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Results for “Reproductive Health”

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At least 433 records · Page 24Linked to original sources

PubMed2004

Living with HIV: challenges in reproductive health care in South Africa.

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 abortions. This paper addresses these issues in South Africa, based on an interview study with eight key informants and a literature review. The South African experience should inform policy-making and programmes in relation to HIV and reproductive health care in other African countries.

Abortion, Induced↗

PubMed2001

[The establishment of an electronic reproductive health surveillance system (ERHSS)].

OBJECTIVE: To establish an electronic reproductive health surveillance system (ERHSS) and a population-based, computerized monitoring and management information system. METHODS: The ERHSS was designed based on the existing perinatal health care (PHC) surveillance, birth defects (BD) surveillance and child health care (CHC) surveillance systems. Advanced computing and network techniques were adopted in designing and developing this system. The use of information technology (IT) and its products has become popular in public health surveillance. RESULTS: The ERHSS was developed by National Center for Maternal and Infant Health (NCMIH) and Beijing InfoUnit Technological Corporation. It consists of four main components: (1) The establishment of electronic data collection system, including the electronic forms and the screening system for high risk factors; (2) The established electronic data transmission system; (3) The established electronic information reporting system; (4) The established back-up system, including card making system, ID search engine and maintenance, etc. CONCLUSION: It is the first time this population-based electronic surveillance system being developed in China. It has many features regarding accuracy, security, smooth operation, optimal performance of real-time data processing, etc. The ERHSS has been set up in 22 counties/cities in China since 1999.

Female↗

PubMed2002

Women's reports of smoking cessation advice during reproductive health visits and subsequent smoking cessation.

OBJECTIVE: To examine associations of women's characteristics with reports of provider advice to quit smoking and smoking cessation 1 year after a reproductive health visit. STUDY DESIGN: Prospective survey. METHODS: As part of a randomized smoking cessation trial, 432 women smokers completed telephone surveys 1 month and 1 year after their reproductive health visit. Most women were white (85%) with a mean age of 36 years. RESULTS: Women more likely to report their provider advised them to quit smoking were white rather than another race (adjusted risk ratio, [RR] = 1.4, confidence interval [CI] = 1.14-1.64), employed versus unemployed (RR = 1.3, CI = 1.04-1.49), engaged in safer versus riskier sexual practices (RR = 1.3, CI = 1.09-1.54), were more rather than less ready to quit (RR = 1.3, Cl = 1.08-1.44), and saw family physicians versus gynecologists (RR = 1.3, CI = 1.12-1.41). Reported provider advice to quit smoking was not associated with subsequent cessation. Women were more likely to have quit smoking by the 1-year follow-up if at baseline they reported an annual Papanicolaou test in the prior 3 years (RR = 1.6, Cl = 1.02-2.26), were more rather than less ready to quit smoking (RR = 2.0, CI = 1.36-2.62), and were less rather than more dependent on nicotine (RR = 0.7, CI = 0.59-0.84). CONCLUSIONS: Provider advice to quit is being directed to women who are most likely to quit and contributes little in explaining subsequent cessation. Providers may not be giving enough cessation advice to minority women, those not considering cessation, and those not prevention oriented. Interventions and system improvements are needed to increase providers' counseling of smokers who are unmotivated and from racial/ethnic minorities.

Adult↗

PubMedDate not supplied

Nutrition in reproductive health.

This article reviews nutrition-related issues affecting women and their reproductive health. Health care providers must be able to perform a basic nutritional assessment to identify risk factors and develop a plan of care to reduce those risk factors and improve health. Guidelines are provided to assist in performing a nutritional status assessment. Nutritional assessment of women of reproductive age should identify factors that may affect fertility, periconceptional health, and pregnancy outcome. Recommendations are provided to assist the health care provider in counseling women regarding the relationship of food choices and exercise to health, fitness, and optimal bodily function. Controversies surrounding the effect of micronutrient deficits and excesses on reproduction and correction for these imbalances are discussed. Women should be encouraged to initiate dietary and other lifestyle changes to allow for optimal reproductive outcomes.

Adolescent↗

PubMedDate not supplied

Sexually transmitted diseases and reproductive health in women.

