Situation analysis: assessing family planning and reproductive health services. Quality of care.
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Abortion, Induced↗
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Rights to sexual and reproductive health: the ICPD and the convention on the elimination of all forms of discrimination against women.
This article examines women's rights to sexual and reproductive health as recognized by the ICPD and expressed in the Women's Convention and other international human rights documents. Rights relating to reproductive and sexual health include the rights to life, liberty, and the security of the person; to health care and information; and to nondiscrimination in the allocation of resources to health services and in their availability and accessibility. Of central importance are the rights to autonomy and privacy in making sexual and reproductive decisions, as well as the responsibility of health care providers to ensure informed consent and confidentiality in relation to health services. The article presents country examples from States parties' periodic reports under the Women's Convention that reflect systemic violations of the above rights in varied forms.
Abortion, Induced↗
Improving midwives' knowledge and skills. JICA Reproductive Health Project. MCH / FP Center.
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Asia↗
Good reproductive health involves many services.
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Delivery of Health Care↗
Uncovering and responding to needs for sexual and reproductive health care among poor urban female adolescents in Nicaragua.
BACKGROUND: To meet the needs of female adolescents from low-income urban areas for sexual and reproductive health (SRH) care, vouchers providing free-of-charge access to SRH care at 19 primary care clinics were distributed in Managua, Nicaragua. These vouchers substantially increased the use of services, demonstrating that many adolescents are willing to use such services, if readily accessible. The voucher redemption made it possible to identify the nature of existing, but largely unmet, needs for SRH care. METHOD: The medical files from 3301 consultations with female adolescents were analysed using descriptive statistical methods and multiple logistic regression. RESULTS: Female adolescents presented SRH problems that merited medical attention. The mean number of problems presented was 1.5 per consultation: 34% of the vouchers were used for contraceptives, 31% for complaints related to sexually transmitted infection (STI) or reproductive tract infection (RTI), 28% for advice/counselling, 28% for antenatal check-up and 18% for pregnancy testing. A new category of health care users emerged: sexually active girls who were neither pregnant nor mothers and who sought contraceptives or STI/RTI treatment. Contraceptive use doubled among the sexually active non-pregnant voucher redeemers. Consultation with a female doctor younger than 36 years was associated with a higher chance of having contraceptives prescribed. CONCLUSION: Accessible and appropriate SRH care has the potential to make an important contribution to the increased contraceptive use, decreased risk of unwanted teenage pregnancies and decreased prevalence of STIs/RTIs among underserved adolescents. Once adolescents access the services, providers have a crucial role in ensuring current and continuing needs are met.
Adolescent↗
Toward an ecology of women's reproductive health.
Medical ecology has been one of the dominant theoretical strands in medical anthropology since the 1960s. It has come to be identified with a rather narrow range of research issues, concerning such matters as adaptation to climate and infectious disease, and has dealt with small-scale foraging societies. An ecological model has potential for dealing broadly with other health issues, in the case explored here, women's reproductive health, a topic that has frequently been approached from either a cultural or biological standpoint rather than the integrated one advocated here.
Anthropology↗
Post primary school teachers' view point on reproductive health and contraceptive practice among schoolgirls in Port Harcourt, Nigeria.
The view point of secondary school teachers on reproductive health, specifically, their attitude towards contraceptive practice among sexually active schoolgirls and general opinion on teenage pregnancy was examined. A sample survey of teachers was conducted in all the registered girls and mixed post primary schools in Port Harcourt. A substantial proportion of teachers were of the opinion that sexually active schoolgirls should not be encouraged to use contraceptives because they damage reproductive organs. A greater proportion (33.8%) of teachers was also of the opinion that schoolgirls should abstain from sex until they are married. This was closely followed by the suggestion that sexually active girls should use contraceptives (20.8%). The majority (48.3%) of teachers, however, advocated a sex education programme in the schools in order to prevent unwanted pregnancy.
Adolescent↗
[Ecological and ethical issues related to the protection of population reproductive health].
The legal and ethical issues related with the protection of population reproductive health, under the conditions of anthropogenic contamination of the environment, including the labor environment, are discussed in the article. A concept of pregnancy planning to ensure a healthy posterity under the mentioned conditioned was formulated. Documents of WHO, ILO and the EU experience in dealing with the issues in question are illustrated. An increasing role of social labor measurement as well as the evolution of law, i.e. civil, labor, and social law, as well as the right to unified medical-and-social insurance, are in the focus of attention. The prospects for a new WHO-ICF classification, as a social UNO classification, are pointed out. The sensitivity--susceptibility--vulnerability chain was analyzed, and a growing social context was underlined in it. The individual and team risks were considered, and the Code of professional ethics of hygienists was paid attention to.
