Joint news release WHO/UNFPA: top level push to tackle priorities in sexual and reproductive health.
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Developing Countries↗
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Results for “Reproductive Health Services”
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Back to the future of abortion law: Roe's rejection of America's history and traditions.
In Roe v. Wade much of Justice Blackmun's judgment was devoted to the history of abortion in Anglo-American law. He concluded that a constitutional right to abortion was consistent with that history. In Webster v. Reproductive Health Services, 281 American historians signed an amicus brief which claimed that Roe was consistent with the nation's history and traditions. This article respectfully questions Justice Blackmun's conclusion and the historians' claim.
Abortion, Legal↗
Institute practices reproductive medicine--and Catholicism.
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Catholicism↗
[Sexual behaviour among adolescents aged 16- and 18-years in Poland in 2005].
OBJECTIVES: Presentation of: frequency of sexual debut and its age among 16- and 18-year-olds; number of sexual partners and use contraception methods among sexually active adolescents. MATERIAL AND METHOD: Representative sample of adolescents aged 16 and 18 years in Poland, students of different type of high schools (N=2893; 1490 boys, 1403 girls) was used. Four questions concerning sexual behaviour were included in anonymous questionnaire and were derived from U.S. the Youth Risk Behavior Survey (YRBS). RESULTS: Among 18-year-olds 49.9% of boys and 47.3% of girls reported sexual debut with mean age 16.5 and 16.8 years respectively. 26.4% of students have had sexual intercourse at age 15 years or earlier. The frequency of sexual initiation increased with age, was higher among adolescents living in towns than in villages and was the highest among vocational school students. 26.3% of adolescents had three or more and 8,8% had six or more sexual partners. 11.1% of sexually active adolescents reported that either they or their partners had use any method of contraception during their last sexual intercourse. The most common contraception methods used was condom (it was reported by 82.9% of boys and 75.2% of girls). 41.1% of adolescents used ineffective methods: withdrawal and "natural methods". CONCLUSIONS: Approximately half of 18-year-olds started their sexual life. There is not gender differences in sexual debut frequency. The risk of unwanted pregnancy, STDs infections and other sexual and reproductive health problems is the highest among girls living in towns and students of vocational schools. The development of family planning and sexual and reproductive health services for young people in Poland is necessary.
Adolescent↗
Sexually transmitted diseases and reproductive health.
Sexually transmitted diseases (STD) are a major health problem, particularly for women in developing countries. Serious sequelae include ascending infections leading to chronic discomfort, ectopic pregnancy and infertility, cervical cancer, and adverse pregnancy outcomes. Primary prevention involves sexual behavior modifications and condom use, and secondary prevention targets early and appropriate management of STD and reproductive tract infections (RTI). There is an urgent need for comprehensive preventive and curative reproductive health services, as well as for inexpensive, simple, rapid, and convenient STD diagnostics and treatment regimens. Female controlled barrier methods are a priority in the field of applied research. In additions, women's voices have to be heard in health and development programs.
Developing Countries↗
The client's view of high-quality care in Santiago, Chile.
The meaning of quality of care for the women who receive reproductive health services at a family planning and maternal and infant care clinic in Santiago, Chile, was examined to describe the clinic's service from the women's point of view. A participatory research project with the staff of the clinic was conducted. The central part of that study, reported here, consisted of interviews with 60 of the 330 women who came to the clinic during two weeks in June 1991. The women defined high quality of care as "being treated like a human being." Among specific elements of care they identified were cleanliness, promptness and availability of service, time made available for consultation, learning opportunities for themselves and their partners, and cordial treatment. Clients' view of quality of care must be supplemented by professional judgments about how well services meet clients' needs. But the client's view is determinant if improvements are to result in greater acceptance and sustained use of the services offered. The issues identified by the clients involve only minor costs for the clinic.
Child Health Services↗
Sexual behaviour and condom acceptance among Nigerian drivers.
A survey of 180 randomly selected drivers was carried out in June 1994 in Ilorin, Nigeria in order to gain information about high-risk sexual behaviours, to ascertain condom use and to identify obstacles to condom acceptance so as to facilitate the design of an intervention to prevent Sexually Transmitted Diseases/Acquired Immuno-deficiency Disease in this target population. Data was collected through face-to-face interview. Three-quarters of the respondents were married. Multiplicity of sexual partners including casual and commercial contacts, was common. Half of the respondents engaged in high-risk sexual behaviour and a high proportion of them (60 percent) reported unwillingness to use the condom. This was mainly due to general dislike and lack of knowledge of the method. Risk perception was poor. These findings support the need for male reproductive health services especially for this sub-population.
Acquired Immunodeficiency Syndrome↗
Quality of care for women in northeast Thailand: intersections of class, gender, and ethnicity.
Based upon ethnographic fieldwork in a rural village community in Northeast Thailand, this article explores issues relating to the quality of care received in reproductive health services from the perspective of village women. Inequalities of power fundamental to gender, class, and ethnic relations are described as elements affecting the service-giving process. The subordinate position of village women is subtly reinforced in the spatial organization, style of communication, and management of the services.