The effect of sexually transmitted diseases (STDs) on the reproductive health of women, the reasons why women bear a disproportionate percent of STD morbidity and mortality, and the factors contributing to an increased risk for STDs and their complications in women are enumerated. Conclusions and recommendations from the 1997 Institute of Medicine report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases, are categorized and addressed. The categories are education, population groups, and clinical practice. The contributions of midwives to implementing pertinent Institute of Medicine recommendations in basic and continuing education programs, individual practice, and in influencing policy are detailed. Factual information about STDs, risk assessment history, essential STD-related services, and treatment guidelines are provided in tables.

Female↗

PubMed1980

Dairy herd reproductive health programs compared with traditional practices.

Reproductive herd health programs have been advocated for many years, and rational approaches that are cost effective have been demonstrated. Dissemination of this information to dairymen can help create a demand for veterinary service. Similarly, the information can be utilized by veterinarians to encourage dairy clients to utilize profitable practices and programs. The study described demonstrated an improvement in biologic goals when a reproductive herd health program was incorporated into the management scheme. The program achieved economic success by reducing costs related to reproduction.

Animals↗

PubMedDate not supplied

[The influence of some medical and social factors on the reproductive health of women].

Some of the social-and-hygienic factors that affect the female reproductive health and their reproductive abilities were investigated. The offered case study belongs to a series of research dealing with the reproductive heath with respect to changing social-and-economic conditions. According to an analysis of the obtained data, the smallest quantity of healthy women were at an age of up to 20 (33.3%). 62.5% of women, who visited their gynecologists infrequently (less than once in a year), had chronic pathologies. A majority of women with chronic pathologies in the reproductive system had higher and special education; besides, they were occupied under hazardous conditions, their dwellings were unsatisfactory, they were not married, they started their sexual experience at an age below 18, and their sex partners were not regular; finally, the abortion rate was high among them. Thus, a stable orientation towards a few-children family developed in such women.

Abortion, Induced↗

PubMed1996

Ethics and reproductive health: a principled approach.

Universal ethical principles can be used to analyse problems in reproductive health. The principle of beneficence obligates people to strive to bring about more beneficial consequences than harmful ones. The principle known as respect for persons presumes that all human beings have dignity and are worthy of respect. Showing equal respect for women as persons means recognizing their autonomy and treating them as capable decision-makers and full participants in medical decisions. A third leading concern of bioethics is justice, which requires a fair distribution of family planning methods, including access to safe abortion in cases of contraceptive failure.

Adolescent↗

PubMedDate not supplied

Moral development and reproductive health decisions.

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.

Attitude of Health Personnel↗

PubMed2004

Strategies for engaging the private sector in sexual and reproductive health: how effective are they?

The private health sector provides a significant portion of sexual and reproductive health (SRH) services in developing countries. Yet little is known about which strategies for intervening with private providers can improve quality or coverage of services. We conducted a systematic review of the literature through PubMed from 1980 to 2003 to assess the effectiveness of private sector strategies for SRH services in developing countries. The strategies examined were regulating, contracting, financing, franchising, social marketing, training and collaborating. Over 700 studies were examined, though most were descriptive papers, with only 71 meeting our inclusion criteria of having a private sector strategy for one or more SRH services and the measurement of an outcome in the provider or the beneficiary. Nearly all studies (96%) had at least one positive association between SRH and the private sector strategy. About three-quarters of the studies involved training private providers, though combinations of strategies tended to give better results. Maternity services were most commonly addressed (55% of studies), followed by prevention and treatment of sexually transmitted diseases (32%). Using study design to rate the strength of evidence, we found that the evidence about effectiveness of private sector strategies on SRH services is weak. Most studies did not use comparison groups, or they relied on cross-sectional designs. Nearly all studies examined short-term effects, largely measuring changes in providers rather than changes in health status or other effects on beneficiaries. Five studies with more robust designs (randomized controlled trials) demonstrated that contraceptive use could be increased through supporting private providers, and showed cases where the knowledge and practices of private providers could be improved through training, regulation and incentives. Although tools to work with the private sector offer considerable promise, without stronger research designs, key questions regarding their feasibility and impact remain unanswered.

