PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Reproductive Health Services”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMedDate not supplied

Future physicians' attitudes on women's reproductive rights: a survey of medical students in an American university.

The July 1989 US Supreme Court decision in Webster v Reproductive Health Services restricts both women's access to legal abortion and physicians' latitude when performing abortions. We surveyed 197 medical students at the Columbia University College of Physicians and Surgeons regarding their general attitudes toward abortion as well as their specific opinions concerning the Webster decision and the possible restriction of minors' access to abortion represented by three then undecided cases. Of those surveyed, 85.8% were pro-choice by self-description as compared with 14.2% pro-life. The antiabortion group was predominantly male (78.6%) and of Catholic background, while there were no significant gender and/or religious correlates among the pro-choice group. The majority of the respondents (83.2%) disagreed with either one or both stipulated restrictions of Webster and 81.4% did not support limiting minors' access to abortion in any way. Moreover, only 19.8% admitted to a change in general attitude toward abortion during their medical education.

Abortion, Legal↗
PubMedDate not supplied

Barriers to sexual and reproductive health care: urban male adolescents speak out.

CONTEXT: Risky sexual behaviors among adolescent males put them at risk for sexually transmitted diseases, HIV/AIDS, and unplanned fatherhood, yet few facilities in the United States provide focused sexual and reproductive health services to these young men. A general acknowledgement exists that the development of such services is needed, yet there is little research to guide providers in making existing services more attractive to young males and in developing new sexual health services for this population. OBJECTIVES: This research aimed to explore attitudes and perceptions of urban black male adolescents regarding the availability of and access to reproductive healthcare. METHODS: Eighteen black male adolescents participated in three focus group discussions held in a central New Jersey city. Transcripts of the discussions were analyzed using the constant comparative method. Resulting categories were grouped into themes, which reflected the adolescents' perceptions and experiences. Member checks were used to verify findings. RESULTS: The adolescents felt that obtaining sexual health services was a stressful experience fraught with both internal and external barriers. Internal barriers included a fear of stigma and a loss of social status, shame, and embarrassment. External barriers included disrespectful providers, a lack of privacy/confidentiality, and challenges in accessing and negotiating the healthcare system. The young males described an idealized clinic environment as informal, welcoming, and respectful. DISCUSSION AND CONCLUSIONS: Providers should focus on improving the quality of care in existing clinics, particularly in the areas of access, privacy, and confidentiality, and on developing adolescent-friendly clinics focusing on male services. Adolescents should be encouraged to visit clinics prior to an acute need for services. There also is a need for providers who are comfortable with and able to communicate with male adolescents.

Adolescent↗
PubMed2004

Implementing the ICPD Programme of Action: what a difference a decade makes.

The Programme of Action adopted at the International Conference on Population and Development in Cairo in 1994 was conceived as a 20-year programme. Now, at its mid-point in 2004, we have reached a time for assessment and re-commitment to its goals. This paper is a reflection on some of the political and other changes that have taken place during the first ten years of the Programme of Action and their implications for its implementation in the coming decade. Many countries have gone ahead and integrated sexual and reproductive health services into primary health care, whether or not the concept has been supported at the international level, and are doing what they can to accommodate the needs of those requiring information and services. The shape of the "playing field" has changed in the past ten years and the goal posts have moved. Yet many countries are adjusting and adapting. The big question, which has yet to be answered, is whether the international community will help or hinder the efforts at country level to achieve the goal of access for all to sexual and reproductive health by 2015.

Adolescent↗
PubMed1999

Balancing effectiveness, side-effects and work: women's perceptions and experiences with modern contraceptive technology in Cambodia.

