against poor women. Since then there have been other decisions that have whittled away at Roe v. Wade. Contraceptive failure is responsible for about 50% of the 1.6 million abortions/year. About 60% of women having an abortion are under 25 years old. Thus, criminalization of abortion would adversely affect many women as well as society. Many prochoice physicians had cared for women who suffered from botched abortions. Physicians under 45 years old tend to not know how to perform a 2nd trimester abortion because most obstetrician/gynecology residency training programs do not require them to learn it, and they do not want to do them. 2nd trimester abortion should be a required part of residency training. Physicians as preservers of women's health should be advocating safe abortion and not adopt the legal vs. illegal abortion
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...
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.
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 ...
Cook, Rebecca J; Dickens, Bernard M
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.
Laskar, Ananya Ray
With changing demographic profile India has more older women than men as life expectancy for women is 67.57 as against 65.46 for men. Gender differences in the aging process reflect biological, economic, and social differences. Both social and health needs of the older women are unique and distinctive as they are vulnerable. The social problems revolve around widowhood, dependency, illiteracy and lack of awareness about the policies and programmes from which they can benefit. Among the medical problems, vision (cataract) and degenerative joint disease top the list, followed by neurological problems. Lifestyle diseases form another single-most important group of health problems in the elderly women. The risk of cardiovascular disease doubles with the outcome being poorer than men. The most common causes of death among women above the age of 60 years are stroke, ischemic heart disease and COPD. Hypertensive heart disease and lower respiratory tract infections contribute to mortality in these women. Common malignancies viz. Cervical, breast and uterus in women are specific to them and account for a sizeable morbidity and mortality. In a study done at Lady Hardinge medical college in Delhi, Hypertension (39.6%) and obesity (12-46.8%) were very common in postmenopausal women. Half or more women had high salt and fat intake, low fruit and vegetable intake and stress. There is a need to recognize the special health needs of the women beyond the reproductive age, to be met through strengthening and reorienting the public health services at all levels starting from primary health care to secondary till tertiary care level with adequate referral linkages. All policies and programs need to have a gender perspective. At present there is lack of sensitization and appropriate training of the health personnel in dealing with the needs of elderly. Women too need to be aware to adopt healthy lifestyle and seek timely care.
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 ...
Vested, Anne; Giwercman, Aleksander; Bonde, Jens Peter
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...
Behrman, Julia Andrea; Weitzman, Abigail
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.
Tilahun, Mesfin; Mengistie, Bezatu; Egata, Gudina; Reda, Ayalu A
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
Women in Africa are facing discrimination and challenges in relation to HIV/AIDS, particularly regarding their sexual and reproductive health care. This includes a lack of information regarding HIV and pregnancy, difficulties with contraceptive use, negative attitudes towards childbearing, and problems in accessing safe legal ...
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.
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.
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:.
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.
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.
Jensen, Tina Kold; Swan, Shanna; Jørgensen, Niels
.1-32.2) higher free testosterone than men with a weekly intake between 1 and 10 units. Alcohol intake was not significantly associated with serum inhibin B, FSH or LH levels in either group of men. The study is the largest of its kind and has sufficient power to detect changes in semen quality and reproductive......STUDY QUESTION: Is there an association between alcohol intake and semen quality and serum reproductive hormones among healthy men from the USA and Europe? SUMMARY ANSWER: Moderate alcohol intake is not adversely associated with semen quality in healthy men, whereas it was associated with higher...... serum testosterone levels. WHAT IS KNOWN ALREADY: High alcohol intake has been associated with a wide range of diseases. However, few studies have examined the correlation between alcohol and reproductive function and most have been conducted in selected populations of infertile men or have a small...
Prescott, Alexandra S.; Luippold-Roge, Genevieve P.; Gurman, Tilly A.
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…
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 ...
Pal, P; Joshi, V
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.
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.
V K Srivastava
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.
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
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 ...
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 ...
Toppari, J; Larsen, J C; Christiansen, Peter
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...
Toppari, J; Larsen, J C; Christiansen, Peter
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...
Garanina I. G.
Full Text Available The author considers the established stereotypes which are summarized prejudices identifying the membership of certain people in a certain group. The article reveals that women are victims of stereotyping them as housekeepers and mothers in the negative sense, which exclude them from performing other roles and functions. There are examples from the foreign legislation where they dispel the stereotype of a woman as a reproductive instrument and uphold the woman‘s right to equal dignity with men in their reproductive choice
Adinma, Echendu D; Adinma, Brian-D J I
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.
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.
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.
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 ...
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.
This research project will contribute to evidence from four country case studies in Syria, South Sudan, Mali, and Colombia or the Democratic Republic of Congo as part of a global project to inform developing operational guidance on interventions related to reproductive, maternal, newborn, child, and adolescent health ...
Toppari, J; Larsen, J C; Christiansen, Peter
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...
Toppari, J.; Larsen, John Christian; Christiansen, Pia
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...
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 ...
van Dalen, H.P.; Micevska Scharf, M.
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
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 ...
Vitko, Michelle; O'Conor, Rachel; Bailey, Stacy Cooper
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
Look, P. F. A. van; Heggenhougen, Kris; Quah, Stella R
.... 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...
N Yamani; M Shakour; S Ehsanpour
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...
Ozcan, Neslihan Keser; Boyacıoğlu, Nur E; Enginkaya, Semra; Dinç, Hüsniye; Bilgin, Hülya
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.
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.
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...
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.
Padmanabhan, V; Veiga-Lopez, A
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
DeUgarte, Daniel A; DeUgarte, Catherine M; Sahakian, Vicken
In a retrospective cohort review of third-party reproduction, we observed that surrogate body mass index (BMI) negatively impacts implantation rates in oocyte-donor in vitro fertilization cycles. A BMI > or =35 kg/m(2) cutoff is associated with a statistically significant decrease in pregnancy rates but not miscarriage rates. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
This article opens by tabulating selected family planning (FP) indicators from the 24 poorest countries (those with a gross national product (GNP) of up to $300 per capita). Consideration of what is poverty and who are the poor concludes that poverty is hard to define but that is it a combination of low income, low life expectancy, illiteracy, and low educational levels; that is, the result of a denial of choices and opportunities. The poorest countries by this criteria differ somewhat from the poorest chosen according to GNP, but most are located in sub-Saharan Africa. The use of national data is complicated by the fact that huge differences exist between rich and poor within countries. The poorest countries have the lowest use of FP, the most restrictive abortion laws, high incidences of mortality associated with unsafe abortion, and high maternal mortality rates. International population and FP assistance is embarrassingly low and unfairly allocated. International assistance must be increased to break the cycle of poverty and improve reproductive health. The International Planned Parenthood Federation (IPPF) believes that improvement of reproductive health for the impoverished is a basic condition for human development and reduction of global inequity. In its policy statement on this topic, the IPPF recommends that local FP associations 1) constantly reevaluate how to maximize their impact on the most vulnerable, 2) be pioneers in the field of sexual and reproductive health, 3) reassess priorities in light of diminishing donor funding, 4) become advocates for increased resources and to further the work they are undertaking, and 5) strengthen collaboration with other development agencies working in the field.
Henningsen, Anna-Karina Aaris; Gissler, M.; Skjaerven, R.
STUDY QUESTIONS Has the perinatal outcome of children conceived after assisted reproductive technology (ART) improved over time? SUMMARY ANSWER The perinatal outcomes in children born after ART have improved over the last 20 years, mainly due to the reduction of multiple births. WHAT IS KNOWN...... with ART outcome and health data from Denmark, Finland, Norway and Sweden. PARTICIPANTS, SETTING AND METHODS We analysed the perinatal outcome of 62 379 ART singletons and 29 758 ART twins, born from 1988 to 2007 in four Nordic countries. The ART singletons were compared with a control group of 362 215...
McFadden, E A
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.
Ljaginskaja, A.M.; Izhewskij, P.W.; Golovko, O.V.
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)
Al Ali Mahmoud T
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.
Barclay, Kieron; Myrskylä, Mikko
As parental ages at birth continue to rise, concerns about the effects of fertility postponement on offspring are increasing. Due to reproductive ageing, advanced parental ages have been associated with negative health outcomes for offspring, including decreased longevity. The literature, however, has neglected to examine the potential benefits of being born at a later date. Secular declines in mortality mean that later birth cohorts are living longer. We analyse mortality over ages 30-74 among 1.9 million Swedish men and women born 1938-60, and use a sibling comparison design that accounts for all time-invariant factors shared by the siblings. When incorporating cohort improvements in mortality, we find that those born to older mothers do not suffer any significant mortality disadvantage, and that those born to older fathers have lower mortality. These findings are likely to be explained by secular declines in mortality counterbalancing the negative effects of reproductive ageing.
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.
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
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.
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.
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 ...
The principal objective of the Third International Conference on Population and Development to be held in Cairo in 1994 is to achieve consensus on a Plan of Action to reinforce reproductive rights of individuals, who bear ultimate responsibility for slowing population growth. The Plan of Action should be adopted by all the peoples of the world in order to stabilize population growth during the next twenty years by means of programs to provide family planning and reproductive health services. The preliminary conference document incorporated recommendations and proposals of two preparatory committees, five regional conferences, six expert meetings, 109 countries, and over 400 nongovernmental organizations from around the world. At current rates of growth, the world's 5.7 billion inhabitants will increase to 9.1 billion by the year 2025, vastly increasing pressure on already limited resources and ecosystems. The central theme of the first World Population Conference in Bucharest in 1974 was the close relationship between population growth and socioeconomic development. The 1974 World Population Plan of Action stressed development of strategies to achieve a better quality of life and rapid socioeconomic development. Recommendations of the 1984 World Population Conference in Mexico remained centered on implementation of the Bucharest Plan of Action with a few additions. Although progress has been achieved in meeting the goals of the Bucharest Plan of Action, growth rates of some developing countries have actually increased. Poverty, unemployment, illiteracy, and discrimination against women are still obstacles to socioeconomic development, and contraceptive usage has not reached optimal levels. Urban migration remains excessive. Progress for many countries over the past decade has been directly related to increasing the access of women to health care and family planning. Themes related to women's status and rights will be incorporated in the 1994 Cairo Conference. The
Mendes, Neuza; Palma, Fátima; Serrano, Fátima
As adolescent pregnancy and sexually transmitted infections (STIs) are major sources of morbidity, preventing them is an important health goal for Portuguese society. To review data on the knowledge, attitudes and statistics on sexual and reproductive health. A systematic review was conducted including peer-reviewed articles addressing issues influencing the sexuality of Portuguese adolescents (aged 13 to 19), published up to 2011 and conducted in any type of setting. After crossing-cleaning the reference list, 33 articles were included. The rate of sexual activity by Portuguese adolescents is high (44%-95%), but there has been an increase in the age of intercourse debut (currently 15.6 years). Early commencement of sexual intercourse is associated with smoking and regular alcohol consumption. Condoms are the most frequently chosen contraceptive method for first (76%-96%) and subsequent (52%-69%) sexual encounters. The perception of a double standard in sex still exists in teenage culture for both genders and influence behavior. There are significant differences between migrant and native adolescents: African adolescents initiate sexual intercourse at earlier ages and are more likely to have unprotected sex. Only one-third of Portuguese teenagers have ever visited a health facility to seek counseling concerning contraception or STIs, and less than half have ever attended classes on reproductive health. Very few (12%) have knowledge about Chlamydia trachomatis infection. The prevalence of STIs in Portuguese youth is unknown. The adolescent fertility rate is still high (14.7 births per 1000 females aged 15-19 years), but it, as well as the rate of abortion, is steadily decreasing. There is still a long way to go towards promoting a resourceful young population. Citizens and institutions must focus on increasing both the competence of youths and external supports. Information must be provided systematically and health services must have greater accessibility. Studies
JOICFP is producing a still photo video consisting of three segments from photos shot in Bangladesh (April 22 - May 2), Thailand (May 2-15), and Mexico (June 29 - July 7) in 1995. The first segment highlights the daily life of a husband, aged 20, and his wife, Moni, aged 14. Moni married at age 13, before the onset of menstruation, and now serves and feeds her husband's large extended family. The Family Planning Association of Bangladesh (FPAB), the local implementing agent of the Sustainable Community-based Family Planning/Maternal and Child Health (FP/MCH) Project with Special Focus on Women, which is supported by the United Nations Population Fund (UNFPA) and executed by JOICFP, introduced Moni to the concept of reproductive health and encouraged her to join other women in activities designed to improve their health and raise their economic status. The second segment depicts the life of a former commercial sex worker who is undergoing occupational skill development training promoted by the Population and Community Development Association. The girl is now a leader of teenagers in her village; she works to change attitudes that sent her to work as a prostitute with an estimated 150,000 other poor rural teenage women. The third segment focuses on teen pregnancy and the efforts of the Mexican Foundation for Family Planning (MEXFAM) in the areas of health care and education for adolescents.
Ohalete, Nnenna; Georges, Jane; Doswell, Willa
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.
In the current debate about healthcare reform in the USA, advocates for government-ensured universal coverage assume that health care is a right. Although this position is politically popular, it is sometimes challenged by a restricted view of rights popular with libertarians and individualists. The restricted view of rights only accepts 'negative' rights as legitimate rights. Negative rights, the argument goes, place no obligations on you to provide goods to other people and thus respect your right to keep the fruits of your labour. A classic enumeration of negative rights includes life, liberty, and the pursuit of happiness. Positive rights, by contrast, obligate you either to provide goods to others, or pay taxes that are used for redistributive purposes. Health care falls into the category of positive rights since its provision by the government requires taxation and therefore redistribution. Therefore, the libertarian or individualist might argue that health care cannot be a true right. This paper rejects the distinction between positive and negative rights. In fact, the protection of both positive and negative rights can place obligations on others. Furthermore, because of its role in helping protect equality of opportunity, health care can be tied to the rights to life, liberty, and the pursuit of happiness. There is, therefore, good reason to believe that health care is a human right and that universal access should be guaranteed. The practical application, by governments and non-governmental organisations, of several of the arguments presented in this paper is also discussed.
Pillai, Vijayan; Wang, Ya-Chien; Maleku, Arati
Globally, millions of people are affected by war and conflicts every year. However, women have increasingly suffered the greatest harm by war in more different ways than men. We conceptualize a reproductive rights approach toward examining the effects of war on women's reproductive health in developing countries. Given the rising concerns of exclusion to adequately address women's rights, sexual and gender-based violence, and post-conflict accountability, we specifically focus on the limitations of the Minimum Initial Service Package, a UN-sponsored reproductive health service program in conflict zones while offering a broad reproductive rights-based conceptual lens for examining reproductive health care services in war-torn areas. In addition, we discuss the roles social workers may play at both micro and macro levels in war-torn areas to bring about both short term and long term gains in women's reproductive health.
Kou, Z X; Wang, S L; Chen, Z L; He, Y H; Yu, W L; Mei, L Y; Zhang, H D
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.
Flanders, Corey E; Gos, Giselle; Dobinson, Cheryl; Logie, Carmen H
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.
... 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, ...
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 ...
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 ...
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.
Westeneng, J.; D'Exelle, B.S.H.
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:
Woodruff, T. J
.... Focusing on exposures to environmental contaminants, particularly during critical periods in development and their potential effects on all aspects of future reproductive life-course, this book...
Made Asri Budisuari
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.
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.
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.
Haruty, Bella; Friedman, Julie; Hopp, Stephanie; Daniels, Ryane; Pregler, Janet
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.
Luffy, Samantha M; Evans, Dabney P; Rochat, Roger W
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.
Sadeu, J C; Hughes, Claude L; Agarwal, Sanjay; Foster, Warren G
Reproductive function and fertility are thought to be compromised by behaviors such as cigarette smoking, substance abuse, and alcohol consumption; however, the strength of these associations are uncertain. Furthermore, the reproductive system is thought to be under attack from exposure to environmental contaminants, particularly those chemicals shown to affect endocrine homeostasis. The relationship between exposure to environmental contaminants and adverse effects on human reproductive health are frequently debated in the scientific literature and these controversies have spread into the lay press drawing increased public and regulatory attention. Therefore, the objective of the present review was to critically evaluate the literature concerning the relationship between lifestyle exposures and adverse effects on fertility as well as examining the evidence for a role of environmental contaminants in the purported decline of semen quality and the pathophysiology of subfertility, polycystic ovarian syndrome, and endometriosis. The authors conclude that whereas cigarette smoking is strongly associated with adverse reproductive outcomes, high-level exposures to other lifestyle factors are only weakly linked with negative fertility impacts. Finally, there is no compelling evidence that environmental contaminants, at concentrations representative of the levels measured in contemporary biomonitoring studies, have any effect, positive or negative, on reproductive health in the general population. Further research using prospective study designs with robust sample sizes are needed to evaluate testable hypotheses that address the relationship between exposure and adverse reproductive health effects.
Shahid, A.; Nasim, S.; Memon, A.A.; Mustafa, M.A.
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)
Meghan T. Gillette
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.
Arousell, Jonna; Carlbom, Aje
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.
Shorey, Shefaly; Yang, Yen Yen; Ang, Emily
The aim of this study was to systematically retrieve, critique and synthesize available evidence regarding the association between negative childbirth experiences and future reproductive decisions. A child's birth is often a joyous event; however, there is a proportion of women who undergo negative childbirth experiences that have long-term implications on their reproductive decisions. A systematic review of quantitative studies was undertaken using Joanna Briggs Institute's methods. A search was carried out in CINAHL Plus with Full Text, Embase, PsycINFO, PubMed, Scopus and Web of Science from January 1996 - July 2016. Studies that fulfilled the inclusion criteria were assessed by two independent reviewers using the Joanna Briggs Institute's Critical Appraisal Tools. Data were extracted under subheadings adapted from the institute's data extraction forms. Twelve studies, which examined either one or more influences of negative childbirth experiences, were identified. The included studies were either cohort or cross-sectional designs. Five studies observed positive associations between prior negative childbirth experiences and decisions to not have another child, three studies found positive associations between negative childbirth experiences and decisions to delay a subsequent birth and six studies concluded positive associations between negative childbirth experiences and maternal requests for caesarean section in subsequent pregnancies. To receive a holistic understanding on negative childbirth experiences, a suitable definition and validated measuring tools should be used to understand this phenomenon. Future studies or reviews should include a qualitative component and/or the exploration of specific factors such as cultural and regional differences that influence childbirth experiences. © 2018 John Wiley & Sons Ltd.
Ndong, I; Steele, C; Mahony, E
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.
Editorial - Promoting Youth Sexual and Reproductive Health in Africa: The Need ... Online Sexual Activities and Sexual Risk-taking among Adolescents and Young ... Opportunities and Limitations for Using New Media and Mobile Phones to ...
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.
Abstract: In Tanzania, reproductive health and HIV services are coordinated by the .... and skills that are effectively managed and are equitably distributed to ensure that ..... to access and use PMTCT services and in reducing stigma, denial and.
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.
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.
Chor, Julie; Oswald, Lora; Briller, Joan; Cowett, Allison; Peacock, Nadine; Harwood, Bryna
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.
Ravindran, T K Sundari
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.
Nguyen, My Hu'o'ng; Gammeltoft, Tine; Christoffersen, Sarah Vigh
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...
Hord, C; David, H P; Donnay, F; Wolf, M
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.
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
Amie B. Jackson
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.
Scheftel, Joni M; Elchos, Brigid L; Rubin, Carol S; Decker, John A
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
Mondillo, Carolina; Varela, María Luisa; Abiuso, Adriana María Belén; Vázquez, Ramiro
Histamine (HA) is a pleiotropic biogenic amine synthesized exclusively by histidine decarboxylase (HDC) in most mammalian tissues. The literature on the role of HA within the male gonad has expanded over the last years, attracting attention to potential unexpected side-effects of anti-histamines on testicular function. In this regard, HA receptors (HRH1, HRH2 and HRH4) have been described in Leydig cells of different species, including human. Via these receptors, HA has been reported to trigger positive or negative interactions with the LH/hCG signaling pathway depending upon its concentration, thereby contributing to the local control of testicular androgen levels. It should then be considered that anti-histamines may affect testicular homeostasis by increasing or decreasing steroid production. Additionally, HRH1 and HRH2 receptors are present in peritubular and germ cells, and HRH2 antagonists have been found to negatively affect peritubular cells and reduce sperm viability. The potential negative impact of anti-histamines on male reproduction becomes even more dramatic if we consider that HA has also been associated with human sexual behavior and penile erection. What is more, although testicular mast cells are the major source of locally produced HA, recent studies have described HDC expression in macrophages, Leydig cells and germ cells, revealing the existence of multiple sources of HA within the testis. Undoubtedly, the more we learn about the testicular histaminergic system, the more opportunities there will be for rational design of drugs aimed at treating HA-related pathologies, with minimum or nule negative impact on fertility. © 2018 Society for Reproduction and Fertility.
Amoo, Emmanuel O; Omideyi, Adekunbi K; Fadayomi, Theophilus O; Ajayi, Mofoluwake P; Oni, Gbolahan A; Idowu, Adenike E
Systematic studies on the association between men's sexual dysfunction (low sexual desire, ejaculation disorders, erectile dysfunctions, genital ulcers, testicular disorders, prostate cancer or sexually transmitted infections) and marital conflict are emerging. However, the coping strategies adopted by wives in such circumstances are not commonly reported in the literature. Male sexual functioning is vital to the marital relationship, lack of it can result in intolerable cohabitation or relationship breakdown, and could also cause infertility, infidelity, and arouse stigma in Nigeria. The understanding of coping strategies by female partners could guide in the counselling and treatment of men's sexual health problems. Effective coping has the potential to lessen or prevent negative outcomes, and thereby could reduce marital conflict. This study examined the coping strategies adopted by women whose husbands have reproductive health challenges in two of the five states with the highest proportion of divorce/separation in Nigeria. Four focus group discussions were conducted in two local government areas. The women were recruited from a quantitative couple-study for men with sexual health problems. Focus group responses were transcribed and analysed using systematic-content-analysis with thematic organisation of the summaries and systematic typologies of participants' responses. The results revealed the coping strategies employed by women in this environment: seeking guidance from their religious leaders and family doctors, physical-sexual-therapy, abstinence and concubinage. The participants indicated that they encountered difficulties in discussing their husbands' sexual health problems with a third party. The study concludes that husband's sexual ability is crucial to the sustenance of the marital relationship. Religious leaders and family doctors often serve as mediators to husband-wife conflict management. Counselling is recommended in cases of sexual health
Lazarus, Jeff; Nadisauskiene, R J; Liljestrand, J
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...
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.
Elfers, John; Carlton, Lidia; Gibson, Paul; Puffer, Maryjane; Smith, Sharla; Todd, Kay
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…
Kaufman, Joan; Liu, Yunguo; Fang, Jing
China's new health reform initiative aims to provide quality accessible health care to all, including remote rural populations, by 2020. Public health insurance coverage for the rural poor has increased, but rural women have fared worse because of lower status and lack of voice in shaping the services they need. Use of prenatal care, safe delivery and reproductive tract infections (RTIs) services is inadequate and service seeking for health problems remains lower for men. We present findings from a study of gender and health equity in rural China from 2002 to 2008 and offer recommendations from over a decade of applied research on reproductive health in rural China. Three studies, conducted in poor counties between 1994 and 2008, identified problems in access and pilot tested interventions and mechanisms to increase women's participation in health planning. They were done in conjunction with a World Bank programme and the global Gender and Health Equity Network (GHEN). Reproductive health service-seeking improved and the study interventions increased local government commitment to providing such services through new health insurance mechanisms. Findings from the studies were summarised into recommendations on gender and health for inclusion in new health reform efforts.
Ritte, Rebecca; Grote, Verena; Boeing, Heiner; Aleksandrova, Krasimira; Trichopoulou, Antonia; Lagiou, Pagona; Trichopoulos, Dimitrios; Palli, Domenico; Berrino, Franco; Mattiello, Amalia; Tumino, Rosario; Tikk, Kaja; Sacerdote, Carlotta; Quirós, José Ramón; Buckland, Genevieve; Molina-Montes, Esther; Chirlaque, María-Dolores; Ardanaz, Eva; Amiano, Pilar; Bueno-de-Mesquita, H Bas; Gils, Carla H van; Peeters, Petra HM; Lukanova, Annekatrin; Wareham, Nick; Khaw, Kay-Tee; Key, Timothy J; Travis, Ruth C; Weiderpass, Elisabete; Dumeaux, Vanessa; Lund, Eliv; Sund, Malin; Andersson, Anne; Romieu, Isabelle; Tjønneland, Anne; Rinaldi, Sabina; Vineis, Paulo; Merritt, Melissa A; Riboli, Elio; Kaaks, Rudolf; Olsen, Anja; Overvad, Kim; Dossus, Laure; Fournier, Agnès; Clavel-Chapelon, Françoise
The association of reproductive factors with hormone receptor (HR)-negative breast tumors remains uncertain. Within the EPIC cohort, Cox proportional hazards models were used to describe the relationships of reproductive factors (menarcheal age, time between menarche and first pregnancy, parity, number of children, age at first and last pregnancies, time since last full-term childbirth, breastfeeding, age at menopause, ever having an abortion and use of oral contraceptives [OC]) with risk of ER-PR- (n = 998) and ER+PR+ (n = 3,567) breast tumors. A later first full-term childbirth was associated with increased risk of ER+PR+ tumors but not with risk of ER-PR- tumors (≥35 vs. ≤19 years HR: 1.47 [95% CI 1.15-1.88] p trend < 0.001 for ER+PR+ tumors; ≥35 vs. ≤19 years HR: 0.93 [95% CI 0.53-1.65] p trend = 0.96 for ER-PR- tumors; P het = 0.03). The risk associations of menarcheal age, and time period between menarche and first full-term childbirth with ER-PR-tumors were in the similar direction with risk of ER+PR+ tumors (p het = 0.50), although weaker in magnitude and statistically only borderline significant. Other parity related factors such as ever a full-term birth, number of births, age- and time since last birth were associated only with ER+PR+ malignancies, however no statistical heterogeneity between breast cancer subtypes was observed. Breastfeeding and OC use were generally not associated with breast cancer subtype risk. Our study provides possible evidence that age at menarche, and time between menarche and first full-term childbirth may be associated with the etiology of both HR-negative and HR-positive malignancies, although the associations with HR-negative breast cancer were only borderline significant
Daniels, C R; Paul, M; Rosofsky, R
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.
Agampodi, Suneth B; Agampodi, Thilini C; Ukd, Piyaseeli
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
cle on sexual health education among engaged couples11. The authors identified ... few hospitals had formal adult hospital-based triage, with staff performing ... tics of HIV opportunistic infections among older adults in Nigeria. Afri Health Sci.
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
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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.
Avila, R; Pinheiro, M; Sazima, M
Inga species are characterised by generalist or mixed pollination system. However, this feature does not enhance reproductive rates in species with very low fruit set under natural conditions. Some ecological and genetic factors are associated with this feature, and to test the effect of massive visits on pollination success in Inga subnuda subsp. luschnathiana, we studied the efficacy of polyads deposited on stigmas of flowers isolated from visitors and polyads exposed to visitors. The proportion of polyads fixed in stigmas decreased after exposure to visitors (24 h) in comparison to stigmas isolated from visitors (hummingbirds, bees, wasps, hawkmoths and bats), and fruit set was very low. Furthermore, nectar production, sugar composition and other floral biology traits were evaluated. Increased nectar production, sugar availability and sucrose dominance during the night indicates adaptation to nocturnal visitors and supports their role as main pollinators; although the brush-flower morphology, time of anthesis, nectar dynamics and chemical composition also allow daytime visitors. Thus the species is an important resource for a diverse group of floral visitors. We conclude that excess visits (diurnal and nocturnal) are responsible for the decrease in fixed polyads in stigmas of I. subnuda subsp. luschnathiana flowers, thus contributing, with others factors, to its low fruit set. Therefore, the generalist pollination system does not result in reproductive advantages because the low fruit set in natural conditions could be the result of a negative effect of visitors/pollinators. © 2014 German Botanical Society and The Royal Botanical Society of the Netherlands.
Sharma, Rakesh; Biedenharn, Kelly R; Fedor, Jennifer M; Agarwal, Ashok
Approximately 10 to 15% of couples are impacted by infertility. Recently, the pivotal role that lifestyle factors play in the development of infertility has generated a considerable amount of interest. Lifestyle factors are the modifiable habits and ways of life that can greatly influence overall health and well-being, including fertility. Many lifestyle factors such as the age at which to start a family, nutrition, weight, exercise, psychological stress, environmental and occupational exposures, and others can have substantial effects on fertility; lifestyle factors such as cigarette smoking, illicit drug use, and alcohol and caffeine consumption can negatively influence fertility while others such as preventative care may be beneficial. The present literature review encompasses multiple lifestyle factors and places infertility in context for the couple by focusing on both males and females; it aims to identify the roles that lifestyle factors play in determining reproductive status. The growing interest and amount of research in this field have made it evident that lifestyle factors have a significant impact on fertility.
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.
Kane, Sumit; Rial, Matilda; Matere, Anthony; Dieleman, Marjolein; Broerse, Jacqueline E.W.; Kok, Maryse
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
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.
Verbiest, Sarah; Malin, Christina Kiko; Drummonds, Mario; Kotelchuck, Milton
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.
Siti Syairah Mohd Mutalip
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.
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
Refaei, Mansoureh; Aghababaei, Soodabeh; Pourreza, Abolghasem; Masoumi, Seyedeh Zahra
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
Moroccan population has known a growing demographic trend. However, beyond the global tendency, reproductive health remains characterised by inequalities and disparities between urban and rural, rich and poor, developed and deprived regions.In this study, we relied mainly on data and statistics provided by the last ...
Reproductive Health and the Question of Abortion in Botswana: A Review. Stephanie S Smith. Abstract. The complications of unsafe, illegal abortions are a significant cause of maternal mortality in Botswana. The stigma attached to abortion leads some women to seek clandestine procedures, or alternatively, to carry the ...
The study examined the relationship between demographic variables and the reproductive health behaviour of the adolescents in Oyo State, Nigeria. Descriptive survey research design was adopted for the study. The sample for the study consisted of 164 adolescents, male and female, in Oyo State, Nigeria. Multi stage ...
Programmatic aspects of postpartum family planning in developing countries: a qualitative analysis of key informant interviews in Kenya and Ethiopia · EMAIL FREE ... Impediments to Media Communication of Social Change in Family Planning and Reproductive Health: Experiences from East Africa · EMAIL FREE FULL ...
Adults may facilitate or obstruct healthy sexual behaviours by adolescents; hence information on their attitude towards adolescent sexual behaviour, including contraceptive use is important. The attitude of teachers to school-based adolescent reproductive health services was assessed among two hundred and twenty three ...
Kane, Sumit; Rial, Matilda; Matere, Anthony; Dieleman, Marjolein; Broerse, Jacqueline E W; Kok, Maryse
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
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.
Challenges of monitoring reproductive health services: a case study of antenatal clinics in Kinondoni municipality, Dar Es Salaam. ... was descriptive cross sectional employing both qualitative and quantitative methods. The sample population included nurse-midwives who manage ANC clinics in Kinondoni Municipality.
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.
Suurmond, J.; Uiters, E.; de Bruijne, M.C.; Stronks, K.; Essink-Bot, M.L.
ABSTRACT: BACKGROUND: Negative events are abusive, potentially dangerous or life-threatening health care events, as perceived by the patient. Patients' perceptions of negative events are regarded as a potentially important source of information about the quality of health care. We explored negative
Peltoniemi, Olli Aarno Tapio; Björkman, Stefan; Oliviero, Claudio
In this review, we address significant characteristics of parturition in the pig and their connection to post-partum reproductive health and fertility. We discuss the normal physiology and behaviour around parturition and the effect of the second phase (expulsion of foetuses) on the third phase of parturition (expulsion of foetal membranes). In addition, we intend to cover retained placenta, and the connection to post-partum uterine health and fertility in the contemporary prolific sow. We al...
Peñas Defago, María Angélica; Morán Faúndes, José Manuel
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.
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.
