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PubMed2006

Assessing knowledge, exploring needs: a reproductive health survey of adolescents and young adults in Pakistan.

RATIONALE & OBJECTIVE: The sexual and reproductive health (SRH) needs of adolescents have increased over the last few years, but are largely unmet. Lack of involvement of youth in the programs and limitations of the mass media in a conservative milieu are some of the issues. Our objectives were to assess the baseline SRH knowledge and to suggest interventions based on needs with regard to SRH promotion, so that the level of existing services could be upgraded. METHODS: A cross-sectional survey was conducted in 20 villages of Lahore, in which 400 adolescents and young adults were interviewed using a semi-structured questionnaire. Respondents were equally divided in gender in all villages, using stratified random sampling. RESULTS: Adolescents and young adults do have some knowledge of SRH issues. Males are relatively more knowledgeable than females about puberty (M = 68%; F = 58%), pregnancy (M = 55%; F = 43%), family planning (M = 62%; F = 50%) and sexually transmitted infections (M = 56%; F = 44%). Yet, a large majority needs clarification on their concepts and perceptions. They believe that having sound SRH knowledge will promote mother & child health and family health. CONCLUSION: Peers, media and a family doctor could be the acceptable source of information on SRH. Life skills programs to increase unmarried girls' cognitive skills and young men's involvement in such programs is a must. Involving families and communities will enhance the effectiveness of youth programs.

Adolescent↗
PubMed2005

Demand for and accessibility to reproductive health service of urban floating population.

The demand for knowledge of productive health and the current status of productive health services provided by relevant governmental institutions were qualitatively and quantitatively studied. The study identified the key factors that influenced the demand for the productive health services and results of the services. It also discussed the effective approaches to control, planning and sustainable development of the reproductive health services for the floating populations.

Adolescent↗
PubMed1992

A reallocation of rights in industries with reproductive health hazards.

The U.S. Supreme Court ruling in United Automobile Workers versus Johnson Controls prohibits hiring policies that exclude fertile women from industries posing reproductive health risks to workers and fetuses. Many toxic substances that threaten the developing fetus also pose risks to adult male and female workers. Exclusionary employment policies are socially undesirable for the following reasons: they may lead to worse reproductive outcomes if the indirect effects of lower wages and less adequate health insurance in the alternative available jobs are considered. Second, the effect of such policies could damage the individual woman's overall well-being through its economic impact and her potential loss in autonomy. Third, occupational segregation into less hazardous but lower-paying jobs reinforces gender stereotypes that are restrictive to women. The Supreme Court ruling in the Johnson Controls case reaffirms the importance of the Civil Rights Act as both a shield against unfair treatment for individual women and a commitment to eradicate sexist attitudes and economic inequality throughout society.

Employment↗
PubMed2004

[Reproductive health: some data and reflections].

Respect for human rights goes beyond the concept of reproductive health. The right to a responsible, satisfactory and safe sex life and the right to choose the number of children means that we must also concern ourselves with such concepts as fertility, unwanted pregnancy and assisted reproduction. Spain has one of the lowest birth rates in the world, with 1.24 children per woman. Data from a recent national survey showed that 7.2% of Spanish women are at risk for an unwanted pregnancy, either due to failure to use contraceptive measures or to use of poorly efficient measures. The abortion ratio, which has been increasing since 1992, was about 7 per 1000 women in 2001. On the other hand, although more and more couples are consulting with problems of sterility, the public health services do not appear to be covering their requirements.

Contraception↗
PubMed1989

Consanguinity and reproductive health in Iraq.

This study investigated the consanguinity rate of 233 families with severely disturbed reproductive health, and compared it to that of 227 families with normal (moderate) levels of reproductive wastage and to that of 155 families with no reproductive disturbance. The results showed that the inbreeding coefficients of the three groups of families were 0.0358, 0.0241 and 0.0208, respectively. Furthermore, the rate of congenital malformations was found to be highly correlated with the consanguinity rate of these families.

Abortion, Spontaneous↗
PubMedDate not supplied

Knowledge, attitudes and practices of secondary-school pupils in Oman: II. reproductive health.