This community-based study presents the results of 17 focus-group discussions primarily among poor married women of reproductive age in urban and rural Cambodia regarding their experiences with modern contraceptive methods and their preferences for different technical attributes, including effectiveness, mode of administration, secrecy and rapid return of fertility. Key findings indicate that women who use modern contraceptive technologies desire highly effective methods of birth control. Cambodian women are primarily interested in longer-acting methods, view weight gain positively and are less concerned about a rapid return to fertility upon discontinuation of a method or secrecy from their partners. Women report a high level of side-effects as well as a high level of individual variation between side-effects and each modern contraceptive method used. Women with more knowledge and experience of modern contraceptive technologies alter their preference for highly effective methods based on a method's perceived suitability. Specifically, women may switch from a modern method associated with negative side-effects to a lesser effective traditional method, either to take a break from unwanted side-effects or discontinue modern methods altogether, if another suitable method is unavailable. These and other findings point to the need for greater development and choice of contraceptive methods with different technical attributes; improved information that clearly and simply describes how each method works within a women's body and its expected side-effects; improved access to reproductive health services; and improved assessment of women's underlying burden of reproductive illness not directly associated with modern contraceptives.

Adult↗
PubMed2002

Quality of maternity care for adolescent mothers in Mbabane, Swaziland.

Early pregnancy and unplanned childbirth may have far-reaching physical, psychological and social consequences for the adolescent girl and her offspring and are therefore public health issues of concern. A number of evidence-based maternity practices might, if properly applied, prevent unnecessary health-related problems in mothers and newborns, postnatally. In order to identify the areas of maternity practice that require improvement in Swaziland, the overall aim of this study was to generate systematic data on the maternity care and social support provided by health professionals (for adolescent mothers and their children) on admission, in the labour ward, and during and after delivery. The study was carried out during a 3-month period from April to June 1998. All pregnant adolescents with an uneventful term pregnancy, admitted to the Mbabane Government Hospital maternity ward in the morning of the study days, were informed about the purpose of the study and asked if they would like to participate. A total of 33 pregnant adolescents agreed and in-depth interviews were conducted with those participants. Observations and checklists were used to assess the maternity care given to the study participants. Results revealed that on admission to the labour ward, verbal communication and interaction between the midwife and the adolescent were minimal, and none of the adolescents was encouraged to bring a social support person to remain with them during labour. During the progress of labour, nearly 50% of the adolescent mothers developed complications and approximately 27% had a lower-segment Caesarean section. Special attention should therefore be paid to adolescent sexual and reproductive health service needs. These should include contraceptive counselling in order to prevent pregnancy at a young age and also to improve their sexual and reproductive health statuses.

Adolescent↗
PubMedDate not supplied

Crossing the public-private sector divide with reproductive health in Cambodia: out-patient services in a local NGO and the national MCH clinic.

Set within the context of recent literature on the private-public divide in the health sector of developing countries generally and Asia specifically, this study considers the major government and the major indigenous non-government clinics offering out-patient reproductive health services in Phnom Penh, Cambodia. Reproductive health is of critical importance in Cambodia, which has one of the highest levels of unmet need for family planning in the developing world and suffers from what is arguably the most severe STD and HIV/AIDS problem in Asia. The study is unusual in that it examines and compares aspects of service delivery and pricing along with the socio-economic profile and health-seeking behaviour of clients self-selecting services in the two settings. The socio-economic status of clients was much higher than the norm in Cambodia but did not differ significantly between the two clinics. A few service indicators suggested that the quality of care was better in the NGO clinic. Underlying variables--such as the broader mandate of the public sector institution and the significant discrepancy between public and private sector salaries--offer an obvious explanation for these differences. The Ministry of Health in Cambodia has been developing policies related to the NGO sector, which has expanded rapidly in Cambodia during the 1990s, and it is struggling to increase staff remuneration within the public sector.

Adult↗
PubMed2000

Making abortions safe: a matter of good public health policy and practice.

Globally, abortion mortality accounts for at least 13% of all maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high mortality and morbidity from abortion tend to occur together. Preventing mortality and morbidity from abortion in countries where these remain high is a matter of good public health policy and medical practice, and constitutes an important part of safe motherhood initiatives. This article examines the changes in policy and health service provision required to make abortions safe. It is based on a wide-ranging review of published and unpublished sources. In order to be effective, public health measures must take into account the reasons why women have abortions, the kind of abortion services required and at what stages of pregnancy, the types of abortion service providers needed, and training, cost and counselling issues. The transition from unsafe to safe abortions demands the following: changes at national policy level; abortion training for service providers and the provision of services at the appropriate primary level health service delivery points; and ensuring that women access these services instead of those of untrained providers. Public awareness that abortion services are available is a crucial element of this transition, particularly among adolescent and single women, who tend to have less access to reproductive health services generally.