T. A. Sokolovskaya
Full Text Available The federal reporting forms over 1986–1995 and the official statistics over 2009–2014 were analyzed using the methods of descriptive statistics and correlation analysis to identify the relationship of neonatal health status to reproductive problems in adulthood. The investigation showed that at the end of the 20th century, the overall structure of newborns showed a larger proportion of very low (1000–1499 g and low (1500–2499 g birth weight babies from 0,42% in 1986 to 0,47% in 1995 and from 4,9 to 5,46%, respectively. Moreover, the common neonatal abnormalities were birth trauma, intrauterine hypoxia, birth asphyxia, congenital abnormalities, growth retardation, and malnutrition. Further, there was a decline in the number of people coming of active reproductive age, men and women alike (24,77% in 2009 and 23,77% in 2014. With this, in 2009–2014, the adult population exhibited increases in the incidence of newly diagnosed cases of diseases of the endocrine, circulatory, and urinary systems (by 6,61, 15,07, and 4,14%, respectively, and female infertility (by 21,25%. Correlation analysis indicated that there was a negative relationship between neonatal hemolytic disease and adult-onset circulatory diseases and anemia (r =–0,45; p<0,05 and r =–0,48; p<0,05; infections specific to the perinatal period, salpingitis and oophoritis (r =–0,30; p<0,05; there was a direct correlation between congenital pneumonia in the newborn and diabetes mellitus, diseases characterized by high blood pressure in adults (r =0,31; p<0,05 and r =0,36; p<0,05; respiratory distress syndrome and insulin-dependent diabetes mellitus (r =0,38; p<0,05. Pathological processes result in a vicious circle: a neonatal patient — a female and/or male patient — pregnancy and/or labor pathology — a sick child.
The objective of the study was to demonstrate the effectiveness of a college course in preconception health and prenatal development at improving reproductive health awareness in college students. Students enrolled in the course completed pretest and posttest assessments and a course evaluation. Students' self-perception of awareness of the positive and negative factors that can affect pregnancy increased from 13% at the beginning of the course to 89 and 93% at the end of the course, respectively. Correspondingly, students' knowledge of course-related information improved across nearly all areas assessed. The average score among students increased from 67 to 90% correct from pretest to posttest. Course evaluation results indicated that over 94% of students found the course to be beneficial and informative. College courses are a practical way to disseminate reproductive and prenatal health information. Educating college students in these areas has clear benefits to both individual students and society and, as such, merits increased attention in college curricula.
Shaw, Dorothy; Cook, Rebecca J
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.
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
Agampodi, Suneth B; Agampodi, Thilini C; UKD, Piyaseeli
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
Agampodi Thilini C
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
Winterhager, Elke; Kidder, Gerald M
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
Family size is reduced among patients with rheumatic diseases. The causes for the low number of children are multifactorial and include impaired sexual function, decreased gonadal function, pregnancy loss, therapy and personal choices. Sexuality contributes to quality of life in patients with rheumatic disease, but is often ignored by health professionals. Both disease-related factors and psychological responses to chronic disease can impair sexual functioning. Toxic effects of anti-inflammatory and immunosuppressive drugs can induce transient or permanent gonadal failure in women and men. Furthermore, permanent infertility can be a consequence of treatment with cyclophosphamide, whereas transient infertility can be caused by NSAIDs in women and sulfasalazine in men. These adverse effects must be communicated to the patients, and measures to preserve fertility should be initiated before the start of gonadotoxic therapy. Management of patients of both genders should include regular family planning, effective treatment of high disease activity, sexual counselling, and, if necessary, infertility treatment.
Kapinga, Orestes Silverius; Hyera, Daniel Frans
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…
Lin, Lan-Ping; Lin, Pei-Ying; Chu, Cordia M.; Lin, Jin-Ding
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…
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
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
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.
Rusakaniko, S; Mbizvo, M T; Kasule, J; Gupta, V; Kinoti, S N; Mpanju-Shumbushu, W; Sebina-Zziwa, J; Mwateba, R; Padayachy, J
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
Raymond, Susan U; Greenberg, Henry M; Leeder, Stephen R
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
Apollonio, D E; Malone, R E
Literature suggests that 'negative advertising' is an effective way to encourage behavioral changes, but it has enjoyed limited use in public health media campaigns. However, as public health increasingly focuses on non-communicable disease prevention, negative advertising could be more widely applied. This analysis considers an illustrative case from tobacco control. Relying on internal tobacco industry documents, surveys and experimental data and drawing from political advocacy literature, we describe tobacco industry and public health research on the American Legacy Foundation's "truth" campaign, an example of effective negative advertising in the service of public health. The tobacco industry determined that the most effective advertisements run by Legacy's "truth" campaign were negative advertisements. Although the tobacco industry's own research suggested that these negative ads identified and effectively reframed the cigarette as a harmful consumer product rather than focusing solely on tobacco companies, Philip Morris accused Legacy of 'vilifying' it. Public health researchers have demonstrated the effectiveness of the "truth" campaign in reducing smoking initiation. Research on political advocacy demonstrating the value of negative advertising has rarely been used in the development of public health media campaigns, but negative advertising can effectively communicate certain public health messages and serve to counter corporate disease promotion.
Robert J Aitken
Full Text Available One of the major causes of defective sperm function is oxidative stress, which not only disrupts the integrity of sperm DNA but also limits the fertilizing potential of these cells as a result of collateral damage to proteins and lipids in the sperm plasma membrane. The origins of such oxidative stress appear to involve the sperm mitochondria, which have a tendency to generate high levels of superoxide anion as a prelude to entering the intrinsic apoptotic cascade. Unfortunately, these cells have very little capacity to respond to such an attack because they only possess the first enzyme in the base excision repair (BER pathway, 8-oxoguanine glycosylase 1 (OGG1. The latter successfully creates an abasic site, but the spermatozoa cannot process the oxidative lesion further because they lack the downstream proteins (APE1, XRCC1 needed to complete the repair process. It is the responsibility of the oocyte to continue the BER pathway prior to initiation of S-phase of the first mitotic division. If a mistake is made by the oocyte at this stage of development, a mutation will be created that will be represented in every cell in the body. Such mechanisms may explain the increase in childhood cancers and other diseases observed in the offspring of males who have suffered oxidative stress in their germ line as a consequence of age, environmental or lifestyle factors. The high prevalence of oxidative DNA damage in the spermatozoa of male infertility patients may have implications for the health of children conceivedin vitro and serves as a driver for current research into the origins of free radical generation in the germ line.
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.
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.
Hunt, Xanthe; Carew, Mark T; Braathen, Stine Hellum; Swartz, Leslie; Chiwaula, Mussa; Rohleder, Poul
There is a body of theoretical work, and some empirical research, which suggests that non-disabled people assume people with physical disabilities are not suitable romantic partners, do not have sexual drives or desires, or are not sexually active. It has also been proposed that people with physical disabilities face barriers to sexual healthcare access which are structural as well as social. The present paper explores non-disabled South Africans' beliefs concerning the degree to which non-disabled respondents enjoy sexual and reproductive rights, and benefit from sexual and reproductive healthcare, compared to people without disability. Using a survey, we asked 1989 South Africans to estimate the degree to which people with physical disabilities and people without disability have sexual rights, and benefit from sexual and reproductive healthcare services, respectively. Respondents were more likely to support the idea that the population without disability were deserving of sexual rights compared to people with physical disabilities. Respondents were more likely to rate the degree to which people with physical disability benefit from sexual and reproductive healthcare as less than that for people without physical disabilities. These findings provide some of the first empirical support that non-disabled people perceive people with physical disabilities as having fewer sexual and reproductive rights, and deriving less benefit from sexual and reproductive health services, than the population without disability. To have diminished sexual rights, and benefit less from sexual and reproductive healthcare, we suggest, evinces a negation of the sexual and reproductive needs and capacity of people with physical disabilities.
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.
The effect of population growth is not limited to national boundaries. Indeed the inability of people in developing countries to control their own fertility has repercussions on global security and on the balance between population and environment as well a on their health and welfare. All nations need to take steps to slow down rapid population growth now, otherwise we will suffer serious consequences. The different between 2 UN projections of world population equals current world population size. Almost 90% of the increase of the larger projection would occur in developing countries, yet they are the least capable of managing big populations. Further major inequalities in reproductive health between developed and developing countries, as well as between men and women exist. The infant mortality rate in developed regions is around 6 times lower than it is in developing regions, child mortality is 7 times lower, and maternal mortality is 15 times lower. International collaboration to rid the world of these inequalities is need to improve reproductive health. Specifically, political and health leaders should mobilize necessary international and national resources. Even though there is more than US $50,000 million in official development assistance funds available annually, the level of population related funding has decreased to less than 1.1% of these funds for 1993-1994. Developed countries could reduce the debt burden to free funds for population activities and to reverse the flow from the poor countries in the Southern Hemisphere to the rich countries in the Northern Hemisphere. Besides developing countries spend much of their money on the military (e.g. sub-Saharan Africa spends US$ 10,000 million). International cooperation leading to peace would make significantly more money available for the social and health sectors, especially reproductive health care.
Terplan, Mishka; Lawental, Maayan; Connah, Melanie Bryant; Martin, Caitlin Eileen
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.
Gupta, Neeru; Mathur, A K; Singh, M P; Saxena, N C
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
Valente, Pablo K
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.
Peltoniemi, Oat; Björkman, S; Oliviero, C
In this review, we address significant characteristics of parturition in the pig and their connection to post-partum reproductive health and fertility. We discuss the normal physiology and behaviour around parturition and the effect of the second phase (expulsion of foetuses) on the third phase of parturition (expulsion of foetal membranes). In addition, we intend to cover retained placenta, and the connection to post-partum uterine health and fertility in the contemporary prolific sow. We also explore factors that support successful parturition or can cause potential problems. Successful parturition in the pig includes the possibility to express adequate maternal behaviour, rapid expulsion of the piglets, complete expulsion of the placenta, neonatal activity and colostrum intake. Abnormal incidents during any phase of parturition can cause subsequent problems. Duration of the expulsion phase of foetuses can be used as a simple measure of whether parturition is considered successful. Prolonged parturition can impair health of the sow and piglet and fertility after weaning. New insights, such as adding more fibre to sow diets during pregnancy, and especially during the period prior to farrowing, may prevent constipation, increase water intake of the sow around parturition and increase milk intake and performance of piglets. Maternal characteristics, including maternal behaviour, ease of parturition, colostrum production and piglet quality parameters, may be utilized to improve success rate of reproductive management during farrowing and early lactation. Additionally, we share some of the recent developments in methods, including ultrasonography in evaluation of post-partum uterine health. In conclusion, successful farrowing is of the greatest importance for reproductive health of the sow and survival of the piglets. We suggest connections exist among prolonged farrowing and yield of colostrum, retained placenta, development of PDS, and impaired involution of the
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.
Matejić, Bojana; Kesić, Vesna
The ethics of reproductive health covers a wide field of different issues, from the ethical dimensions of assisted reproduction, life of newborns with disabilities to the never-ending debate on the ethical aspects of abortion. Furthermore, increasing attention is paid to the ethical dimensions of using stem cells taken from human embryos, the creation of cloned embryos of patients for possible self-healing, and the increasingly present issue of reproductive cloning. Development of vaccines against human papillomavirus (HPV) has introduced new ethical aspects related to reproductive health and the need for a consensus of clinical and public-healthcare population. Today immunization with HPV vaccine is a measure for the primary prevention of cervical cancer and it provides effective protection against certain types of viruses included in the vaccine. The most often mentioned issues of discussions on ethical concerns about HPV vaccination are the recommended age of girls who should be informed and vaccinated (12-14 years), attitudes and fears of parents concerning discussion with their preadolescent daughters on issues important for their future sexual behavior, dilemma on the vaccination of boys and the role of the chosen pediatrician in providing information on the vaccination. In Serbia, two HPV vaccines have been registered but the vaccination is not compulsory. Up-till-now there has been no researches on the attitudes of physicians and parents about HPV vaccination. Nevertheless, it is very important to initiate education of general and medical public about the fact that the availability of vaccine, even if we disregard all aforementioned dilemmas, does not lead to the neglect of other preventive strategies against cervical cancer, primarily screening. The National Program for Cervical Cancer Prevention involves organized screening, i.e. regular cytological examinations of the cervical smear of all women aged 25-69 years, every three years, regardless of the
Full Text Available The ethics of reproductive health covers a wide field of different issues, from the ethical dimensions of assisted reproduction, life of newborns with disabilities to the never-ending debate on the ethical aspects of abortion. Furthermore, increasing attention is paid to the ethical dimensions of using stem cells taken from human embryos, the creation of cloned embryos of patients for possible self-healing, and the increasingly present issue of reproductive cloning. Development of vaccines against human papillomavirus (HPV has introduced new ethical aspects related to reproductive health and the need for a consensus of clinical and public-healthcare population. Today immunization with HPV vaccine is a measure for the primary prevention of cervical cancer and it provides effective protection against certain types of viruses included in the vaccine. The most often mentioned issues of discussions on ethical concerns about HPV vaccination are the recommended age of girls who should be informed and vaccinated (12-14 years, attitudes and fears of parents concerning discussion with their preadolescent daughters on issues important for their future sexual behavior, dilemma on the vaccination of boys and the role of the chosen pediatrician in providing information on the vaccination. In Serbia, two HPV vaccines have been registered but the vaccination is not compulsory. Up-till-now there has been no researches on the attitudes of physicians and parents about HPV vaccination. Nevertheless, it is very important to initiate education of general and medical public about the fact that the availability of vaccine, even if we disregard all aforementioned dilemmas, does not lead to the neglect of other preventive strategies against cervical cancer, primarily screening. The National Program for Cervical Cancer Prevention involves organized screening, i.e. regular cytological examinations of the cervical smear of all women aged 25-69 years, every three years
Finger, William, Comp.; Tipton, Margaret, Comp.
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,…
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...
Lin, Lan-Ping; Lin, Pei-Ying; Hsu, Shang-Wei; Loh, Ching-Hui; Lin, Jin-Ding; Lai, Chia-Im; Chien, Wu-Chien; Lin, Fu-Gong
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...
Richey, Lisa Ann
of the Cairo consensus and process? How has the health of people around the world been affected by neo-liberal economic policies? What have these meant for women's rights, including reproductive rights? The book presents detailed case studies from various countries ranging from India and China, to Egypt......, Tanzania, Uganda and across Africa to Argentina, Peru and throughout Latin America, as well as overarching themed essays. From the politics of abortion and immigration to rising levels of fundamentalist violence and sex selective abortions, the volume explores a range of issues from several vantage points...
Poulsen, Grete Lottrup; Andersson, A-M; Leffers, H
Phthalates adversely affect the male reproductive system in animals, inducing hypospadias, cryptorchidism, reduced testosterone production and decreased sperm counts. Phthalate effects are much more severe after in utero than adult exposure. Little is known about human health effects. This study...... with small AGI showed a high prevalence of cryptorchidism and small genital size. Taken together these studies suggest an antivirilizing effect of phthalates in infants. Most of these findings are in line with animal observations. However, the possible effects of MEP appear to be limited to humans. This may...
Leodoro J. Labrague
Full Text Available This investigation explored gender-related norms, sexuality, and reproductive health among education students in a government university in Samar, Philippines. A descriptive-analytical design of study was adopted for this investigation and data were collected over a period of five months. Five hundred fifty (550 education students who were enrolled in the different year level completed the modified John Clelands’ Illustrative Questionnaire for Young People. Results indicated that 14.73% of the students reported having had early sexual experience where in 69.14 % had it unplanned. Among sexually active students, only 17.28% used contraception, with condoms and withdrawal as the most popular choices. Respondents were also found to have some misconceptions regarding HIV/AIDS and STI’s. Result also showed that dating was still acceptable, however, the idea of abortion and sexual coercion were considered wrong. No significant differences in the knowledge about HIV/AIDS and STI’s and gender norms were found across year level. Findings suggest a greater need for education, support and advocacy relative to sexuality so as to create a more positive school environment conducive for holistic growth and development of all students. Thus, school administrators should improve/enhance existing policies and programs relative to reproductive health among college students of the University such as health promotion activities, sexuality education, counseling and alike.
Wang, Aolin; Padula, Amy; Sirota, Marina; Woodruff, Tracey J.
Unstructured Abstract Chemical exposures during pregnancy can have a profound and life-long impact on human health. Due to the omnipresence of chemicals in our daily life, there is continuous contact with chemicals in food, water, air and consumer products. Consequently, human biomonitoring studies show that pregnant women around the globe are exposed to a variety of chemicals. In this review, we provide a summary of current data on maternal and fetal exposure as well as health consequences from these exposures. We review several chemical classes including polychlorinated biphenyls (PCBs), perfluoroalkyl substances (PFAS), polybrominated diphenyl ethers (PBDEs), phenols, phthalates, pesticides, and metals. Additionally, we discuss environmental disparities and vulnerable populations, and future research directions. We conclude by providing some recommendations for prevention of chemical exposure and its adverse reproductive health consequences. PMID:27513554
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
Full Text Available Abstract Background Negative events are abusive, potentially dangerous or life-threatening health care events, as perceived by the patient. Patients' perceptions of negative events are regarded as a potentially important source of information about the quality of health care. We explored negative events in hospital care as perceived by immigrant patients. Methods Semi-structured individual and group interviews were conducted with respondents about negative experiences of health care. Interviews were transcribed and analyzed using a framework method. A total of 22 respondents representing 7 non-Dutch ethnic origins were interviewed; each respondent reported a negative event in hospital care or treatment. Results Respondents reported negative events in relation to: 1 inadequate information exchange with care providers; 2 different expectations between respondents and care providers about medical procedures; 3 experienced prejudicial behavior on the part of care providers. Conclusions We identified three key situations in which negative events were experienced by immigrant patients. Exploring negative events from the immigrant patient perspective offers important information to help improve health care. Our results indicate that care providers need to be trained in adequately exchanging information with the immigrant patient and finding out specific patient needs and perspectives on illness and treatment.
Benagiano, Giuseppe; d'Arcangues, Catherine; Harris Requejo, Jennifer; Schafer, Alessandra; Say, Lale; Merialdi, Mario
The Special Programme of Research in Human Reproduction (HRP), co-sponsored by the UNDP, UNFPA, WHO, and the World Bank, is celebrating 40 years of activities with an expansion of its mandate and new co-sponsors. When it began, in 1972, the main focus was on evaluating the acceptability, effectiveness, and safety of existing fertility-regulating methods, as well as developing new, improved modalities for family planning. In 1994, HRP not only made major contributions to the Plan of Action of the International Conference on Population and Development (ICPD); it also broadened its scope of work to include other aspects of health dealing with sexuality and reproduction, adding a specific perspective on gender issues and human rights. In 2002, HRP's mandate was once again broadened to include sexually transmitted infections and HIV/AIDS and in 2003 it was further expanded to research activities on preventing violence against women and its many dire health consequences. Today, the work of the Programme includes research on: the sexual and reproductive health of adolescents, women, and men; maternal and perinatal health; reproductive tract and sexually transmitted infections (including HIV/AIDS); family planning; infertility; unsafe abortion; sexual health; screening for cancer of the cervix in developing countries, and gender and reproductive rights. Additional activities by the Programme have included: fostering international cooperation in the field of human reproduction; the elaboration of WHO's first Global Reproductive Health Strategy; work leading to the inclusion of ICPD's goal 'reproductive health for all by 2015' into the Millennium Development Goal framework; the promotion of critical interagency statements on the public health, legal, and human rights implications of female genital mutilation and gender-biased sex selection. Finally, HRP has been involved in the creation of guidelines and tools, such as the 'Medical eligibility criteria for contraceptive use
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.
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...
Full Text Available Nutritional infertility is very common in societies where women fail to eat enough to match their energy expenditure and such females often present as clinical cases of anorexia nervosa. The cellular and molecular mechanisms that link energy balance and central regulation of reproduction are still not well understood. Peripheral hormones such as estradiol, testosterone and leptin, as well as neuropeptides like kisspeptin and neuropeptides Y (NPY play a potential role in regulation of reproduction and energy balance with their primary target converging on the hypothalamic median eminence-arcuate region. The present study was aimed to explore the effects of negative energy state resulting from intermittent fasting dietary restriction (IF-DR regimen on complete hypothalamo-hypophysial-gonadal axis in Wistar strain young female and male rats. Significant changes in body weight, blood glucose, estrous cyclicity and serum estradiol, testosterone and LH level indicated the negative role of IF-DR regimen on reproduction in these young animals. Further, it was elucidated whether serum level of metabolic hormone, leptin plays a mechanistic role in suppressing hypothalamo-hypophysial-gonadal (HPG axis via energy regulators, kisspeptin and NPY in rats on IF-DR regimen. We also studied the effect of IF-DR regimen on structural remodeling of GnRH axon terminals in median eminence region of hypothalamus along with the glial cell marker, GFAP and neuronal plasticity marker, PSA-NCAM using immunostaining, Western blotting and RT-PCR. Together these data suggest that IF-DR regimen negatively influences reproduction in young animals due to its adverse effects on complete hypothalamus-hypophysial-gonadal axis and may explain underlying mechanism(s to understand the clinical basis of nutritional infertility.
Kumar, Sushil; Kaur, Gurcharan
Nutritional infertility is very common in societies where women fail to eat enough to match their energy expenditure and such females often present as clinical cases of anorexia nervosa. The cellular and molecular mechanisms that link energy balance and central regulation of reproduction are still not well understood. Peripheral hormones such as estradiol, testosterone and leptin, as well as neuropeptides like kisspeptin and neuropeptides Y (NPY) play a potential role in regulation of reproduction and energy balance with their primary target converging on the hypothalamic median eminence-arcuate region. The present study was aimed to explore the effects of negative energy state resulting from intermittent fasting dietary restriction (IF-DR) regimen on complete hypothalamo-hypophysial-gonadal axis in Wistar strain young female and male rats. Significant changes in body weight, blood glucose, estrous cyclicity and serum estradiol, testosterone and LH level indicated the negative role of IF-DR regimen on reproduction in these young animals. Further, it was elucidated whether serum level of metabolic hormone, leptin plays a mechanistic role in suppressing hypothalamo-hypophysial-gonadal (HPG) axis via energy regulators, kisspeptin and NPY in rats on IF-DR regimen. We also studied the effect of IF-DR regimen on structural remodeling of GnRH axon terminals in median eminence region of hypothalamus along with the glial cell marker, GFAP and neuronal plasticity marker, PSA-NCAM using immunostaining, Western blotting and RT-PCR. Together these data suggest that IF-DR regimen negatively influences reproduction in young animals due to its adverse effects on complete hypothalamus-hypophysial-gonadal axis and may explain underlying mechanism(s) to understand the clinical basis of nutritional infertility.
Courtois, Frédérique; Alexander, Marcalee; McLain, Amie B Jackson
Sexual function and to a lesser extent reproduction are often disrupted in women with spinal cord injuries (SCI), who must be educated to better understand their sexual and reproductive health. Women with SCI are sexually active; they can use psychogenic or reflexogenic stimulation to obtain sexual pleasure and orgasm. Treatment should consider a holistic approach using autonomic standards to describe remaining sexual function and to assess both genital function and psychosocial factors. Assessment of genital function should include thoracolumbar dermatomes, vulvar sensitivity (touch, pressure, vibration), and sacral reflexes. Self-exploration should include not only clitoral stimulation, but also stimulation of the vagina (G spot), cervix, and nipples conveyed by different innervation sources. Treatments may consider PDE5 inhibitors and flibanserin on an individual basis, and secondary consequences of SCI should address concerns with spasticity, pain, incontinence, and side effects of medications. Psychosocial issues must be addressed as possible contributors to sexual dysfunctions (eg, lower self-esteem, past sexual history, depression, dating habits). Pregnancy is possible for women with SCI; younger age at the time of injury and at the time of pregnancy being significant predictors of successful pregnancy, along with marital status, motor score, mobility, and occupational scores. Pregnancy may decrease the level of functioning (eg, self-care, ambulation, upper-extremity tasks), may involve complications (eg, decubitus ulcers, weight gain, urological complications), and must be monitored for postural hypotension and autonomic dysreflexia. Taking into consideration the physical and psychosocial determinants of sexuality and childbearing allows women with SCI to achieve positive sexual and reproductive health.
Full Text Available A huge number of chemicals are produced and used in the world, and some of them can have negative effects on the reproductive health of workers. To date, most chemicals and work environments have not been studied for their potential to have damaging effects on the workers' reproductive system. Because of the lack of information, many workers may not be aware that such problems can be related to occupational exposures. Newly industrialized countries such as Republic of Korea have rapidly amassed chemicals and other toxicants that pose health hazards, especially to the reproductive systems of workers. This literature review provides an overview of peer-reviewed literature regarding the teratogenic impact and need for safe handling of chemicals. Literature searches were performed using PubMed, Google Scholar, and ScienceDirect. Search strategies were narrowed based on author expertise and 100 articles were chosen for detailed analysis. A total of 47 articles met prespecified inclusion criteria. The majority of papers contained studies that were descriptive in nature with respect to the Medical Subject Headings (MeSH terms and keywords: “reproductive and heath or hazard and/or workplace or workers or occupations.” In the absence of complete information about the safe occupational handling of chemicals in Republic of Korea (other than a material safety data sheet, this review serves as a valuable reference for identifying and remedying potential gaps in relevant regulations. The review also proposes other public health actions including hazard surveillance and primary prevention activities such as reduction, substitution, ventilation, as well as protective equipment.
A huge number of chemicals are produced and used in the world, and some of them can have negative effects on the reproductive health of workers. To date, most chemicals and work environments have not been studied for their potential to have damaging effects on the workers' reproductive system. Because of the lack of information, many workers may not be aware that such problems can be related to occupational exposures. Newly industrialized countries such as Republic of Korea have rapidly amassed chemicals and other toxicants that pose health hazards, especially to the reproductive systems of workers. This literature review provides an overview of peer-reviewed literature regarding the teratogenic impact and need for safe handling of chemicals. Literature searches were performed using PubMed, Google Scholar, and ScienceDirect. Search strategies were narrowed based on author expertise and 100 articles were chosen for detailed analysis. A total of 47 articles met prespecified inclusion criteria. The majority of papers contained studies that were descriptive in nature with respect to the Medical Subject Headings (MeSH) terms and keywords: "reproductive and heath or hazard and/or workplace or workers or occupations." In the absence of complete information about the safe occupational handling of chemicals in Republic of Korea (other than a material safety data sheet), this review serves as a valuable reference for identifying and remedying potential gaps in relevant regulations. The review also proposes other public health actions including hazard surveillance and primary prevention activities such as reduction, substitution, ventilation, as well as protective equipment.
Sudhinaraset, May; Afulani, Patience; Diamond-Smith, Nadia; Bhattacharyya, Sanghita; Donnay, France; Montagu, Dominic
Background: Globally, substantial health inequities exist with regard to maternal, newborn and reproductive health. Lack of access to good quality care-across its many dimensions-is a key factor driving these inequities. Significant global efforts have been made towards improving the quality of care within facilities for maternal and reproductive health. However, one critically overlooked aspect of quality improvement activities is person-centered care. Main body: The objective of this paper is to review existing literature and theories related to person-centered reproductive health care to develop a framework for improving the quality of reproductive health, particularly in low and middle-income countries. This paper proposes the Person-Centered Care Framework for Reproductive Health Equity, which describes three levels of interdependent contexts for women's reproductive health: societal and community determinants of health equity, women's health-seeking behaviors, and the quality of care within the walls of the facility. It lays out eight domains of person-centered care for maternal and reproductive health. Conclusions: Person-centered care has been shown to improve outcomes; yet, there is no consensus on definitions and measures in the area of women's reproductive health care. The proposed Framework reviews essential aspects of person-centered reproductive health care.
Granek, Leeat; Nakash, Ora
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.
Jurewicz, Joanna; Hanke, Wojciech
Phthalates are a family of industrial chemicals that have been used for a variety of purposes. As the potential consequences of human exposure to phthalates have raised concerns in the general population, they have been studied in susceptible subjects such as pregnant women, infants and children. This article aims at evaluating the impact of exposure to phthalates on reproductive outcomes and children health by reviewing most recent published literature. Epidemiological studies focusing on exposure to phthalates and pregnancy outcome, genital development, semen quality, precocious puberty, thyroid function, respiratory symptoms and neurodevelopment in children for the last ten years were identified by a search of the PubMed, Medline, Ebsco, Agricola and Toxnet literature bases. The results from the presented studies suggest that there are strong and rather consistent indications that phthalates increase the risk of allergy and asthma and have an adverse impact on children's neurodevelopment reflected by quality of alertness among girls, decreased (less masculine) composite score in boys and attention deficit hyperactivity disorder. Results of few studies demonstrate negative associations between phthalate levels commonly experienced by the public and impaired sperm quality (concentration, morphology, motility). Phthalates negatively impact also on gestational age and head circumference; however, the results of the studies were not consistent. In all the reviewed studies, exposure to phthalates adversely affected the level of reproductive hormones (luteinizing hormone, free testosterone, sex hormone-binding globulin), anogenital distance and thyroid function. The urinary levels of phthalates were significantly higher in the pubertal gynecomastia group, in serum in girls with premature thelarche and in girls with precocious puberty. Epidemiological studies, in spite of their limitations, suggest that phthalates may affect reproductive outcome and children health
Sudha, S; Morrison, Sharon
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.
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,
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
Holtze, Susanne; Lukač, Maja; Cizelj, Ivan; Mutschmann, Frank; Szentiks, Claudia Anita; Jelić, Dušan; Hermes, Robert; Göritz, Frank; Braude, Stanton; Hildebrandt, Thomas Bernd
The olm (Proteus anguinus) is a troglomorphic, neotenous amphibian with extraordinary life expectancy and unique adaptations that deserve further investigation. A low reproductive rate and habitat decline render it threatened by extinction. Establishing captive populations for maintenance and artificial breeding may one day become crucial to the species. Longitudinal, in-vivo assessment of inner organs is invaluable to our understanding of reproductive physiology, health, and behavior. Using ultrasound, we measured heart rate and assessed health and reproductive status of 13 captive olms at Zagreb Zoo. Heart rate averaged 42.9 ± 4.6 bpm (32-55 bpm), as determined via pulsed-wave Doppler at 4-12 MHz. By using frequencies of up to 70 MHz (ultrasound biomicroscopy), inner organs were visualized in detail. Assessment of the gastrointestinal tract provided insights into feeding status and digestive processes. Several subclinical pathologies were detected, including biliary sludge, subcutaneous edema, ascites, and skin lesions. Detection of skin lesions by ultrasound was more sensitive than visual adspection. Olms with ultrasonographically detected skin lesions tested positive for Saprolegnia and were treated. Three of the four affected individuals survived and subsequently tested negative for Saprolegnia. Sex was reliably determined; only one individual proved male. The reason for this extreme female-biased sex-ratio remains unknown. However, as most of the individuals were flushed from the caves by strong currents in spring, the sample may not be representative of natural populations. In female olms, different stages of ovarian follicular development were observed with diameters ranging between 0.1 and 1.1 mm. Results were confirmed by comparing ultrasound, necropsy, and histological findings of one dead specimen. In summary, ultrasound proved a valuable tool to support conservation and captive breeding programs by allowing non-invasive assessment of physiological
Full Text Available The olm (Proteus anguinus is a troglomorphic, neotenous amphibian with extraordinary life expectancy and unique adaptations that deserve further investigation. A low reproductive rate and habitat decline render it threatened by extinction. Establishing captive populations for maintenance and artificial breeding may one day become crucial to the species. Longitudinal, in-vivo assessment of inner organs is invaluable to our understanding of reproductive physiology, health, and behavior. Using ultrasound, we measured heart rate and assessed health and reproductive status of 13 captive olms at Zagreb Zoo. Heart rate averaged 42.9 ± 4.6 bpm (32-55 bpm, as determined via pulsed-wave Doppler at 4-12 MHz. By using frequencies of up to 70 MHz (ultrasound biomicroscopy, inner organs were visualized in detail. Assessment of the gastrointestinal tract provided insights into feeding status and digestive processes. Several subclinical pathologies were detected, including biliary sludge, subcutaneous edema, ascites, and skin lesions. Detection of skin lesions by ultrasound was more sensitive than visual adspection. Olms with ultrasonographically detected skin lesions tested positive for Saprolegnia and were treated. Three of the four affected individuals survived and subsequently tested negative for Saprolegnia. Sex was reliably determined; only one individual proved male. The reason for this extreme female-biased sex-ratio remains unknown. However, as most of the individuals were flushed from the caves by strong currents in spring, the sample may not be representative of natural populations. In female olms, different stages of ovarian follicular development were observed with diameters ranging between 0.1 and 1.1 mm. Results were confirmed by comparing ultrasound, necropsy, and histological findings of one dead specimen. In summary, ultrasound proved a valuable tool to support conservation and captive breeding programs by allowing non-invasive assessment of
... can be prevented or minimized by limiting the number of embryos that are put into the woman's body. Learn More Assisted Reproductive Technologies (American Society for Reproductive Medicine) - PDF Also ...
