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PubMed2006

Integration of sexual and reproductive health in the medical curriculum in Pakistan.

OBJECTIVE: To assess the knowledge of medical practitioners regarding management of selected reproductive tract infections, diagnosis of sexual dysfunction and identification of sexual abuse and to assess the attitudes and practices of health care providers regarding sexual and reproductive rights in order to recommend areas that need to be incorporated in a sexual and reproductive health curriculum. DESIGN: A cross-sectional survey. PLACE AND DURATION OF STUDY: From March to August 2003 in the District Turbat of Balochistan, Pakistan. SUBJECT AND METHODS: Selected indicators of knowledge, attitudes and practices regarding sexual and reproductive health of primary care physicians were assessed using a pre-tested questionnaire and formal/informal interviews. Variables were identified from the literature and previous in-depth interviews, and then formulated into respective questions. A Lichert scale marked from 1 to 5 was used for categorizing responses into agreed, neutral and disagreed. Descriptive statistics were computed using SPSS version 10 for windows. Qualitative interviews were translated and transcribed and analyzed according to pre-judged and emerging themes. RESULTS: Out of 45 physicians interviewed, nearly half scored less than 50% in the knowledge section. Attitudes and practices assessed suggested a tendency to be judgmental, gender/rights discriminatory and with little provision for enabling clients to make their own decisions, so essential for quality sexual health service provision. CONCLUSION: Keeping in view the importance of the sexual health issues and a lack of ability of health care providers to handle it effectively, deficient areas of sexual health must be integrated into the medical curriculum. Medical educators have the responsibility to train physicians and other health professionals in the core competencies to improve the sexual and reproductive health of their communities.

Adult↗
PubMed1996

Population and women's reproductive health: an international perspective.

This paper gives a brief overview of current world population or demographic issues, followed by a discussion of the ICPD proceedings and various notable aspects of the ICPD Programme of Action. It then focuses on six of the most pressing reproductive health concerns facing women today: gender inequalities, access to contraceptive services, sexually transmitted diseases (including HIV), maternal mortality, unsafe abortion, and adolescent pregnancy. Because the ICPD Programme of Action is intended to have far-reaching consequences for each of these issues, it is taken as a focal point of analysis.

Abortion, Legal↗
PubMed2000

Semen quality and reproductive health of young Czech men exposed to seasonal air pollution.

This study of male reproductive health in the Czech Republic resulted from community concern about potential adverse effects of air pollution. We compared young men (18 years of age) living in Teplice, a highly industrialized district with seasonally elevated levels of air pollution, to those from Prachatice, a rural district with relatively clean air. Surveys were scheduled for either late winter, after the season of higher air pollution, or at the end of summer, when pollution was low. Participation included a physical examination, donation of a semen sample, and completion of a questionnaire on health, personal habits, and exposure to solvents and metals through work or hobby. Analysis of data from 408 volunteers showed that the men from Teplice and Prachatice were similar in physical characteristics, personal habits, and work- or hobby-related exposures. Sixty-six percent (272) of these men donated a single semen sample for routine semen analysis, computer-aided sperm motion analysis, and sperm chromatin structure assay. The mean (median) sperm concentration and sperm count were 61. 2 (44.0) million/mL semen and 113.3 (81.5) million, respectively, and were not associated with district of residence or period of elevated air pollution. However, periods of elevated air pollution in Teplice were significantly associated with decrements in other semen measures including proportionately fewer motile sperm, proportionately fewer sperm with normal morphology or normal head shape, and proportionately more sperm with abnormal chromatin. These results suggest that young men may experience alterations in sperm quality after exposure to periods of elevated air pollution, without changes in sperm numbers.

Adolescent↗
PubMed1986

A model clinic approach to the reproductive health concerns of the mentally handicapped.

An interdisciplinary model clinic for the consideration of reproductive health and sexuality concerns in a noninstitutionalized, mentally handicapped population is presented. Common concerns of this population group and their management are discussed. A program for menstrual hygiene control was developed using a combination of hormonal medication and home-based behavior modification training. Group sexuality counseling was provided for both patients and their families to enhance the avoidance of sexual abuse, the understanding of sexual development, and intrafamily communication. An ethics committee, composed of persons within the community, offered advice in questions of contraception and/or sterilization.

Adolescent↗
PubMed1998

Parents' viewpoint on reproductive health and contraceptive practice among sexually active adolescents in the Port Harcourt local government area of Rivers State, Nigeria.