Delivery of Health Care↗

PubMedDate not supplied

[Impact of working conditions at a gas-processing enterprise on reproductive health: results of clinical observation and experimental study].

Five-year clinical and statistical studies were made to examine the effects of hydrogen sulfide-containing natural gas and its condensate on reproductive health in 275 female workers at the Orenburg gas-processing enterprise and on reproductive function in 80 female albino rats in the experimental setting. A combined exposure to the components and processing products of hydrogen sulfide-containing natural gas and its condensate of the gas-processing enterprise in the concentrations not greater than the maximum allowable ones for each substance individually was found to adversely affect female reproductive health, as manifested by pathological changes in infertility-complicated ovarian and menstrual functions, by a high incidence of complications during pregnancy and at labor; by anomalies in neonatal physical development and health. Experiments confirmed that a combined exposure to the components of hydrogen sulfide-containing natural gas and its condensate caused morphological disadaptive changes in the ovaries, impairments in the fetoplacental barrier, anomalies in the postnatal development of the offspring of experimental animals.

Animals↗

PubMed1999

Social network influences on reproductive health behaviors in urban northern Thailand.

Prevention approaches for reproductive health have evolved from an emphasis on individually focused models of behavior change to a recognition that risk reduction occurs within a context of social norms. Prevention programs can be improved by understanding how social structure influences sexual behavior and using that understanding to develop strategies for positive change. In a dynamic, urban context, communities are better conceptualized as informal networks of ties. These network structures may help to protect, or conversely, expose members to reproductive risk behaviors. Using data from a study of social and sexual networks conducted in northern Thailand, this article describes partner relations and social structure in the modern, urban context, and illustrates the links between individual, relational and structural properties and reproductive risk behaviors. Triangulation of ethnographic, survey and social network data collection and analytic tools provide an opportunity to interpret individual behaviors, meanings of relationships and structural properties of networks. Intervention approaches should build on existing networks, and address the complex meanings of romantic and sexual partnerships.

Community Networks↗

PubMed2000

Syndromic management of vaginal discharge among women in a reproductive health clinic in India.

OBJECTIVES: To examine the performance of the syndromic approach in the management of vaginal discharge among women attending a reproductive health clinic in New Delhi, India. METHODS: Women who sought services from the clinic and who had a complaint of vaginal discharge were interviewed, underwent a pelvic examination, and provided samples for laboratory investigations of bacterial vaginosis, candidiasis, syphilis, trichomoniasis, and Chlamydia trachomatis and Neisseria gonorrhoeae infections. Data analysis focused on the prevalence of infection and on the performance of the algorithm recommended by the national authorities for the management of vaginal discharge. RESULTS: The most common infection among 319 women was bacterial vaginosis (26%). At least one sexually transmitted infection was detected in 21.9% of women. The prevalence of C trachomatis infection was 12.2%; trichomoniasis 10%; syphilis 2.2%; N gonorrhoeae was not isolated. An algorithm based on risk assessment and speculum assisted clinical evaluation was not helpful in predicting cervical infections associated with C trachomatis (sensitivity 5% and PPV 9%). This algorithm was sensitive (95%) though not specific (22%) in selecting women for metronidazole therapy effective against bacterial vaginosis or trichomoniasis, and overtreatment was a problem (PPV 38%). The sensitivity, specificity, and PPV of this algorithm for the treatment of candidiasis were 46%, 98%, and 88% respectively. The cost per case assessed using the algorithm was $2 and the cost per infection correctly treated was $4.25. CONCLUSIONS: The prevalence of cervical infection associated with C trachomatis was high among these "low risk" women. The syndromic approach is not an efficient tool for detecting this condition, and alternative approaches to evaluation and intervention are required. The syndromic management of vaginal discharge among women seeking family planning and other reproductive health services should focus on vaginal infections, thus enhancing quality of care and addressing women's concerns about their health.

Algorithms↗

PubMed2002

Role of progesterone antagonists and new selective progesterone receptor modulators in reproductive health.