Environment↗
Rural women's knowledge of AIDS in the higher prevalence states of India: reproductive health and sociocultural correlates.
This study aimed to identify socio-cultural and reproductive health correlates of knowledge about AIDS among rural women using multivariate analysis of 1998-1999 National Family Health Survey (NFHS) data from two Indian states, Maharashtra and Tamil Nadu, where the urban HIV prevalence is relatively high. Analysis using multiple logistic regression was undertaken, modelling women's knowledge of AIDS, of whether the disease can be avoided, and of effective means of protection. Although 47% of all rural women in Maharashtra were aware of AIDS only about 28% knew that one can avoid it, and only about 16% possessed correct knowledge about its transmission. In Tamil Nadu, where overall 82% of rural women had awareness of AIDS, about 71% knew that one can avoid the disease but only about 31% possessed correct knowledge about its transmission. In both states, women from socially and economically backward groups had lower odds both of having awareness of AIDS and knowledge of ways to avoid getting the disease. Associations with socio-cultural and reproductive variables and the impact of contact with family planning services differed in the two states. The spread of the epidemic to rural areas presents a need actively to disseminate AIDS related knowledge for health protection rather than waiting for knowledge to follow the appearance of the disease in communities. Approaches to health promotion that do not consider differing contextual factors are unlikely to succeed. In particular, innovative strategies to disseminate knowledge among disadvantaged population groups are needed.
Adolescent↗
Abortion legislation after Webster v. Reproductive Health Services: model statutes and commentaries.
The following Article analyzes the United States Supreme Court's examination of abortion rights in Webster v. Reproductive Health Services. The Article then proposes model statutes restricting abortion in light of the Webster decision. The Cumberland Law Review invites and encourages commentary on both sides of the issue.
Abortion, Illegal↗
Building families-Implementing balanced sexual and reproductive health: A Joint IFFS and ISA Scientific Statement.
One of the main initiatives of the World Health Organization (WHO) is the promotion of Sexual and Reproductive Health (SRH). Sexuality, infertility, and contraception are three interconnected pillars of SRH, each essential for achieving global equity in family planning and family building. This scientific Statement, jointly developed by the International Federation of Fertility Societies (IFFS) and the International Society of Andrology (ISA), advocates for inclusive, evidence-based care for all individuals and couples, regardless of geography or socioeconomic status. The Statement underscores the need to enhance practitioner and policymaker education to support access to infertility evaluations and treatments for both men and women and to promote the availability of comprehensive contraceptive services for all in need. The Statement addresses three core domains: sexuality, infertility, and contraception. It emphasizes a biopsychosocial approach to SRH, highlighting the complex interplay between sexual function and fertility. Infertility is a multifactorial condition requiring early, holistic, and multidisciplinary management, including integrated male and female evaluations, medically assisted reproduction, and fertility preservation strategies. Contraception is explored through the lens of global unmet needs, expanding options for male contraceptives, and the importance of socio-culturally sensitive education and counseling. The joint efforts of the IFFS and ISA call for couple-centered SRH, acknowledging the sociocultural and policy challenges that affect access to care in a region-specific manner. This Statement aims to serve as a clinical and advocacy guide for practitioners and stakeholders, reinforcing that reproductive autonomy and access to care are vital components and duties for policymakers when developing public health strategies.
contraception↗
Building Families-Implementing Balanced Sexual and Reproductive Health: A Joint IFFS and ISA Scientific Statement.
One of the main initiatives of the World Health Organization (WHO) is the promotion of Sexual and Reproductive Health (SRH). Sexuality, infertility, and contraception are three interconnected pillars of SRH, each essential for achieving global equity in family planning and family building. This scientific Statement, jointly developed by the International Federation of Fertility Societies (IFFS) and the International Society of Andrology (ISA), advocates for inclusive, evidence-based care for all individuals and couples, regardless of geography or socioeconomic status. The Statement underscores the need to enhance practitioner and policymaker education to support access to infertility evaluations and treatments for both men and women and to promote the availability of comprehensive contraceptive services for all in need. The Statement addresses three core domains: sexuality, infertility, and contraception. It emphasizes a biopsychosocial approach to SRH, highlighting the complex interplay between sexual function and fertility. Infertility is a multifactorial condition requiring early, holistic, and multidisciplinary management, including integrated male and female evaluations, medically assisted reproduction, and fertility preservation strategies. Contraception is explored through the lens of global unmet needs, expanding options for male contraceptives, and the importance of socio-culturally sensitive education and counseling. The joint efforts of the IFFS and ISA call for couple-centered SRH, acknowledging the sociocultural and policy challenges that affect access to care in a region-specific manner. This Statement aims to serve as a clinical and advocacy guide for practitioners and stakeholders, reinforcing that reproductive autonomy and access to care are vital components and duties for policymakers when developing public health strategies.
contraception↗
Micronutrients and reproductive health issues: an international perspective.