The viewpoint of parents on reproductive health, specifically their attitude towards contraceptive use among sexually active adolescent daughters and general opinion on adolescent pregnancy, was examined. A sample survey of parents of pregnant adolescents in Port Harcourt was conducted. A greater proportion (79.1%) of parents did not favour the use of contraceptives by sexually active adolescents because according to their parents, contraception kills. Also, most (87.8%) parents did not usually discuss sexual matters with their adolescent girls. However, the majority (93.2%) of parents would want a sex education programme in schools in order to prevent unwanted pregnancy.

Adolescent↗
PubMedDate not supplied

Physical, mental, and reproductive health of Québec women physicians.

In order to address the personal and professional characteristics as well as the physical, mental, and reproductive health of women physicians, a survey was mailed to a random sample of 3,000 women and men physicians in the province of Québec, Canada. The data obtained from women physicians were compared with those from men physicians and with available data on a comparable subgroup of professional women. The sociodemographic and health data highlight the physical and mental health status of women physicians. These data, which provide a global picture of Québec women physicians, indicate that in spite of the challenges, they seem to reconcile their professional and parental activities without major repercussions on their physical and mental health.

Adult↗
PubMed2005

[The experience in Uruguay: the Bill for the Defense of Reproductive Health].

This article reports on the recent Uruguayan experience with the debate on sexual and reproductive rights. While the Bill for the Defense of Reproductive Health did not pass in the Senate, both the prior process and the subsequent impacts have been relevant, generating a social debate that is still incipient but has involved the mass media, academia, and the political parties and spawning a discussion that has involved both houses of Congress for the first time. Within this context, an outstanding role has been played by NGOs devoted to the defense of women's rights (especially sexual and reproductive), who established a coordinating body that included the trade union movement, which supported the bill. The debate also led to international ties that projected it beyond the country's borders. The article briefly reviews the background and basis for the bill, the research it entailed, and the international commitments assumed by Uruguay, before concluding with a summary of the bill itself and the challenges it poses in terms of sexual and reproductive rights, specifically with regard to voluntary interruption of pregnancy.

Abortion, Illegal↗
PubMed1998

The use of reproductive health services by young women in Australia.

Retrospective analysis of clinical data from 8 State/Territory Family Planning Organizations (FPO) was conducted to determine the reproductive health services used by young women. Between July, 1996 and June, 1997, a total of 185, 879 client visits were recorded at FPO clinics, of which 72,303 (39%) were by young clients. The results showed that young women tended to use a combined oral pill, postcoital pill and spermicides more than those older than 25 years (p<0.05). Young women were also more likely to use services for management of sexually transmitted disease (STD), counselling for HIV, STD and sexual assault (p<0.05). However, there were considerable differences among the 3 groups of women: Aboriginal clients, those who did not speak English at home, and those who were born outside Australia. This study confirms that young women are using FPO services especially for emergency/postcoital contraception, STD screening and counselling. FPOs need to continue their existing role of providing reproductive and sexual health services catering to the need of this special segment of the population.

Adolescent↗
PubMed1995

Hypnosis in reproductive health care: a review and case reports.

Hypnosis has many applications in the field of reproductive health care. This paper describes its use in the treatment of sexual dysfunction, urinary incontinence, chronic pelvic pain, hyperemesis gravidarum, and pain relief in labor and delivery. Four case reports are used for illustration. Misconceptions about the risks and benefits of hypnosis are discussed. Information about training for clinicians in hypnosis is described.

Adolescent↗
PubMed2003

The reliability and validity of willingness to pay surveys for reproductive health pricing decisions in developing countries.

This paper examines the reliability, theoretical and predictive validity of willingness to pay (WTP) surveys for setting prices for reproductive health services in developing countries. Four country applications were conducted; the surveys used similar elicitation methods (a series of three closed-ended questions to cover the range of target prices, followed by a single open ended question to elicit maximum WTP) and samples of current or potential users of family planning, gynecology, and prenatal care services. In all four applications, respondents were able to understand WTP questions and responded with high levels of internal consistency. Evidence supporting theoretical validity was also found in all surveys. Higher income and more highly motivated users had higher WTP than lower income and less motivated users. Predictive validity was assessed in one study. Services utilization predicted by a WTP survey was compared with actual post-price increase utilization. Adding WTP to information already possessed by program managers resulted in a threefold increase in ability to predict utilization change as a result of a price increase, and in nearly half of cases predicted percent change in utilization was within 10% of observed change. WTP surveys when used for reproductive services price setting appear reliable and valid, and improve a program manager's ability to predict client responses to price changes.

Attitude to Health↗
PubMed1994

Sexual behaviour, reproductive health and contraceptive use among adolescents and young adults in Mbale District, Uganda.