Ethnicity↗
Unplanned pregnancies in Harare, Zimbabwe: what is the contraceptive history and awareness of the mothers?
OBJECTIVES: The study aimed to estimate the proportion of unplanned pregnancies among mothers delivering at the referral Harare Hospital and to describe their levels of contraceptive use and awareness in relation to the planning of pregnancy. DESIGN: Systematic sample of mothers who had just delivered identified through maternity delivery, records. The study was analysed as a case-referent study where cases where mothers who had unintended pregnancies and those with intended or planned pregnancies served as referents. SETTING: Postnatal wards of Harare Maternity Hospital. SUBJECTS: 923 mothers following delivery. MAIN OUTCOME MEASURES: Socio-demographic characteristics, pregnancy planning, contraceptive history and contraceptive knowledge. RESULTS: Of the 923 deliveries studied, 377 (41%) were unintended (cases), of which 9% were unwanted. Mothers aged 19 years or below (Odds ratio [OR] = 2.4; 95% confidence interval [CI] = 1.6 to 3.7) and those aged 35 years or above (OR = 3.2, 95% CI = 1.8 to 5.5) were significantly more likely to report the index pregnancy as having been unintended. Nulliparous (OR = 2.4) and parity five or more (OR = 8.2) mothers were at significantly increased risk of unintended pregnancy. Mothers presenting with unintended pregnancies were also significantly more likely to be single (OR = 7.8), divorced/separated or widowed (OR = 6.0). Contraceptive ever use was 53% and 58% in cases and referents, respectively. The combined oral contraceptive pill was the most commonly known and used method of contraception. Contraceptive failure was reported by 23% of mothers with unplanned pregnancies. Previous use of the progesterone only pill (OR = 2.2), the condom (OR = 2.3) or the IUCD (OR = 6.3) were significantly associated with the likelihood of reporting with unplanned pregnancy. Mothers in both groups were concerned about contraceptive method failure, irregular menstruation and perceived subsequent infertility with contraception. Failure to discuss family planning with the male partner (OR = 2.3) or partner refusing use of contraception (OR = 2.8) constituted risk factors for unplanned pregnancy. CONCLUSION: Results point to the need for wider contraceptive counselling and provisions which encourage and involve the male partner. Programmes for reproductive health services and education should target women in identified high risk circumstances.
Adolescent↗
Three strategies to promote sustainability of CEMOPLAF clinics in Ecuador. Céntros Médicos de Orientación y Planificación Familiar.
The continuing trend of donor attention and resources away from Latin America threatens the sustainability of nongovernmental family planning organizations in that region. Managers can improve sustainability through cost control, cost recovery, and income generation. The Population Council's INOPAL II and INOPAL III projects and Family Health International assisted CEMOPLAF, an Ecuadoran private voluntary organization, in carrying out operations research in each of these areas. Studies included cost-savings analysis from altering IUD revisit norms (cost control), an ability-to-pay study that showed potential gains from increased prices for reproductive health services (cost recovery), and a feasibility study to estimate income from ultrasound services (income generation). Results indicate that any one intervention will probably have a limited impact, and that managers likely will need to undertake several initiatives simultaneously to make significant progress toward sustainability.
Adolescent↗
Contraceptive method choices among adolescents in a Nigerian tertiary institution.
This study was undertaken to describe adolescents, use of contraceptive methods and to examine factors that motivate their choice. Face-to-face interview of single, randomly selected 971 males and females aged 18-24 years in a Nigerian tertiary institution was conducted. Among sexually active males and females 72 percent and 81 percent respectively had ever used contraception. The commonest methods ever used by the males and females respectively were the condom (43 percent) and rhythm (31 percent). While females were mainly motivated by pregnancy prevention irrespective of the sexual relationship, the males were more concerned about disease prevention in unstable sexual relationships. However, adolescents whose choice was motivated by disease prevention did not choose the condom significantly more frequently than other methods. The college clinic, complimented by other programmes, should be strengthened for reproductive health services.
Adolescent↗
[Investigation of reproductive health status and service needs among unmarried young men in Changshu].
OBJECTIVES: To investigate the status of pre-marital reproductive health education, sexual psychology behavior, contraception and pre-marital abortion in unmarried young men to get the correct way for pre-marital guidence and education. METHODS: The survey adopted the society-psychology-behavior methodology. Five hundred and ten objects who had pre-marital sexual living history were investigated randomly. RESULTS: The reasons of making sexual pre-marital relations were thinking marriage and curiosity. 81.2% of them thought the best way of contraception is to use the condom. 34.8% of them used the prevenception when they had the first sexual experience. 39.7% of the objects adopted contraceptions every time, and 27.1% of the objects made the women pregnancy which resulted 22.4% women using the IUD for contraception. 63.6% of them thought the main reason of not using contraception was the fear to get trouble. The main source of contraceptives was pharmacy (59.8%). CONCLUSIONS: This survey suggested that the prevalence of pre-marital sexual behavior is relatively high in Changshu. It should be taken several methods to give unmarried young men the reproductibe education.