Full Text Available Background In the period of middle childhood, social experiences (both educational and social may constitute a critical moment in time for the ultimate results of development in the case of an individual. Negative life events and coping skills may guarantee a positive or negative direction of development, exerting an influence on the mental health of children. In the study, a four-factor model of mental health was adopted, taking into consideration psychopathological symptoms within the scope of externalizing and internalizing disorders, the level of the performance of developmental tasks, and the sense of life satisfaction. The present study investigated the correlation between stress, coping and mental health in children in middle childhood. Participants and procedure The study included 182 individuals aged between 9 and 12 years. The following aspects were subjected to assessment: the level of mental health, the number and severity of negative life events, and the strategies of coping with stress. In order to determine the strongest predictors of the four dimensions of mental health of children, hierarchical regression analysis was applied. Results It was found that the strongest predictor of mental health of children in the period of middle childhood was individual and accumulated negative stress events. Lower significance was found for the subjective assessment of the severity of events being experienced. It was found that a factor protecting against disorders was active methods of coping. Conclusions The study suggests that it is not only psychopathological symptoms that constitute the negative consequence of the effect of stress. Negative stress events influence the positive dimensions of mental health, including the level of performance of developmental tasks and the sense of life satisfaction in children in the period of middle childhood. The obtained results show the specific character of the discussed period of development. However
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
Patel, Preeti; Roberts, Bayard; Guy, Samantha; Lee-Jones, Louise; Conteh, Lesong
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.
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.
Canning, David; Schultz, T Paul
We consider the evidence for the effect of access to reproductive health services on the achievement of Millennium Development Goals 1, 2, and 3, which aim to eradicate extreme poverty and hunger, achieve universal primary education, and promote gender equality and empower women. At the household level, controlled trials in Matlab, Bangladesh, and Navrongo, Ghana, have shown that increasing access to family planning services reduces fertility and improves birth spacing. In the Matlab study, findings from long-term follow-up showed that women's earnings, assets, and body-mass indexes, and children's schooling and body-mass indexes, substantially improved in areas with improved access to family planning services compared with outcomes in control areas. At the macroeconomic level, reductions in fertility enhance economic growth as a result of reduced youth dependency and an increased number of women participating in paid labour. Copyright © 2012 Elsevier Ltd. All rights reserved.
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
Mbeeli, Thomas; Samahiya, Muine; Ravishankar, Nirmala; Zere, Eyob; Kirigia, Joses M
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
Jayashree S Gothankar
Full Text Available Objective: To assess knowledge and practices related to menstruation and reproductive health amongst college going adolescent girls. Materials and Methods: Cross-sectional study done on 323 adolescent girls admitted in the year 2012 to professional colleges belonging to the health sciences faculty of a private university in Pune, India, using self-administered proforma. Results: Mean age of onset of menarche was 13.35 years. Many girls (86.65% had knowledge of menstruation prior to menarche. For 68% of girls, mother was a source of menstrual information. Half of the girls reported some form of restriction in activities during menstruation due to religious reasons. 11% girls suffered from some form of reproductive tract infections (RTIs. Practices related to menstruation revealed that cloth piece is used for menstrual protection by 3% of girls. Soaked sanitary pads were disposed sanitarily by 96% of girls. Adolescent of medical faculty had significantly more knowledge than nursing faculty adolescents regarding emergency contraceptives (P < 0.05. Only four girls reported a history of sexual contact, of these, three were aware of emergency contraceptives, while one used them to prevent pregnancy. Conclusions: Adolescent girls received knowledge of menstruation prior to menarche from their mothers. Restriction in activity during menstruation due to religious reasons is practiced by many girls. Sanitary pad was used by almost all girls, and all disposed the same in a sanitary manner. More than half of the girls were aware about emergency contraceptives. Prevalence of RTI was found to be low and very few girls reported history of sexual exposure.
Full Text Available Objective: To assess the level of knowledge of the adolescent girls regarding reproductive health issues.Materials and methods: A cross sectional descriptive type of study was carried out among 150unmarried adolescent girls of Vashantek slum in Dhaka city by face to face interview using a semistructuredquestionnaire from January to June 2008.Results: The mean age of the respondents were 16.4±2.9 years ranging from 10-19 years. Out of 150respondents, 130 had history of menstruation and their median age of menarche was 13 years. Thecorrect knowledge was high among the adolescent having secondary level of education than the SSCand above or primary level of education and the difference was statistically significant (p<0.05. Aboutthree-fourths of the respondents had sufficient knowledge about hygienic menstrual practice. Majority ofthe girls could mention the legal age of marriage. Regarding the demerits of early marriage, majoritymentioned some of the demerits but not all. Three-fifths of the respondents had no knowledge onimportance of family planning and regarding the methods of family planning, majority of them had noknowledge. Majority of the respondents heard the disease AIDS but regarding the knowledge oncausative agent half of them had no knowledge. More than two-fifths had no knowledge on mode oftransmission of AIDS. It was also found that majority of the respondents had no knowledge on symptomsof AIDS and three-fifths had no knowledge on prevention of AIDS.Conclusion: So formal, informal and special educational program may be taken to educate theadolescent girls on reproductive health issues and government should be more concerned about this.
Patel, P; Roberts, B; Guy, S; Lee-Jones, L; Conteh, L
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...
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
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.
Smith, Sarah A
Recent evidence of negative sexual and reproductive health (SRH) outcomes for Micronesian migrants warrants a review of what is currently known about Micronesian SRH beliefs, customs, behaviors, outcomes, and access to SRH services. A systematic literature review employing the matrix method was conducted using the same key terms for 8 databases. Peer-reviewed articles published between 1990 and 2010 were abstracted for several key components, including topics, methodology, and other important elements necessary to assess major findings, strengths, and weaknesses. Thirty-two articles matched the inclusion criteria for review. Of these articles, the major research of interest was behavior relating to sexual risk behavior, pregnancy, health care seeking, and HIV/AIDS for various populations throughout Micronesia. Study populations ranged from pregnant women seeking prenatal care to students in high school. No cohesive body of SRH literature exists for one topic or one community within Micronesia to date.
...] 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...
...] 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...
Jaruseviciene, Lina; Lazarus, Jeff; Zaborskis, Apolinaras
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....
H.P. van Dalen (Hendrik)
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
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.
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
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.
Background: Unintended pregnancy, abortion and STI, including HIV are common sexual and reproductive health problems among young people in Kenya and Zambia. Yet, the reproductive health services are underutilised. Nurses and midwives are key providers in the promotion young people s sexual and reproductive health in Kenya and Zambia. Aim: The overall aim was to describe and explore young people s sexual and reproductive health needs and experiences and to describe health ...
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.
Paul R. Gladden
Full Text Available Recent findings indicate that a slow Life History (LH strategy factor is associated with increased levels of Executive Functioning (EF, increased emotional intelligence, decreased levels of sexually coercive behaviors, and decreased levels of negative ethnocentrism. Based on these findings, as well as the generative theory, we predicted that slow LH strategy should inhibit negative androcentrism (bias against women. A sample of undergraduates responded to a battery of questionnaires measuring various facets of their LH Strategy, (e.g., sociosexual orientation, mating effort, mate-value, psychopathy, executive functioning, and emotional intelligence and various convergent measures of Negative Androcentrism. A structural model that the data fit well indicated a latent protective LH strategy trait predicted decreased negative androcentrism. This trait fully mediated the relationship between participant biological sex and androcentrism. We suggest that slow LH strategy may inhibit negative attitudes toward women because of relatively decreased intrasexual competition and intersexual conflict among slow LH strategists. DOI: 10.2458/azu_jmmss.v4i1.17774
Finlay, Jocelyn E; Fox, Ashley M
An unresolved debate in demography concerns the causal sequence between the supply of contraception and the demand for smaller families in fertility decline. Through a mixed-methods approach, we explored the effect of a sudden increase in access to legal abortion on subsequent fertility decline when Ghana's criminal code was amended in 1985. Using Ghana Demographic and Health Surveys, we constructed a panel of women aged 15-34 years and undertook a spline regression analysis to examine the effect of legal changes in 1985 and fertility decline controlling for social determinants of fertility. In addition, we conducted 17 key informant interviews (KIIs) to understand the reasons for the legal change and competing explanations for fertility decline. Multivariate results indicated that the timing of the liberalization of the abortion law coincided with the onset of Ghana's fertility decline. The KIIs indicated that the reasons for the liberalization of reproductive health laws were in response to famine and physician advocacy. While the timing of the abortion law liberalization coincided with the fertility decline in Ghana, we are unable to decouple the effect of the legal change from the effects of a severe famine that affected the region at the same time. Further research on documented and undocumented abortion in Ghana should be conducted to validate the contribution of legal abortion to fertility decline. © 2013.
Kaddour, Afamia; Hafez, Raghda; Zurayk, Huda
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.
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. .
Kågesten, Anna; Parekh, Jenita; Tunçalp, Ozge; Turke, Shani; Blum, Robert William
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.
Bukowinski, Anna T; Conlin, Ava Marie S; Gumbs, Gia R; Khodr, Zeina G; Chang, Richard N; Faix, Dennis J
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.
Adinma, J I B; Adinma, E D
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.
Hansen, Bo Terning; Kjaer, Susanne Krüger; Plum, Christian Edinger Munk
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....
...] Joint Meeting of the Advisory Committee for Reproductive Health Drugs and the Drug Safety and Risk... Reproductive Health Drugs and the Drug Safety and Risk Management Advisory Committee. General Function of the...., [[Page 59143
Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra
To examine the costs to the public health care system of couples in medically assisted reproduction.......To examine the costs to the public health care system of couples in medically assisted reproduction....
Islam, Fakhar ul; Jalali, Samina; Shafqat, Mustafa Nawaz; Shah, Syed Tahir Abbas
Endosulfan is an organochlorine pesticide that is toxic to aquatic life. Endosulfan might hamper the reproductive health of indigenous fish in agricultural areas of Pakistan where this pesticide is sprayed widely. The aim of the current study is to investigate the toxic effects of endosulfan on selected reproductive parameters of male freshwater fish, Cyprinion watsoni. Two concentrations of endosulfan (0.5 and 1 ppb for 30 days exposure) were tested for their effects on body weight, body length, and testicular weight, length, and width. Testicular testosterone was assayed from tissue extracts using enzyme immunoassay (EIA). A significant increase in the mortality rate was observed in both treated groups during both spawning and quiescent seasons. The overall behavior of fish in the aquarium was normal in all control and treated groups. However, the treated fish exhibited anxiety after treatment with endosulfan. The body weight and length, and testicular weight, length and width were not significantly different to the control group. The testicular testosterone concentrations were significantly lower in both endosulfan-treated groups compared to the control. The decrease was dose-dependent, with a significant difference between the two treated groups. The histomorphological results demonstrated various testicular alterations in the treated groups. These alterations included an increase in interlobular areas and clumping patterns in spermatocytes/spermatids. Because spermatids eventually differentiate into sperms, their low count will directly result in lower sperm count. Taken together, these results suggest that endosulfan is a toxicant that at least disturbs testosterone levels (possibly others) and negatively impacts the reproductive health of male freshwater fish.
Patel, P; Dahab, M; Tanabe, M; Murphy, A; Ettema, L; Guy, S; Roberts, B
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.
Zivaridelavar, Maryam; Kazemi, Ashraf; Kheirabadi, Gholam Reza
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...
Arianna Oliveira Santana Lopes
Full Text Available The article discusses issues associated to women's health, since search what are the sexual and reproductive rights for women in situations of incarceration, highlighting the essentiality of these and if they are applied in Brazilian prisons. Therefore, was realized a literature review to assess the situation of the Brazilian women's prisons with regular year 2003 to 2012. When examined there was a wide disparity of reality experienced by these women by numerous factors, ranging from the barriers imposed by the prison as restriction on conjugal visits, the very attempt to play a role of motherhood and, of course, which drew more attention: the discrimination based on gender, since man reassembles his relationships more easily and generally leaves the companion incarcerated for cultural and social arising male sex. Concludes with the emerging need for change this situation in order to provide a better way to live in such a hostile environment to women incarcerated, where the same have their rights violated and nothing is done to such default.
Arianna Oliveira Santana Lopes
Full Text Available The article discusses issues associated to women's health, since search what are the sexual and reproductive rights for women in situations of incarceration, highlighting the essentiality of these and if they are applied in Brazilian prisons. Therefore, was realized a literature review to assess the situation of the Brazilian women's prisons with regular year 2003 to 2012. When examined there was a wide disparity of reality experienced by these women by Saúde da mulher em situação de prisão: direitos sexuais e reprodutivos numerous factors, ranging from the barriers imposed by the prison as restriction on conjugal visits, the very attempt to play a role of motherhood and, of course, which drew more attention: the discrimination based on gender, since man reassembles his relationships more easily and generally leaves the companion incarcerated for cultural and social arising male sex. Concludes with the emerging need for change this situation in order to provide a better way to live in such a hostile environment to women incarcerated, where the same have their rights violated and nothing is done to such default.
Gill-Atkinson, Liz; Vaughan, Cathy; Williams, Hennie
Background Australia's philanthropic sector is growing and could support efforts to improve sexual and reproductive health (SRH). However, philanthropy is often misunderstood in Australia and there is limited evidence of philanthropic support for SRH initiatives. We aimed to understand the barriers and facilitators to philanthropic funding of SRH initiatives in Australia. A qualitative approach was used and involved 13 in-depth interviews with professionals from the philanthropic sector, and from organisations and services involved in SRH. Barriers to organisations in seeking philanthropic funding for SRH activities included insufficient resources for writing grant applications and the small financial value of philanthropic grants. Facilitators to seeking philanthropic funding for SRH included a perception that government funding is shrinking and that philanthropic research grants are less competitive than government grants. Philanthropic participants identified that barriers to funding SRH include the sensitive nature of SRH and the perceived conservative nature of philanthropy. Facilitators identified by these participants in supporting SRH initiatives included networking and relationships between grant-makers and grant-seekers. All participants agreed that philanthropy does and could have a role in funding SRH in Australia. The findings of this research suggest that barriers to philanthropic funding for SRH in Australia exist for organisations attempting to access philanthropic funding. Philanthropic organisations could provide more financial support to Australian SRH service providers, as happens in countries such as the United States and United Kingdom. Addressing these barriers and promoting the facilitators could lead to increased awareness of SRH by Australia's philanthropic sector.
Prather, Cynthia; Fuller, Taleria R.; Marshall, Khiya J.; Jeffries, William L.
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
Prather, Cynthia; Fuller, Taleria R; Marshall, Khiya J; Jeffries, William L
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.
Kresowik, Jessica; Sparks, Amy; Duran, Eyup H; Shah, Divya K
To compare rates of clinical pregnancy (CPR) and live birth (LBR) following embryo transfer (ET) performed by reproductive endocrinology and infertility (REI) fellows before and after a prolonged lapse in clinical training due to an 18-month research rotation. Retrospective cohort study. Not applicable. All women undergoing in vitro fertilization (IVF) and IVF-intracytoplasmic sperm injection (ICSI) cycles with ET performed by REI fellows from August 2003 to July 2012. Eighteen-month lapse in clinical training of REI fellows. CPR and LBR before and after the lapse in clinical training were calculated and compared per fellow and as a composite group. Alternating logistic regression models were used to calculate the odds of clinical pregnancy and live birth following transfers performed before and after the lapse in training. Unadjusted odds of clinical pregnancy and live birth were similar between the two time periods both for individual fellows and for the composite group. Alternate logistic regression analysis revealed no significant difference in CPR (odds ratio [OR] 0.94, 95% confidence interval [CI] 0.83-1.07) or LBR (OR 1.05, 95% CI 0.94-1.18) after the lapse in training compared with before. A research rotation is common in REI fellowship training programs. This prolonged departure from clinical training does not appear to negatively affect pregnancy outcome following fellow ET. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Pinto Aguirre, Guido
Full Text Available The main purpose of this paper is to understand the relationship existing between Gender-Based Violence (GVB and the Use of Reproductive Health and Family Planning services. To carry out this task, we use multivariate logit regression models to explore the direction and strength of the relationship, using a population-based sample for Bolivian women during 2003-2004. Results show a strong, negative and significant relationship between GVB and use of RH/FP services at the population-level, after adjusting for respondent’s and partner’s individual and household characteristics. That is, GBV is strongly and significantly associated with the use of RH/FP services, in a way that women experiencing domestic violence are less likely to use those services.
Sarin, A R
In India the 1991 census showed a declining sex ratio. The number of females was 929 per 1000 males compared to 934 in 1981. Early childhood mortality, malnutrition, high maternal mortality, and female feticide may all be contributing to this disturbing trend. Only 39.42% of women are literate compared to 63.86% of males. At least 50% of women suffer from anemia. Indian women face a 50-times higher rate of pregnancy- and delivery-related deaths than the women in the industrialized countries, a consequence of difficult access to health care, ignorance, poverty, and repeated and close pregnancies. Reproductive tract infections (RTIs) are common with outcomes such as ectopic pregnancy, infertility, and chronic pelvic pain. Also, cervical cancer is still a major killer of Indian women. Another area of concern is the population explosion. Overpopulation brings malnourished and dying children, slums, unemployment, deforestation, desertification and an unending cycle of poverty, illiteracy, and disease. India's population has reached 862 million, and according to the 1991 census there has been an increase of 23.5% during the past decade. India's annual population growth rate of 2.11% is only marginally less than the 2.23% of the preceding decade. The density of population has increased to 267 per square km compared to 216 in 1981. At the present rate of growth, the population by the turn of the century would reach 1 billion. Perhaps the real cause of failing to halt the galloping population growth is related to different human rights standards for men and women. Society accepts that men have the ultimate say when it comes to family planning and determining the size of the family. The medical profession can be an instrument of change, especially in regard to women's health related to wider sociological, cultural, historical, and economic issues.
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.
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.
Cooper, Diane; Morroni, Chelsea; Orner, Phyllis; Moodley, Jennifer; Harries, Jane; Cullingworth, Lee; Hoffman, Margaret
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.
Golbasi, Zehra; Taskin, Lale
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.
Müller, Alex; Spencer, Sarah; Meer, Talia; Daskilewicz, Kristen
Adolescents have significant sexual and reproductive health needs. However, complex legal frameworks, and social attitudes about adolescent sexuality, including the values of healthcare providers, govern adolescent access to sexual and reproductive health services. These laws and social attitudes are often antipathetic to sexual and gender minorities. Existing literature assumes that adolescents identify as heterosexual, and exclusively engage in (heteronormative) sexual activity with partners of the opposite sex/gender, so little is known about if and how the needs of sexual and gender minority adolescents are met. In this article, we have analysed data from fifty in-depth qualitative interviews with representatives of organisations working with adolescents, sexual and gender minorities, and/or sexual and reproductive health and rights in Malawi, Mozambique, Namibia, Zambia and Zimbabwe. Sexual and gender minority adolescents in these countries experience double-marginalisation in pursuit of sexual and reproductive health services: as adolescents, they experience barriers to accessing LGBT organisations, who fear being painted as "homosexuality recruiters," whilst they are simultaneously excluded from heteronormative adolescent sexual and reproductive health services. Such barriers to services are equally attributable to the real and perceived criminalisation of consensual sexual behaviours between partners of the same sex/gender, regardless of their age. The combination of laws which criminalise consensual same sex/gender activity and the social stigma towards sexual and gender minorities work to negate legal sexual and reproductive health services that may be provided. This is further compounded by age-related stigma regarding sexual activity amongst adolescents, effectively leaving sexual and gender minority adolescents without access to necessary information about their sexuality and sexual and reproductive health, and sexual and reproductive health services.
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.
Dec 4, 2009 ... perception, STIs and HIV/AIDS, family planning, male-female relationship, and vulnerability to sexual violence. The data ... abnormality (Center for Reproductive Law and ...... the example of Ghanaian prostitutes in the.
Merklinger-Gruchala, Anna; Jasienska, Grazyna; Kapiszewska, Maria
Air pollution can influence women's reproductive health, specifically menstrual cycle characteristics, oocyte quality, and risk of miscarriage. The aim of the study was to assess whether air pollution can affect the length of the overall menstrual cycle and the length of its phases (follicular and luteal). Municipal ecological monitoring data was used to assess the air pollution exposure during the monitored menstrual cycle of each of 133 woman of reproductive age. Principal component analyses were used to group pollutants (PM 10 , SO₂, CO, and NO x ) to represent a source-related mixture. PM 10 and SO₂ assessed separately negatively affected the length of the luteal phase after standardization (b = -0.02; p = 0.03; b = -0.06; p = 0.02, respectively). Representing a fossil fuel combustion emission, they were also associated with luteal phase shortening (b = -0.32; p = 0.02). These pollutants did not affect the follicular phase length and overall cycle length, neither in single- nor in multi-pollutant models. CO and NO x assessed either separately or together as a traffic emission were not associated with overall cycle length or the length of cycle phases. Luteal phase shortening, a possible manifestation of luteal phase deficiency, can result from fossil fuel combustion. This suggests that air pollution may contribute to fertility problems in women.
Cottingham, Jane; Berer, Marge
The range of medicines and technologies that are essential for sexual and reproductive health care is well established, but access to them is far from universally assured, particularly in less developed countries. This paper shows how the pharmaceutical industry plays a major role in the lack of access to essential medicines for sexual and reproductive health care, by a) investing in products for profit-making reasons despite their negative health impact (e.g. hormone replacement therapy), b) marketing new essential medicines at prices beyond the reach of countries that most need them (e.g. HPV vaccines), and c) failing to invest in the development of new products (e.g. microbicides and medical abortion pills). Small companies, some of them non-profit-making, struggle to fill some of that demand (e.g. for female condoms). International patent protection contributes to high prices of medicines, and while international agreements such as compulsory licensing under TRIPS and the Medicines Patent Pool allow for mechanisms to enable poorer countries to get access to essential medicines, the obstacles created by "big pharma" are daunting. All these barriers have fostered a market in sub-standard medicines (e.g. fake medical abortion pills sold over the internet). An agenda driven by sexual and reproductive health needs, based on the right to health, must focus on universal access to essential medicines at prices developing countries can afford. We call for greater public investment in essential medicines, expanded production of affordable generic drugs, and the development of broad strategic plans, that include affordable medicines and technologies, for addressing identified public health problems, such as cervical cancer. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
Anderson, Kayla N; Koh, Bibiana D; Connor, Jennifer J; Koerner, Ascan F; Damario, Mark; Rueter, Martha A
Compared with singletons, what is the parent mental health, parent-child and couple relationship satisfaction, and child adjustment of 6- to 12-year-old assisted reproduction technology (ART) twins and their families? There are no differences between 6- and 12-year-old ART twin and singleton families in parent mental health or family relationships; however, twins had significantly fewer behavior and attention problems than singletons in middle childhood. When ART twins are younger than 5 years old, parents have more mental health difficulties and poorer parent-child relationship quality, and no differences have been found in ART twin and singletons' psychosocial adjustment. However, studies have only examined the implications of ART twin status in families with infant and toddler aged children. A cross-sectional study of 300 6-12-year-old ART children (n = 124 twins and n = 176 singletons) from 206 families at a reproductive endocrinology clinic in the USA. Patients from one clinic with a child born between 1998 and 2004 were invited to participate in an online survey (82% recruitment rate). Participants provided information on each 6- to 12-year-old ART child in the family, and responded to questions on parent mental health, family relationships and child adjustment. There were no differences in parent mental health or family relationships in families with 6- to 12-year-old ART twins versus singletons. However, twins (M = 2.40, SE = 0.35) had significantly fewer behavior problems than singletons (M = 3.47, SE = 0.36; F(1, 201) = 4.54, b = 1.08, P difficulties and lower parent-child relationship quality than singleton families. This study indicates the negative effects of twin status may have ameliorated by middle childhood, and twins may even have more optimum psychosocial adjustment than singletons in this developmental period. This research is based on a collaborative research effort supported by University of Minnesota Agriculture Experiment Station Project
Padmanabhan, V.; Veiga-Lopez, A.
The 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 (~5 mo gestation and ~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 non-invasive 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 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 three 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/metabolic diseases, insulin resistance, hypertension and behavioral deficits. Collectively, the reproductive and metabolic deficits of prenatal T-treated sheep provide proof of concept for the
Zivaridelavar, Maryam; Kazemi, Ashraf; Kheirabadi, Gholam Reza
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.
Sevig, Umit; Yilmaz, Senay; Başer, Mürüvvet; Taşci, Sultan
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.
...). The main results paper on the baseline CAMS data, "Breast Cancer in Younger Women: Reproductive and Late Health Effects of Treatment," was completed and accepted for publication by the Journal of Clinical Oncology...
Dickinson, Clare; Attawell, Kathy; Druce, Nel
This paper considers new developments to strengthen sexual and reproductive health and HIV linkages and discusses factors that continue to impede progress. It is based on a previous review undertaken for the United Kingdom Department for International Development in 2006 that examined the constraints and opportunities to scaling up these linkages. We argue that, despite growing evidence that linking sexual and reproductive health and HIV is feasible and beneficial, few countries have achieved...
Farhi, A; Reichman, B; Boyko, V; Hourvitz, A; Ron-El, R; Lerner-Geva, L
This study assessed the risk for maternal complications in women and neonatal outcomes in children conceived following assisted reproductive treatment as compared with spontaneously conception and also separately evaluated conventional IVF and intracytoplasmic sperm injection (ICSI). The prospective cohort included 1161 women with singleton pregnancies: 561 who conceived following assisted reproduction (223 following IVF and 338 following ICSI) and 600 who conceived spontaneously. No differences were observed in pregnancy complications (including spontaneous abortion, pregnancy-induced hypertension, gestational diabetes and Caesarean delivery) except for significantly increased risk for excess vaginal bleeding in assisted reproduction pregnancies (21.4% versus 12.9%; OR 1.67, 95% CI 1.18-2.37), which was prominent in women who reported polycystic ovary syndrome. Neonates born following assisted reproduction had increased risk for prematurity (10.6% versus 5.3%; OR 1.72, 95% CI 1.04-2.87), and IVF, but not ICSI, was associated with significantly increased risk for prematurity (OR 2.36, 95% CI 1.28-4.37) and low birthweight (OR 1.89, 95% CI 1.03-3.46). In conclusion, this study observed only an increased risk for excess vaginal bleeding as a pregnancy-associated complication in singleton pregnancies following assisted compared with spontaneous conception. However, singleton neonates born following IVF, but not ICSI, were at increased risk for prematurity. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
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.
Nair, M K C; Paul, Mini K; Leena, M L; Thankachi, Yamini; George, Babu; Russell, P S; Pillai, H Vijayan
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.
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
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.
Natividad, Maria Dulce F
This study examines the relationship between state policies, religion, reproductive politics, and competing understandings of embodied sexual and reproductive morality. Using ethnographic and life history interviews, this study looks at the lives of Filipino urban poor women and how they interpret, follow and resist Catholic Church doctrines and practices as these relate to sexuality and reproduction. Taking everyday morality as embedded in social practice, this paper argues that women's subjective reinterpretations of Catholic teachings regarding contraception and abortion render religion pliant in a way that restores moral equilibrium in women's lives. It is in this process of adjusting and re-adjusting this moral order that women are able to construct their moral worlds. Further, this article investigates how social class, gender and religion work in tension with one another in women's everyday decisions and how the constraints and opportunities that poor women encounter in their everyday lives are enabled by the state and its institutions.
L O Omokanye
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
Full Text Available Abstract Background The continued poor sexual and reproductive health (SRH outcomes in sub-Saharan Africa highlight the difficulties in reforming policies and laws, and implementing effective programmes. This paper uses one international and two national case studies to reflect on the challenges, dilemmas and strategies used in operationalising sexual and reproductive health and rights (SRHR in different African contexts. Methods The international case study focuses on the progress made by African countries in implementing the African Union’s Maputo Plan of Action (for the Operationalisation of the Continental Policy Framework for Sexual and Reproductive Health and Rights and the experiences of state and non-state stakeholders in this process. The case was developed from an evaluation report of the progress made by nine African countries in implementing the Plan of Action, qualitative interviews exploring stakeholders’ experiences and perceptions of the operationalisation of the plan (carried out as part of the evaluation in Botswana and Nigeria, and authors’ reflections. The first national case study explores the processes involved in influencing Ghana’s Domestic Violence Act passed in 2007; developed from a review of scientific papers and organisational publications on the processes involved in influencing the Act, qualitative interview data and authors’ reflections. The second national case study examines the experiences with introducing the 2006 Sexual Offences Act in Kenya, and it is developed from organisational publications on the processes of enacting the Act and a review of media reports on the debates and passing of the Act. Results Based on the three cases, we argue that prohibitive laws and governments’ reluctance to institute and implement comprehensive rights approaches to SRH, lack of political leadership and commitment to funding SRHR policies and programmes, and dominant negative cultural framing of women’s issues
Ying, Cui; Li, Yang; Hui, Han
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.
Wang, Guo-yao; Ji, Yun-xin; Ding, Hui-qing; Gui, Zhong-bao; Liang, Xiao-ming; Fu, Jian-fei; Cheng, Yue
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.
The study was aimed to provide basic information regarding reproductive status of Gaddi sheep reared by nomadic tribe of Himachal Pradesh. Female genitalia of Gaddi sheep (n=190) were collected from unorganized abattoirs around Palampur over a period of one and half years. Out of total genitalia examined, 80.53% ...
Effects of maternal micronutrient supplementation on fetal loss and under-2-years child mortality: Long-term follow-up of a randomised controlled trial from Guinea- ... Cultural and Ethical Challenges of Assisted Reproductive Technologies in the Management of Infertility among the Yoruba of Southwestern Nigeria · EMAIL ...
Zaky, Hassan H M; Khattab, Hind A S; Galal, Dina
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.
Valerie J. Lewis
Full Text Available Adolescents, like adults, frequently experience discrimination, which can be particularly salient in the context of reproductive health care. We examined urban Black adolescent females’ perceived experiences of racial discrimination during reproductive health care encounters. Structured face-to-face interviews were conducted with female African American patients, from age 13 through 20, who obtained reproductive health care services at a single site. Twenty-four participants were enrolled. All were in or graduated from high school, with a mean age of 16.8 years. These young Black women reported infrequent race-based discrimination in the health care setting; however, many reported commonly experiencing discrimination in other places. An awareness of the discrimination that minority young women experience in non–health care settings can help providers demonstrate cultural humility when addressing such concerns with their patients. With this information, providers can provide anticipatory guidance and the tools necessary to navigate complex social systems.
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.
Djalalinia, Shirin; Ramezani Tehrani, Fahimeh; Malekafzali, Hossein; Hashemi, Zeynab; Peykari, Niloofar
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
Sundari Ravindran, T K; Fonn, Sharon
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.
Raisa Viktorovna Nifantova
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.
Connor, Thomas H.; Lawson, Christina C.; Polovich, Martha; McDiarmid, Melissa A.