We examined the knowledge, attitudes and practices of Omani adolescents with regard to reproductive health in a nationally representative secondary school-based sample of 1670 boys and 1675 girls. Through a self-administrated questionnaire the adolescents were asked about puberty, marriage, birth spacing and AIDS and sexually transmitted infections. Only half of the sample knew the changes at puberty of their own sex, while even fewer knew the changes in the opposite sex. Girls were inclined significantly towards later age of marriage than boys. The mean number of children desired by the sample was 4.9. About two-thirds of the adolescents had a positive attitude toward modern contraceptive methods and intended to use them in the future. Knowledge of fertility period was poor as was knowledge of AIDS and sexually transmitted infections. There was a high rate of approval (80%) of female genital cutting by both sexes.

Adolescent↗
PubMed1995

Reproductive health clinic raided and closed in Bogota, Colombia.

On December 17, armed criminal investigative forces acting under the direction of Colombia's secretary and deputy secretary of health, brutally raided the main clinic of the Orientame reproductive health care federation in Bogota, Colombia. Allegedly responding to charges that the clinic was providing abortions, investigators entered the clinic without warning, brandishing automatic weapons. Once inside, they threatened and physically assaulted patients and clinic staff, destroyed office equipment, broke down doors, and ordered the clinic to close. Since its founding in 1977, Orientame has become Colombia's second largest non-governmental family planning organization. The federation, consisting of three clinics, provides a full range of obstetric, gynecological, and information services, including family planning counseling, cancer screening, treatment for sexually transmitted diseases, prenatal care, adoption placement and counseling, and treatment of incomplete abortion. Serving approximately 250,000 women in its 17 years of operation, Orientame has a sliding fee scale and often waives costs for women who are unable to pay. Were Orientame to close its doors permanently, women facing complications from unsafe abortions but unable to pay private doctors would be forced to go to public hospitals and risk arrest. Despite the country's prohibition of abortions not necessary to save a woman's life, an estimated 288,400 Colombian women underwent abortions in 1989; 57,680 were hospitalized for complications from unsafe or incomplete procedures.

Abortion, Induced↗
PubMed1993

Exposure to hazardous substances and reproductive health. Agency for Toxic Substances and Disease Registry.

The extent to which environmental or occupational chemical exposures affect reproductive health remains largely unknown. Teratogenic effects usually take place during critical periods of organogenesis. Common concerns of patients include the possible effects of drinking contaminated water on the fetus as well as the breast-fed infant, and the possible effects of a chemical exposure on fertility and pregnancy.

Animals↗
PubMed2001

Explaining discrepancies in reproductive health indicators from population-based surveys and exit surveys: a case from Rwanda.

OBJECTIVES: Reproductive health programmes often need exit surveys and population-based surveys for monitoring and evaluation. This study investigates why such studies produce discrepant estimates of condom use, sexual behaviour and condom brand knowledge, and discusses the implications for future use of exit surveys for programme monitoring. METHODS: Logistic regression is used to explain differences between a household survey of 1295 persons and an exit survey among a random sample of 2550 consumers at retail outlets in RWANDA: RESULTS: Discrepancies in ever use of condoms and risky sexual behaviours are due to differences in socioeconomic status of the two samples. After controls, exit surveys at most outlet types have the same results as the household survey. Only exit surveys at bars, nightclubs and hotels yield significantly different estimates. However, the above-average knowledge of Prudence Plus condoms in the exit interviews is not attributable to socioeconomic or demographic variables, most likely because respondents have seen the product at the outlets. CONCLUSIONS: Information about condom use and sexual behaviour obtained from exit surveys appears as accurate as that obtained through household surveys. Nevertheless, exit surveys must be used cautiously. Because exit surveys may include wealthier and better-educated respondents, they are not representative of the general population. The composition of exit survey samples should be validated through existing household surveys. Comparisons across survey types are generally unadvisable, unless they control for sample differences. When generalizing to the population at large is not needed (e.g. for studies aimed at identifying the characteristics and behaviour of users of particular products or services), exit surveys can provide an appropriate alternative to household surveys.

Adolescent↗
PubMed1999

Reproductive health risk behavior survey of Colombian high school students.