Micronutrients may have a role in enhancing reproductive health of women living in the developing world. Two illustrative micronutrients, zinc and vitamin A, have received some attention in this regard. Numerous animal experiments and observational studies suggest the potential role of zinc deficiency in labor and delivery-related complications such as premature rupture of membrane, placental abruption, preterm labor and inefficient uterine contraction. These associations have not been confirmed in supplementation studies. Zinc does not appear to be a limiting factor in intrauterine growth in the developing world, contrary to some evidence of its suggested benefit among women residing in industrialized countries. One study in Nepal found that maternal vitamin A or beta-carotene supplementation reduces pregnancy-related mortality but not infant mortality. These findings are corroborated by observations of the significantly higher risk of mortality among night-blind women compared to non-night-blind women long after the termination of pregnancy and the resolution of night blindness. Maternal multiple micronutrient supplementation needs more careful evaluation before its use in large-scale programs. Two recent trials indicated that a prenatal multiple micronutrient supplement provides no added advantage over iron and folate in reducing outcomes such as low birth weight and probably no survival benefit. Data are also suggestive that adding zinc may negate the beneficial effect of iron and folic acid on birth weight. Research is needed to further our understanding of nutrient-nutrient interactions.
Female↗
Reproductive health counseling at pregnancy testing: a pilot study.
OBJECTIVES: To pilot brief reproductive health counseling for women obtaining pregnancy testing in a managed-care setting who did not desire pregnancy. METHODS: Women received counseling, access to contraception and a booster call at 2 weeks. Changes in contraceptive behavior were evaluated. RESULTS: Of 85 women who completed counseling, 58 (68%) completed follow-up. Participants reported that counseling was useful at baseline (94%) and follow-up (83%). The staff found the intervention important (100%) and implementation feasible (100%). Forty-one percent of participants improved their use of contraception (from no use or from less effective use to more effective use). Twenty-nine percent continued highly effective use and 9% recessed from highly effective use. Of 22 participants with risk of sexually transmitted disease, 3 (14%) began using condoms consistently, while 1 (5%) continued using condoms consistently. CONCLUSIONS: Counseling at pregnancy testing was well accepted by the staff and participants. Observed behavioral changes suggest that this intervention may be effective in increasing effective use of contraception.
Adolescent↗
Relationship of anxiety, stress, and psychosocial development to reproductive health.
In this review of articles on prenatal stress, anxiety, development, and reproductive health outcomes in pregnancy, the focus is on recent research in which the relationships among the major types of stressors, anxiety, and development, on the one hand, and maternal, fetal, and neonatal problems or complications, on the other hand, were examined. Available and effective treatment measures, although limited, are introduced and discussed at length in a follow-up article. Recommendations for policy development based on current research and treatment methods and directions for future research and treatment studies are presented in a third article.
Animals↗
Sexuality and reproductive health care in São Paulo, Brazil.
Gender inequalities influence the quality of reproductive health care in many ways. The lack of gender sensitivity in the provision of activities related to illness prevention and health care, as well as women's difficulties in controlling their own sexuality, are fundamental aspects of this problem. Two recent studies carried out in São Paulo, Brazil, examined factors associated with the use of methods to control fertility and to prevent STDs/AIDS. Both studies identified a strong resistance to extending the use of barrier methods among the female population, even though doing so is particularly important to help contain the spread of HIV/AIDS among women in this country. Findings include that gender-sensitive strategies must be developed to stimulate the process of behavior change. These strategies should be combined with holistic approaches to women's health care, so that prenatal and gynecological care, family planning, cervical cancer screening, and STDs/AIDS prevention are included within the same program.
Adolescent↗
Reproduction, risk and reality: family planning and reproductive health in northern Vietnam.
In collaboration with the National Committee for Population and Family Planning, a study was conducted in 1994 in two Vietnamese communes to provide community level information on women's reproductive health and behaviors. A survey of 504 rural and 523 urban women collected five-year histories of reproduction, contraception, abortion and symptoms of Reproductive Tract Infections (RTI). This analysis focuses on the relationships between women's individual characteristics, use of family planning and abortion, and reported RTI symptoms. The findings reveal that IUDs do not raise women's likelihood of experiencing RTI symptoms in either commune. A recent abortion, however, strongly increases women's likelihood of having RTI symptoms in the rural commune, while low-socioeconomic status is associated with RTI symptoms in the urban commune.
Adult↗