UNLABELLED: Given the importance of progesterone in female reproductive health, it was inevitable that analogues of this molecule would be developed to treat a variety of gynecologic maladies. Such medications, termed progesterone antagonists, act to counteract the effect of progesterone. A newer class of molecules, the selective progesterone receptor modulators (SPRMs), have both agonist and antagonist activities depending upon the site of action. These compounds have been studied for their effect on endometrial growth, endometrial vascular development, the hypothalmic-pituitary-ovarian axis and cervical integrity. Such research has led to a number of potential clinical applications. Progesterone antagonists are well established in their use for termination of pregnancy, although SPRMs seem to have a diminished capacity for induction of abortion. Similarly, antagonists work well to soften and dilate the cervix before surgery, but such efficacy by SPRMs is unlikely. Other applications for progesterone antagonists include induction of labor, the treatment of endometriosis, fibroids and contraception; SPRMs also may prove useful in the treatment of endometriosis and fibroids, as well as for postmenopausal hormone replacement therapy and the treatment of dysfunctional uterine bleeding. Finally, these compounds may aid investigators in unraveling many of the nuances of the role of progesterone in reproductive function. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this article, the reader will be able to describe the receptor action and selective modulation of progesterone, explain the effects of progesterone receptor modulators, and list the potential clinical applications of progesterone antagonists and selective progesterone receptor modulators.

Female↗

PubMed1992

The check-up of reproductive health and genetic counseling.

The Hungarian Family Planning Program was a feasibility study on combining methods of periconceptional care. The first step was the check-up of reproductive health, including family history of the couples, case history of females, pre-pregnancy examination (vaginal and cervical smears), and the measurement of basal body temperature, sperm examination, psycho-sexual exploration and exclusion of some risk factors. This preconception screening program was carried out by graduate trainee nurses to identify those participants secondary health services. The data of 4,240 couples attending in the Budapest Center indicated a useful relationship between the check-up of reproductive health and genetic counseling clinics, by selecting couples requiring genetic counseling and preventing other couples making unnecessary visits.

Adolescent↗

PubMedDate not supplied

Reproductive health hazards in the pharmaceutical industry.

The continual development of new compounds and the ongoing search for more potent drugs and new technologies in the pharmaceutical industry present a challenging environment for the recognition and evaluation of reproductive health hazards. This chapter discusses toxicology and offers an overview of the organization and implementation of a reproductive health program.

Bacterial Infections↗

PubMed1998

Improving the fit: adolescents' needs and future programs for sexual and reproductive health in developing countries.

Demand is growing in developing countries for sexual and reproductive health programs for young people. However, little scientifically based evidence exists about which program approaches are most effective in shaping healthy behaviors. Careful evaluation and research must be increased, but meanwhile, planners need guidance as they expand programming. Research indicates that current programs often do not match the needs and health-seeking behaviors of young people. Behavioral theories and expert opinion agree that adolescents must be taught generic and health-specific skills necessary for adopting healthy behaviors. Constraints on financial and human resources, coupled with the great size of the youth population, highlight the need to find less costly ways to reach young people. These observations generate six programming principles to help planners and communities experiment with a wide variety of programming approaching.

Adolescent↗

PubMed1993

Planned Parenthood v Casey. The impact of the new undue burden standard on reproductive health care.

The recent US Supreme Court decision in Planned Parenthood v Casey, by changing the legal standard by which restrictions on abortion are evaluated, will have a profound effect on access to reproductive health care in the United States. This article reviews the Pennsylvania antiabortion restrictions at issue in Casey and discusses the ways in which the new constitutional standard fundamentally weakens the legal protections previously afforded women and physicians in the 1973 case, Roe v Wade. While the majority opinion reaffirmed a woman's right to choose an abortion, the opinion opens the door to a multitude of new restrictive abortion laws, which diminish, and in some cases completely block, a woman's ability to exercise that right. The effect of weakened legal protection will fall most heavily on young, poor, minority, and rural women, who will be unable to overcome obstacles imposed by mandatory waiting periods, biased counseling, and parental notification requirements. The restrictions are also likely to exacerbate the shortage of physicians providing abortion services by making the procedure more costly and the providers' jobs more dangerous. Finally, the medical community can help to ensure women access to comprehensive and competent reproductive health care.

Abortion Applicants↗