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Results for “Reproductive Health Services”

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PubMed2003

Client and staff views on facilities and services, before and after the convergence of sexual, reproductive and women's services.

OBJECTIVE: To evaluate client and staff views on existing facilities and services, before and after the convergence of sexual, reproductive and women's services. METHODS: Evaluation involved questionnaire survey of clients and staff, one-to-one interviews with staff and review of routinely collected clinical activity data. RESULTS: The integration of the three services led to a reduction in stigma associated with attending sexual health services. Despite some staff concerns, the number of men attending the services did not decrease. There was increased satisfaction with the new service, especially the quality of facilities. There were increased numbers of referrals between clinical services in the Sandyford Initiative. CONCLUSIONS: Sexual, reproductive and women's services can be integrated to provide improved facilities for clients.

Adult↗
PubMedDate not supplied

[Expression of needs in the field of the basic care in sexual health].

This article approaches the ethical-political meanings present in basic attention to sexual and reproductive health in Cuiabá-MT. Aspects related to the contradictory expression of needs and demands in the field of the sexuality are argued. Its correlation with the historical forms of attention to the health is emphasized, also considering the social and cultural character of these interpretations and practices in health and the sexuality. The relevance of a wide understanding of needs in the field of sexuality to the construction of projects of integral attention is approached, considering the way these needs are presented in a given health service.

Adult↗
PubMed2006

Use of private gynaecologist does not relate to better prevention outcomes - an ecological analysis from Finland.

BACKGROUND: Control of reproduction and prevention of reproductive health problems are important reasons for women to use health services, but the proper organisational level of service provision is not clear. The purpose of this study was to investigate whether visits to private gynaecologists correlate with better health outcomes and worse participation in organised screening for cancer programs. METHODS: This is an ecological analysis using municipalities and groups of women at 5-year age intervals within municipalities as study units. First, the Finnish municipalities (n = 452) were classified into three groups by the age-adjusted level of use of private gynaecologists. Secondly, each age group within municipalities was classified into tertiles by the level of private gynaecologist use. The outcomes were participation in cervical and organised breast cancer screening for cancer programmes, stage of gynaecological and breast cancers at diagnosis, and abortion rates and ratios. All data were obtained from national registers by groups at 5-year age intervals and by municipality. Raw and adjusted (age groups, and in some analyses, municipality social class index) odds ratios, total and by urbanity, were calculated. RESULTS: The proportions of women participating in cervical cancer and organised breast cancer screening for cancer were somewhat higher in the groups having a low use of private gynaecologists. The proportions of local cancers of all cervical, uterine, ovarian and breast cancers were similar in the three groups, even though the first analysis method suggested somewhat better results for the low-use group in case of cervical cancer and for the high-use group in case of uterine and breast cancer. The rates of induced abortion were higher in municipalities having a high use of private gynaecologists than in those having lower use. CONCLUSION: This ecological analysis suggests that frequent use of private gynaecologists relates somewhat to lower organised screening for cancer participation, and is not better in preventing abortions or in detecting cancer earlier. Our results suggest that a planned system relying mainly on general practitioners and public health nurses as the first line care providers is equally good for women's reproductive health as that in which specialists are used.

Adult↗
PubMedDate not supplied

Improving reproductive health: integrating STD and contraceptive services.

The International Conference on Population and Development held in Cairo in 1994 recommended that family planning (FP) services be expanded, with more attention given to the prevention and treatment of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV). Although such integration of FP and STD services seems a natural union, historical, philosophical, and structural differences in the two fields pose obstacles to integration in many settings. This paper examines selected experiences with FP/STD integration in the United States and developing countries and reviews practical issues that have application to FP providers, STD prevention programs, and those in general practice. Priority areas for future research include: 1) the usefulness and uses of STD risk assessment in FP populations, 2) the relationship between STD/HIV transmission and use of various contraceptive methods, 3) the feasibility of getting high-risk individuals to use dual methods for pregnancy and STD prevention, and 4) the impact adding STD services will have on training requirements, clinic costs, and quality of care within established FP programs. As clinicians in public and private settings assume more comprehensive roles in the provision of both types of services, program managers can facilitate the process of FP and STD service integration by promoting a focus on meeting the client's reproductive health needs.

Developing Countries↗
PubMedDate not supplied

Reproductive and sexual health benefits in private health insurance plans in Washington State.

CONTEXT: Although unintended pregnancy and sexually transmitted diseases (STDs) are considerable problems in the United States, private health insurance plans are inconsistent in their coverage of reproductive and sexual health services needed to address these problems. METHODS: A survey administered to a market-representative sample of 12 health insurance carriers in Washington State assessed benefit coverage for gynecologic services, maternity services, contraceptive services, pregnancy termination, infertility services, reproductive cancer screening, STD services, HIV and AIDS services, and sterilization, as well as for the existence of confidentiality policies. "Core" services in each category were defined based on U.S. Preventive Services Task Force and other recommendations. RESULTS: Of the 91 top-selling plans on which data were collected, 8% were indemnity plans, 14% were point-of-service plans, 21% were preferred-provider organization plans and 57% were health maintenance organization (HMO)-type products; they had a combined enrollment of 1.4 million individuals. Coverage of core services varied widely by type of plan. While a high proportion of plans covered core gynecologic, maternity, reproductive cancer screening, STD and HIV and AIDS services, nearly half of plans did not cover any kind of contraceptive method. Approximately 13% of female enrollees did not have core coverage for gyneco!ogic services, 19% for matemity services, 75% for contraception, 37% for sterilization and 53% for pregnancy termination; 98% of women and men were not covered for infertility treatment. Most carriers did not have specific policies for maintaining privacy of sensitive health information. Overall, benefit coverage was lower for indemnity, preferred-provider organization and HMO plans in Washington State than has previously been seen nationally. CONCLUSIONS: A sizable proportion of women and men in Washington State who rely on private-sector health insurance lack comprehensive coverage for key reproductive and sexual health services.

Family Planning Services↗
PubMed1993

New reproductive technologies: Equity and access to reproductive health care.

While attention has focused on the promise of new reproductive technologies to provide cures for infertility, efforts aimed at preventing infertility have languished, and the major cause of infant morbidity and morality--lack of prenatal care--has worsened. This article explores the social and ethical issues arising out of the uses of three new reproductive technologies: surrogacy, in vitro fertilization, and prenatal screening. In addition, coerced medical interventions during pregnancy are described. Examination of the social circumstances surrounding the use of these medical technologies supports the conclusion that new reproductive technologies have increased, rather than decreased, inequities in access to and allocation of health care resources.

Coercion↗
PubMed2000

Recognizing adolescents' 'evolving capacities' to exercise choice in reproductive healthcare.

All countries (except Somalia and the USA) have adopted the UN Convention on the Rights of the Child, which usually applies to individuals aged under 18 years. The Convention requires governments to 'respect the responsibilities, rights and duties of parents [or others acting as parents] ellipsis in a manner consistent with the evolving capacities of the child'. Many adolescents gain capacity to make decisions for themselves concerning reproductive and sexual health services, and to decide issues of confidentiality. Immature adolescents must be given usual protections. The Convention sets a legal limit on parental power to deny capable adolescents reproductive and sexual health services. The question whether an adolescent is a 'mature minor' must be decided by health service providers independently of parental judgment. The specific duties of government and health service providers to implement adolescent rights regarding their reproductive and sexual health needs are examined.

Adolescent↗