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PubMed1998

Emergency contraception among refugees and the displaced.

In 1994, the international relief community began to recognize and address the reproductive health needs of refugees and displaced populations. A minimum initial service package of reproductive health services for refugees and the displaced, which includes emergency contraception (EC), was developed and recommended for use in refugee settings. This paper describes the experience of one international relief organization, the International Rescue Committee (IRC), in introducing EC into its worldwide reproductive health program. A recent IRC survey found that EC is available in 4 out of 14 settings where it provides reproductive health services. A case study from Tanzania demonstrates the modes of delivery, the demand for EC by women who have experienced sexual violence, and the community responses to this method of contraception. More information, education, and communication directed at refugee communities; more donor support for supplies; and institutional commitment to train staff are needed to expand refugee access to EC.

Contraceptives, Postcoital↗
PubMed2002

[Utilization of health service in women with reproductive tract infections in urban and rural areas].

OBJECTIVE: To provide insight on psychosocial factors underlying utilization of health services of women whom perceived reproductive tract infection (RTI) symptoms. METHODS: A cross-sectional study, adopted Aday and Andersen's Social Behaviour Model was conducted in 1998 - 1999 in China. Hebei province and Beijing were purposely chosen as the research sites. All eligible married women aged 21 to 60, 864 subjects, were interviewed in person. RESULTS: Findings showed that the percentage of self-reported symptoms of RTIs was 35.6 in urban compared to 46.8 in the rural areas. The proportion of women with RTIs who utilized health services was 27.5 versus 26.7 percent among the two groups. Urban women, mostly 'white collar' class, with free medical service, satisfied with health providers, receiving information from health provider and having severe current experience RTIs, were more likely to use health services. Rural women, however, having both severe prior experience and current experience of RTIs, high family income, having much knowledge about self-medication, perceiving less social stigma of getting RTIs, and perceiving severity of RTIs, were more likely to use health services. CONCLUSION: These findings showed that there was a great need on providing culturally acceptable reproductive health education at different places so as to improve women's ability of self-care. Regular medical check-up for women is also important for improving the quality of health service. Reform on health insurance seemed necessary. Factors as social stigma related to RTIs, giving women social and moral support also need to be taken into account.

Adult↗
PubMed2004

Experience from Bangladesh: implementing emergency obstetric care as part of the reproductive health agenda.

This paper describes the activities of the Ministry of Health and Family Welfare of the Government of Bangladesh and UNFPA to introduce emergency obstetric care (EmOC) services into the reproductive health care agenda. Working through the existing system of Maternal and Child Welfare Centers (MCWC), the quality and availability of comprehensive Reproductive Health and Emergency Obstetric Care services was improved. Investments in training, infrastructure, management information systems, quality assurance mechanisms and linkages between health care facilities in Bangladesh, have produced positive results in terms of increased utilization of these services. The Ministry of Health first implemented services in one division of the country and later scaled up to include all of the MCWCs nationally. While there are still obstacles to preventing obstetric deaths in Bangladesh, this experience shows that improvements in the quality and expansion of the range of services in existing health systems is an important step toward increasing the use of reproductive health care services by the women who need them most.

Bangladesh↗
PubMed1983

Teenagers' assessment of reproductive health-care services.

Adolescent clients of a Teen Health Clinic were surveyed to determine those aspects of the service that were considered crucial to patient acceptance and program continuance. A simple one-page questionnaire enabled the clients to express their feelings about personnel, services, environment, and educational materials used in the clinic. Eighty-five percent of the clients expressed positive reactions to the clinic, while only 25.5% offered negative statements. Most respondents indicated clinic staff as the feature they liked most about the service and mentioned routine clinical activities as the part they liked least. Of the topics on which teenage clients wanted more information, 68% indicated that they wanted factual data rather than information about feelings, emotions, or relationships.

Adolescent↗
PubMed2005

Reducing HIV/AIDS transmission among African-American females: is the female condom a solution?

Rates of HIV/AIDS have increased at an alarming rate among minority women, especially African-American women. Suggestions that have been presented to decrease HIV/AIDS transmission among African-American women include promoting abstinence and the use of the male condom. Little recognition and support have been given for promoting the female condom as a viable solution to combating the HIV/AIDS epidemic.

Black or African American↗
PubMed1997

Reproductive health care experiences of women with physical disabilities: a qualitative study.