Objectives Antineoplastic drugs are known reproductive and developmental toxicants. Our objective was to review the existing literature of reproductive health risks to workers who handle antineoplastic drugs. Methods A structured literature review of 18 peer-reviewed, English language publications of occupational exposure and reproductive outcomes was performed. Results While effect sizes varied with study size and population, occupational exposure to antineoplastic drugs appears to raise the risk of both congenital malformations and miscarriage. Studies of infertility and time-to-pregnancy also suggested an increased risk for sub-fertility. Conclusions Antineoplastic drugs are highly toxic in patients receiving treatment and adverse reproductive effects have been well documented in these patients. Healthcare workers with chronic, low level occupational exposure to these drugs also appear to have an increased risk of adverse reproductive outcomes. Additional precautions to prevent exposure should be considered. PMID:25153300
Nordkap, Loa; Joensen, Ulla Nordström; Blomberg Jensen, Martin
of various low-dose exposures to endocrine disrupters in our environment are responsible for the adverse effects in the male reproductive system. Semen quality may be the most sensitive marker of adverse environmental exposures, and we suggest that standardized surveillance studies of semen quality...... entities share the same patho-physiological etiology caused by disturbed testicular development in early fetal life. It seems likely that the rapid rise in TDS-associated conditions can, at least partly, be explained by environmental factors. Animal studies provide strong evidence that manmade chemicals...... to endocrine disrupters also in adulthood may affect semen quality and reproductive hormones. Causal relationships are inherently difficult to establish in humans, and a clear connection between the disorders and specific toxicants has not been established. It seems likely that the cumulative effects...
Full Text Available The purpose of this paper is to review the way cooperation for development has dealt with sexual and reproductive rights by looking at the following three aspects of the question (with the case of Mexico as an example: the actors confronting one another over theissues under discussion (the international donor agencies and specifically the United Nations; the Vatican and the national churches; and the feminist movement; initiatives taking an empowerment approach; and a realistic, viable perspective on possible ways of establishing North-South cooperation relations.In relation to options on support and financing for reproductive rights projects, the resistance of cooperation agencies to incorporate the issue is analyzed. Then the paper discusses elements of a proposal for adoption of a global strategy, some possible pointsof departure, dilemmas faced by bodies receiving applications, and possible strategies for alliances between bodies in North and South.
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
Le classement des problèmes de la santé reproductive afin de définir les priorités des services. Le Rapport du Développement Mondial de 1993 a proposé un nouveau paradigme à l'établissement des priorités dans les services de santé. Les deux démarches importantes par rapport à cette approche sont les estimations ...
Le projet a abouti à l'identification des partenaires sociaux internes et externes et les besoins des écoles médicales nigérianes dans l'enseignement de la santé de reproduction. La participation des enseignants (l'approche de bas en haut) a provoqué un sens de la propriété du document et elle a encouragé de grandes ...
Full Text Available Background & objectives: Male reproductive function in the general population has been receiving attention in recent years due to reports of various reproductive and developmental defects, which might be associated with various lifestyle and environmental factors. This study was carried out to determine the role of various lifestyle and environmental factors in male reproduction and their possible association with declining semen quality, increased oxidative stress as well as sperm DNA damage. Methods: Semen samples were obtained from 240 male partners of the couples consulting for infertility problem. Semen analysis was carried out using WHO criteria and subjects were categorized on the basis of self reported history of lifestyle as well as environmental exposure. The oxidative and antioxidant markers; lipid peroxidation (LPO, superoxide dismutase (SOD and catalase (CAT as well as DNA damage by acridine orange test (AO were determined. Results: The presence of abnormal semen parameters was significantly higher among the lifestyle and/or environmental exposed subjects as compared to the non-exposed population. Further, the levels of antioxidants were reduced and sperm DNA damage was more among the lifestyle and/or environmental exposed subjects, though the changes were not significant. Interpretation & conclusions: These findings indicated that various lifestyle factors such as tobacco smoking, chewing and alcohol use as well as exposure to toxic agents might be attributed to the risk of declining semen quality and increase in oxidative stress and sperm DNA damage.
Cristina Iuliana El Mahdy
Full Text Available The main component of the body: the water, alongside with many function which it has,represents a constituent in the diet of animal. There are many and various factors that influence the daily water requirements of animals: some dependent on animal: and others dependent on the environment. Water quality administered to livestock must meet the requirements for potability prerequisite to maintaining the health, externalization full productive potential and sustaining breeding. Knowing the importance of water quality consists in the negative action which can exert on the body to exceeding certain thresholds translated through: reducing water consumption simultaneously with the decrease milk production, decreased feed conversion rate and average daily gain, degradation of health status by reducing the local resistance, decrease overall body resistance, metabolic, digestive, skeletal disorders and impaired reproduction sphere translated through:decreasing fertility, abortions; elements interfering with the absorption of other essential water body, producing chronic or acute poisoning. The water composition plays essential role depending on which is supplemented or not as the case the quantity of the macro and trace minerals from feedingstuff according to the synergism or antagonism action between the minerals present.
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.
In this paper, the negative and the positive effects of alcohol on health are reviewed. It is first of all established facts that a high alcohol intake implies an increased risk of a large number of health outcomes, such as dementia, breast cancer, colorectal cancer, cirrhosis, upper digestive tr...... good reasons therefore....
The Health Gap identifies and addresses key gaps in gender and health research: women and AIDS, tropical disease, the working environment, barriers to quality health care, and the health of adolescent and older women. It also identifies new and emerging themes in women's health and sets priorities for future action.
Newman, Karen; Fisher, Sarah; Mayhew, Susannah; Stephenson, Judith
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.
Wang, Hongxiang; Chen, Bin; Xu, Yong; Miao, Qing; Wu, Zhenming; Ju, Qiang; Huang, Yiran
To determine whether the attitudes to sexual and reproductive health of a cohort of university students had changed from 2005 to 2013. Questionnaires (1,000) on sexual and reproductive health attitudes were randomly distributed to students at Shanghai Jiaotong University in May 2013. All participants volunteered for the study and their answers were anonymous. The questionnaire contents included personal information and 72 MCQs, which covered four categories: knowledge about sexual/reproductive health and STDs; attitude to sexual behavior; attitudes to pornographic books/movies; desire of the participants for education on sexual/reproductive health. The participants had not received sexual/reproductive health education since their admission to the university. Their study majors were broadly similar to those participants in the April 2005 survey. The high sensitivity of the content of the questionnaire made it imperative to maintain anonymity and high security of the collected data. The return rate of questionnaires were 98% (request age from 19~21 years). Personal hygiene was much greater in females than in males. The proportion of females and males who held a positive attitude to premarital sexual behavior was significantly increased (P education should be based on the actual needs of young people, teaching reforms, and special attention paid to practical teaching.
Tork, Hanan Mohamed Mohamed; Al Hosis, Khalid Fahad
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.
Yuniarti, E.; Fadilah, M.; Darussyamsu, R.; Nurhayati, N.
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.
Samuel Olu Adeyoyin
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.
Ramos, S; Gogna, M
Beginning in July 1993, a 5-year program has sought to provide social research, training, and technical assistance in reproductive health and sexuality in Argentina, Chile, Peru, and Colombia by 1) building research capacity and promoting an interdisciplinary approach to reproductive health and sexuality and 2) promoting a gender perspective to these issues. The target groups are women's nongovernmental organizations (NGOs); family planning, reproductive health, and women's health providers; and social scientists conducting health-related research. Training activities include regional workshops, a Regional Resident Fellowship Program to support graduate-level education, and provision of technical assistance. The first 3 years of the program have revealed that the basic training needs in these areas include 1) helping women's NGOs improve their record-keeping capacity, evaluation processes, theoretical and methodological background, and institutional-building ability; 2) sensitizing women's health providers to sociocultural dimension of health-illness issues and to a gender and human rights perspective; and 3) training social scientist researchers to apply their skills in applied research, develop their theoretical background, and improve research quality control procedures. The main challenges for training activities in the field of reproductive health and sexuality are posed by the complexity of the issues and their interdisciplinary nature.
Mouhanna, Farah; DeJong, Jocelyn; Afifi, Rima; Asmar, Khalil; Nazha, Bassel; Zurayk, Huda
Reproductive health education (RHE) programmes in schools are a well-recognised means of helping young people make informed decisions relating to their sexual health and well-being. Very little research however has investigated attitudes towards such programmes among students in the Arab world. A national HIV education curriculum was developed in…
Whitehead, Brenda R; Bergeman, C S
Because subjective health reports are a primary source of health information in a number of medical and research-based contexts, much research has been devoted to establishing the extent to which these self-reports of health correspond to health information from more objective sources. One of the key factors considered in this area is trait affect, with most studies emphasizing the impact of negative affect (negative emotions) over positive affect (positive emotions), and focusing on high-arousal affect (e.g., anger, excitement) over moderate- or low-arousal affect (e.g., relaxed, depressed). The present study examines the impact of both Positive and Negative Affect (PA/NA)-measured by items of both high and low arousal-on the correspondence between objective health information and subjective health reports. Another limitation of existing literature in the area is the focus on samples suffering from a particular diagnosis or on specific symptom reports; here, these effects are investigated in a sample of community-dwelling older adults representing a broader spectrum of health. 153 older adults (Mage = 71.2) took surveys assessing Perceived Health and Affect and underwent an objective physical health assessment. Structural equation modeling was used to investigate the extent to which the relationship between Objective Health and Perceived Health was moderated by PA or NA, which would indicate the presence of affective health bias. Results reveal a significant moderation effect for NA, but not for PA; PA appeared to serve a more mediational function, indicating that NA and PA operate on health perceptions in distinct ways. These findings provide evidence that in our high-functioning, community-dwelling sample of older adults, a) affective health bias is present within a general health context, and not only within specific symptom or diagnostic categories; and b) that both PA and NA play important roles in the process. Copyright © 2016 Elsevier Ltd. All rights
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.
Objectives This study aims at examining parent-young people communication about sexual and reproductive health related topics and factors associated with it from both young people’s and parents’ perspectives. Methods A cross-sectional study was conducted among 2,269 young people aged 10–24 years in Nekemte town and semi urban areas, western Ethiopia. Chi-square and multivariate logistic regression analyses were conducted using SPSS for windows version 16. The qualitative data was coded, and categorized in to emerging themes using the open code software version 3.4. Result About a third of young people-32.5% (32.4% of females and 32.7% males) engaged in conversation about sexual and reproductive health topics with their parents/parent figures during the last six months. In logistic regression analyses, young people who were aged 15–19 years were more likely to report parent-communication compared to the other age groups (AOR = 1.57; 95%CI = 1.26-1.97). Female young people are more likely to discuss with their mothers, (AOR = 1.89, 95% CI = 1.13-3.2), sister (AOR = 2.16, 95% CI = 1.19-3.9) and female friends (AOR = 11.7, 95% CI = 7.36-18.7) while males are more likely to discuss with male friends (AOR = 17.3, 95%CI = 10-4-28.6). Educated young people were more likely to parent-communicate(AOR = 1.70, 95%CI = 1.30-2.24). Fear of parent, cultural taboos attached to sex, embarrassments, and parents’ lack of knowledge related to sexual and reproductive health were found to be barriers for parent communication. Parent-communication takes place not only infrequently but also in warning, & threatening way. Conclusion Parent-young people communication about sexual health is occurring rarely in the family and bounded by certain barriers. Programmes/policies related to young people’s reproductive health should address not only individual or behavioral factors but also cultural and social factors that negatively
Rocha, C S; Rato, L; Martins, A D; Alves, M G; Oliveira, P F
The pineal hormone melatonin controls several physiological functions that reach far beyond the regulation of the circadian rhythm. Moreover, it can be produced in extra-pineal organs such as reproductive organs. The role of melatonin in the mammalian seasonal and circadian rhythm is well known. Nevertheless, its overall effect in male reproductive physiology remains largely unknown. Melatonin is a very powerful endogenous antioxidant that can also be exogenously taken safely. Interestingly, its antioxidant properties have been consistently reported to improve the male reproductive dysfunctions associated with pathological conditions and also with the exposure to toxicants. Nevertheless, the exact molecular mechanisms by which melatonin exerts its action in the male reproductive system remain a matter of debate. Herein, we propose to present an up-to-date overview of the melatonin effects in the male reproductive health and debate future directions to disclose possible sites of melatonin action in male reproductive system. We will discuss not only the role of melatonin during darkness and sleep but also the importance of the antioxidant properties of this hormone to male fertility. Since melatonin readily crosses the physiological barriers, such as the blood-testis barrier, and has a very low toxicity, it appears as an excellent candidate in the prevention and/or treatment of the multiple male reproductive dysfunctions associated with various pathologies.
Background With health sector reform in Vietnam moving towards greater pluralism, commune health stations (CHSs) have been subject to growing competition from private health services and increasing numbers of patients bypassing CHSs for higher-level health facilities. This study describes the pattern of reproductive health (RH) and family planning (FP) service utilization among women at CHSs and other health facilities, and explores socio-demographic determinants of RH service utilization at the CHS level. Methods This study was based on a cross-sectional survey conducted in Thua Thien Hue and Vinh Long provinces, using a multi-stage cluster sampling technique. Questionnaire-based interviews with 978 ever-married women at reproductive age provided data on socio-demographic characteristics, current use of FP methods, history of RH service use, and the health facility attended for their most recent services. Multiple logistic regression analyses were used to identify socio-demographic determinants of their use of CHS RH services. Results Eighty nine percent of ever-married women reported current use of birth control with 49% choosing intra-uterine device (IUD). Eighty nine percent of pregnant women attended facility-based antenatal care (ANC) with 62% having at least 3 check-ups during their latest pregnancy. Ninety one percent of mothers had their last delivery in a health facility. Seventy-one percent of respondents used CHS for IUD insertion, 55% for antenatal check-ups, and 77% gynecological examination. District and provincial/central hospitals dominated the provision of delivery service, used by 57% of mothers for their latest delivery. The percentage of women opting for private ANC services was reported at 35%, though the use of private delivery services was low (11%). Women who were farmers, earning a lower income, having more than 2 children, and living in a rural area were more likely than others to use ANC, delivery, and/or gynecological check-up services
Les résultats ont permis de présumer que les garçons adolescents reçoivent très peu de renseignements sur la santé reproductive à l'école, des parents ou des services de santé et qu'il y a plusieurs obstacles à l'accès aux services publics tels que les restrictions imposées par l'âge et les attitudes hostiles de la part du ...
Pieter Van Wielendaele
Full Text Available Diuretic hormones (DH related to the vertebrate Corticotropin Releasing Factor (CRF have been identified in diverse insect species. In the migratory locust, Locusta migratoria, the CRF-like DH (CRF/DH is localized in the same neurosecretory cells as the Ovary Maturating Parsin (OMP, a neurohormone that stimulates oocyte growth, vitellogenesis and hemolymph ecdysteroid levels in adult female locusts. In this study, we investigated whether CRF-like DH can influence feeding and reproduction in the desert locust, Schistocerca gregaria. We identified two highly similar S. gregaria CRF-like DH precursor cDNAs, each of which also encodes an OMP isoform. Alignment with other insect CRF-like DH precursors shows relatively high conservation of the CRF/DH sequence while the precursor region corresponding to OMP is not well conserved. Quantitative real-time RT-PCR revealed that the precursor transcripts mainly occur in the central nervous system and their highest expression level was observed in the brain. Injection of locust CRF/DH caused a significantly reduced food intake, while RNAi knockdown stimulated food intake. Therefore, our data indicate that CRF-like DH induces satiety. Furthermore, injection of CRF/DH in adult females retarded oocyte growth and caused lower ecdysteroid titers in hemolymph and ovaries, while RNAi knockdown resulted in opposite effects. The observed effects of CRF/DH may be part of a wider repertoire of neurohormonal activities, constituting an integrating control system that affects food intake and excretion, as well as anabolic processes like oocyte growth and ecdysteroidogenesis, following a meal. Our discussion about the functional relationship between CRF/DH and OMP led to the hypothesis that OMP may possibly act as a monitoring peptide that can elicit negative feedback effects.
Full Text Available Adolescence is a period in which young people are exposed to various physiological disorders, diseases and social consequences of risky behavior. Sudden changes in society leading to increased poverty, changes of values and increased crime rate can all cause risky behavior among young people. The aim of the study was to establish the attitudes and knowledge of secondary school students in Vojvodina related to the human body, physiological processes, sexual maturation and reproductive health. The study also focused on students' attitudes towards sexual intercourse and to what extent the topics related to reproductive health are present in the school curriculum. In this investigation we used data obtained in a recent research on second, third and fourth-year secondary students in some municipalities of Vojvodina in 2012 and 2013. The students were examined in the municipalities of Ruma, Senta, Čoka, Kanjiža and Subotica. We applied the method of survey. The questions were both open and closed, and divided into four groups: knowledge on the human body and sexual organs, information on sexual maturation and reproductive health, attitudes towards sexual intercourse and students' views on the content of reproductive health issues in the curriculum. The adolescents do not know enough about the human body and the basic physiological processes and show insufficient awareness of the importance of using contraception to preserve their reproductive health. Most of the students express a positive opinion of introducing a special subject into the curriculum that would deal with issues related to reproductive health. The obtained data are consistent with other previous studies in Serbia, suggesting that nothing has changed in this segment of our medical culture. The results suggest that young people need sexual education that corresponds to their age and needs, in order to be able to increase their knowledge and improve skills that can help them maintain
Sidze, E.M.; Pradhan, J.; Beekink, E.; Maina, T.M.; Maina, B.W.
Understanding the flow of resources at the country level to reproductive health is essential for effective financing of this key component of health. This paper gives a comprehensive picture of the allocation of resources for reproductive health in Kenya and the challenges faced in the
Larrañaga, Isabel; Martín, Unai; Bacigalupe, Amaia
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.
Coates, Amy L; Hill, Peter S; Rushton, Simon; Balen, Julie
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.
Alvarez, Maria do Carmo Avamilano; Cuenca, Angela Maria Belloni; Noronha, Daisy Pires; Schor, Néia
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.
Bienefeld, M.K.; McLaughlin, J.R.
The evidence regarding the effects of occupational exposure to low levels of ionizing radiation on reproductive health is limited. However, exposure to high doses of ionizing radiation is associated with increased risk of adverse reproductive outcomes. The resulting uncertainty about the effects of occupational exposures has caused concern among some workers, therefore, we have designed a study to examine this question among Canadian medical radiation technologists. A short mailed questionnaire will be sent to all CAMRT members to obtain information about reproductive history, and a sample of respondents will receive a second questionnaire requesting information about other important exposures. Occupational dose records will be retrieved from the National Dose Registry. Using this information, relative risks for each outcome will be calculated for different radiation dose levels. This article provides a brief review of the literature on ionizing radiation exposure and reproductive outcomes, and an outline of the proposed study
Saha, Kalyan B; Singh, Neeru; Chatterjee Saha, Uma; Roy, Jyotirmoy
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
Crockett, Cailin; Cooper, Bergen
Despite their demographic significance and the lifetime impact of gender disparities on their health and rights, women considered older than reproductive age are excluded from most investments in global public health. While development policies linking human rights with access to sexual and reproductive healthcare have yielded progress towards improving the status of women and girls, older women have not benefited from these initiatives. Yet as women grow older, they experience a range of health conditions rooted in their reproductive biology - from ageing with fistula, to cervical and breast cancers. Current approaches to global women's health ignore these serious conditions, harming older women through the perpetuation of gender norms that construe women's health through a narrow reproductive lens. Meanwhile, older women are generally absent from global ageing discourse, which lacks a gender perspective, creating a dual invisibility as the field of global women's health presumes ageing women are accounted for. Reclaiming the sexual rights framework suggested by the International Conference on Population and Development and the Beijing Platform for Action, we call for the revision of global health policies to incorporate a life course approach to women's health as a matter of human rights. Published by Elsevier B.V.
Stefansson, Lilja S.; Webb, M. Elizabeth; Hebert, Luciana E.; Masinter, Lisa; Gilliam, Melissa L.
Background: Adolescents experience numerous barriers to obtaining sexual and reproductive health care (SRHC). Mobile Health Units (MHUs) can remove some barriers by traveling to the community. This pilot study developed Mobile SRHC through an iterative process on an existing MHU and evaluated it among adolescents and providers. Methods: Mobile…
Ancheta, Rosedelia; Hynes, Colin; Shrier, Lydia A
The objective of this study was to explore the associations of sources, content, and timing of reproductive health education with cognitive and behavioral sexual risk in a sample of high-risk female adolescents and young adults. Female adolescents and young adults (n=113, median age 17 years) receiving treatment for a sexually transmitted disease (STD) reported sources of reproductive health education, topics covered, and when first formal education occurred. Dependent variables included sexual risk knowledge; condom attitudes, negotiation skills, and use (consistent and at last sex); and number of sexual partners. Most participants reported receiving reproductive health education from both parental (80%) and formal sources (92%). Parents discussed the menstrual cycle (94%) more frequently than other sex education topics, while formal sources focused most on teaching about STDs (91%). Although median age of first formal instruction was 12 years, 26% of girls received their first formal education during or after the year they initiated coitus. Girls with a parental source of education and those receiving formal instruction on pregnancy reported greater ability to negotiate condom use. Girls who received education later in relation to the onset of sexual activity and those with a parental source of education reported more sexual partners. Early reproductive health education and education from both parental and formal sources is associated with reduced sexual risk among high-risk adolescent girls. Interestingly, receiving parental education is also associated with more sexual partners, suggesting that parental educational efforts may be reactive to their daughters' increasing sexual risk behavior. Future research should examine multiple sources of reproductive health education and the timing of education from these sources to enhance understanding the dynamic interactions between reproductive health education and adolescent sexual risk.
Akbari, Nahid; Ramezankhani, Ali; Pazargadi, Mehrnoosh
At the 1994 International Conference on Population and Development (ICPD), held in Cairo, the global community agreed to the goal of achieving universal access to sexual and reproductive health (SRH) and rights by 2015. This research explores the accelerators and decelerators of achieving universal access to the sexual and reproductive health targets and accordingly makes some suggestions. We have critically reviewed the latest national reports and extracted the background data on each SRH indicator. The key stakeholders, both national and international, were visited and interviewed at two sites. A total of 55 in-depth interviews were conducted with religious leaders, policy-makers, senior managers, senior academics, and health care managers. Six focus-group discussions were also held among health care providers. The study was qualitative in nature. Obstacles on the road to achieving universal access to SRH can be viewed from two perspectives. One gap exists between current achievements and the targets. The other gap arises due to age, marital status, and residency status. The most recently observed trends in the indicators of the universal access to SRH shows that the achievements in the "unmet need for family planning" have been poor. Unmet need for family planning could directly be translated to unwanted pregnancies and unwanted childbirths; the former calls for sexual education to underserved people, including adolescents; and the latter calls for access to safe abortion. Local religious leaders have not actively attended international goal-setting programs. Therefore, they usually do not presume a positive attitude towards these goals. Such negative attitudes seem to be the most important factors hindering the progress towards universal access to SRH. Lack of international donors to fund for SRH programs is also another barrier. In national levels both state and the society are interactively playing their roles. We have used a cascade model for presenting the
Manu, Abubakar A; Mba, Chuks Jonathan; Asare, Gloria Quansah; Odoi-Agyarko, Kwasi; Asante, Rexford Kofi Oduro
Young people aged 10-24 years represent one-third of the Ghanaian population. Many are sexually active and are at considerable risk of negative health outcomes due to inadequate sexual and reproductive health knowledge. Although growing international evidence suggests that parent-child sexual communication has positive influence on young people's sexual behaviours, this subject has been poorly studied among Ghanaian families. This study explored the extent and patterns of parent-child sexual communication, and the topics commonly discussed by parents. A cross-sectional design was used to sample 790 parent-child dyads through a two-stage cluster sampling technique with probability proportional to size. Interviewer-administered questionnaire method was used to gather quantitative data on parent-child communication about sex. Twenty sexual topics were investigated to describe the patterns and frequency of communication. The Pearson's chi-square and z-test for two-sample proportions were used to assess sexual communication differences between parents and young people. Qualitative data were used to flesh-out relevant issues which standard questionnaire could not cover satisfactorily. About 82.3% of parents had at some point in time discussed sexual and reproductive health issues with their children; nonetheless, the discussions centered on a few topics. Whereas child-report indicated that 78.8% of mothers had discussed sexual communication with their children, 53.5% of fathers had done so. Parental discussions on the 20 sexual topics ranged from 5.2%-73.6%. Conversely, young people's report indicates that mother-discussed topics ranged between 1.9%-69.5%, while father-discussed topics ranged from 0.4% to 46.0%. Sexual abstinence was the most frequently discussed topic (73.6%), followed by menstruation 63.3% and HIV/AIDS 61.5%; while condom (5.2%) and other contraceptive use (9.3%) were hardly discussed. The most common trigger of communication cited by parent
Afsar, H.A.; Sohani, S.; Younas, M.; Mohammad, S.
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)
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
Wright, Elizabeth J; White, Katherine M; Obst, Patricia L
As research examining what constitutes Facebook false self-presentation is lacking, the aim of this study was to develop a preliminary inventory of Facebook false self-presentation behaviors, as well as identify predictors and possible outcomes. Participants (N = 211) completed questions regarding frequency of engagement in Facebook false self-presentation behaviors, as well as self-esteem, social influences, motivation strategies, well-being, depression, anxiety, and stress. Results indicated the presence of two distinct false self-presentation behaviors: lying (e.g., untruthful status updates, profile creation) and liking behaviors (e.g., liking posts dishonestly), each associated with different predictors and outcomes. Results indicated that moral norms significantly predicted lying behaviors; and age, self-esteem, group norms, and moral norms significantly predicted liking behaviors. Unexpectedly, liking behaviors were associated with depression, anxiety, and stress, whereas lying behaviors were related to anxiety only. Findings highlight associations between online self-presentation strategies, in particular liking behaviors, on Facebook and possible offline negative mental health.
The lack of reliable data limits the ability of health providers, planners, and community ... approaches and established guidelines from the World Health Organization; ... governance processes; develop a dashboard of data and related analysis; ...
Nov 11, 2003 ... Department of Community Health and Primary Health Care ... percent approved of teaching sex education to adolescents in schools, 55.6% approved of contraceptive use by the ..... own biases in the light of scientific facts.
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
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.
Webber, Gail C; Spitzer, Denise L
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
Spitzer Denise L
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
Ngwena, Charles G; Brookman-Amissah, Eunice; Skuster, Patty
The African Commission on Human and Peoples' Rights recently adopted General Comment No 2 to interpret provisions of Article 14 of the Protocol to the African Charter on the Rights Women. The provisions relate to women's rights to fertility control, contraception, family planning, information and education, and abortion. The present article highlights the General Comment's potential to promote women's sexual and reproductive rights in multiple ways. The General Comment's human rights value goes beyond providing states with guidance for framing their domestic laws, practices, and policies to comply with treaty obligations. General Comment No 2 is invaluable in educating all stakeholders-including healthcare providers, lawyers, policymakers, and judicial officers at the domestic level-about pertinent jurisprudence. Civil society and human rights advocates can use the General Comment to render the state accountable for failure to implement its treaty obligations. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Suely Gomes Costa
Full Text Available This article analyses the nature of the tensions brought about by the entrance of women into public space and the rise of protectionist systems in Brazil. It places both experience and theory in the long-range context of women’s history, gender relations and feminist movements. Feminist struggles and domesticity patterns reaffirm the home as the place par excellence of protectionist practices, something that prevented or delayed the advent of public protectionist systems. The different relationships among those women who remained at home and those that managed to develop their activities outside the domestic environment will certainly establish inequalities as to the obtention of social rights. The article examines evidence of change in the historical trend in the struggle for universal reproductive rights during the 1980s.
Cabal, Luisa; Olaya, Monica Arango; Robledo, Valentina Montoya
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.
Full Text Available OBJECTIVES Complex and diverse factors are related to reproductive health (RH behavior among adolescents according to the social and cultural context of each countries. This study examined the prevalence of active RH and factors related to active RH behavior among Indonesian adolescents. METHODS A cross-sectional study was conducted among 1,040 of students who were selected through a multi-stage random sampling technique. A self-administered questionnaire was developed, including the World Health Organization Illustrative Questionnaire for Interview-Surveys with Young People, pubertal development scale, and sexual activity scale, modified in accordance to the Indonesian context. The data were analyzed using descriptive and comparative statistics, as well as logistic regression analyses. RESULTS The prevalence of active RH behavior were more higher in boys (56.6%; 95% confidence interval [CI], 50.6% to 62.6% than in girls (43.7%; 95% CI, 37.6% to 49.8%. Negative attitudes towards RH were a factor related to active RH behavior in both boys and girls. Smoking and kind relationship envisioned before marriage (pacaran [courtship] and nikah siri [non-registered marriage] were factors related to active RH behavior in boys; whereas the absence of access to information on substance abuse was an additional factor in girls. Moreover, an interaction was found between access to information on development and smoking (boys and attitudes on RH (girls as independent variables associated with active RH behavior. CONCLUSIONS Sex education for adolescents in Indonesia, particularly in the context of a health promotion program, should be developed based on prevalent social, cultural, and religious values to prevent active RH behavior. Such programs should focus on the kind of relationship envisioned before marriage and smoking for boys and access to information on subtance abuse for girls.
Kotch, J B; Ossler, C C; Howze, D C
Many occupations in which women comprise the majority of the workforce involve exposure to biological, physical, and chemical hazards. Potential reproductive effects of work-related substances include impaired reproductive capacity, mutagenesis, teratogenesis, and transplacental carcinogenesis. However, female-dominated occupations tend to be only minimally regulated by the US Occupational Safety and Health Administration, and the corporate response to the issue of reproductive and fetal health has been to institute "protective discrimination policies" such as the demotion or exclusion of women of childbearing age from certain jobs. This article rates the effectiveness of alternate policy responses to increase women's occupational health and safety through use of a series of analysis criteria: equity, efficiency, preference satisfaction, right to privacy, avoidance of stigma, and unintended consequences. Policy options include the following: 1) do nothing, 2) leave current policies intact while supporting a research program to document the health consequences of specific occupational risks to women's reproductive health, 3) restrict women for who pregnancy is not ruled out from occupations or work areas known or suspected to be hazardous, 4) improve working conditions for all women, and 5) improve working conditions for all workers. Policy analysis suggests the working conditions of all workers should be improved. This alternative reduces inequity, eliminates stigma, maintains privacy, and honors preferences. Implementation of this policy would be expensive, requiring an increase in knowledge of the effects of industrial substances on female and male reproductive health, expansion of the technical capacity to control occupational hazards, and an increase in the resources of programs that monitor and regulate occupational health. However, this approach is in accord with growing concern that workers should not have to compromise their health to keep their jobs.
Though gender equity is widely considered to be a key to improving maternal health in developing countries, little empirical evidence has been presented to support this claim. This paper investigates whether or not and how female autonomy within the household affects women's use of reproductive health care in Tajikistan, where the situation of maternal health and gender equity is worse compared with neighbouring countries. Estimation is performed using bivariate probit models in which woman's...
Sarnquist, Clea C; Rahangdale, Lisa; Maldonado, Yvonne
Review key topics and recent literature regarding reproductive health and family planning needs for HIV-infected women in Sub-Saharan Africa. Electronic searches performed in PubMed, JSTOR, and Web of Science; identified articles reviewed for inclusion. Most HIV-infected women in Sub-Saharan Africa bear children, and access to antiretroviral therapy may increase childbearing desires and/or fertility, resulting in greater need for contraception. Most contraceptive options can be safely and effectively used by HIV-infected women. Unmet need for contraception is high in this population, with 66- 92% of women reporting not wanting another child (now or ever), but only 20-43% using contraception. During pregnancy and delivery, HIV-infected women need access to prevention of mother-to-child transmission (PMTCT) services, a skilled birth attendant, and quality post-partum care to prevent HIV infection in the infant and maximize maternal health. Providers may lack resources as well as appropriate training and support to provide such services to women with HIV. Innovations in biomedical and behavioral interventions may improve reproductive healthcare for HIV-infected women, but in Sub-Saharan Africa, models of integrating HIV and PMTCT services with family planning and reproductive health services will be important to improve reproductive outcomes. HIV-infected women in Sub-Saharan Africa have myriad needs related to reproductive health, including access to high-quality family planning information and options, high-quality pregnancy care, and trained providers. Integrated services that help prevent unintended pregnancy and optimize maternal and infant health before, during and after pregnancy will both maximize limited resources as well as provide improved reproductive outcomes.