PURPOSE: To establish rates of potentially risky sexual behaviors among Colombian adolescent students. METHODS: A total of 230 9th and 11th graders at a Colombian high school (69% of enrolled students) were anonymously surveyed about selected reproductive health behaviors using the Centers for Disease Control and Prevention's self-administered Youth Risk Behavior Survey. RESULTS: The response rate was >90%. The group was demographically representative of students. Twenty-nine percent of the group had engaged in intercourse (13% of 9th and 43% of 11th graders). Male gender [beta = 0.7873; odds ratio (OR) = 2.09; 95% confidence interval (CI) = 1.57-3.08] and increasing age (beta = 0.3413; OR = 1.41; 95% CI = 1.02-1.93) were each significantly correlated with prior sexual activity. Compared with females, males initiated intercourse at a significantly earlier age (beta = 0.284; p < .001) but did not report significantly more partners (means 2.1 vs. 1.4; chi2 = 1.25; p = .262). Forty-eight percent of respondents used contraception during their last encounter. Sixty-three percent used oral contraceptives or condoms, while the remainder used less effective methods. Contraceptive use did not correlate with gender or age. Age was significantly and positively correlated with use of alcohol prior to sexual activity (B = 1.28; OR = 3.6; 95% CI = 1.49-8.44). CONCLUSIONS: Compared with U.S. populations of similar ages, the Colombian group surveyed had fewer sexually active members, reported fewer partners, and used contraception with lower frequency.

Adolescent↗
PubMedDate not supplied

Methods for evaluating reproductive health of women.

The use of urine as a practical sample for evaluating the reproductive health of women in population-based studies is still being developed and applied. The adaptation of enzyme-based assays for the assessment of ovarian steroids as well as simple computer algorithms for interpreting the data both simplify and increase the efficiency of modern reproductive epidemiologic studies. New statistical approaches and new assays have extended physiologic monitoring to include early pregnancy, luteal phase function, and ovulation. While urine is superior to blood sampling, it is important to remember, however, the limitations of urinary hormone measurements when applying them alone to identify specific types of reproductive failure because variations in metabolism and excretion rate still contribute some uncontrollable variation. The rate of progress in developing and refining these methods over the past 5 years indicates that urinary methods of reproductive monitoring will continue to dominate this field and eventually be used in the clinic as well.

Abortion, Spontaneous↗
PubMed1995

Reproductive health in the American workplace.

Helping workers understand their risk of reproductive and developmental hazard exposure can be demanding for the occupational health nurse. The lack of conclusive information about most suspected hazards, as well as concern over job security and advancement, make this issue doubly challenging. Further research is needed to verify or rule out the suspected toxic effects of a hazard. The occupational health nurse must make every effort to keep abreast of new research findings and federal or state requirements related to reproductive hazards. The key to promoting the reproductive health of American workers is primary prevention (Bernhardt, 1990). Educating and counseling workers about reproductive hazards so that they can make informed decisions about their reproductive health, along with implementing engineering controls or ergonomic changes to reduce the risk of exposure, should be the goal of all occupational health programs.

Female↗
PubMed1994

Reproductive health. An ethical perspective.

There are a number of important ethical issues involved in the area of women's reproductive health care. Only a few of these could be covered in this short paper. Abortion is perhaps the most controversial issue of all and raises a number of ethical issues related to the rights of the woman versus the rights of the fetus. Since abortion is legal in the United States, the issue of the role of the obstetrician-gynecologist is discussed, particularly as related to the shortage of physicians willing to perform the procedure and the paucity of abortion training in obstetrics/gynecology residency programs. Other issues discussed include teen pregnancy, contraceptive research and pharmaceutical company contraceptive pricing strategies, high rates of maternal mortality in the developing world and human immunodeficiency virus and acquired immunodeficiency syndrome among women and children.

Abortion, Legal↗
PubMed2002

Infertility in South Africa: women's reproductive health knowledge and treatment-seeking behaviour for involuntary childlessness.

BACKGROUND: Infertility is a major reproductive health problem in Africa. This paper presents the findings of two studies which focus on the knowledge that infertile women have about fertility and the causes of infertility, their treatment-seeking behaviour and their expectations of an infertility clinic. METHODS: A total of 150 infertile women from a culturally diverse, urban community in South Africa participated in the two studies. Both qualitative and quantitative research methods were applied using in-depth, semi-structured interviews and structured questionnaires. RESULTS: The women who participated had little knowledge about human reproduction and modern treatment options for infertility. They were highly motivated to find treatment and accessed both traditional and modern health care. Treatment barriers within modern health care were identified. CONCLUSIONS: The importance of health education and counselling is recognized, and both need to be integrated into infertility management, particularly in the developing world. The introduction of clinical guidelines is recommended in order to overcome treatment barriers and improve the delivery of health services.

Adult↗