Results from a survey of adolescents and young adults in Mbale District in Uganda are presented. First sexual experience among female and male respondents occurs at quite an early age, 15 years for males and 16 years for females. Most respondents claimed to have received information on reproductive health. The accuracy of these self-assessments was rather poor as a relatively small proportion of the respondents could identify the safe period in a woman's menstrual cycle. The incidence of adolescent pregnancy is generally high and slightly higher in rural than in urban areas. A relatively large proportion of pregnancies occur out of wedlock. The respondents' contraceptive knowledge was quite good but many still engaged in unprotected sexual relations. The most commonly used methods were the condom and the pill. The main reasons given for non-use were lack of knowledge about contraceptives, beliefs that they were not safe, and their non-availability. This calls for improvements in family planning education and in accessibility of contraceptives.

Adolescent↗
PubMed2001

Major reproductive health characteristics in male Gulf War Veterans. The Danish Gulf War Study.

INTRODUCTION: The male reproductive system could have been affected by various hazardous agents and exposures during and in the aftermath of the Persian Gulf War scenario. We tested the hypothesis that, compared to controls, male Danish Gulf War Veterans would have adverse sex hormone levels, decreased fertility, and a larger proportion of adverse pregnancy outcomes including spontaneous abortions, congenital diseases and malformations. MATERIAL AND METHODS: A cross-sectional study was performed during the period January 1997 to January 1998 which included 661 male subjects who had been deployed in the Persian Gulf within the period August 2 1990 until December 31 1997. A control group of 215 Danish military men, not deployed in the Gulf region, was selected with random matching by age and type of work. All participants underwent clinical and paraclinical examinations, and had an interview based on a previously completed comprehensive questionnaire. A venous blood sample was drawn to determine serum concentrations of the follicle-stimulating hormone (FSH), the luteinizing hormone (LH), testosterone, serum hormone binding globulin (SHBG), and inhibin B. The free androgen index was calculated from testosterone and SHBG levels. RESULTS: No differences were found between Gulf War Veterans and controls with respect to any of the reproductive hormones measured, nor with respect to fertility or the prevalence of spontaneous abortions, congenital diseases or malformations among the offspring. Also cohabitational characteristics were similar. CONCLUSION: Based on the results of this study we conclude that the biological reproductive health of male Danish Gulf War Veterans seemed to be unaffected by their engagement in the post war peace-keeping mission.

Adult↗
PubMedDate not supplied

Reproductive health practices in women attending an inner-city STD clinic.

Inner-city sexually transmitted disease (STD) clinics may provide an important access point to educate patients at high risk for reproductive health problems and their peers in order to effect behavior change. In a pilot study to evaluate the knowledge, health practices, and behavior of patients attending an inner-city STD clinic, 116 women were surveyed concerning their reproductive and general health practices, their knowledge of both, and screened for STDs. The women who had a history of first intercourse before age 18 years had a statistically significant higher rate of infection. Thirty-three percent of the patients did not know the purpose of a Pap smear; of the 67% who stated that they did know, only 30% actually stated that a Pap smear is used to detect cancer. STD clinics offer a unique opportunity for the integration of health care services and education to a group of high-risk patients.

Adolescent↗
PubMed1987

Reproductive health: Caribbean women in New York City, 1980-1984.

"People from the Caribbean represent one of the largest immigrant groups in New York City. This study focuses on the reproductive health of first generation Caribbean immigrants. Birth and death certificate data were used to generate descriptive profiles of risk-factor prevalence and reproductive outcomes to Caribbean and comparison populations." Data on single live births for 1980-1984 take into consideration ethnic differences, age, place of birth, parity, mother's education, method of payment for health care, prenatal care, and birth weight.

Age Factors↗
PubMed2002

[Investigation of reproductive health status and service needs among unmarried young men in Changshu].

OBJECTIVES: To investigate the status of pre-marital reproductive health education, sexual psychology behavior, contraception and pre-marital abortion in unmarried young men to get the correct way for pre-marital guidence and education. METHODS: The survey adopted the society-psychology-behavior methodology. Five hundred and ten objects who had pre-marital sexual living history were investigated randomly. RESULTS: The reasons of making sexual pre-marital relations were thinking marriage and curiosity. 81.2% of them thought the best way of contraception is to use the condom. 34.8% of them used the prevenception when they had the first sexual experience. 39.7% of the objects adopted contraceptions every time, and 27.1% of the objects made the women pregnancy which resulted 22.4% women using the IUD for contraception. 63.6% of them thought the main reason of not using contraception was the fear to get trouble. The main source of contraceptives was pharmacy (59.8%). CONCLUSIONS: This survey suggested that the prevalence of pre-marital sexual behavior is relatively high in Changshu. It should be taken several methods to give unmarried young men the reproductibe education.

Adult↗