Full Text Available Abstract Background Dealing with pregnancy, childbirth and the care of newborn babies is a challenge for female asylum seekers and their health care providers. The aim of our study was to identify reproductive health issues in a population of women seeking asylum in Switzerland, and to examine the care they received. The women were insured through a special Health Maintenance Organisation (HMO and were attending the Women's Clinic of the University Hospital in Basel. We also investigated how the health professionals involved perceived the experience of providing health care for these patients. Methods A mixed methods approach combined the analysis of quantitative descriptive data and qualitative data obtained from semi-structured interviews with health care providers and from patients' files. We analysed the records of 80 asylum-seeking patients attending the Women's Clinic insured through an HMO. We conducted semi-structured interviews with 10 care providers from different professional groups. Quantitative data were analysed descriptively. Qualitative data analysis was guided by Grounded Theory. Results The principal health problems among the asylum seekers were a high rate of induced abortions (2.5 times higher than in the local population, due to inadequate contraception, and psychosocial stress due to the experience of forced migration and their current difficult life situation. The language barriers were identified as a major difficulty for health professionals in providing care. Health care providers also faced major emotional challenges when taking care of asylum seekers. Additional problems for physicians were that they were often required to act in an official capacity on behalf of the authorities in charge of the asylum process, and they also had to make decisions about controlling expenditure to fulfil the requirements of the HMO. They felt that these decisions sometimes conflicted with their duty towards the patient. Conclusion
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.
Katz, Karen R; McDowell, Misti; Green, Mackenzie; Jahan, Shamim; Johnson, Laura; Chen, Mario
Little is known about the sexual and reproductive health care needs of female sex workers in Dhaka, Bangladesh. Survey data were collected from 354 hotel-based and 323 street-based female sex workers using a venue-based stratified cluster sampling approach. In addition, in-depth interviews were conducted with 20 female sex workers recruited from drop-in centers. We calculated unmet need for family planning and examined fertility desires, use of condoms and other contraceptive methods, experiences with gender-based violence, sexual and reproductive health service needs, and preferences on where to receive services. The prevalence of unmet need was 25% among hotel-based female sex workers and 36% among street-based female sex workers. Almost all participants reported having used condoms in the past 30 days, and 44% of hotel-based sex workers and 30% of street-based sex workers reported dual method use during that period. Condom use was inconsistent, however, and condom breakage and nonuse for extra money were common. Many women reported experiencing gender-based violence. Sexual and reproductive health services had been obtained by 64% of hotel-based and 89% of street-based sex workers in the past six months; drop-in centers were their preferred site for receiving health services. Female sex workers in Dhaka need family planning and other sexual and reproductive health services and prefer receiving them from drop-in centers.
Mac-Seing, Muriel; Zarowsky, Christina
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.
Averitt Taylor, Jessica
This article provides an overview of the historical arguments surrounding reproductive health policy and current policy initiatives. Because reproductive policy itself is a vast subject matter with sometimes blurry boundaries, the struggle concerning the advent of birth control is used to illustrate the historic complexities of policy affecting such a wide array of individuals. The battle over introduction of the birth control pill is pertinent because the very same arguments are used today in debates over reproductive health policy.
Prevalence of Du Phenotype amongst Rhesus Negative Females in Port Harcourt, Nigeria. CA Nwauche, OA Ejele, AOU Okpani ... Live Births after Intracytoplasmic Sperm Injection in the Management of Oligospermia and Azoospermia in Nigeria. RA Ajayi, JH Parsons, VN Bolton ...
Reese Masterson, Amelia; Usta, Jinan; Gupta, Jhumka; Ettinger, Adrienne S
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.
Lechuga, Julia; Garcia, Dina; Owczarzak, Jill; Barker, Maria; Benson, Meghan
Community health worker (CHW) programs have existed for over 50 years across the world. However, only recently has research evidence documented their effectiveness. Research is still needed to identify issues related to implementation and sustainability of CHW programs. This article explores the role and challenges of U.S. Latino CHWs trained to deliver a comprehensive sexual and reproductive health educational intervention to Latino families. We conducted a semistructured interview with a purposive convenience sample of 19 CHWs. Findings suggest that CHWs occupy roles that go beyond those they were trained for. CHWs serve not only as educators but also as providers of social support, facilitators of access to resources, patient navigators, and civil rights advocates. Lack of clarity of the role of a CHW influenced perceptions of adequacy of compensation, training, and integration into the agency that trained them. Policy facilitating the standardization of the CHW occupational category and role expectations is imperative to ensure successful implementation and sustainability of U.S. CHW programs. © 2015 Society for Public Health Education.
Nguyen, Ha; Snider, Jeremy; Ravishankar, Nirmala; Magvanjav, Oyunbileg
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.
Bloom, S S; Tsui, A O; Plotkin, M; Bassett, S
Women in India suffer from a high incidence of reproductive disease, disability and death. Very little work has been done on men, but a much higher incidence of sexual experience outside marriage and sexually transmitted diseases (STDs) among males than previously expected for this population is now being documented. In north India, women are dependent on their husbands and other family members for health-related decisions. Therefore, the behaviour, knowledge and attitudes of men are integral to the reproductive health status of couples there. This study explores knowledge about three distinct areas of reproductive health among 6549 married men in five districts of the northern state of Uttar Pradesh, India. Factors contributing to men's knowledge in the areas of fertility, maternal health and STDs were investigated. Results showed that very few men had basic knowledge in any of these areas. The likelihood of reporting knowledge was associated with a set of determinants that differed in their magnitude and effect across the areas of reproductive health explored. In particular, men's belief about the ability of an individual to prevent pregnancy demonstrated an independent association with men's knowledge. After controlling for factors such as age, parity and educational and economic status, men who believed it not possible to prevent a pregnancy were less likely to know when during the menstrual cycle women would become pregnant and certain facts about STDs, but they were more likely to be able to name two or more symptoms of serious maternal health conditions. Possible explanations for this trend are discussed.
Fonn, Sharon; Sundari Ravindran, T K
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.
Yu, C Y; Yu, W L; Xu, M; Xing, Z L
Objective: To investigate the distribution of shift work of female workers in different industries and the relationship between shift work and reproductive health, then provide reference for the female workers' labor protection. Methods: From June to September 2016, cluster sampling questionnaire survey was performed among female workers from 11 industries including electronics, medicine and health, pharmacy. To investigate the general information, shift - work information, reproductive health and childbearing history of these female workers. Results: A total of 63 711 usable questionnaires were collected, resulting in a response rate of 96.94%.A total of 13 546 workers worked in shifts, accounting for 21.26%, the highest proportion was in the medical industry 30.61%, metallurgy 30.81%, petrochemical engineerin 26.78% respectively. Compared with the workers who did not work in shifts, those who worked in shifts had significantly higher rate of abnormal menstruation, rate of reproductive system infection in married workers, the rate of infertility (χ(2)=19.108、10.673、21.510, P <0.05) ; Compared with the workers who did not work in nightshifts, those who worked in nightshifts had significantly higher rate of abnormal menstruation, rate of reproductive system infection among married workers and rate of infertility (χ(2)=140.043、71.901、29.024, P <0.01) . Conclusion: The highest rate of shift work was in the medical industry, metallurgy, petrochemical engineering industry. Workers who worked in shifts have serious reproductive health issues, the occurrence of abnormal menstruation, reproductive system infection and infertility may associated with shift work.
Payne, Craig A; Vander Ley, Brian; Poock, Scott E
This article discusses some of the aspects of heifer development that contribute to long-term health and productivity, such as disease prevention and control. Nutrition is also an important component of long-term health, and body condition score is discussed as a way to determine whether the nutrient demands of heifers are being met. Copyright © 2013 Elsevier Inc. All rights reserved.
government became the main funding source for RH services (44.2%), partly reflecting government enhanced commitment to increase resources for maternal and child health, and due to exemption of pregnant women from paying for health care. Nevertheless, this commitment didn't last and the financing burden was borne ...
Maternal and Child Health Services in the Context of the Ebola Virus Disease: Health Care Workers' Knowledge, Attitudes and Practices in Rural Guinea · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Alexandre Delamou, Sidikiba Sidibé, Alison Marie El Ayadi, ...
Ivanova, Olena; Dræbel, Tania; Tellier, Siri
BACKGROUND: Health policies are important instruments for improving population health. However, experience suggests that policies designed for the whole population do not always benefit the most vulnerable. Participation of vulnerable groups in the policy-making process provides an opportunity fo...
structural, socio-cultural and financial barriers. For South. Africa ... all social services, health included. Health policies on the ... is estimated to be undocumented, children and youth under the age of ... from various UN. Agencies, 5 were peer-reviewed publications, 3 were media publications and 2 publications by the South.
Rocío Rivas Martín
Full Text Available Introduction: Health care to women is mainly focused on their gynecological and reproductive health. It is directed toward heterosexual women, their coital relations and the gestation, and doesn´t consider other practices and health issues. In recent years, lesbian women have become more visible in society, recalling that should not focus solely on sexual vaginal coitus and demanding their desire of being mothers.Objetives: With this study we try to be closer to lesbian women´s perceptions about their sexual and reproductive health, as well as trying to determine the factors that influence their health care and their relationship with the health system. Methodology: For this purpose was carried out a qualitative study among lesbian women of different ages. Techniques of collected data used were in-depth interview and discussion group. Results: The results show that lesbians feel safe at the risk of contracting sexually transmitted infections; in addition they express their difficulties to reveal their sexual identity to healthcare professionals as well as problems accessing maternity. Conclusions: We conclude with the idea of the need for greater diversity and sexual health training for professionals, as well as further research on gynecological, sexual and reproductive health of this group of population.
Valenzuela, M S; Herold, J M; Morris, L; López, I M
In 1988 a survey was carried out in order to obtain information on knowledge about reproduction, sexual activity, attitudes, and use of contraceptive methods among residents between 15 and 24 years of age in Greater Santiago. For this purpose, a multistage, self-weighted, non-replacement probability sample was chosen from the entire Santiago urban area. After 2,898 households were visited, 865 women and 800 men were selected and interviewed. For the interview, a questionnaire with 156 questions was developed; many questions were similar to those included in similar surveys in Brazil and Guatemala. The interviewers were professionals who had received prior training. Although 75% of the interviewees had attended sex education classes, they had erroneous ideas on various basic subjects. Sixty-nine percent of the women interviewed had undergone menarche before attending these classes. In addition, 35.4% of the women and 65.0% of the men had had sexual relations prior to marriage, and less than 20% had used any contraceptive method. More than 60% of the interviewees who had children had conceived them before marrying. These findings point up the necessity of offering sex education classes for children and young people, as well as facilitating their access to family planning services, in order to decrease the number of illegitimate and unwanted children that are born in Chile.
Russel J. Reiter
Full Text Available Melatonin has a wide variety of beneficial actions at the level of the gonads and their adnexa. Some actions are mediated via its classic membrane melatonin receptors while others seem to be receptor-independent. This review summarizes many of the published reports which confirm that melatonin, which is produced in the ovary, aids in advancing follicular maturation and preserving the integrity of the ovum prior to and at the time of ovulation. Likewise, when ova are collected for in vitro fertilization-embryo transfer, treating them with melatonin improves implantation and pregnancy rates. Melatonin synthesis as well as its receptors have also been identified in the placenta. In this organ, melatonin seems to be of particular importance for the maintenance of the optimal turnover of cells in the villous trophoblast via its ability to regulate apoptosis. For male gametes, melatonin has also proven useful in protecting them from oxidative damage and preserving their viability. Incubation of ejaculated animal sperm improves their motility and prolongs their viability. For human sperm as well, melatonin is also a valuable agent for protecting them from free radical damage. In general, the direct actions of melatonin on the gonads and adnexa of mammals indicate it is an important agent for maintaining optimal reproductive physiology.
Reiter, Russel J.; Rosales-Corral, Sergio A.; Manchester, Lucien C.; Tan, Dun-Xian
Melatonin has a wide variety of beneficial actions at the level of the gonads and their adnexa. Some actions are mediated via its classic membrane melatonin receptors while others seem to be receptor-independent. This review summarizes many of the published reports which confirm that melatonin, which is produced in the ovary, aids in advancing follicular maturation and preserving the integrity of the ovum prior to and at the time of ovulation. Likewise, when ova are collected for in vitro fertilization-embryo transfer, treating them with melatonin improves implantation and pregnancy rates. Melatonin synthesis as well as its receptors have also been identified in the placenta. In this organ, melatonin seems to be of particular importance for the maintenance of the optimal turnover of cells in the villous trophoblast via its ability to regulate apoptosis. For male gametes, melatonin has also proven useful in protecting them from oxidative damage and preserving their viability. Incubation of ejaculated animal sperm improves their motility and prolongs their viability. For human sperm as well, melatonin is also a valuable agent for protecting them from free radical damage. In general, the direct actions of melatonin on the gonads and adnexa of mammals indicate it is an important agent for maintaining optimal reproductive physiology. PMID:23549263
OBJECTIVE: To report the pregnancy outcomes in Irish female renal transplant recipients on modern maintenance immunosuppression. METHODS: The Republic of Ireland transplant database was accessed to identify the patient cohort in question. All female renal transplant recipients whose transplantation was in Ireland before or during their reproductive years were included. A questionnaire was sent to the identified women. A chart review was performed for those women who reported a pregnancy following renal transplantation. RESULTS: Two hundred and ten women met the inclusion criteria. There was a response rate of 70% (n = 148). Eighteen women reported 29 pregnancies. The live birth rate was 76%. The mean gestation of the live births was 36.2 weeks with a mean birth weight of 3.0 kg. There were six cases of pre-eclampsia. Twin pregnancies and those entering pregnancy with a creatinine greater than 135 micromol\\/l had particularly complicated clinical courses. Four women had not conceived post transplant despite actively trying for over 1 year. Two women utilised assisted fertility methods (in vitro fertilisation), one of whom became pregnant. CONCLUSIONS: A significant proportion of women who attempt to conceive following renal transplantation are successful, without the use of assisted fertility. Pregnancy in this setting warrants meticulous multidisciplinary care.
...] Joint Meeting of the Advisory Committee for Reproductive Health Drugs and the Drug Safety and Risk... Reproductive Health Drugs and the Drug Safety and Risk Management Advisory Committee. General Function of the... presentation may be limited. If the number of registrants requesting to speak is greater than can be reasonably...
...] Joint Meeting of the Advisory Committee for Reproductive Health Drugs and the Drug Safety and Risk... Reproductive Health Drugs and the Drug Safety and Risk Management Advisory Committee. General Function of the... East, Adelphi, MD. The conference center telephone number is: 301 985-7300. Contact Person: Kalyani...
...] Joint Meeting of the Advisory Committee for Reproductive Health Drugs and the Drug Safety and Risk... Reproductive Health Drugs and the Drug Safety and Risk Management Advisory Committee. General Function of the... before February 7, 2013. Time allotted for each presentation may be limited. If the number of registrants...
...] Joint Meeting of the Advisory Committee for Reproductive Health Drugs and the Drug Safety and Risk... Reproductive Health Drugs and the Drug Safety and Risk Management Advisory Committee. General Function of the..., Adelphi, MD. The conference center telephone number is 301-985-7300. Contact Person: Kalyani Bhatt, Center...
Nobelius, Ann-Maree; Kalina, Bessie; Pool, Robert; Whitworth, Jimmy; Chesters, Janice; Power, Robert
This paper defines how out-of-school adolescents from Masaka District in rural southwest Uganda currently receive sexual and reproductive health information and how they would prefer to receive that information. Information adolescents feel they lack falls into three broad categories: sexual and reproductive health issues, the negotiation of sex…
... Management Advisory Committee; Amendment of Notice AGENCY: Food and Drug Administration, HHS. ACTION: Notice... of the Advisory Committee for Reproductive Health Drugs and the Drug Safety and Risk Management... Advisory Committee for Reproductive Health Drugs and the Drug Safety and Risk Management Advisory Committee...
Asklund, Camilla; Jørgensen, Niels; Skakkebaek, N E
Some studies have suggested an association between paternal subfertility and hypospadias among their sons, although the association has not been systematically investigated. We therefore compared male reproductive health among a group of fathers of boys with hypospadias and a group of fathers to ...
Westhoff, Wayne W.; Lopez, Guillermo E.; Zapata, Lauren B.; Wilke Corvin, Jaime A.; Allen, Peter; McDermott, Robert J.
Background: Following the occurrence of natural or man-made disaster, relief worker priorities include providing water, food, shelter, and immunizations for displaced persons. Like these essential initiatives, reproductive health education and services must also be incorporated into recovery efforts. Purpose: This study examined reproductive…
Gómez, Anu Manchikanti; Speizer, Ilene S.; Beauvais, Harry
We examine sexual violence and reproductive health outcomes among sexually experienced youth in Port-au-Prince, Haiti, using the Priorities for Local AIDS Control methodology to identify participants in locations where sexual partnerships are formed. Sexual violence is common and is significantly associated with condom use, pregnancy experience and recent STI symptoms. PMID:19380102
United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.
This document announces web sites that address adolescent reproductive and sexual health. The web sites are arranged alphabetically by name, and refer to the owner of the site rather than the title. The profile of each site consists of basic information such as the address of the organization or owner, fax number, telephone number, e-mail address,…
Semen quality and reproductive health of young Czech men exposed to seasonal air pollution.Selevan SG, Borkovec L, Slott VL, Zudova Z, Rubes J, Evenson DP, Perreault SD.U.S. Environmental Protection Agency, Washington, DC 20460, USA.This study of male repr...
Rijsdijk, L.E.; Lie, R.; Bos, A.E.R.; Leerlooijer, J.N.; Kok, G.
This paper presents the findings from an explorative study comparing sexual and reproductive health and rights (SRHR) against local realities for young people in Uganda. This was done by analysing statements by Ugandan adolescents extracted from focus group discussions relating to two SRHRs central
In this paper, we describe the historical transition of sexuality education in Japan and the direction of sexuality education taken by the Ministry of Education, Culture, Sports, Science and Technology (MEXT). Reproductive health/rights, a key concept in sex education, is also discussed. In Japanese society, discussion on sexuality has long been considered taboo. After the Second World War, sexuality education in Japan began as "purity education." From 1960 until the early 1970s, physical aspects such as genital organs, function, secondary sexual characteristics, and gender differences were emphasized. Comprehensive education as a human being, including physiological, psychological, and social aspects, began to be adopted in the late 1970s. In 2002, it was criticized that teaching genital terms at primary schools and teaching about sexual intercourse and contraceptive methods at junior high schools were "overdue guidance" and "extreme contents." Sexuality education in schools has become a problem and has stagnated for about 10 years. Currently, schools teach sexuality education that does not deviate from the MEXT course guidelines. The direction of MEXT regarding sexuality education should be examined from the basic position that sexual activity by children is inappropriate. Reproductive health/rights apply the concept of human rights to sexuality and reproduction. Reproductive health/rights are key concepts that support sex education and women's health.
van der Geugten, J.; Dijkstra, M.; van Meijel, B.K.G.; den Uyl, M.H.G.; de Vries, N.
There have been few assessments of sexual and reproductive health (SRH) education programmes in sub-Saharan Africa from the students' and educators' perspective. This study examined students' opinions on an SRH programme in northern Ghana and explored the facilitators and barriers for educators
A. I. Olugbenga-Bello
Full Text Available Introduction. All over the world, numbers of prisoners have being increasing with majority in the sexually active age group; hence diseases such as HIV, Tuberculosis and Hepatitis are more prevalent in prisons than in the community. This study thus aims to provide an overview of the reproductive health status of adult prison inmates in Osun State. Methodology. This is a cross-sectional study among adult inmates in Osun State prison. Data was obtained from 209 selected respondents using pre-tested semi structured questionnaire. Result. Majority of the respondents were in the age group 20–39 years with mean age of 30.9+7.5. 73.2% are aware of STIs, 93.3% HIV/AIDS and 81.3% contraception. 54.6% had multiple sexual partners before incarceration and 23.3% of them used condom always. 89.5% were not involved in any sexual practice inside the prison, 9.1% masturbated and 1.4% had homosexual partners. Less than 6% had access to male condoms gotten from prison staffs and prison clinics. Conclusion and recommendation. No comprehensive reproductive health care system to address reproductive health services in prisons. Respondents’ knowledge about STIs, HIV/AIDS and contraception is good, but their condom usage is low compared with the knowledge. Government should put in place specific reproductive health programmes in prisons.
Berro Pizzarossa, Lucia; Perehudoff, Katrina
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
Amira Mohamed Elhassan
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.
Full Text Available Objectives: To assess status of reproductive health and nutrition amongst girls attending high school in an urban area of Bangladesh. Methods: This cross sectional descriptive study was conducted in four selected girl’s high schools. A structured pre-tested questionnaire and a checklist were used to collect data through face-to-face interview and anthropometry. Results: A total of 360 adolescents girls were interviewed. The mean age at menarche of the respondents was found to be 12.4 years. More than half (54.2% of the respondents were malnourished (BMI < 18.5. More than four-fifths (83% were found to be suffering from reproductive health problems during or after menstruation. The most common complain (60% disclosed by the adolescent girls was dysmenorrhoea. Majority (300 of the respondents acknowledged practicing unhygienic protective measures during menstruation. Conclusion: More than half of the adolescents were malnourished, practiced unhygienic protective measures during menstruation and disclosed different types of reproductive health complaints. Findings of the study strongly recommend that adolescent girls of urban Bangladesh need proper and appropriate management of their reproductive health problems. Ibrahim Med. Coll. J. 2008; 2(1: 9-11
The discovery in the mid-1970s that occupational exposures to pesticides could diminish or destroy the fertility of workers sparked concern about the effects of hazardous substances on male reproductive health. More recently, there is evidence that sperm quantity and quality may ...
The purpose of this study is to determine the understanding of reproductive health among parents and female adolescents with Down syndrome. This cross-sectional study involved 22 parents and 22 female adolescents with Down syndrome in Kuala Lumpur, Malaysia. The parents were required to fill up the socio-demographic information in questionnaire…
NK De Vries; Jolien van der Geugten; prof Berno van Meijel; M Dijkstra; M Den Uyl
There have been few assessments of sexual and reproductive health (SRH) education programmes in sub-Saharan Africa from the students’ and educators’ perspective. This study examined students’ opinions on an SRH programme in northern Ghana and explored the facilitators and barriers for educators
Olugbenga-Bello, A. I.; Adeoye, O. A.; Osagbemi, K. G.
Introduction. All over the world, numbers of prisoners have being increasing with majority in the sexually active age group; hence diseases such as HIV, Tuberculosis and Hepatitis are more prevalent in prisons than in the community. This study thus aims to provide an overview of the reproductive health status of adult prison inmates in Osun State. Methodology. This is a cross-sectional study among adult inmates in Osun State prison. Data was obtained from 209 selected respondents using pre-tested semi structured questionnaire. Result. Majority of the respondents were in the age group 20–39 years with mean age of 30.9 + 7.5. 73.2% are aware of STIs, 93.3% HIV/AIDS and 81.3% contraception. 54.6% had multiple sexual partners before incarceration and 23.3% of them used condom always. 89.5% were not involved in any sexual practice inside the prison, 9.1% masturbated and 1.4% had homosexual partners. Less than 6% had access to male condoms gotten from prison staffs and prison clinics. Conclusion and recommendation. No comprehensive reproductive health care system to address reproductive health services in prisons. Respondents' knowledge about STIs, HIV/AIDS and contraception is good, but their condom usage is low compared with the knowledge. Government should put in place specific reproductive health programmes in prisons. PMID:25763387
He, D.; Zhou, Y.; Ji, N.; Wu, S.; Wang, Z.; Decat, P.; Moyer, E.; Minkauskiene, M.; Pang, C.; Cheng, Y.
Aim: The purpose of this study was to broadly assess the level of knowledge, attitude and behaviors related to sexual and reproductive health (SRH) among unmarried female migrants in China. Material and Methods: This cross-sectional study was conducted and a self-administered questionnaire was
AJRH Managing Editor
Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, London, UK3 ... having pleasurable and safe sexual experiences, free ..... don't know how to do it and where to .... Where young women have low status.
Dec 4, 2009 ... Health Among Secondary School Students in Bolgatanga,. Upper East ... perception, STIs and HIV/AIDS, family planning, male-female relationship, and vulnerability to sexual violence. ..... More education/counseling. 4.3. 15.2.
Rawlins, Barbara J; Kim, Young-Mi; Rozario, Aleisha M; Bazant, Eva; Rashidi, Tambudzai; Bandazi, Sheila N; Kachale, Fannie; Sanghvi, Harshad; Noh, Jin Won
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
Tangmunkongvorakul, Arunrat; Banwell, Cathy; Carmichael, Gordon; Utomo, Iwu Dwisetyani; Seubsman, Sam-Ang; Kelly, Matthew; Sleigh, Adrian
This study sheds light on obstacles to safe sexual health for young Thais and their need for appropriate sexual and reproductive health services. The study population was 1,745 unmarried adolescents aged 17-20 who resided or worked in Chiang Mai, the major city in northern Thailand. The study used quantitative and qualitative methods to explore the vulnerability of sexually active adolescents as well as the lack of support and care for them from parents and health providers. We found that young Thais still prefer pharmacies for self-medication and use government health care facilities as a last resort. Current health services are not suitable for young people in northern Thailand because they lack privacy and impose judgemental attitudes, especially towards sexually active adolescent females. Current programs for adolescent sexual and reproductive health focus on education and counselling and do not provide appropriate privacy or clinical care. There is a pressing need for advocacy, policy support for the development of youth-friendly sexual and reproductive health services in Thailand. PMID:23082599
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
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.
Wamoyi, Joyce; Fenwick, Angela; Urassa, Mark; Zaba, Basia; Stones, William
Many programmes on young people and HIV/AIDS prevention have focused on the in-school and channeled sexual and reproductive health messages through schools with limited activities for the young people's families. The assumption has been that parents in African families do not talk about sexual and reproductive health (SRH) with their children. These approach has had limited success because of failure to factor in the young person's family context, and the influence of parents. This paper explores parent-child communication about SRH in families, content, timing and reasons for their communication with their children aged 14-24 years in rural Tanzania. This study employed an ethnographic research design. Data collection involved eight weeks of participant observation, 17 focus group discussions and 46 in-depth interviews conducted with young people aged 14-24 years and parents of young people in this age group. Thematic analysis was conducted with the aid of NVIVO 7 software. Parent-child communication about SRH happened in most families. The communication was mainly on same sex basis (mother-daughter and rarely father-son or father-daughter) and took the form of warnings, threats and physical discipline. Communication was triggered by seeing or hearing something a parent perceived negative and would not like their child to experience (such as a death attributable to HIV and unmarried young person's pregnancy). Although most young people were relaxed with their mothers than fathers, there is lack of trust as to what they can tell their parents for fear of punishment. Parents were limited as to what they could communicate about SRH because of lack of appropriate knowledge and cultural norms that restricted interactions between opposite sex. Due to the consequences of the HIV pandemic, parents are making attempts to communicate with their children about SRH. They are however, limited by cultural barriers, and lack of appropriate knowledge. With some skills training on
Full Text Available Abstract Background Many programmes on young people and HIV/AIDS prevention have focused on the in-school and channeled sexual and reproductive health messages through schools with limited activities for the young people's families. The assumption has been that parents in African families do not talk about sexual and reproductive health (SRH with their children. These approach has had limited success because of failure to factor in the young person's family context, and the influence of parents. This paper explores parent-child communication about SRH in families, content, timing and reasons for their communication with their children aged 14-24 years in rural Tanzania. Methods This study employed an ethnographic research design. Data collection involved eight weeks of participant observation, 17 focus group discussions and 46 in-depth interviews conducted with young people aged 14-24 years and parents of young people in this age group. Thematic analysis was conducted with the aid of NVIVO 7 software. Results Parent-child communication about SRH happened in most families. The communication was mainly on same sex basis (mother-daughter and rarely father-son or father-daughter and took the form of warnings, threats and physical discipline. Communication was triggered by seeing or hearing something a parent perceived negative and would not like their child to experience (such as a death attributable to HIV and unmarried young person's pregnancy. Although most young people were relaxed with their mothers than fathers, there is lack of trust as to what they can tell their parents for fear of punishment. Parents were limited as to what they could communicate about SRH because of lack of appropriate knowledge and cultural norms that restricted interactions between opposite sex. Conclusions Due to the consequences of the HIV pandemic, parents are making attempts to communicate with their children about SRH. They are however, limited by cultural barriers
Wang, Hongxiang; Chen, Bin; Xu, Yong; Miao, Qing; Wu, Zhenming; Ju, Qiang; Huang, Yiran
Objectives: To determine whether the attitudes to sexual and reproductive health of a cohort of university students had changed from 2005 to 2013. Methods: Questionnaires (1,000) on sexual and reproductive health attitudes were randomly distributed to students at Shanghai Jiaotong University in May 2013. All participants volunteered for the study and their answers were anonymous. The questionnaire contents included personal information and 72 MCQs, which covered four categories: knowledge about sexual/reproductive health and STDs; attitude to sexual behavior; attitudes to pornographic books/movies; desire of the participants for education on sexual/reproductive health. The participants had not received sexual/reproductive health education since their admission to the university. Their study majors were broadly similar to those participants in the April 2005 survey. The high sensitivity of the content of the questionnaire made it imperative to maintain anonymity and high security of the collected data. Results: The return rate of questionnaires were 98% (request age from 19~21 years). Personal hygiene was much greater in females than in males. The proportion of females and males who held a positive attitude to premarital sexual behavior was significantly increased (P < 0.0001). 80% of the participants understood the need to use condoms with strangers; however, still high proportion of participants lacked of this knowledge (P = 0.142). About one third of the participants still did not believe that unmarried pregnancy was acceptable (no significant change from 2005 to 2013). There was significantly improved knowledge about the way in which AIDS spreads. Conclusions: College students are more open today compared to the 2003 survey. A higher level of sexual knowledge has been achieved but there scope for further improvement. Sex education should be based on the actual needs of young people, teaching reforms, and special attention paid to practical teaching. PMID
Full Text Available Jennifer Manlove, Heather Fish, Kristin Anderson Moore Child Trends, Bethesda, MD, USA Background: US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs, highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. Materials and methods: This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants – sexual activity, number of sexual partners, condom use, and other contraceptive use – among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent–youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Results: Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome. We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent–youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use. Conclusion: Future efforts should
Full Text Available Female genital mutilation/cutting (FGM/FGC constitutes a tragic health and human rights issue of girls and women in a number of countries, mainly in Africa. The practice has serious health consequences, both physical and psychological. Attempts to eradicate the practice have not been successful over the past few decades. Medicalisation of the practice has added to its propagation, and this is not valid from ethical and professional standpoints. Further efforts need to be exerted to eliminate the practice and alleviate the sufferings that millions of girls and women worldwide are unnecessarily subjected to. This article reviews the problem and discusses the consequences to health for women and girls, and suggests ways to eradicate the practice.
During the first decade of the 21st century a new "dramatic story" about the growing global surrogacy industry brought renewed attention to surrogacy as a social problem and a health policy issue. This paper asks: What cultural assumptions about gender, family and the global reproductive health market are revealed in current U.S. media coverage of and public discourses about surrogacy? From a qualitative analysis of prominent news accounts of surrogacy that were published in 2008, New York Times articles and blogs published on the topic between 2006 and 2010, and over 1000 online reader comments to these articles, I identify key frames used to discursively construct and debate the international surrogacy market. This study reveals the distinct contrast between the occasions when reproductive labor is rhetorically distanced from commodification processes and when it is linked to those processes. The findings contribute to intersectional analyses of assisted reproductive practices and women's health/bodies/gametes. In particular, this study's analysis of recent media framings of and public discourses about surrogacy across the globe serves as another illustration that national/classed/racialized bodies continue to be reproductively stratified via differently gendered discourses about women, motherhood and family. Copyright © 2011 Elsevier Ltd. All rights reserved.