Abortion, Legal↗
PubMedDate not supplied

IEC interventions for health: a 20 year retrospective on dichotomies and directions.

In January 1997, the World Health Organization's Family Planning and Population Unit (WHO/FPP) commissioned a retrospective qualitative study of 20 years of experience in information, education, and communication (IEC) as it had been applied to public health initiatives globally. The purpose of the study, which relied on a literature search, a field survey, and in-depth interviews, was to examine lessons learned from two decades of experience in applying IEC interventions in support of public health in order to improve the integration of reproductive health services through IEC initiatives. While the focus of the study was on ways in which IEC can support reproductive health strategies, the discourse surrounding this effort pointed to a number of generic issues of interest or concern to all health education, communication, and promotion practitioners. An analysis and synthesis of "best practices" as perceived by IEC program managers, field implementers, donors, and evaluators revealed significant dichotomies and differences of opinion that have emerged in the field of IEC in recent years and helped to identify several areas for future operations research. This article articulates those divergent opinions, cites major areas for further research, and highlights a strategic approach to partnerships aimed at improving the delivery of health and communication programs.

Communication↗
PubMed2003

Implementing reproductive and child health services in rural Maharashtra, India: a pragmatic approach.

The Government of India has been providing limited maternal and child health services through its Family Welfare programme, but this system is characterised by weaknesses that include inefficient work schedules; non-availability of functioning equipment; poor contraceptive and drug supplies; poor skills and knowledge of health workers; and poor access to services in villages without health centres. For the new Reproductive and Child Health programme to deliver an even wider range of services, the health system will need to be strengthened and the quality of service delivery improved. This paper describes a seven-year operations research project in Parner block, Ahmednagar district, Maharashtra, India, undertaken by the Foundation for Research in Health Systems in partnership with state and district health administrations. It shows the feasibility of establishing a more efficient system, with a minimum of affordable inputs, that increases the use of services by women. Four critical policy changes were implemented: service delivery in each village was changed from household visits to a clinic base, stringent monitoring mechanisms were put in place, in-service training for health workers was instituted and the range of services was gradually increased. This experience is now being applied more widely, with eventual phasing up to full district and state level.

Child↗
PubMed1999

Expanding contraceptive choice: findings from Brazil.

This article presents findings from a participatory action research project in a municipality in southern Brazil that models a new and holistic approach to broadening women's contraceptive choices. The project encourages a collaborative process between researchers, community members, and public health managers to diagnose service-delivery problems, to design and implement interventions, and to evaluate their effectiveness. Findings from the baseline evaluation revealed major constraints in availability of and access to family planning and reproductive health services for women, as well as severe deficiencies in quality of care. Interventions designed to address these weaknesses, bound by the limited resources of the public sector, focused on training, restructuring of providers' roles and service-delivery patterns, the management process, the creation of a referral center, and the introduction of injectables, vasectomy services, and a program for adolescents. Evaluation results show the project's considerable impact in broadening reproductive options, although not all issues, especially those related to sustainability, have been resolved.

Adolescent↗
PubMed2006

The role of reproductive health for attainment of the millennium development goals.

Universal access to reproductive health services is a major aim of current efforts towards attaining the Millennium Development Goals, and reproductive rights and poverty reduction are crosscutting issues for this current focus of international development. Political statements should be complemented by financial commitments for mobilizing resources and the formulation of country-owned action plans. Upscaling services will necessitate strengthening health systems, integrating care, and building capacities. Policy makers, service providers, and stakeholders have responsibilities and duties to ensure that frameworks are available for the adequate provision of services. The implementation of multiple international development strategies currently constitutes a priority for reaching the targets by 2015.

Delivery of Health Care↗
PubMed2000

Adolescent sexual and reproductive health.

This paper assesses how young people and adolescents are defined within each country according to its laws and policies. Additionally, the reproductive health situation of adolescents varies with gender and age. Age of onset of intercourse, age of marriage and child bearing, use of contraception, and the status of women in society all vary with country and region of the world. These variations have direct implications for the population's reproductive health, with potential consequences leading to disability, infertility, sexual violence and abuse, and even death. Nutritional status, access to educational opportunities, access to reproductive health services and commodities, and some life style behaviours such as alcohol, tobacco and other drug abuse, may all have an impact on the future reproductive health of the current and the next generations.