OBJECTIVE: To explore the reproductive health care experiences of women with physical disabilities and how reproductive health care experiences could be improved. DESIGN: A qualitative interview study was conducted. PARTICIPANTS: Ten women, ages 28 to 47 years, with physical disabilities, including multiple sclerosis, cerebral palsy, and paralysis, were recruited through the investigators' contacts with local disability groups. RESULTS: Interviewees encountered numerous barriers to quality reproductive health care services, including inaccessible equipment and facilities, limited contraceptive options, health care providers' insensitivity and lack of knowledge about disabilities, and limited information tailored to their needs. Providers sometimes appeared surprised that they would be sexually active, and did not ask about contraceptive use or assess for sexually transmitted diseases. Although most interviewees had private health insurance, some had problems seeing preferred providers. Accessing reproductive health care services is so difficult that some women avoid regular gynecologic visits. Suggestions for improving services included involving women with disabilities in teaching health care providers about their special needs and self-advocacy training to help disabled women become more knowledgeable partners in their own health care. CONCLUSIONS: Additional research should address the gaps in knowledge about the reproductive health care needs of women with disabilities.

Adult↗
PubMed2003

Expanding access to emergency contraception: the case of Brazil and Colombia.

Emergency contraception was proven effective nearly 30 years ago yet remains greatly under-utilised. In the Latin American and Caribbean region, it would serve the goals of reducing unwanted pregnancy, unsafe abortion and related morbidity, and as a back-up to condom use and a bridge to longer-term contraceptive methods if made more widely known and available. The International Planned Parenthood Federation Western Hemisphere Region has developed a model for the integration of emergency contraception into sexual and reproductive health care services. This model is being tested in a two-year project with national affiliates in Brazil, Chile, Colombia, the Dominican Republic and Venezuela, and will contribute to the work of the Latin American Consortium for Emergency Contraception. Case studies of Brazil and Colombia describe how health sector reforms, e.g. decentralisation and managed competition among health insurers and service providers, have influenced promotion strategies. The experience of Profamilia Colombia with registration of a dedicated product and providing emergency contraception within its national network of clinics, with a focus on staff training and work with young people, is described. In Brazil, BEMFAM's study of different modalities for offering emergency contraception, e.g. through contractual agreements with municipalities and its own clinics, is highlighted.

Brazil↗
PubMed2005

Sexual and reproductive health and rights in the United Kingdom at ICPD+10.

At the mid-point of the Programme of Action of the 1994 International Conference on Population and Development, we reviewed the situation in the UK in key areas. In recent years, greater attention has been paid to sexual health at a national policy level, including strategies on teenage pregnancy and sexual health, but there is still a long way to go. The law against female genital mutilation has been strengthened, twice as many men attend family planning clinics as ten years ago, access to abortion services funded by the National Health Service has improved substantially, up to 80% of contraceptive advice and care is accessed through general practice, a national screening programme for chlamydia is being rolled out, the age of consent has been equalised for men and women and for heterosexuals and homosexuals, and new recommended standards for sexual health and HIV services have been developed. However, many family planning services do not involve young men, waiting times for an abortion are too long, the abortion law has never been extended to Northern Ireland, and there are rising rates of STIs and HIV. Rapid improvements in sexuality education, training and improved resources for family planning and abortion providers and the re-introduction of national public information campaigns about all aspects of sexual health are all required.

Adolescent↗
PubMedDate not supplied

Reproductive tract infection in women of reproductive age group in Sitapur/Shahjahanpur District of Uttar Pradesh.

CARE India with its UP Office has initiated demand generation and acceptability of services for reproductive health and birth spacing services at community level in two districts in the state of Uttar Pradesh. A total of 3,49,000 women of reproductive age will benefit from participation in program activities over the next five years. Out of total surveyed population of 3662, 798 women of reproductive age group were identified of whom 272 were found to be symptomatically positive in relation of STDs/RTIs giving the overall prevalence rate of 34%. Clinical as well as the microbiological examination was carried out on 193 of these 272 women in field conditions. Those found clinically and/or microbiologically positive were provided treatment and preventive advice. Total of 150 (77.7%) women were diagnosed on the basis of symptoms (syndromic approach) and 151 (78.2%) were diagnosed on the basis of clinical examinations. However, 137 (70.9%) were confirmed microbiologically positive. A large extent was found in the age group of 15 to 24 years. Confirmed cases were comparatively less among nulliparous women (63.6%) than multipara (73.2%) cases. 64.1% women were having watery discharge while 29.1% were having complaint of curd discharge. The discharge was offensive in only 1.9% cases while 4.9% reported mixed discharge. 54.4% women complaining of vaginal discharge were suffering from PID. The discharge were either bacterial alone (26.1%) or bacterial mixed with candidiasis (16.5%) or trichomoniasis (8.7%). Compared to syndromic approach, an improvement in the sensitivity (81.8%) and predictive accuracy (74.1%) was noted when cases were detected with the help of clinical examination.

Adolescent↗