Mumtaz, Zubia; Salway, Sarah
Recent research and policy discourse commonly view the limited autonomy of women in developing countries as a key barrier to improvements in their reproductive health. Rarely, however, is the notion of women's autonomy interrogated for its conceptual adequacy or usefulness for understanding the determinants of women's reproductive health, effective policy formulation or program design. Using ethnographic data from 2001, including social mapping exercises, observation of daily life, interviews, case studies and focus group discussions, this paper draws attention to the incongruities between the concept of women's autonomy and the gendered social, cultural, economic and political realities of women's lives in rural Punjab, Pakistan. These inadequacies include: the concept's undue emphasis on women's independent, autonomous action; a lack of attention to men and masculinities; a disregard for the multi-sited constitution of gender relations and gender inequality; an erroneous assumption that uptake of reproductive health services is an indicator of autonomy; and a failure to explore the interplay of other axes of disadvantage such as caste, class or socio-economic position. This paper calls for alternative, more nuanced, theoretical approaches for conceptualizing gender inequalities in order to enhance our understanding of women's reproductive wellbeing in Pakistan. The extent to which our arguments may be relevant to the wider South Asian context, and women's lives in other parts of the world, is also discussed.
Madimenos, Felicia C; Snodgrass, J Josh; Liebert, Melissa A; Cepon, Tara J; Sugiyama, Lawrence S
Clinical and epidemiological research suggest that bone mineral density (BMD) in women is shaped by various reproductive factors such as parity and lactation patterns. However, the extent of these effects on BMD remains unclear because of contradictory findings and a focus on industrialized populations. Because fertility patterns in these groups are vastly different than those of women from non-Western, subsistence populations, our current understanding of the reproductive effects on skeletal health is incomplete. Using a life history perspective, this study examines the relationship between reproductive factors and bone density among women from the Indigenous Shuar population, an Amazonian Ecuadorian forager-horticulturalist group. This preliminary, cross-sectional study included 130 premenopausal and postmenopausal women (14-86 years old) from the Morona-Santiago region of Ecuador. Anthropometrics were recorded, as was estimated BMD using a calcaneal ultrasonometer. A reproductive history questionnaire was administered that included questions regarding menarche, parity, lactation patterns, and menopause. Among postmenopausal women, early menarche and greater stature were significantly associated with higher bone density values. Among premenopausal women, few significant relationships between bone values and reproductive variables were documented; effects of lactation appeared to be transient and restored following weaning. Although preliminary and not based on longitudinal data, these findings suggest that the effects of reproduction are transient as the system of calcium homeostasis in premenopausal women efficiently restores the bone loss that results from metabolically active reproductive states. Further, this research suggests that the timing of early life history events may canalize bone density phenotype. Copyright © 2012 Wiley Periodicals, Inc.
Mohammad Ali Morowatisharifabad
Full Text Available Background: Despite the important role of feelings in health care seeking behavior (HCSB, this subject has not yet been adequately investigated. HCSB-related feelings begin with the onset of disease symptoms and persist in different forms after treatment. The aim of current study was to explore the feelings that women of reproductive age experience when they seek health care.Methods: In this deductive, qualitative content analysis, participants were selected by purposeful sampling. Semi-structured, in-depth interviews with 17 women of reproductive age and 5 healthcare staffs in Qom, Iran were carried out until data saturation was achieved. Qualitative data were concurrently analyzed by deductive content analysis, using the Health Promotion Model (HPM. The MAXQDA10 software was used to manage qualitative data analysis.Results: Three main categories were drawn from data to explain the HCSB-related feelings of participants consisting of (1 feeling of inner satisfaction with the treatment with 2 subcategories including "peace of mind" and "feeling alive", (2 multiple roles of fear with 5 subcategories including "fear about the consequences of delay", "fear of having hidden diseases", "fear of unknown experiences", "fear of hearing bad news" and "fear of medical errors" and (3uncomfortable feelings with 3 subcategories including "feeling uneasy when attending health facility", "feeling embarrassed" and "feeling worthless due to dealing the doctor".Conclusion: This study revealed that the inner feelings of women varied widely, ranging from positive or motivating feelings to negative or inhibitory ones, given their experiences with the formal health care system and the current situation of medical and health services. Highlighting patients’ perceived inner satisfaction and reducing fear and uncomfortable feelings by adopting culture-based practical strategies can enhance women’s HCSB.
Contraceptive Use: Knowledge, Perceptions and Attitudes of Refugee Youths in Oru Refugee Camp, Nigeria · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT ... Assessing the Importance of Gender Roles in Couples' Home-Based Sexual Health Services in Malawi · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT
Religious perceptions and attitudes of men towards discontinuation of female genital cutting in Nigeria: evidence from the 2013 Nigeria Demographic and Health Survey · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Ayotunde Titilayo, Martin E. Palamuleni, John ...
However, the majority (56.9%) disagreed that a woman can practice family planning without the consent of her husband. ... Development (ICPD) held in Cairo in 1994 ... relationship between human rights and health, ... mutually reinforcing, encompassing socio-cultural ... A self-administered questionnaire was designed.
Botswana as at June 2005 when this study was conducted. ... clinics/hospitals for follow-ups in case of certain health conditions; and (iv) The immigrants and ... Perceptions of public healthcare providers a Oucho JO, PhD b Ama NO, PhD a Centre for Research in Ethnic Relations, University of Warwick, United Kingdom b ...
Methods: A Medline search and search of other internet search engines for published studies on contraceptive commodity security and maternal and child health in West Africa was done. The journals were accessed online and from public libraries. Results: Contraceptive prevalence rate in West Africa is generally low.
Knowledge of School Health Programme among Public Primary School Teachers in Oyo State, South-Western Nigeria: A Rural- Urban Comparative Study · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Ayodeji M. Adebayo, Modupe O. Onadeko, 55-60 ...
issues among high school students with their parents, Bullen ... through targeted family life education activities among students and parents. [Ethiop. J. ... sexual issues and impact of this communication on ..... Males were about five times more likely than females to .... Prevention and Control Office and Regional Health.
engagement of the male gender in health and development is critical for social ... involvement in the care and support for people affected by HIV and AIDS. ... their roles; and encouraged men to see PMTCT as an intervention that 'real men' ...
Risk Factors for Premature Births: A Cross-Sectional Analysis of Hospital Records in a Cameroonian Health Facility. Andreas Chiabi, Evelyn M Mah, Nicole Mvondo, Seraphin Nguefack, Lawrence Mbuagbaw, Karen K Kamga, Shiyuan Zhang, Emile Mboudou, Pierre F Tchokoteu, Elie Mbonda ...
In South Africa, the private sector has responded to the HIV epidemic by providing treatment in the form of highly active antiretroviral therapy (HAART). The private sector has paved the way for policy and treatment regimens, while the public sector has reviewed health-systems capacity and the political will to provide ...
Woodruff, Tracey J; Parker, Jennifer D; Darrow, Lyndsey A; Slama, Rémy; Bell, Michelle L; Choi, Hyunok; Glinianaia, Svetlana; Hoggatt, Katherine J; Karr, Catherine J; Lobdell, Danelle T; Wilhelm, Michelle
In the past decade there have been an increasing number of scientific studies describing possible effects of air pollution on perinatal health. These papers have mostly focused on commonly monitored air pollutants, primarily ozone (O(3)), particulate matter (PM), sulfur dioxide (SO(2)), carbon monoxide (CO), and nitrogen dioxide (NO(2)), and various indices of perinatal health, including fetal growth, pregnancy duration, and infant mortality. While most published studies have found some marker of air pollution related to some types of perinatal outcomes, variability exists in the nature of the pollutants and outcomes associated. Synthesis of the findings has been difficult for various reasons, including differences in study design and analysis. A workshop was held in September 2007 to discuss methodological differences in the published studies as a basis for understanding differences in study findings and to identify priorities for future research, including novel approaches for existing data. Four broad topic areas were considered: confounding and effect modification, spatial and temporal exposure variations, vulnerable windows of exposure, and multiple pollutants. Here we present a synopsis of the methodological issues and challenges in each area and make recommendations for future study. Two key recommendations include: (1) parallel analyses of existing data sets using a standardized methodological approach to disentangle true differences in associations from methodological differences among studies; and (2) identification of animal studies to inform important mechanistic research gaps. This work is of critical public health importance because of widespread exposure and because perinatal outcomes are important markers of future child and adult health.
The impact of male factor infertility is likely to increase if adequate ... World Health Organization in 1991 estimated that, 8–12% .... is concentration increases in the food chain leading to ..... Emokpae MA, Uadia PO, Sadiq NM. .... 2001;46:210-4.
Elizabeth M Miller
Full Text Available Women experience significant changes in iron status throughout their reproductive lifespans. While this is evident in regions with high rates of malnutrition and infectious disease, the extent of reproductive-related changes is less well known in countries with low rates of iron deficiency anemia, such as the United States. The goal of this study is determine the relationship between women's reproductive variables (pregnancy, parity, currently breastfeeding, regular menstruation, hormonal contraceptive use, and age at menarche and iron status (hemoglobin, ferritin, transferrin receptor, and % transferrin saturation using an anthropological framework for interpreting the results. Data from women aged 18-49 were taken from the 1999-2006 US NHANES, a nationally representative cross-sectional sample of US women. Using multiple imputation and complex survey statistics, women's reproductive variables were regressed against indicators of iron status. Pregnant women had significantly poorer iron status, by most indicators, than non-pregnant women. All biomarkers demonstrated significantly lower iron levels with increasing parity. Women who were having regular periods had iron indicators that suggested decreased iron levels, while women who used hormonal contraceptives had iron indicators that suggested increased iron levels. Despite relatively good iron status and widespread availability of iron-rich foods in the US, women still exhibit patterns of iron depletion across several reproductive variables of interest. These results contribute to an ecological approach to iron status that seeks to understand variation in iron status, with the hopes that appropriate, population-specific recommendations can be developed to improve women's health.
Edith Maria Barbosa Ramos
Full Text Available It approaches the theory that deny the right to health in order to highlight the fragility of arguments and demonstrate the ability to build a ethical justification for gua- ranteeing the right to health. Highlights the complexity of the right to health and the universality of their ownership, as well as discusses the identification of the right to health with the right to social assistance. It analyzes the theories of denial of the right to health from a proposal that presents libertarian. Noteworthy is the discussion on the relations proposed by this theory, between the right to health and the right to property, in order to justify the setting of a minimal state. We put in evidence the idea of n atural and social lotteries, the duty of beneficence and the idea of decent minimum, to introduce a reflec- tion on the health market.
Peretz, Jackye; Vrooman, Lisa; Ricke, William A.; Hunt, Patricia A.; Ehrlich, Shelley; Hauser, Russ; Padmanabhan, Vasantha; Taylor, Hugh S.; Swan, Shanna H.; VandeVoort, Catherine A.
Background: In 2007, an expert panel reviewed associations between bisphenol A (BPA) exposure and reproductive health outcomes. Since then, new studies have been conducted on the impact of BPA on reproduction. Objective: In this review, we summarize data obtained since 2007, focusing on a) findings from human and animal studies, b) the effects of BPA on a variety of reproductive end points, and c) mechanisms of BPA action. Methods: We reviewed the literature published from 2007 to 2013 using a PubMed search based on keywords related to BPA and male and female reproduction. Discussion: Because BPA has been reported to affect the onset of meiosis in both animal and in vitro models, interfere with germ cell nest breakdown in animal models, accelerate follicle transition in several animal species, alter steroidogenesis in multiple animal models and women, and reduce oocyte quality in animal models and women undergoing in vitro fertilization (IVF), we consider it an ovarian toxicant. In addition, strong evidence suggests that BPA is a uterine toxicant because it impaired uterine endometrial proliferation, decreased uterine receptivity, and increased implantation failure in animal models. BPA exposure may be associated with adverse birth outcomes, hyperandrogenism, sexual dysfunction, and impaired implantation in humans, but additional studies are required to confirm these associations. Studies also suggest that BPA may be a testicular toxicant in animal models, but the data in humans are equivocal. Finally, insufficient evidence exists regarding effects of BPA on the oviduct, the placenta, and pubertal development. Conclusion: Based on reports that BPA impacts female reproduction and has the potential to affect male reproductive systems in humans and animals, we conclude that BPA is a reproductive toxicant. Citation: Peretz J, Vrooman L, Ricke WA, Hunt PA, Ehrlich S, Hauser R, Padmanabhan V, Taylor HS, Swan SH, VandeVoort CA, Flaws JA. 2014. Bisphenol A and reproductive
Oni, Gbolahan; Fatusi, Adesegun; Tsui, Amy; Enquselassie, Fikre; Ojengbede, Oladosu; Agbenyega, Tsiri; Ojofeitimi, Ebenezer; Taulo, Frank; Quakyi, Isabella
Poor reproductive health constitutes one of the leading public health problems in the world, particularly in sub-Saharan Africa (SSA). We report here an academic partnership that commenced in 2003 between a US institution and six universities in SSA. The partnership addresses the human resources development challenge in Africa by strengthening public health education and research capacity to improve population and reproductive health (PRH) outcomes in low-resource settings. The partnership's core activities focused on increasing access to quality education, strengthening health research capacity and translating scholarship and science into policy and practices. Partnership programmes focused on the educational dimension of the human resources equation provide students with improved learning facilities and enhanced work environments and also provide faculty with opportunities for professional development and an enhanced capacity for curriculum delivery. By 2007, 48 faculty members from the six universities in SSA attended PRH courses at Johns Hopkins University, 93 PRH courses were offered across the six universities, 625 of their master's students elected PRH concentrations and 158 had graduated. With the graduation of these and future student cohorts, the universities in SSA will systematically be expanding the number of public health practitioners and strengthening programme effectiveness to resolve reproductive health needs. Some challenges facing the partnership are described in this article.
Sharma, Rakesh; Biedenharn, Kelly R; Fedor, Jennifer M; Agarwal, Ashok
Approximately 10 to 15% of couples are impacted by infertility. Recently, the pivotal role that lifestyle factors play in the development of infertility has generated a considerable amount of interest. Lifestyle factors are the modifiable habits and ways of life that can greatly influence overall health and well-being, including fertility. Many lifestyle factors such as the age at which to start a family, nutrition, weight, exercise, psychological stress, environmental and occupational exposu...
Boyer, Cherrie B; Shafer, Mary-Ann
.... The common thread through these negative health outcomes is volitional behavior. Such behaviors do not only result in illness or injury, but also negatively impact performance of military duties and threaten military readiness...
Boyer, Cherrie B; Shafer, Mary-Ann
.... The common thread through these negative health outcomes is volitional behavior. Such behaviors do not only result in illness or injury, but also negatively impact performance of military duties and threaten military readiness...
De Sanctis, Vincenzo; Soliman, Ashraf; Mohamed, Yassin
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
Dickinson, Clare; Attawell, Kathy; Druce, Nel
This paper considers new developments to strengthen sexual and reproductive health and HIV linkages and discusses factors that continue to impede progress. It is based on a previous review undertaken for the United Kingdom Department for International Development in 2006 that examined the constraints and opportunities to scaling up these linkages. We argue that, despite growing evidence that linking sexual and reproductive health and HIV is feasible and beneficial, few countries have achieved significant scale-up of integrated service provision. A lack of common understanding of terminology and clear technical operational guidance, and separate policy, institutional and financing processes continue to represent significant constraints. We draw on experience with tuberculosis and HIV integration to highlight some lessons. The paper concludes that there is little evidence to determine whether funding for health systems is strengthening linkages and we make several recommendations to maximize opportunities represented by recent developments.
Rogers, Claire; Earnest, Jaya
This exploratory study piloted in Brisbane, Australia, reports on findings from in-depth focus-group discussions conducted with Sudanese and Eritrean women in Brisbane. We investigated and documented their experiences and knowledge of sexual and reproductive health and contraception, and explored their views on sexuality and relationships education within the family environment of minority ethnic communities in Australia. Underpinned by a qualitative psychosocial framework, the study also involved key-informant interviews with health and multicultural not-for-profit sector professionals. Through the knowledge and experiences shared by the participants, the key themes of cultural insensitivity, exclusion and poor communication within the family were highlighted by participants as determining factors in the achievement of sexual and reproductive health and good quality sex and relationships education. Participants proposed recommendations for how minority ethnic communities in Australia can more effectively support and communicate within the family environment to increase their own and their children's knowledge and understanding.
Full Text Available The most prevalent, curable sexually important diseases are those caused by Chlamydia trachomatis (C. trachomatis and genital mycoplasmas. An important characteristic of these infections is their ability to cause long-term sequels in upper genital tract, thus potentially affecting the reproductive health in both sexes. Pelvic inflammatory disease (PID, tubal factor infertility (TFI, and ectopic pregnancy (EP are well documented complications of C. trachomatis infection in women. The role of genital mycoplasmas in development of PID, TFI, and EP requires further evaluation, but growing evidence supports a significant role for these in the pathogenesis of chorioamnionitis, premature membrane rupture, and preterm labor in pregnant woman. Both C. trachomatis and genital mycoplasmas can affect the quality of sperm and possibly influence the fertility of men. For the purpose of this paper, basic, epidemiologic, clinical, therapeutic, and public health issue of these infections were reviewed and discussed, focusing on their impact on human reproductive health.
Kimball, Richard; Wissner, Michael
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.
Full Text Available Suzanne Cochrane,1 Caroline A Smith,2 Alphia Possamai-Inesedy,3 Alan Bensoussan2 1School of Science and Health, 2Centre for Complementary Medicine Research, 3School of Social Sciences and Psychology, University of Western Sydney – Campbelltown Campus, Penrith, NSW, Australia Background: Acupuncture and other modalities of Chinese/East Asian medicine have been used to treat women's health for many centuries. Gynecology specialties focus particularly on menstrual and reproductive disorders. Both the adoption of the use of acupuncture outside Asia, and the incorporation of scientific analysis in Asia have challenged biomedical conceptions of what can be achieved with this treatment method. The scale of research activity in relation to acupuncture and women's health has increased over the last 20 years. Objective: This review aims to explore the research evidence in relation to acupuncture use for women's reproductive disorders, focusing on both clinical findings and experimental research on acupuncture's mechanisms of action in relation to women's health. Methods: A narrative literature search was undertaken using searches of electronic databases and manual searches of journals and textbooks. The search included all literature published prior to June 2013. The literature was assessed as to the nature of the study it was reporting and findings synthesized into a commentary. Results: For acupuncture's mechanism of action the search resulted in 114 relevant documents; in relation to clinical reports on the use of acupuncture for women's health 204 documents were found and assessed. Conclusion: There is preliminary data indicating acupuncture may improve menstrual health and coping for women experiencing delays falling pregnant. There is experimental data showing that acupuncture can influence female reproductive functioning, although the actual mechanisms involved are not yet clarified. Further well-conducted clinical research would benefit our
Full Text Available Abstract Background Of the 140 000 Burmese* refugees living in camps in Thailand, 30% are youths aged 15-24. Health services in these camps do not specifically target young people and their problems and needs are poorly understood. This study aimed to assess their reproductive health issues and quality of life, and identifies appropriate service needs. Methods We used a stratified two-stage random sample questionnaire survey of 397 young people 15-24 years from 5,183 households, and 19 semi-structured qualitative interviews to assess and explore health and quality of life issues. Results The young people in the camps had very limited knowledge of reproductive health issues; only about one in five correctly answered at least one question on reproductive health. They were clear that they wanted more reproductive health education and services, to be provided by health workers rather than parents or teachers who were not able to give them the information they needed. Marital status was associated with sexual health knowledge; having relevant knowledge of reproductive health was up to six times higher in married compared to unmarried youth, after adjusting for socio-economic and demographic factors. Although condom use was considered important, in practice a large proportion of respondents felt too embarrassed to use them. There was a contradiction between moral views and actual behaviour; more than half believed they should remain virgins until marriage, while over half of the youth experienced sex before marriage. Two thirds of women were married before the age of 18, but two third felt they did not marry at the right age. Forced sex was considered acceptable by one in three youth. The youth considered their quality of life to be poor and limited due to confinement in the camps, the limited work opportunities, the aid dependency, the unclear future and the boredom and unhappiness they face. Conclusions The long conflict in Myanmar and the resultant
Full Text Available The study has aimed to evaluate results of reproductive health training in the First army as a part the Reproductive Health Program of Turkish Armed Forces (TAF. Hard copies of training results from the a sample of 9 reproductive health classrooms between November 2006 and February 2007 have been collected and analyzed after entering in a SPSS file. A Pre-test and a post-test included the same 25 questions on RH issues were given to the soldiers. Total mean scores and scores for 5 modules of Sexual Health, Sexually Transmitted Infections (STIs, Contraceptives, Safe Motherhood, and Gender, were estimated. By deciding 60 as cutting point, achievement of soldiers was also evaluated. Total Pre and posttest mean scores were compared between groups according to the achievement, hometown, and region of residency, educational level, and marital status. Furthermore, Relative efficiency, Efficiency attributed to training course and Efficiency Ratio has been also calculated. The mean pre-test score of soldiers is 60.4 ± 21.0 and it has been significantly increased up to 82.8 ± 14.5 after the training course (p<0.05. This significant increase was also found for each of sub dimensions similar to total score (p<0.05. While 52.5 % of soldiers have been successful on pretest, this percent has been rise up to 93.1% for the post test (p<0.05.. The relative efficiency of intervention as 6.9, efficiency attributed to training as 40.6%, and efficiency ratio as 85.5% have been estimated. Involving in reproductive health training has improved soldiers� awareness particularly on women�s health. [TAF Prev Med Bull 2012; 11(1.000: 41-48
Njuki, Rebecca; Abuya, Timothy; Kimani, James; Kanya, Lucy; Korongo, Allan; Mukanya, Collins; Bracke, Piet; Bellows, Ben; Warren, Charlotte E
Current assessments on Output-Based Aid (OBA) programs have paid limited attention to the experiences and perceptions of the healthcare providers and facility managers. This study examines the knowledge, attitudes, and experiences of healthcare providers and facility managers in the Kenya reproductive health output-based approach voucher program. A total of 69 in-depth interviews with healthcare providers and facility managers in 30 voucher accredited facilities were conducted. The study hypothesized that a voucher program would be associated with improvements in reproductive health service provision. Data were transcribed and analyzed by adopting a thematic framework analysis approach. A combination of inductive and deductive analysis was conducted based on previous research and project documents. Facility managers and providers viewed the RH-OBA program as a feasible system for increasing service utilization and improving quality of care. Perceived benefits of the program included stimulation of competition between facilities and capital investment in most facilities. Awareness of family planning (FP) and gender-based violence (GBV) recovery services voucher, however, remained lower than the maternal health voucher service. Relations between the voucher management agency and accredited facilities as well as existing health systems challenges affect program functions. Public and private sector healthcare providers and facility managers perceive value in the voucher program as a healthcare financing model. They recognize that it has the potential to significantly increase demand for reproductive health services, improve quality of care and reduce inequities in the use of reproductive health services. To improve program functioning going forward, there is need to ensure the benefit package and criteria for beneficiary identification are well understood and that the public facilities are permitted greater autonomy to utilize revenue generated from the voucher program.
Clubb, Susan; Velez, Jafet; Garner, Michael M; Zaias, Julia; Cray, Carolyn
The Puerto Rican parrot ( Amazona vittata ) has become an iconic and high-profile conservation species. The cornerstone of the recovery plan for this critically endangered species is an active captive breeding program, management of the wild population, and a long-term reintroduction program. In 2002, 40 adult Puerto Rican parrots that had not produced viable offspring were selected for reproductive assessment at 2 aviary populations in Puerto Rico (Iguaca and Río Abajo), which are the only sources of parrots for release. The goal was to enhance reproductive potential and produce productive pairings in an attempt to augment the population growth and provide ample individuals for reintroduction. Seven Hispanolian Amazon parrots ( Amazona ventralis ) that were used as surrogate parents for the Puerto Rican parrots were also included in the study. This assessment included physical examination, endoscopic evaluation, hematologic and plasma biochemical profiles, viral screening, and hormonal assays. Results of general physical examination and hematologic and plasma biochemical testing revealed overall good health and condition of this subset of the population of Puerto Rican parrots; no major infectious diseases were found. Endoscopic examination also revealed overall good health and condition, especially of females. The apparent low fertility of male birds warrants further investigation. The findings helped to define causes of reproductive failure in the selected pairs and individual birds. New pairings resulting from the assessment helped to augment reproduction of this critically endangered species.
Full Text Available This paper presents data which clearly reveal that the behavior model of young people in the Bosnian Serb Republic is characterized by an insufficient degree of information and poor knowledge on reproductive health, an increase in the number of alcohol consumers, drugs and cigarettes which leads to an increase in risky behavior, entering sexual relations and an earlier age, an increase in the number of sexually transmitted diseases and unwanted pregnancies which often result in abortions or premature birth. At the same time young people recognize the necessity for more information, mention competent authorities and expect help from them. At the same time, they show readiness to learn through peer education. On the other hand, the estimated results which we obtained by using available sources, because of the lack of a population census, give us information on the grave demographic situation in the Bosnian Serb Republic and negative tendencies in the future. When we speak of the total fertility rate and compare these data with countries of Europe and the surrounding areas, we can unfortunately only state that many factors - the most important being: war events, insecurity, unfavorable economic and social situation, significant migration of not only young people but of whole families - caused severely low total fertility rate in the Bosnian Serb Republic. Even worse, these tendencies are further decreasing and society is moving towards open depopulation with unforeseeable demographic, economic and national consequences. At the same time, it has been ascertained that young people are getting married at a later age, deciding on becoming parents at a later age and acting more riskily which decreases their fertility capacity and decreases their share in the total fertility capacity, making the already bad demographic picture of the Bosnian Serb Republic even worse.
Ezenwa, Vanessa O; Snider, Matthew H
Parasites are ubiquitous components of the environment that contribute to behavioural and life-history variation among hosts. Although it is well known that host behaviour can affect parasite infection risk and that parasites can alter host behaviour, the potential for dynamic feedback between these processes is poorly characterized. Using Grant's gazelle (Nanger granti) as a model, we tested for reciprocal effects of behaviour on parasites and parasites on behaviour to understand whether behaviour-parasite feedback could play a role in maintaining variation in male reproductive behaviour. Adult male gazelles either defend territories to attract mates or reside in bachelor groups. Territoriality is highly variable both within- and between-individuals, suggesting that territory maintenance is costly. Using a combination of longitudinal and experimental studies, we found that individual males transition frequently between territorial and bachelor reproductive status, and that elevated parasite burdens are a cost of territoriality. Moreover, among territorial males, parasites suppress aspects of behaviour related to territory maintenance and defence. These results suggest that territorial behaviour promotes the accumulation of parasites in males, and these parasites dampen the very behaviours required for territory maintenance. Our findings suggest that reciprocal feedback between host behaviour and parasitism could be a mechanism maintaining variation in male reproductive behaviour in the system. © 2016 The Author(s).
Assessment of adolescents' communication on sexual and reproductive health matters with parents and associated factors among secondary and preparatory schools' students in Debremarkos town, North West Ethiopia.
Shiferaw, Kasiye; Getahun, Frehiwot; Asres, Getahun
Sexuality and reproductive health are among the most fundamental aspects of life. Poor parental involvement in preparing young people for safe sexual life and good reproductive health was part of the blame for the lack of skills on sexual decision making. Despite the growing needs, there is no adequate health service or counseling specifically suitable for this specific age group and research on the role of parents in this process has yielded inconsistent results. The objective of the study is to assess adolescents' communication on sexual and reproductive health issues with parents and associated factors among secondary and preparatory schools students in Debremarkos town. School based study was conducted among secondary and preparatory schools students in Debremarkos town, from April 8 to 21, 2012. Multistage sampling and self administered questionnaires were employed. The proportion of the students who had discussion on sexual & reproductive health issues with their parent was found to be 254 (36.9%). Mother who able to read and write (AOR = 2; 95% CI 1.3 to 3.1), adolescents accepting discussion of sexual & reproductive health issues (AOR = 2.5 95% CI 1.3 to 4.5), adolescents who ever got SRH information (AOR = 2; 95% CI 1.4 to 2.9), adolescents who ever had sexual intercourse (AOR = 1.7; 95% CI 1.1 to 2.6) were found to have significant positive associations, and being grade 12 students (AOR = 0.4; 95% CI 0.2 to 0.7) and having less than three family size (AOR = 0.5; 95% CI 0.2 to 0.9) showed significant negative associations. Study unveils that parent -adolescent communications on sexual and reproductive health issues is low, only about one third of the students were communicating on SRH issues. Therefore; there is a need to equip and educate parents on different sexual & reproductive health issues. Comprehensive family life education should also be initiated for the students and parents.
Oronje, Rose N
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.
Erulkar, Annabel; Tamrat, Tigest
Few reproductive health programs are targeted to married adolescent girls. This study measures changes associated with a program for married adolescent girls and a parallel husbands' program, in rural Ethiopia. The married girls' program provided information on communication, 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, accompaniment to the clinic, family planning use, voluntary counseling and testing (VCT), and domestic violence. Overall, 1,010 married girls were interviewed. Participation in the girls' groups was associated with improvements in help with domestic work, accompaniment to the clinic, family planning and VCT. Further improvements were recorded when both partners participated. For example, participating girls were nearly 8 times more likely to receive VCT (OR 7.7) than nonparticipants, and more than 18 times more likely if both partners participated (OR 18.3). While these results are promising, there were indications of selectivity bias that could have contributed to the positive results. Programs engaging both wives and husbands can result in incremental improvements to the health and well-being of girls married early.
Zhang Xiao-song; Zhao Geng-li; Wang Lin-hong; Wu Jiu-ling; Peter Xenos
Objective: To understand the prevalence of RTIs/STIs, the incidence of sex violence and the KAP of the sex and reproductive health among unmarried floating young women.Methods: During Ocb.2002 to Feb.2003, in the maternal and child health hospital of Beijing, Shenzhen, Nanning and Zhengzhou, 1,219 unmarried floating young women who wanted termination of pregnancy and was under 24 years old before induced abortion received gynecological and laboratory examination. At the same time, they also answered a self-questionnaire. Results: The mean age of all respondents was (22.0±1.6) years old. The respondents' average age of having first sexual activity was (20.3±1.8) years old. The rate of induced abortion history was 38.7%. 17.5% of young women had never used contraception. The incidence of sex violence was 15.6%. The prevalence of RTIs and STIs was 56.1% and 9.7%, respectively. Young women were lack of the knowledge about reproductive health care. Conclusions: The reproductive health situation of unmarried floating young women was serious, especially on sex violence and RTIs/STIs and higher rate of induced abortion.
Archana, Siddaiah; Nongkrynh, B; Anand, K; Pandav, C S
High prevalence of reproductive morbidities is seen among adolescents in India. Health workers play an important role in providing health services in the community, including the adolescent reproductive health services. A study was done to assess the feasibility of training female health workers (FHWs) in the classification and management of selected adolescent girls' reproductive health problems according to modified WHO algorithms. The study was conducted between Jan-Sept 2011 in Northern India. Thirteen FHWs were trained regarding adolescent girls' reproductive health as per WHO Adolescent Job-Aid booklet. A pre and post-test assessment of the knowledge of the FHWs was carried out. All FHWs were given five modified WHO algorithms to classify and manage common reproductive morbidities among adolescent girls. All the FHWs applied the algorithms on at least ten adolescent girls at their respective sub-centres. Simultaneously, a medical doctor independently applied the same algorithms in all girls. Classification of the condition was followed by relevant management and advice provided in the algorithm. Focus group discussion with the FHWs was carried out to receive their feedback. After training the median score of the FHWs increased from 19.2 to 25.2 (p - 0.0071). Out of 144 girls examined by the FHWs 108 were classified as true positives and 30 as true negatives and agreement as measured by kappa was 0.7 (0.5-0.9). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 94.3% (88.2-97.4), 78.9% (63.6-88.9), 92.5% (86.0-96.2), and 83.3% (68.1-92.1) respectively. A consistent and significant difference between pre and post training knowledge scores of the FHWs were observed and hence it was possible to use the modified Job Aid algorithms with ease. Limitation of this study was the munber of FHWs trained was small. Issues such as time management during routine work, timing of training, overhead cost of training etc were not
Tezcan, Sabahat; Adali, Tuğba
Adolescent marriage is an important issue given its social and medical consequences. This study focuses on the recent trends in adolescent marriage and reproductive health in Turkey to provide insights for action. Data from the Demographic and Health Surveys of 1998 and 2008 were used. Adolescent marriage and reproductive health indicators were assessed for urban-rural residences, demographic regions and educational levels. Logistic regression was used to predict marriage and birth in adolescence. Despite the decrease in the proportion of married adolescents from 1998 to 2008, the findings suggest no improvement in some marriage characteristics. In both surveys, over 60% of ever-married adolescents had been pregnant at least once. There is an increase in contraceptive use and antenatal care. Our findings showed that in Turkey, women living in rural areas, from poor households, with more traditional parental families, with less education, and who are not working are more likely to get married in their adolescent ages.