Journal Article↗
PubMed2003

Adolescent mothers' utilization of contraceptive services in South Africa.

BACKGROUND: In South Africa, contraceptives, as well as emergency contraceptives, are available free of charge. Since 1996, changed legislation has enabled women of all ages to choose whether they wish their pregnancies to be terminated during the first 12 weeks of pregnancy. Therefore, adolescent mothers, 19 years or younger at the time of their babies' birth, were investigated regarding why they failed to use contraceptive, emergency contraceptive or termination of pregnancy services. AIM: To explore the knowledge of young mothers regarding contraception. METHOD: An exploratory descriptive survey, utilizing questionnaires and convenience sampling. FINDINGS: The majority of the participating 250 adolescent mothers lacked knowledge about contraceptives, emergency contraceptives and termination of pregnancy services. Merely legalizing the termination of pregnancies, and providing free contraceptive and emergency contraceptive services, did not affect the utilization of these services by the 250 adolescent mothers investigated. CONCLUSION: Young mothers require more knowledge to enable them to make better informed decisions, and the services need to become more readily accessible and user friendly to adolescents. Reproductive health services provided specifically to adolescents could enhance the utilization of such services.

Adolescent↗
PubMed2006

Reproductive health care and family planning needs among incarcerated women.

OBJECTIVES: Women in correctional institutions have substantial reproductive health problems, yet they are underserved in receipt of reproductive health care. We assessed the level of risk for sexually transmitted diseases (STDs) and the reproductive health needs of 484 incarcerated women in Rhode Island to plan an intervention for women returning to the community. METHODS: We used a 45-minute survey to assess medical histories, pregnancy and birth control use histories, current pregnancy intentions, substance use during the past 3 months, histories of childhood sexual abuse, and health attitudes and behaviors. RESULTS: Participants had extremely high risks for STDs and pregnancy, which was characterized by inconsistent birth control (66.5%) and condom use (80.4%), multiple partners (38%), and a high prevalence of unplanned pregnancies (83.6%) and STDs (49%). Only 15.4% said it was not likely that they would have sexual relations with a man within 6 months after release. CONCLUSION: Reproductive health services must be offered to incarcerated women. Such interventions will benefit the women, the criminal justice systems, and the communities to which the women will return.

Adult↗
PubMed2006

Missed opportunities for reproductive and child health services of clients in urban NGO clinics of Bangladesh.

OBJECTIVES: The study was undertaken to identify the extent of missed opportunities of clients for selected reproductive and child health services, including the reasons and factors contributing to missed opportunities, in NGO clinics in Bangladesh. METHODS: A cross-sectional survey of 6 NGO clinics from 6 randomly-selected municipality areas was conducted for one month during July-August 2000. In total, 1,478 clients were consecutively selected both from fixed and satellite clinics. A structured questionnaire was used for conducting exit-interviews. RESULTS: Missed opportunities among female clients of reproductive age included tetanus toxoid (54%), family planning (26%), postnatal care (16%), reproductive tract infection (15%), and antenatal care (11%). The missed opportunities among children aged less than 5 years were the highest (42%) for acute respiratory infections, followed by diarrhoea (38%) and immunization (22%). Although the clients of clinics had specific health needs, over 50% did not perceive their importance, resulting in missed opportunities. Significantly higher missed opportunities for tetanus toxoid were observed among women aged 26 years and over and also among housewives. Missed opportunity for family-planning method was significantly lower (p < 0.01) among women aged 26 years and over compared to women aged 20-25 years. Missed opportunities for child immunization were significantly higher (p < 0.05) among the children living nearer ( <1 km) to the clinic compared to children who lived >1 km away from the clinic. CONCLUSIONS: The findings suggest that providing a broader range of services alone is not enough to ensure their use. A systematic screening mechanism should be in place for regular appraisal of clients for their missed opportunities. Behavioral change communication needs to be introduced to increase awareness among clients about the availability of additional services.

Adult↗