Adult↗
[New approaches to medical social problems in caring family reproductive health].
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Family Health↗
Adolescents' access to reproductive health and family planning services in Dakar (Senegal).
This paper analyses the issue of adolescents' access to family planning services and information on reproductive health. The data used in this paper are a part of a broader study conducted in 1995 in Dakar (Senegal) by the Committee for Studies on Women, Family and Environment in Africa (COSWFEVA/CEFFEVA) and Family Health International. The findings present information on adolescents' perceptions of premarital sexual activity and contraceptive use and the different types of barriers to access to family planning, using data obtained primarily from focus group discussions with adolescents 16 to 20 years old and a mystery client study. In this approach, 12 of the adolescents participating in the focus group discussions visited clinics as clients and requested contraceptive methods or information. The results indicate that adolescents did not approve of premarital sexual relations, were less likely to approve of contraceptive use by adolescents than by married men and women, and felt embarrassed to go to the services. They were also disappointed by the providers' reception and response to their needs. The content of the counselling offered by the providers was moralistic, encouraging girls to abstain from having sexual intercourse until marriage. The discussions of the findings related adolescents' and providers' attitudes to the socio-cultural context in which adolescent sexuality takes place. In this context, sexuality is closely linked to marriage and childbearing, which affects the impact of classical programs on adolescent health. Alternative solutions such as the life skills development approach could be promoted in order to reach both in-school and out-of-school adolescents.
Adolescent↗
Reproductive health needs: comparing women at high, drug-related risk of HIV with a national sample.
Women who inject drugs or have injection drug-using sex partners are at high risk of acquiring human immunodeficiency virus (HIV) infection and of transmitting HIV perinatally. Many of these women need standard reproductive health care services, specialized HIV care, pre- and postnatal care, and drug treatment, but the extent of the unmet need for such health services is unknown. Large-scale national surveys that estimate drug use do not include reproductive health topics and vice versa. In addition, such surveys typically employ a household sampling method that tends not to include drug-using women. This paper presents evidence from three convenience samples that a high-risk population of women who use drugs has limited access to reproductive health services, and that this population is not represented in the National Survey of Family Growth (NSFG), the national survey that informs public policy regarding reproductive health care in the United States. Policy makers would be well served by regular surveillance of the multiple service needs of women with HIV-risk-related behaviors.
Adolescent↗
What high-risk women are telling us about access to primary and reproductive health care and HIV prevention services.
Focus group discussions on barriers to health care and attitudes toward family planning, reproductive health services, and condom use were conducted with 63 women at high risk for HIV due to their own injection drug use, sex with injection drug users, sex industry work, or a history of multiple sexually transmitted diseases. Barriers identified include the high cost of health care, perceived poor quality of care and experiences of discrimination and stigmatization, geographic accessibility, fear of legal/social services punitive actions, misperceptions about the efficacy of birth control methods and condom usage, lack of sterilization services, and lack of male involvement. Where possible, findings from the focus groups are supported with quantitative survey data from a sample of high-risk women (n = 723). Recommendations are made for improving care for high-risk women.
Adult↗
Integration of a sexuality counseling service into a reproductive health program for persons with mental retardation.
A socialization and sexuality counseling program was instituted as an integral part of a gynecologic service begun at the University of Michigan for persons with mental retardation. One hundred three patients were seen between 1986 and 1989 for counseling. Patients were referred for a variety of reasons, the most common being sexual behavior deemed inappropriate by the referring agent (i.e., direct care givers, parents, teachers, workshop supervisors, and other community professionals). Other concerns included sexual abuse, sterilization requests, sexuality and socialization education, marital questions, pregnancy assistance, abortion counseling, and family stress. Treatment techniques included gynecologic examination and follow-up, psychosexual education, psychiatric evaluation and follow-up, and group and individual psychosexual counseling. A majority of the patients improved during treatment. It is proposed that such a counseling program can play a useful role in the preparation of people with mental retardation to live in their communities as they deal with day-to-day decision making and should be an integral part of reproductive health care for this population.
Adolescent↗
Unmet need for reproductive health in India.
Using data from the National Family Health Survey of 1992-93 and the individual reproductive histories of a cross-section of 70 women from rural Tamil Nadu, this paper exposes the limited extent to which women in India have been able to achieve their reproductive intentions and the failure of health services to meet their considerable reproductive health needs. Of the 70 women, 69 had been unable to achieve their reproductive intentions, not only non-users of contraception but also ever-users, and all 69 had an unmet need for reproductive health services. Sterilisation is often the first and only method of contraception taken up and only after a series of wanted, mistimed and unwanted pregnancies, miscarriages, induced abortions and neonatal and infant deaths. Women who wanted to have more children than they were able to were also found. Given the paradigm policy shift in India from promoting fertility reduction only to meeting women's reproductive and sexual health needs, a more useful concept for measuring 'unmet need' for services in programme planning is required, one such as the HARI index, that would capture the extent to which individual women are achieving their reproductive intentions in good health. Without this, the same problems will only recur in younger women.
Birth Intervals↗