Sandra Mara Campos Alves
Full Text Available The research was conducted in 27 Brazilian courts of law. We aimed to know the legal demands on health and the arguments made by the patient, the defense, and the judge in judicial hearings. For this, we used the method of case law research. The research unit was Brazilian judicial processes with the material object of health demands, decided between 2012 and 2013. The results showed reliance on constitutional arguments for both the request and the decision, while the defense was based on diverse and obsolete legal points. It was concluded that judges have decided questions about health using purely legal arguments and reproducing points made by the patient. The defense of the Brazilian health system is fragile due to the lack of an adequate legal rationale.
Lu, C.; Xu, L.; Wu, J.; Wang, Z.; Decat, P.; Zhang, W.-H.; Cheng, Y.; Moyer, E.; Wu, S.; Minkauskiene, M.; van Braeckel, D.; Temmerman, M.
The objective of this study was to investigate the current sexual and reproductive health (SRH) status including SRH-related knowledge and associated factors, self-reported symptoms of reproductive tract infection (RTI), medical assistance seeking behavior, sexual experience and contraceptive use,
Full Text Available Background: The South African legal and policy framework for sexual and reproductive healthcare provision for teenagers is complex. Objective: The article outlines the dilemmas emanating from the legal and policy framework, summarises issues with implementation of the legal and policy framework in practice, and summarises recent changes to the law. Methods: In-depth analysis of the legal and policy framework. Training workshops with a purposive sample of nurses and other healthcare providers in the Western Cape. Findings: Tensions between consent and confidentiality imposed by the Termination of Pregnancy Act, the Children’s Act, the National Health Act and the Criminal Law (Sexual Offences and Related Matters Amendment Act render conflicting obligations on healthcare providers. Healthcare providers’ experiences with service provision in this context show that the conflicting roles they inhabit render their service provision to teenagers more challenging. Conclusion: Healthcare providers need to learn about their legal obligations surrounding adolescent sexual and reproductive health services.
Hughes Rinker, Cortney
Self-governance and responsibility are two traits associated with neoliberal citizenship in scholarly and popular discourses, but little of the literature on this topic focuses on North Africa. My goal, in this article, is not only to fill this void but also to complicate understandings of neoliberalism through an examination of the relationship between reproductive health care, development policy, and popular Islamic beliefs in Morocco. My discussion is based on fieldwork in Rabat, Morocco, which included observations in health clinics, interviews with patients and staff, and visits to patients' homes. By analyzing the childbearing and childrearing practices of Moroccan women who visited the clinics, I pose that neoliberal logic cannot be predefined or understood as a monolithic concept. I demonstrate that women were active in their own governance and accountable for their reproductive behaviors, but they did so because of their understandings of what Islam says about fertility and motherhood.
Negash, Wassie; Dessalegn, Muluken; Yitayew, Berhanu; Demsie, Mohammed; Wagnew, Maereg; Nyagero, Josephat
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.
Full Text Available Abstract Background This study investigates factors determining the timing of antenatal care (ANC visit and the type of delivery assistant present during delivery among a national representative sample of Ghanaian women. Method Data for the study was drawn from the women questionnaire (N=4,916 of the 2008 Ghana Demographic and Health Survey among 15–49-years-old women. Multivariate logistic regression analysis was used to explore factors determining the type of delivery assistance and timing of ANC visit for live births within five years prior to the survey. Results Majority of Ghanaian women attended ANC visit (96.5% but many (42.7% did so late (after the first trimester, while 36.5% had delivery without the assistance of a trained personnel (30.6% or anyone (5.9%. Age (OR=1.5, CI=1.1-1.9, OR for 25-34-year-olds compared to 15-24-year-olds, religion (OR=1.8, CI=1.2-2.8, OR for Christians versus Traditional believers wealth index (OR=2.6, CI=1.7-3.8, OR for the richest compared to the poorest were independently associated with early ANC visit. Likewise, age, place of residence, education and partner’s education were associated with having a delivery assisted by a trained assistant. Also, Christians (OR=1.8, CI=1.1-3.0 and Moslems (OR=1.9, CI=1.1-3.3 were more likely to have trained delivery assistants compared to their counterparts who practised traditional belief. Furthermore, the richer a woman the more likely that she would have delivery assisted by a trained personnel (OR=8.2, CI= 4.2-16.0, OR for the richest in comparison to the poorest. Conclusions Despite the relatively high antenatal care utilisation among Ghanaian women, significant variations exist across the socio-demographic spectrum. Furthermore, a large number of women failed to meet the WHO recommendation to attend antenatal care within the first trimester of pregnancy. These findings have important implications for reducing maternal mortality ratio by three-quarters by the
Full Text Available Abstract Background Experiences at sexual debut may be linked to reproductive health later in life. Additionally, young women with older sexual partners may be at greater risk for HIV and sexually transmitted infections. This study examines sexual debut with an older partner and subsequent reproductive health outcomes among 599 sexually experienced women aged 15–24 who utilized voluntary counseling and testing or reproductive health services in Port-au-Prince, Haiti. Methods Logistic regression models, controlling for socioeconomic and demographic factors, examined whether age differences at first sex were significantly associated with STI diagnosis in the previous 12 months and family planning method use at last intercourse. Results Sixty-five percent of women reported sexual initiation with a partner younger or less than 5 years older, 28% with a partner 5 to 10 years older, and 7% with a partner 10 or more years older. There was a trend towards decreased likelihood of recent use of family planning methods in women who had first sexual intercourse with a partner 5 to 9 years older compared to women with partners who were younger or less than 5 years older. Age differences were not linked to recent STI diagnosis. Conclusion Programs focusing on delaying sexual debut should consider age and gender-based power differentials between younger women and older men. Future research should examine whether wide age differences at sexual debut are predictive of continued involvement in cross-generational relationships and risky sexual behaviors and explore the mechanisms by which cross-generational first sex and subsequent reproductive health may be connected.
Indonesia is now entering the Fifth Country Program Cycle of Population. The reproductive health and family well-being of the youth forms part of the country program. In order to translate this component into concrete action program, a project document in its first draft was developed for UNFPA (UN Population Fund) funding by the government and with the assistance of UNFPA CST, Bangkok and UNFPA Field Office in Jakarta. The project aims to raise the level of commitment and degree of participation of families, particularly parents, for developing among their pre-adolescent and adolescent children a better understanding of the concepts/process of adolescent reproductive health and desirable attitudes and values dealing with family well-being. This is to be achieved through family-centered learning approaches that will contribute to the adoption of the small, happy, and prosperous family norm. To achieve this goal, the project will develop national capacity by creating management teams, developing sets of training and counseling materials, delivering key messages through the media, upgrading skills in adolescent counseling and developing better understanding of adolescent reproductive health and family well-being issues among the facilitators. The strategy to be used is to set up small groups of 20-30 families which will regularly meet to discuss adolescent problems and issues with the help of cadres. They will be supported by provincial reproductive health and family well-being counseling centers which will also be set up to handle serious cases difficult for parents to handle. These centers, to be run by NGOs, will provide counseling services to parents and youth, evolve innovative and culturally acceptable counseling techniques, and at the same time serve as material and information collection, development and dissemination centers. The project will be launched in collaboration with seven NGOs in seven selected provinces. It is currently under review by UNFPA and
Chau, Yu Moon; West, Sandra; Mapedzahama, Virginia
The aim of this review was to synthesize current evidence on the effects of night work on the major stages of women's reproductive health, specifically the menstrual cycle, fertility, pregnancy, and menopause. Current understanding suggests that night work (work that causes disruption of a worker's circadian [day/night] rhythms) adversely affects workers' health and well-being. A complex relationship exists between circadian rhythms and reproductive hormones, and this may potentially increase the vulnerability of women to the detrimental effect of night work, including during menopause. A systematic search was conducted (March-May 2011) via CINAHL, MEDLINE, Sociological Abstracts, and Business Source Premier for primary research studies written in English using the key words "shift-work" and "female/women." Findings of identified articles were themed to pregnancy, fertility, aspects of menstrual cycles, and menopause. Twenty articles were identified, (13 articles concerning pregnancy, 3 addressing fertility, and 4 addressing aspects of the menstrual cycle) but no studies addressing menopause were located. All identified articles demonstrated problematic approaches to the determination of night-work exposure. Evidence of the impact of night work on female reproductive health as presented in the current literature is inconclusive. Moreover, available evidence needs to be interpreted with caution, given the various limitations and inconsistencies among the studies in the measurement of night-work exposure and shift-work patterns. Studies that focus specifically on night work are needed to facilitate an understanding of the impact of circadian disruption on the reproductive health of women undertaking night work. © 2013 by the American College of Nurse-Midwives.
This work explores the modern day discourse on sexuality in Chile with particular attention given to the influence of the Catholic Church on reproductive health policy. The Catholic Church has historically been involved in popular social reform efforts in the 19th and 20th centuries, and was also heavily involved as the protectorate of human rights during the Pinochet dictatorship. Due to this popular reputation of the Church after the dictatorship and during the transition to democracy, the ...
Gavin, Loretta E; Williams, Jessica R; Rivera, Maria I; Lachance, Christina R
When caring for an adolescent client, providers of contraceptive services must consider whether and how to encourage parent/guardian-child communication about the adolescent's reproductive health. The objective of this systematic review was to summarize the evidence on the effectiveness of programs designed to increase parent-child communication about reproductive health. The review was used to inform national recommendations on quality family planning services. Data analysis occurred from mid-2011 through 2012. Several electronic bibliographic databases were used to identify relevant articles, including PubMed, CINAHL, PsycINFO, and Popline, published from January 1985 through February 2011. Sixteen articles met the inclusion criteria: all studies examined the impact on at least one medium- or short-term outcome, and two studies assessed the impact on teen pregnancy. One study examined the impact of a program conducted in a clinic setting; the remainder examined the impact of programs in community settings. All studies showed a positive impact on at least one short-term outcome, and 12 of 16 studies showed an increase in parent-child communication about reproductive health. Four of seven studies found an impact on sexual risk behavior. Most programs increased parent-child communication, and several resulted in reduced sexual risk behavior of adolescents. This suggests that delivering a clinic-based program that effectively helps parents/guardians talk to their adolescent child(ren) about reproductive health, or referring parents/guardians to an evidence-based program in the community, may be beneficial. However, further rigorous research on delivery of these programs in clinical settings is needed. Published by Elsevier Inc.
Crossland, Nadine; Hadden, Wilbur C.; Vargas, William; Valadez, Joseph; Jeffery, Caroline
Purpose\\ud \\ud Suboptimal sexual and reproductive health (SRH) increases morbidity, mortality, and gender inequity and slows development. In Uganda, youths represent 20% of the population, and the burden of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), is substantial.\\ud \\ud Methods\\ud \\ud We analyzed survey data collected using the lot quality assurance sampling (LQAS) technique from two time periods, 2003–2004 and 2012. We assessed knowledge, behavior...
Yoost, Jennie Lee; Starcher, Rachael Whitley; King-Mallory, Rebecca Ann; Hussain, Nafeeza; Hensley, Christina Ann; Gress, Todd William
To evaluate the use of telehealth to teach reproductive health to rural areas with high rates of teen pregnancy. Prospective cohort study. Two high schools in rural West Virginia. High school female students who attended telehealth sessions. Teleconferencing equipment connected rural high schools to a distal academic institution. Telehealth sessions included reproductive health and life skills topics. Demographic information, session pre- and post-tests, and 6- month assessment was obtained. Reproductive health knowledge, behavior, and self-efficacy were assessed at intervention and at 6 months, along with Likert scale evaluation of telehealth as an educational tool. Fifty-five students participated in the program with an average age of 16.14 (SD 1.24) years. Only 20% (10/50) of subjects' mothers and 12% (6/50) of subjects' fathers had achieved education beyond high school, and 20% (10/50) of subject's mothers had experienced teen pregnancies (age 18 or younger). Sexual activity was reported among 52% (26/50) of subjects, 4/50 (8%) reported desire to become pregnant within the next year, and 4/50 (8%) reported already pregnant. Thirty-seven students completed the 6-month follow-up survey. Reported condom use increased from 20% (10/50) at baseline to 40% (15/37) at 6 months (P = .04) and hormonal contraception use increased from 22% (11/50) to 38% (14/37) (P = .12). Report of human papillomavirus vaccination increased from 38% (10/26) to 70% (26/37) (P = .001) among all subjects. At 6 months, 91.8% (34/37) reported the use of telehealth was "very effective" as a means to teach the material. Telehealth is an effective tool to teach reproductive health to rural areas. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Manlove, Jennifer; Fish, Heather; Moore, Kristin Anderson
US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs), highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants - sexual activity, number of sexual partners, condom use, and other contraceptive use - among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent-youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome). We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent-youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use). Future efforts should conduct replications of existing program evaluations, identify implementation components linked to impacts, rigorously evaluate programs that appear promising, and
Alden, Dana L; Do, Mai Hoa; Bhawuk, Dharm
Health-care managers are increasingly interested in client perceptions of clinic service quality and satisfaction. While tremendous progress has occurred, additional perspectives on the conceptualization, modeling and measurement of these constructs may further assist health-care managers seeking to provide high-quality care. To that end, this study draws on theories from business and health to develop an integrated model featuring antecedents to and consequences of reproductive health-care client satisfaction. In addition to developing a new model, this study contributes by testing how well Western-based theories of client satisfaction hold in a developing, Asian country. Applied to urban, reproductive health clinic users in Hanoi, Vietnam, test results suggest that hypothesized antecedents such as pre-visit expectations, perceived clinic performance and how much performance exceeds expectations impact client satisfaction. However, the relative importance of these predictors appears to vary depending on a client's level of service-related experience. Finally, higher levels of client satisfaction are positively related to future clinic use intentions. This study demonstrates the value of: (1) incorporating theoretical perspectives from multiple disciplines to model processes underlying health-care satisfaction and (2) field testing those models before implementation. It also furthers research designed to provide health-care managers with actionable measures of the complex processes related to their clients' satisfaction.
Carlos A. Ibáñez
system, but moderate and low frequency physical training is able to recover adipose tissue deposition and reproductive system alterations induced by high fat diet. This study highlights the importance of a balanced diet and continued physical activity during adolescence, with regard to metabolic and reproductive health.
Labbok, Miriam H; Smith, Paige Hall; Taylor, Emily C
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
Ab Rahman, Azriani; Ab Rahman, Razlina; Ibrahim, Mohd Ismail; Salleh, Halim; Ismail, Shaiful Bahri; Ali, Siti Hawa; Muda, Wan Manan Wan; Ishak, Maizun; Ahmad, Amaluddin
The objectives of this study were to describe the knowledge of sexual and reproductive health among adolescents attending school and to compare the levels of knowledge between males and females and between older and younger groups of adolescents. Across-sectional study was conducted among 1,034 secondary school students using a self administered validated questionnaire. The items with the fewest correct responses included: whether one can get pregnant after a single act of sexual intercourse (30.4%), whether sexual intercourse causes sexually transmitted diseases (STDs) (12.4%) and whether washing the vagina after sexual intercourse prevents pregnancy (17.0%). Their main source of sexual information was friends (64.4%). An independent t-test revealed the mean knowledge score was significantly higher among females than males on items assessing whether the genitalia may be touched freely by family members, females having attained menarche may become pregnant if having sex, whether pregnancy will occur if there is penetration of the penis into the vagina, whether premarital sexual intercourse causes pregnancy and if there is a relationship between abandoned babies and premarital pregnancies. The mean knowledge score assessing whether pregnancy can be prevented using condoms was higher among males than females. The mean knowledge scores were significantly higher among form four and form five students than forms one, two and three students. Lack of knowledge regarding important aspects of sexual and reproductive health warrant the need to strengthen sexual and reproductive health education.
Ayse Cakir Gungor
Full Text Available Aim: Many training programs for females about contraception have been developed. In this study, we aimed to investigate the perspectives of males on contraception and their knowledge on reproductive health. Material and Method: Husbands of pregnant women who presented in our obstetric clinic were invited to complete a questionnaire. Results: A total of 178 men answered our questionnaire. Among their wives, 11.1% (17/153 terminated their at least one unintended pregnancy. 142 of them (79.8% knew about modern contraceptive methods, and 104 (58.4% of them used at least one of these methods. Condoms were perceived as the best contraceptive method for 46.1% (35/76 because of their easiness to use and cheapness, and 41.7% (25/60 of the participants stated that they would like to use condom from then on. 55.6% (40/72 stated that they would never use oral contraceptives because of their possible side effects on their wives. 20 of the questions addressed to the participants were about reproductive health. The participants answered approximately 70% of all questions correctly. The correct answering rate for every question ranged between 39.6% and 96.1%. Discussion: In our study, we investigated attitudes and knowledge about contraception and reproductive health among men who were married and fertile. The findings from this study can provide a foundation for further education programs for men in these areas.
Labbok, Miriam H; Smith, Paige Hall; Taylor, Emily C
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.
Linn Berger Håkonsen
Full Text Available Maternal cigarette smoking may affect the intrauterine hormonal environment during pregnancy and this early fetal exposure may have detrimental effects on the future trajectory of reproductive health. In this review, we discuss the epidemiological literature on the association between prenatal exposure to maternal cigarette smoking and several aspects of reproductive health. The literature points towards an increased risk of the urogenital malformation cryptorchidism, but a potential protective effect on the risk of hypospadias in sons following prenatal cigarette smoking exposure. Studies on sexual maturation find a tendency towards accelerated pubertal development in exposed boys and girls. In adult life, prenatally exposed men have impaired semen quality compared with unexposed individuals, but an influence on fecundability, that is, the biological ability to reproduce, is less evident. We found no evidence to support an association between prenatal cigarette smoking exposure and testicular cancer. Among adult daughters, research is sparse and inconsistent, but exposure to cigarette smoking in utero may decrease fecundability. In conclusion, prenatal exposure to cigarette smoking may cause some long-term adverse effects on the reproductive health.
Tamang, Laxmi; Raynes-Greenow, Camille; McGeechan, Kevin; Black, Kirsten I
Youth have the right to utilise sexual and reproductive health (SRH) services and information to protect themselves from negative SRH outcomes. This study aimed to assess knowledge, experience and use of SRH services amongst youth living in urban areas of the Kathmandu Valley. We conducted a two stage cluster sampling cross-sectional household survey of young men and women aged 15-24 living in the Kathmandu Valley using a structured questionnaire. Amongst the 680 young men and 720 young women participants, less than two-thirds had knowledge about the fertile period and less than a half about pregnancy risk at first sex. Over three quarters of young men and women had knowledge of condoms, and pills but less than half knew about implants or intrauterine devices. Age at first sex was similar for men and women but women were significantly less likely to have participated willingly in their first sexual encounter and were less likely to have used any contraception (for both p cultural and religious environment that hampers open expression of sexual and reproductive issues, particularly for young women. Copyright © 2016. Published by Elsevier B.V.
Duc, Nguyen Huu Chau; Nakamura, Keiko; Kizuki, Masashi; Seino, Kaoruko; Rahman, Mosiur
This study aimed to examine changes in utilization of reproductive health services by wealth status from 2000 to 2011 in Vietnam. Data from the Vietnam Multiple Indicator Cluster Surveys in 2000, 2006, and 2011 were used. The subjects were 550, 1023, and 1363 women, respectively, aged between 15 and 49 years who had given birth in the previous one or two years. The wealth index, a composite measure of a household's ownership of selected assets, materials used for housing construction, and types of water access and sanitation facilities, was used as a measure of wealth status. Main utilization indicators were utilization of antenatal care services, receipt of a tetanus vaccine, receipt of blood pressure measurement, blood examination and urine examination during antenatal care, receipt of HIV testing, skilled birth attendance at delivery, health-facility-based delivery, and cesarean section delivery. Inequalities by wealth index were measured by prevalence ratios, concentration indices, and multivariable adjusted regression coefficients. Significant increase in overall utilization was observed in all indicators (all p skilled birth attendance, 0.29 in 2006 and 0.12 in 2011 for blood examination, and 0.18 in 2006 and 0.09 in 2011 for health-facility-based delivery. The multivariable adjusted regression coefficients of reproductive health service utilization by wealth category were 0.06 in 2000 and 0.04 in 2011 for antenatal care, 0.07 in 2000 and 0.05 in 2011 for skilled birth attendance, and 0.07 in 2006 and 0.05 in 2011 for health-facility-based delivery. More women utilized reproductive health services in 2011 than in 2000. Inequality by wealth status in utilization of antenatal care, skilled birth attendance, and health-facility-based delivery had been reduced.
A favourable context for women with HIV to prevent unintended pregnancy is a cornerstone of reproductive rights and will contribute to achieving universal access to reproductive health, a Millennium Development Goal target. This analysis explores the reproductive trajectories of Mexican women with HIV post-diagnosis and their access to reproductive counselling and use of contraceptives. In-depth interviews and short surveys were conducted with women of reproductive age living with HIV. Results indicate that sexual and reproductive health counselling in HIV care focuses on the male condom and does not routinely address reproductive desires or provide information about or access to other contraceptive methods. Unintended pregnancies result from inconsistent condom use and condom breakage. Women experienced discriminatory denial of and pressure to accept particular contraceptive methods because of their HIV status. Mexican women with HIV are not enjoying their constitutionally guaranteed right to freely choose the number and spacing of their children. Mexico's commitment to reproductive rights and the Popular Health Insurance offer policy and financial frameworks for providing family planning services in public HIV clinics. To ensure respectful implementation, rights-based training for HIV healthcare providers and careful monitoring and evaluation will be needed.
The entomopathogenic fungal endophytes Purpureocillium lilacinum (formerly Paecilomyces lilacinus) and Beauveria bassiana negatively affect cotton aphid reproduction under both greenhouse and field conditions.
Castillo Lopez, Diana; Zhu-Salzman, Keyan; Ek-Ramos, Maria Julissa; Sword, Gregory A
The effects of two entomopathogenic fungal endophytes, Beauveria bassiana and Purpureocillium lilacinum (formerly Paecilomyces lilacinus), were assessed on the reproduction of cotton aphid, Aphis gossypii Glover (Homoptera:Aphididae), through in planta feeding trials. In replicate greenhouse and field trials, cotton plants (Gossypium hirsutum) were inoculated as seed treatments with two concentrations of B. bassiana or P. lilacinum conidia. Positive colonization of cotton by the endophytes was confirmed through potato dextrose agar (PDA) media plating and PCR analysis. Inoculation and colonization of cotton by either B. bassiana or P. lilacinum negatively affected aphid reproduction over periods of seven and 14 days in a series of greenhouse trials. Field trials were conducted in the summers of 2012 and 2013 in which cotton plants inoculated as seed treatments with B. bassiana and P. lilacinum were exposed to cotton aphids for 14 days. There was a significant overall effect of endophyte treatment on the number of cotton aphids per plant. Plants inoculated with B. bassiana had significantly lower numbers of aphids across both years. The number of aphids on plants inoculated with P. lilacinum exhibited a similar, but non-significant, reduction in numbers relative to control plants. We also tested the pathogenicity of both P. lilacinum and B. bassiana strains used in the experiments against cotton aphids in a survival experiment where 60% and 57% of treated aphids, respectively, died from infection over seven days versus 10% mortality among control insects. Our results demonstrate (i) the successful establishment of P. lilacinum and B. bassiana as endophytes in cotton via seed inoculation, (ii) subsequent negative effects of the presence of both target endophytes on cotton aphid reproduction using whole plant assays, and (iii) that the P. lilacinum strain used is both endophytic and pathogenic to cotton aphids. Our results illustrate the potential of using these
The entomopathogenic fungal endophytes Purpureocillium lilacinum (formerly Paecilomyces lilacinus and Beauveria bassiana negatively affect cotton aphid reproduction under both greenhouse and field conditions.
Diana Castillo Lopez
Full Text Available The effects of two entomopathogenic fungal endophytes, Beauveria bassiana and Purpureocillium lilacinum (formerly Paecilomyces lilacinus, were assessed on the reproduction of cotton aphid, Aphis gossypii Glover (Homoptera:Aphididae, through in planta feeding trials. In replicate greenhouse and field trials, cotton plants (Gossypium hirsutum were inoculated as seed treatments with two concentrations of B. bassiana or P. lilacinum conidia. Positive colonization of cotton by the endophytes was confirmed through potato dextrose agar (PDA media plating and PCR analysis. Inoculation and colonization of cotton by either B. bassiana or P. lilacinum negatively affected aphid reproduction over periods of seven and 14 days in a series of greenhouse trials. Field trials were conducted in the summers of 2012 and 2013 in which cotton plants inoculated as seed treatments with B. bassiana and P. lilacinum were exposed to cotton aphids for 14 days. There was a significant overall effect of endophyte treatment on the number of cotton aphids per plant. Plants inoculated with B. bassiana had significantly lower numbers of aphids across both years. The number of aphids on plants inoculated with P. lilacinum exhibited a similar, but non-significant, reduction in numbers relative to control plants. We also tested the pathogenicity of both P. lilacinum and B. bassiana strains used in the experiments against cotton aphids in a survival experiment where 60% and 57% of treated aphids, respectively, died from infection over seven days versus 10% mortality among control insects. Our results demonstrate (i the successful establishment of P. lilacinum and B. bassiana as endophytes in cotton via seed inoculation, (ii subsequent negative effects of the presence of both target endophytes on cotton aphid reproduction using whole plant assays, and (iii that the P. lilacinum strain used is both endophytic and pathogenic to cotton aphids. Our results illustrate the potential of
Aslani, Azam; Pournik, Omid; Abu-Hanna, Ameen; Eslami, Saeid
Internet forms an opportunity to inform, teach, and connect professionals and patients. However, much information on Internet is incomplete, inaccurate, or misleading, and not only in the medical domain. Because of the potential for damage from misleading and inaccurate health information, many organizations and individuals have published or implemented scoring tools for evaluating the appropriateness or quality of these resources. The objective of this study is to identify and summarize scoring tools that have evaluated web-sites providing reproductive health information in order to compare them and recommend an overarching evaluation tool. We searched Ovid MEDLINE(R) (1946 to July 2013) and OVID Embase (1980 to July 2013); and included English language studies that have evaluated the quality of websites providing reproductive health information. Studies only assessing the content of websites were excluded. We identified 5 scoring tools: 1-The HON (health on the net) Code of Conduct for medical and health Web sites, 2-Silberg scores, 3-Hogne Sandvik scale, 4-Jim Kapoun's Criteria for Evaluating Web Pages, and 5-The Health Information Technology Institute (HITI) criteria. We have compared these scales and identified 14 criteria: authorship, ownership, currency, objectivity/content, transparency/source, interactivity, privacy/ethics, financial disclosure, navigability/links, complementarity, advertising policy, design, quantity, and accessibility. We integrated these criteria and introduced a new tool with 10 criteria. Website evaluation tools differ in their evaluation criteria and there is a lack of consensus about which to use; therefore, an integrated easy to use set of criteria is needed.
Gavin, Loretta E; Catalano, Richard F; David-Ferdon, Corinne; Gloppen, Kari M; Markham, Christine M
Positive youth development (PYD) may be a promising strategy for promoting adolescent health. A systematic review of the published data was conducted to identify and describe PYD programs that improve adolescent sexual and reproductive health. Eight databases were searched for articles about PYD programs published between 1985 and 2007. Programs included met the following criteria: fostered at least one of 12 PYD goals in multiple socialization domains (i.e., family, school, community) or addressed two or more goals in at least one socialization domain; allocated at least half of the program activities to promoting general PYD outcomes (as compared with a focus on direct sexual health content); included youth younger than 20 years old; and used an experimental or quasi-experimental evaluation design. Thirty programs met the inclusion criteria, 15 of which had evidence of improving at least one adolescent sexual and reproductive health outcome. Program effects were moderate and well-sustained. Program goals addressed by approximately 50% or more of the effective programs included promoting prosocial bonding, cognitive competence, social competence, emotional competence, belief in the future, and self-determination. Effective programs were significantly more likely than those that did not have an impact to strengthen the school context and to deliver activities in a supportive atmosphere. Effective programs were also more likely to build skills, enhance bonding, strengthen the family, engage youth in real roles and activities, empower youth, communicate expectations, and be stable and relatively long-lasting, although these differences between effective and ineffective programs were not statistically significant. PYD programs can promote adolescent sexual and reproductive health, and tested, effective PYD programs should be part of a comprehensive approach to promoting adolescent health. However, more research is needed before a specific list of program
Miguel Barbosa Fontes
Full Text Available This study assessed the main determinants of sexual and reproductive health of Brazilian youth. It was approved by the Ethics Committee of the Medicine Faculty of the University of Brasília, and it received support from Paho and Brazilian Ministry of Health. 1.208 youngsters (18 to 29 years old in 15 states and Federal District were interviewed at their residences, during the second semester of 2011. Margin of error, adjusted regional and nationally, was 2.8% (CI: 95%, regarding the assessed sample. A KAP scale (knowledge, attitudes, and practices with 17 questions (-17 to +17 points was generated. A questionnaire was pre-tested for consistency and validity analysis was performed. KAP scale was used as dependent variable in adjusted linear regression models. Mean KAP score was 5.65 points. Gaps in KAP were: 70% of the youth do not know when the fertility period of a woman is. 42% of youth do not recognize condoms as a method to prevent unwanted pregnancy and STDs. The main factors associated to explaining variances in KAP are gender, education, religion, access to health services, having had sexual intercourse in the last 12 months, and having friends as the main personal reference (p < 0.05. Youngsters with higher education, women, non-Protestant, who claim to know where to find health services have better KAP level of reproductive health. Studies are necessary to support public policies that increase the KAP levels in sexual and reproductive health of the most vulnerable groups, such as the segment comprising low education, men and Protestants.
L. Moore (Laurence); M. Chersich (Matthew); R. Steen (Richard); S. Reza-Paul (Sushena); A. Dhana (Ashar); B. Vuylsteke (Bea); Y. Lafort (Yves); F. Scorgie (Fiona)
textabstractBackground: Female sex workers (FSWs) experience high levels of sexual and reproductive health (SRH) morbidity, violence and discrimination. Successful SRH interventions for FSWs in India and elsewhere have long prioritised community mobilisation and structural interventions, yet little
Banerjee, Sushanta K; Andersen, Kathryn L; Warvadekar, Janardan; Aich, Paramita; Rawat, Amit; Upadhyay, Bimla
Young, rural Indian women lack sexual and reproductive health (SRH) information and agency and are at risk of negative sexual and reproductive health outcomes. Youth-focused interventions have been shown to improve agency and self-efficacy of young women to make decisions regarding their sexual and reproductive health. The objectives of this study were to assess young women's sexual and reproductive health knowledge; describe their health-seeking behaviors; describe young women's experiences with sexual and reproductive health issues, including unwanted pregnancy and abortion; and identify sources of information, including media sources. A cross-sectional survey with a representative sample of 1381 married and unmarried women young women (15-24 years) from three rural community development blocks in Jharkhand, India was conducted in 2012. Participants were asked a series of questions related to their SRH knowledge and behavior, as well as questions related to their agency in several domains related to self-efficacy and decision-making. Linear regression was used to assess factors associated with greater or less individual agency and to determine differences in SRH knowledge and behavior between married and unmarried women. Despite national policies, participants married young (mean 15.7 years) and bore children early (53 % with first birth by 17 years). Women achieved low composite scores on knowledge around sex and pregnancy, contraception, and abortion knowledge. Around 3 % of married young women reported experiencing induced abortion; 92 % of these women used private or illegal providers. Married and unmarried women also had limited agency in decision-making, freedom of mobility, self-efficacy, and financial resources. Most of the women in the sample received SRH information by word of mouth. Lack of knowledge about sexual and reproductive health in this context indicates that young rural Indian women would benefit from a youth-friendly SRH intervention to
Full Text Available 1–3 year students attending medical and preventive faculty of a medical university were our research object. Our research had many stages, and at the first one our goal was to examine and to assess basic behavioral risks for reproductive health of students attending medical and preventive faculty of a medical university. We conducted a sociological examination via questioning. 428 students were questioned as per materials collecting program which included 74 parameters; they accounted for 91.6 % out of the overall official number of students, 45.0 % male students and 40.0 % female students combined work and studies. We detected that, as per questioning results, the specific weight of students who took care of their health amounted to 79.2 % boys and 95.2 % girls. However, the students tended to have bad habits, i.e. constant alcohol intake or smoking. And although information on diseases prevention and on how to pursue healthy lifestyle was perfectly available to them, students didn't try to use it and preserve their health. All the respondents said they were against abortion. Girls were likely to adopt a complex approach when choosing a contraceptive, they resorted to hormonal agents, and, with their partners' consent, to condoms. But they often took hormonal agents without any consultations with a gynecologist or an endocrinologist. Contraceptives were rather rarely applied, and students appeared to have no knowledge on risk factors causing reproductive health deterioration. They also tended to be negligent and too self-confident when it came to reproductive health protection. A risk of abortions was very high for girls who didn't use contraceptives, and also all students ran rather high risk of catching sexual diseases. Sexual education is needed to correct contraceptive behavior; medical workers are a main source of information on reproductive health of young people in 7–10 % cases only. We need to create interactive educational programs
Baheiraei, Azam; Bakouei, Fatemeh; Mohammadi, Eesa; Majdzadeh, Reza; Hosseni, Mostafa
Women's health is a public health priority. The origins of health inequalities are very complex. The present study was conducted to determine the association between social capital and health status in reproductive-age women in Tehran, Iran. In this population-based, cross-sectional study, the Social Capital Integrated Questionnaire, the SF-36 and socio-demographic questionnaires were used. Analysis of data by one-way ANOVA test and stepwise multiple linear regression showed that the manifestation dimensions of social capital (groups and networks, trust and solidarity, collective action and cooperation) can potentially lead to the outcome dimensions of social capital (social cohesion and inclusion, and empowerment and political action), which in turn affect health inequities after controlling for socio-demographic differences. © The Author(s) 2015.
Greathouse, K Leigh; Faucher, Mary Ann; Hastings-Tolsma, Marie
The microbes residing in the human gut, referred to as the microbiome, are intricately linked to energy homeostasis and subsequently obesity. Integral to the origins of obesity, the microbiome is believed to affect not only health of the human gut but also overall health. This microbiome-obesity association is mediated through the process of energy extraction, metabolism, and cross talk between the brain and the gut microbiome. Host exposures, including diet, that potentially modify genetic predisposition to obesity and affect weight management are reviewed. The higher prevalence of obesity among women and recent evidence linking obesity during pregnancy with offspring health make this topic particularly relevant. Current limitations in microbiome research to address obesity and future advances in this field are described. Applications of this science with respect to applied nursing and overall health care in general are included, with emphasis on the reproductive health of women and their offspring.
Anwar, Jasim; Mpofu, Elias; Matthews, Lynda R; Shadoul, Ahmed Farah; Brock, Kaye E
The reproductive and mental health of women contributes significantly to their overall well-being. Three of the eight Millennium Development Goals are directly related to reproductive and sexual health while mental disorders make up three of the ten leading causes of disease burden in low and middle-income countries. Among mental disorders, depression and anxiety are two of the most prevalent. In the context of slower progress in achieving Millennium Development Goals in developing countries and the ever-increasing man-made and natural disasters in these areas, it is important to understand the association between reproductive health and mental health among women with post-disaster experiences. This was a cross-sectional study with a sample of 387 women of reproductive age (15-49 years) randomly selected from the October 2005 earthquake affected areas of Pakistan. Data on reproductive health was collected using the Centers for Disease Control reproductive health assessment toolkit. Depression and anxiety were measured using the Hopkins Symptom Checklist-25, while earthquake experiences were captured using the Harvard Trauma Questionnaire. The association of either depression or anxiety with socio-demographic variables, earthquake experiences, reproductive health and access to health facilities was estimated using multivariate logistic regression. Post-earthquake reproductive health events together with economic deprivation, lower family support and poorer access to health care facilities explained a significant proportion of differences in the experiencing of clinical levels of depression and anxiety. For instance, women losing resources for subsistence, separation from family and experiencing reproductive health events such as having a stillbirth, having had an abortion, having had abnormal vaginal discharge or having had genital ulcers, were at significant risk of depression and anxiety. The relationship between women's post-earthquake mental health and
Wajid, Abdul; White, Franklin; Karim, Mehtab S
As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH) services in two areas with different levels of service in Punjab, Pakistan. A cross-sectional survey was conducted to interview Married Women of Reproductive Age (MWRA). Information was collected on MWRA knowledge regarding danger signs during pregnancy, delivery, postnatal periods, and MNH care seeking behavior. After comparing MNH service utilization, the two areas were compared using a logistic regression model, to identify the association of different factors with the intervention after controlling for socio-demographic, economic factors and distance of the MWRA residence to a health care facility. The demographic characteristics of women in the two areas were similar, although socioeconomic status as indicated by level of education and better household amenities, was higher in the intervention area. Consequently, on univariate analysis, utilization of MNH services: antenatal care, TT vaccination, institutional delivery and use of modern contraceptives were higher in the intervention than control area. Nonetheless, multivariable analysis controlling for confounders such as socioeconomic status revealed that utilization of antenatal care services at health centers and TT vaccination during pregnancy are significantly associated with the intervention. Our findings suggest positive changes in health care seeking behavior of women and families with respect to MNH. Some aspects of care still require attention, such as knowledge about danger signs and neonatal care, especially umbilical cord care. Despite overall success achieved so far in response to the Millennium Development Goals, over the past two decades decreases in maternal mortality are far from the 2015 target. This report identifies some of the key factors to improving MNH and serves as an interim measure of a national and global challenge that remains
Full Text Available BACKGROUND: As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH services in two areas with different levels of service in Punjab, Pakistan. METHODS: A cross-sectional survey was conducted to interview Married Women of Reproductive Age (MWRA. Information was collected on MWRA knowledge regarding danger signs during pregnancy, delivery, postnatal periods, and MNH care seeking behavior. After comparing MNH service utilization, the two areas were compared using a logistic regression model, to identify the association of different factors with the intervention after controlling for socio-demographic, economic factors and distance of the MWRA residence to a health care facility. RESULTS: The demographic characteristics of women in the two areas were similar, although socioeconomic status as indicated by level of education and better household amenities, was higher in the intervention area. Consequently, on univariate analysis, utilization of MNH services: antenatal care, TT vaccination, institutional delivery and use of modern contraceptives were higher in the intervention than control area. Nonetheless, multivariable analysis controlling for confounders such as socioeconomic status revealed that utilization of antenatal care services at health centers and TT vaccination during pregnancy are significantly associated with the intervention. CONCLUSIONS: Our findings suggest positive changes in health care seeking behavior of women and families with respect to MNH. Some aspects of care still require attention, such as knowledge about danger signs and neonatal care, especially umbilical cord care. Despite overall success achieved so far in response to the Millennium Development Goals, over the past two decades decreases in maternal mortality are far from the 2015 target. This report identifies some of the key factors to improving MNH and serves as an
Fagbamigbe, Adeniyi F; Bamgboye, Elijah A; Yusuf, Bidemi O; Akinyemi, Joshua O; Issa, Bolakale K; Ngige, Evelyn; Amida, Perpetua; Bashorun, Adebobola; Abatta, Emmanuel
Recently, Nigeria emerged as the largest economy in Africa and the 26th in the world. However, a pertinent question is how this new economic status has impacted on the wealth and health of her citizens. There is a dearth of empirical study on the wealth distribution in Nigeria which could be important in explaining the general disparities in their health seeking behavior. An adequate knowledge of Nigeria wealth distribution will no doubt inform policy makers in their decision making to improve the quality of life of Nigerians. This study is a retrospective analysis of the assets of household in Nigeria collected during the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS Plus 2). We used the principal component analysis methods to construct wealth quintiles across households in Nigeria. At 5% significance level, we used ANOVA to determine differences in some health outcomes across the WQs and chi-square test to assess association between WQs and some reproductive health seeking behaviours. The wealth quintiles were found to be internally valid and coherent. However, there is a wide gap in the reproductive health seeking behavior of household members across the wealth quintiles with members of households in lower quintiles having lesser likelihood (33.0%) to receive antenatal care than among those in the highest quintiles (91.9%). While only 3% were currently using modern contraceptives in the lowest wealth quintile, it was 17.4% among the highest wealth quintile (p wealth quintiles showed a great disparity in the standard of living of Nigerian households across geo-political zones, states and rural-urban locations which had greatly influenced household health seeking behavior.
Furken, C; Nakao, T; Hoedemaker, M
It was the purpose of this study to determine the effects of non-esterified fatty acids (NEFA) concentrations at different time periods of the transition period as well as lactation number on metabolism, health, reproduction and milk production in dairy cows. This trial was conducted in a single dairy herd located in Northern Germany. Of the herd, which comprised 330 lactating Holstein cows housed in a free stall barn and fed a total mixed ration (TMR), 83 primiparous and multiparous cows were randomly selected. Animals were checked for body condition score (BCS), locomotion score, calving data, quality of colostrum, reproductive measures, daily rectal temperature of the first 10 days post-partum (p. p.), health data and culling rates up to 200 days in milk (DIM) as well as milk production until 305 DIM. Three different time periods were considered: 3 and 1 week ante partum (a. p.); partus and 1 week p. p.; 3 weeks p. p. Animals with NEFA concentrations ≥ 0.4 mmol/l ante partum had a higher risk of no ovarian activity in week 5 p. p. and of subclinical ketosis post partum than cows with lower NEFA concentrations (p reproduction of dairy cows.
Nair, M K C; Leena, M L; Paul, Mini K; Pillai, H Vijayan; Babu, George; Russell, P S; Thankachi, Yamini
To assess parents' and teachers' attitude towards Adolescent Reproductive Sexual Health Education (ARSHE). The study group consisted of a random sample of 795 parents and 115 teachers belonging to three urban schools (one boys only, one girls only and one co-education) and one co-education rural school at Thiruvananthapuram district, Kerala, where an ICMR supported ARSHE intervention programme was done subsequently. A self-administered questionnaire for parents and teachers developed by an ICMR taskforce for ARSHE programme was used to assess their opinion on the need, content and the appropriate person to provide adolescent reproductive sexual health education in a school setting. 65.2% of parents and 40.9% teachers have not discussed growth and development issues with their adolescents. Only 5.2% teachers and 1.1% parents discussed sexual aspects with adolescents. 44% of parents agreed that information on HIV/AIDS/STD should be provided. More than 50% of parents were not sure whether information on topics like masturbation, dating, safe sex, contraceptives, pregnancy, abortion and childcare should be provided to adolescents. Results pointed out the need for introducing reproductive and sexual education in the school setting. Only 1.1% of parents and 5.2% teachers actually discussed sexual aspects with adolescents which highlights the need for parent and teacher awareness programs before ARSHE is introduced in the schools.
Anderson, R Eleanor; Ahn, Roy; Nelson, Brett D; Chavez, Jean; de Redon, Emily; Burke, Thomas
In resource-limited settings, severe shortages of anesthetists and anesthesiologists lead to surgical delays that increase maternal and neonatal mortality and morbidity. To more clearly understand the individual components of the anesthesia gap pertaining to reproductive health surgeries and procedures in resource-limited settings. Medline, the Cochrane Library, CINAHL, Embase, and POPLINE were systematically searched for reports published before December 31, 2013. Search terms were related to obstetric surgery, resource-limited settings, and anesthesia. Studies that addressed the use of anesthesia in reproductive procedures in resource-limited settings were included. Reviewers independently evaluated the full text of identified studies, extracted information related to study objectives and conclusions, and identified the anesthesia gap. Overall, 14 publications met the inclusion criteria. A significant lack of infrastructure, equipment and supplies, and trained personnel were identified as key factors responsible for a lack of anesthesia services. A shortage of trained anesthesia providers, equipment, supplies, medications, and infrastructure, along with limitations in transportation in resource-limited settings have produced a wide gap between available anesthesia services and the demand for them for reproductive health surgeries and procedures. Safe, affordable, and scalable solutions to address the anesthesia gap are urgently needed. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Gaughran, Margaret; Asgary, Ramin
Rates of sexually transmitted infections (STIs) and unplanned pregnancy are high in Kenya, and limited reproductive health education exists in schools. We designed and implemented a 6-week reproductive health curriculum in Laikipia District, Kenya, in 2011, which included didactic sessions, educational games, and open discussions. We applied a mixed quantitative and qualitative methods to evaluate this curriculum including a comprehensive 35-item survey to assess pre- and post-training knowledge, attitudes, and practices of female teenagers regarding STIs/HIV and family planning using paired t-test as well as complementary focus groups (n=42) and individual interviews (n=20). Average age for 42 female teenagers was 16.5 (± 1.31) years. Pre-test questionnaires revealed lack of knowledge about different types of STIs, specifically chlamydia, but adequate knowledge of basic contraception including abstinence and condom use. By the conclusion of the study, we observed improvement in following educational domains: general knowledge of HIV/AIDS (85% ± 7.5% to 94% ± 5.6%) (pmasturbation and its perceived consequences, and issues surrounding female circumcision. Important misconceptions and gaps in reproductive practices were identified and addressed using a mixed methods approach. Despite prior basic knowledge and positive attitudes on STI prevention and family planning, complementary teaching approaches were instrumental in improving overall knowledge of STIs other than HIV as well as family planning. The curriculum was feasible, well received, and achieved its educational goals.
Full Text Available Deterioration of the environment in the XX-XXI century under the influence of chemical, physical, radiological and other factors is not only and not just an ecological catastrophe of modern times, but a direct threat to the health and life of human society as a whole. Among the most important factors influencing people's health occupy chemical the leading place, because since 1957 more than 50 million chemical substances were synthesized, but only 15% of them have a toxicological evaluation, and 30% of the diseases in Europe are associated with chemical factor (ECHA-EXA. Chemical "pressing" determines a significant reduction in the reproduction of the population of Europe, and for Ukraine it means a large-scale depopulation, among possible reasons of which a significant role belongs to the deterioration of the reproductive capacity of population, men in particular, and this work is devoted to this problem. On the basis of profound analysis of literature data, complex ecologic-hygienic researches we identified markers of exposure, prognosticaly significant markers of impact for the early diagnostics of disorders of male generative system in conditions of low-dose impact of xenobiotics. We achieved convincing evidence of ecologically determined character of unogenital diseases and fertility decrease, we developed scientifically-justified principles of management of risk of development of ecologically-determined reproductive pathology in men.
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.
Collins, Gretchen G; Jeelani, Roohi; Beltsos, Angeline; Kearns, William G
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.
Full Text Available Abstract Background Russian society has faced dramatic changes in terms of social stratification since the collapse of the Soviet Union. During this time, extensive reforms have taken place in the organisation of health services, including the development of the private sector. Previous studies in Russia have shown a wide gap in mortality between socioeconomic groups. There are just a few studies on health service utilisation in post-Soviet Russia and data on inequality of health service use are limited. The aim of the present study was to analyse health (self-rated health and self-reported chronic diseases and health care utilisation patterns by socioeconomic status (SES among reproductive age women in St. Petersburg. Methods The questionnaire survey was conducted in 2004 (n = 1147, with a response rate of 67%. Education and income were used as dimensions of SES. The association between SES and health and use of health services was assessed by logistic regression, adjusting for age. Results As expected low SES was associated with poor self-rated health (education: OR = 1.48; personal income: OR = 1.42: family income: OR = 2.31. University education was associated with use of a wider range of outpatient medical services and increased use of the following examinations: Pap smear (age-adjusted OR = 2.06, gynaecological examinations (age-adjusted OR = 1.62 and mammography among older (more than 40 years women (age-adjusted OR = 1.98. Personal income had similar correlations, but family income was related only to the use of mammography among older women. Conclusions Our study suggests a considerable inequality in health and utilisation of preventive health service among reproductive age women. Therefore, further studies are needed to identify barriers to health promotion resources.
Dubikaytis, Tatiana; Larivaara, Meri; Kuznetsova, Olga; Hemminki, Elina
Russian society has faced dramatic changes in terms of social stratification since the collapse of the Soviet Union. During this time, extensive reforms have taken place in the organisation of health services, including the development of the private sector. Previous studies in Russia have shown a wide gap in mortality between socioeconomic groups. There are just a few studies on health service utilisation in post-Soviet Russia and data on inequality of health service use are limited. The aim of the present study was to analyse health (self-rated health and self-reported chronic diseases) and health care utilisation patterns by socioeconomic status (SES) among reproductive age women in St. Petersburg. The questionnaire survey was conducted in 2004 (n = 1147), with a response rate of 67%. Education and income were used as dimensions of SES. The association between SES and health and use of health services was assessed by logistic regression, adjusting for age. As expected low SES was associated with poor self-rated health (education: OR = 1.48; personal income: OR = 1.42: family income: OR = 2.31). University education was associated with use of a wider range of outpatient medical services and increased use of the following examinations: Pap smear (age-adjusted OR = 2.06), gynaecological examinations (age-adjusted OR = 1.62) and mammography among older (more than 40 years) women (age-adjusted OR = 1.98). Personal income had similar correlations, but family income was related only to the use of mammography among older women. Our study suggests a considerable inequality in health and utilisation of preventive health service among reproductive age women. Therefore, further studies are needed to identify barriers to health promotion resources.
Full Text Available Finland is one of the donor countries that is most supportive in family planning (FP, Sexual and Reproductive Health and Rights (SRHR and gender issues. This study examines Finnish ODA for FP and SRHR: its decision-making structure, other stakeholders and funding levels. Data consists of documents from the Ministry for Foreign Affairs (MFA and interviews conducted at the MFA and with other experts. While Parliament decides on the overall level of ODA funding, the Minister for Foreign Trade and Development has considerable autonomy. Other stakeholders such as the All-Party Parliamentary Group on Population and Development and the Family Federation of Finland (Vestliitto engage in advocacy work and have influenced development policy. Although the Development Policy 2007 mentions the importance of health and SRHR issues and HIV/AIDS is a cross-cutting issue, interviewees stated that the importance of health and SRHR in ODA has declined and that the implementation of cross-cutting issues is challenging. Multilateral funding for UNFPA, UNAIDS and GFATM, and thus the proportion of SRHR funding within the health sector, is however currently rising. Funding for population-related activities has increased and represented 4.8% of Finlands total ODA in 2009. Almost all of this funding is directed towards basic reproductive health and HIV/AIDS issues and the majority is directed through multilateral channels (78% in 2009, mainly UNFPA and UNAIDS. IPPF, Ipas and Marie Stopes International also receive support.
Patrícia Carvalho Oliveira
Full Text Available The objective was to investigate and compare sexual and reproductive knowledge and sources of information, between public school adolescents from Goiânia-Goiás. A cross-sectional study conducted with 2,449 students. We analyzed data from the self-reported questionnaire using the Statistical Package for Social Sciences, version 13.0. We investigated the differences between proportions using c2 tests and a significance level (p<0.05. We observed a statistical difference between sex considering the knowledge about Sexually Transmitted Infections and, STI and contraception prevention (p<0.000. Additionally, male adolescents presented higher exposure risk to sexual relations without preservative (p<0.000. About the acquisition of preventive methods for STIs and contraception, women were more knowledgeable about access to devices, as well as; they searched different sources and content information about sexual and reproductive health. We concluded that male adolescents presented higher social and individual vulnerability profiles.
Skakkebaek, Niels E
. There is little doubt that environmental factors associated with modern lifestyles have - in a broad sense - had an adverse influence on male reproductive health. The hypothesis that exposure to endocrine-disrupting chemicals plays a fundamental role in this trend is plausible. This is based on evidence from......During the past few decades there has been a significantly increasing trend in germ cell tumours all over the world, particularly in countries with Caucasian populations. The changes in incidence have occurred so fast that only environmental factors can explain this development. This review focuses...... animal studies that demonstrate adverse reproductive effects caused by a number of endocrine-disrupting chemicals to which humans are exposed as part of our modern lifestyle....
Denneson, Lauren M; Chen, Jason I; Pisciotta, Maura; Tuepker, Anais; Dobscha, Steven K
This study describes responses to OpenNotes, clinical notes available online, among patients receiving mental health care and explores whether responses vary by patient demographic or clinical characteristics. Survey data from 178 veterans receiving mental health treatment at a large Veterans Affairs medical center included patient-reported health self-efficacy, health knowledge, alliance with clinicians, and negative emotional responses after reading OpenNotes. Health care data were extracted from the patient care database. Reading OpenNotes helped many participants feel in control of their health care (49%) and have more trust in clinicians (45%), although a few (8%) frequently felt upset after reading their notes. In multivariate models, posttraumatic stress disorder was associated with increased patient-clinician alliance (p=.046) but also with negative emotional responses (p<.01). Patients receiving mental health care frequently reported benefits from reading OpenNotes, yet some experienced negative responses.
Full Text Available Background: Since adolescent girls comprise a major reproductive age group, their role is critical in determining the India's future population goal. This apart, evidence ofchange in sexual behavior and growing spread of HIV infection, has generatedfresh reproductive health concerns, which need to be accountedfor by policy makers to develop appropriate family life educational strategies.Objectives:To assess the level of knowledge ofoubertal changes, reproductive tract infections and HIV/AIDS among adolescents.To assess the attitude of adolescent girls regarding age at marriage, age at first birth, small family concept.To identify the preferred source of information by adolescents on reproductive health.Study design: cross- sectional studySampling Technique: thirty cluster methodology Study setting: Rural areas of Luc knowParticipants: 455 unmarried adolescent girls of (10-19 years age .Statistical A nalysis: Chi square test and Fischer exact testResult: Three fourth of the girls were aware of at least one pubertal change. In spite of being aware that RTI is a curable disease, only 8.5% of the girls having RTI sought treatmentfor it. About 80% ofadolescent girls had heard of HIV/AIDS. 47.7% ofadolescents were unaware that it is incurable. Heterosexual relation was cited by most (73.2% ofthe girls as mode oftransmission of HIV. Sex with partner only and use ofcondom as a preventive measure was identified by 52.6% and 39.2% girls respectively. Early marriage and early child bearing (<2I years was preferred by 10.7% and 33.6% of girls respectively. Family size oftwo or less was preferred by 69.2%> Irrespective ofany age group, majority of the girls preferred afamily member to get information on reproductive health problems
Suh, Siri; Moreira, Philippe; Ly, Moussa
In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. The most notable improvement across regions was in infection prevention.Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality.
Full Text Available Abstract Background In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. Methods This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. Results The most notable improvement across regions was in infection prevention. Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Conclusion Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality.
Pandey, Shilpi; Porter, Maureen; Bhattacharya, Siladitya
Researchers are being urged to involve patients in the design and conduct of studies in health care with limited insight at present into their needs, abilities or interests. This is particularly true in the field of reproductive health care where many conditions such as pregnancy, menopause and fertility problems involve women who are otherwise healthy. To ascertain the feasibility of involving patients and members of the public in research on women's reproductive health care (WRH). University and tertiary care hospital in north-east Scotland; 37 women aged 18-57. Four focus groups and one individual interview were audio-recorded and verbatim transcripts analysed thematically by two researchers using a grounded theory approach. Most participants were interested in WRH, but some participated to promote a health issue of special concern to them. Priorities for research reflected women's personal concerns: endometriosis, polycystic ovary syndrome, menopause, fertility risks of delaying parenthood and early post-natal discharge from hospital. Women were initially enthusiastic about getting involved in research on WRH at the design or delivery stage, but after discussion in focus groups, some questioned their ability to do so or the time available to commit to research. None of the respondents expected payment for any involvement, believing that the experience would be rewarding enough in itself. Involving patients and public in research would include different perspectives and priorities; however, recruiting for this purpose would be challenging. © 2014 John Wiley & Sons Ltd.
Malta, Monica; Todd, Catherine S; Stibich, Mark A; Garcia, Thais; Pacheco, Diego; Bastos, Francisco I
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.
Stefansson, Lilja S; Webb, M Elizabeth; Hebert, Luciana E; Masinter, Lisa; Gilliam, Melissa L
Adolescents experience numerous barriers to obtaining sexual and reproductive health care (SRHC). Mobile Health Units (MHUs) can remove some barriers by traveling to the community. This pilot study developed Mobile SRHC through an iterative process on an existing MHU and evaluated it among adolescents and providers. Mobile SRHC was developed through a mixed-method, multiphase study. Three key informant interviews with MHU providers, an adolescent needs assessment survey, and a Youth Model Development Session informed model development. Emergency contraception (EC), oral contraceptive pills (OCPs), and depot-medroxyprogesterone acetate (DMPA) were sequentially incorporated into MHU services. Administrative data assessed method distribution and surveys assessed patient satisfaction. Key informants held positive attitudes toward implementing Mobile SRHC into their practice. Needs assessment surveys (N = 103) indicated a majority was interested in learning about sexual health (66.0%) and obtaining birth control (54.4%) on an MHU. Over 3 months, 123 adolescents participated in Mobile SRHC. Seven packs and 9 prescriptions of EC, 8 3-month packs and 10 prescriptions of OCPs, and 5 injections and 5 prescriptions of DMPA were distributed. Ninety-two percent of adolescent participants reported they would recommend Mobile SRHC to friends. Mobile SRHC is a feasible approach for reproductive health care among adolescents. © 2018, American School Health Association.
Full Text Available Abstract Background Providing reproductive and sexual health services is an important and challenging aspect of caring for displaced populations, and preventive and curative sexual health services may play a role in reducing HIV transmission in complex emergencies. From 1995, the non-governmental "Reproductive Health Group" (RHG worked amongst refugees displaced by conflicts in Sierra Leone and Liberia (1989–2004. RHG recruited refugee nurses and midwives to provide reproductive and sexual health services for refugees in the Forest Region of Guinea, and trained refugee women as lay health workers. A cross-sectional survey was conducted in 1999 to assess sexual health needs, knowledge and practices among refugees, and the potential impact of RHG's work. Methods Trained interviewers administered a questionnaire on self-reported STI symptoms, and sexual health knowledge, attitudes and practices to 445 men and 444 women selected through multistage stratified cluster sampling. Chi-squared tests were used where appropriate. Multivariable logistic regression with robust standard errors (to adjust for the cluster sampling design was used to assess if factors such as source of information about sexually transmitted infections (STIs was associated with better knowledge. Results 30% of women and 24% of men reported at least one episode of genital discharge and/or genital ulceration within the past 12 months. Only 25% correctly named all key symptoms of STIs in both sexes. Inappropriate beliefs (e.g. that swallowing tablets before sex, avoiding public toilets, and/or washing their genitals after sex protected against STIs were prevalent. Respondents citing RHG facilitators as their information source were more likely to respond correctly about STIs; RHG facilitators were more frequently cited than non-healthcare information sources in men who correctly named the key STI symptoms (odds ratio (OR = 5.2, 95% confidence interval (CI 1.9–13.9, and in men and
Bobo, Firew Tekle; Yesuf, Elias Ali; Woldie, Mirkuzie
Disparities in health services utilization within and between regional states of countries with diverse socio-cultural and economic conditions such as Ethiopia is a frequent encounter. Understanding and taking measures to address unnecessary and avoidable differences in the use of reproductive and maternal health services is a key concern in Ethiopia. The aim of the study was to examine degree of equity in reproductive and maternal health services utilization in Ethiopia. Data from Ethiopia demographic health survey 2014 was analyzed. We assessed inequities in utilization of modern contraceptive methods, antenatal care, facility based delivery and postnatal checkup. Four standard equity measurement methods were used; equity gaps, rate-ratios, concertation curve and concentration index. Inequities in service utilization were exhibited favoring women in developed regions, urban residents, most educated and the wealthy. Antenatal care by skilled provider was three times higher among women with post-secondary education than mothers with no education. Women in the highest wealth quantile had about 12 times higher skilled birth attendance than those in lowest wealth quantile. The rate of postnatal care use among urban resident was about 6 times that of women in rural area. Use of modern contraceptive methods was more equitably utilized service while, birth at health facility was less equitable across all economic levels, favoring the wealthy. Considerable inequity between and within regions of Ethiopia in the use of maternal health services was demonstrated. Strategically targeting social determinants of health with special emphasis to women education and economic empowerment will substantially contribute for altering the current situation favorably.
Fadda, Salvatore; Giorgi, Gabriele; Benitez Muñoz, Juan Luis; Justicia Justicia, Fernando; Solinas, Giuliana
Purpose: The purpose of this paper is to investigate the prevalence of workplace bullying in an Italian university. Design/methodology/approach: More than 200 workers have completed the Italian version of the Negative Acts Questionnaire and the General Health Questionnaire. Findings: The results show a spread of low to medium negative actions in…
Full Text Available Abstract Background This article describes the local concepts indigenous Nahua women hold regarding their reproduction. Specifically it provides a description of two indigenous illnesses—isihuayo and necaxantle, it discusses their etiology, symptoms, and treatments, and it analyzes them within the local ethnomedical framework and sociopolitical context. A perception of female vulnerability is shown to be an underlying shaper of women’s experiences of these illnesses. Methods This research took place in a small Nahua village in Mexico. Qualitative data on local perceptions of these illnesses were collected by a combination of participant observation and interviews. Ethnobotanical data was obtained through interviews, and medicinal plants were collected in home gardens, fields, stream banks, and forested areas. The total study population consisted of traditional birth attendants (N = 5, clinicians (N = 8, and laywomen (N = 48. Results Results showed that 20% of the village women had suffered from one or both of these illnesses. The article includes a detailed description of the etiology, symptoms, and treatments of these illnesses. Data shows that they were caused by mechanical, physical, and social factors related to a woman’s weakness and/or lack of support. Traditional birth attendants often treated women’s illnesses. Five medicinal plants were salient in the treatment of these illnesses: Ocimum basilicum L., Mentzelia aspera L., Pedilanthus tithymaloides (L. Poit., and Piper umbellatum L. were used for isihuayo, while Solanum wendlandii Hook f. was used for necaxantle. Conclusions The research on these two ethnomedical conditions is a useful case study to understanding how indigenous women experience reproductive health. Reproductive health is not simply about clinically-based medicine but is also about how biomedicine intersects with the local bodily concepts. By describing and analyzing indigenous women’s ill health, one can focus
Amy M. Metzger
Full Text Available Background and aims: Faith-based organizations (FBOs provide a substantial portion of the health care services in many African countries. FBO facilities do consider family planning and reproductive health services as essential to reducing maternal and child mortality, and to the growth of healthy families. Many health facilities, however, struggle to maintain adequate stocks of reproductive health (RH supplies because of the various RH supply chains and funding sources, which often operate separately from other medicines and supplies. The purpose of this study is to identify the types of supply chain systems used by African faith-based health facilities to acquire reproductive health products (clotrimazole, combined oral contraceptive pills, contraceptive implants, CycleBeads®, emergency contraception, Erythromycin, female condoms, injectable contraceptives, intra-uterine contraceptive devices, magnesium sulfate, male condoms, Methyldopa, Misoprostol, Nifedpine, Oxytocin, and Progestin-only pills, to describe their problems and challenges, and to identify possible corrective actions. Methods: Through email surveys, phone interviews, and on-site visits, we studied the supply chains of 46 faith-based health facilities in 13 African countries. Sixteen RH commodities, including contraceptives, were selected as indicators. Results: Of the 46 facilities surveyed, 55 percent faced stockouts of one or more products in the three months prior to the survey. Stockouts were less common for contraceptives than for other RH products. Significant strengths of the FBO supply chain included creativity in finding other sources of commodities in the face of stockouts, staff designated to monitor quality of the commodities, high capacity for storage, low incidence of expired products, few instances of poor quality, and strong financial sustainability mechanisms, often including patient fees. Weaknesses included unreliable commodity sources and power supplies, long
Wynn, L L; Foster, Angel M; Trussell, James
The words and metaphors that people use to describe sexuality and reproductive health reflect experiences with peers, sexual partners, health service providers and public health campaigns. In this paper we analyse 1134 emails sent to an emergency contraception website in the USA over the course of one year. Through an examination of the terminology used by authors to describe contraceptive methods, sexual intercourse and other sexual