PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Reproductive Health Services”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 559 records · Page 31Linked to original sources
PubMed2002

Providers of primary care to homeless women in Los Angeles County.

Little is known about the access barriers homeless women face at the sites where they are most likely to receive primary health care. To investigate this issue, we administered a mail survey to administrators and clinicians at clinic sites that were actual or potential providers of primary health care to homeless women in Los Angeles County in 1997. The response rate was 65%. Ninety percent of the homeless women seen by responding sites were seen at only 34% of those sites (designated as "major providers"). Deficiencies were identified in several structural and process characteristics that enhance access to and quality of care for homeless women, including clinician training in care for homeless persons; formal screening for homeless status and associated risk factors; and on-site provision of comprehensive health services, including mental health, substance abuse, reproductive health, and ancillary services. Some, but not all, deficiencies were less severe at major providers. Our results suggest that, although providers of care to homeless women share challenges faced by many safety net providers, there are several policy interventions that could improve access to and quality of care for homeless women.

Community Health Centers↗
PubMed2005

Diversity in sexual health: problems and dilemmas.

The increase in migrant populations in western Europe has led to specific problems and dilemmas in the area of sexual and reproductive health and service provision. In general, these problems and dilemmas can be divided into four categories: (1) epidemiology of diseases and risk factors; (2) psychosocial and cultural aspects; (3) communication; and (4) moral and ethical dilemmas. Regarding epidemiology, there is an increased prevalence in migrant groups of unwanted pregnancy and abortion, HIV/STDs, and sexual violence. Effective contraceptive use is hampered by knowledge deficits, uncertain living conditions, ambivalence regarding the use of contraceptives, and problems accessing (information on) contraception. Psychosocial and cultural aspects relate to the norms and attitudes individuals and groups have regarding the family, social relationships, sexuality, and gender. These norms and attitudes have an impact on the sexual and reproductive choices people make and the possibilities and restrictions they feel in this respect. Problems in communication concern not only language but also communication styles, the way patients present their problems, and the expectations they have from the service provider. Communication problems inevitably lead to a lower quality of care. Moral and ethical dilemmas arise where cultures collide, for example regarding sexuality education and virginity problems. Two examples of practical situations in which migrant patients ask for help with sexual or reproductive health problems will be described.

Adolescent↗
PubMed2004

Effectiveness of an NGO primary health care programme in rural Bangladesh: evidence from the management information system.

This paper considers evidence of the effectiveness of a non-governmental organization (NGO) primary health care programme in rural Bangladesh. It is based on data from the programme's management information system reported by 27 partner NGOs from 1996-2002. The data indicate relatively high coverage has been achieved for reproductive and child health services, as well as lower infant and child mortality. On the basis of a crude indicator of socio-economic status, the programme is poverty-focused. There is good service coverage among the poorest one-third and others, and the infant and child mortality differential has been eliminated over recent years. A rapid decline in infant mortality among the poorest from 1999-2002 reflects a reduction in neonatal mortality of about 50%. Allowing for some under-reporting and possible misclassification of deaths to the stillbirths category, neonatal mortality is relatively low in the NGO areas. The lower child and maternal mortality for the NGO areas combined, compared with estimates for Bangladesh in recent years, may at least in part be due to high coverage of reproductive and child health services. Other development programmes implemented by many of the NGOs could also have contributed. Despite the limited resources available, and the lower infant and child mortality already achieved, there appears to be scope for further prevention of deaths, particularly those due to birth asphyxia, acute respiratory infection, diarrhoeal disease and accidents. Maternal mortality in the NGO areas was lower in 2000-02 than the most recent estimate for Bangladesh. Further reduction is likely to depend on improved access to qualified community midwives and essential obstetric care at government referral facilities.

Bangladesh↗
PubMed2005

Involving service users in sexual health service development.

OBJECTIVES: The study objectives were to document users' experience of family planning and genitourinary medicine clinics and young people's services working within the time constraints of rapid service development and maximising the utility of this data for service improvement. METHODS: A total of 93 users of family planning and genitourinary medicine services participated in one of 13 facilitated discussion groups. Some 61% of the sample were women, 64% were aged over 25 years and 47% were Black Caribbean or Black African. The clinic journey was drawn on a wall covered with paper and participants added their comments during the discussion. RESULTS: Users had similar concerns across the three service types. Users perceived some receptionists and clinicians as un-friendly and judgmental and described others providing a quality service often under difficult conditions. Reception was insufficiently confidential, waiting environments uncomfortable, waiting times long and more information was needed throughout service use. CONCLUSIONS: Those elements of sexual health services known to be a source of dissatisfaction among young people may also be a problem for older service users and are experienced across different types of sexual health service. This preliminary study demonstrates the feasibility and acceptability of focus group evaluations of sexual health services. This approach generates qualitative data from relatively large numbers of users within a time-scale consistent with service development.

Adolescent↗
PubMed2006

User involvement in the provision of HIV services: some lessons learned from a user group in an HIV treatment centre in London.

In recent years attention has been focused on the greater participation of health service users in the identification of health service need, service design and delivery and service evaluation. This approach attempts to improve communication between health professionals and the health communities they serve in order to deliver more effective services. The establishment of user groups in HIV services has been one approach by which clinicians have attempted to establish ways that service users could help in the improvement of clinical services. This research article describes the process in the involvement of a user group in an east London HIV service. It describes the challenges that faced both the service users and the clinical staff and it analyses the factors that led to the discontinuation of the user group. The article discusses factors and challenges that must be addressed before meaningful user involvement in HIV services can be established.

HIV Infections↗
PubMed2005

A qualitative study of women's use of emergency contraception.

BACKGROUND: While the use of emergency contraception (EC) is becoming more widespread in Australia, little is known about the reasons for, and the social context of, this use. METHODS: In order to explore the use of EC from the perspective of users, a qualitative study was conducted with women presenting to one of three health care settings in Melbourne, Australia for EC. RESULTS: Thirty-two women ranging in age from 18 to 45 years were interviewed. While a number of themes were discussed with the women, this paper reports on four 'types of users' of EC identified from the data. 'Controllers' experienced failure of their contraceptive method and were very uncomfortable needing EC. They changed their contraceptive strategy in an attempt to avoid needing EC in the future. 'Thwarted controllers' were similar to controllers except that they could not improve their contraceptive strategy due to medical or social limitations. 'Risk takers' saw the use of EC as a component of their overall contraceptive strategy. They did not rely on EC regularly, but were comfortable to use it occasionally when the need arose. A final group of women were 'caught short' by a sexual experience that was unplanned and therefore they did not manage to use their chosen contraceptive strategy. CONCLUSIONS: The findings from this study challenge the assumptions that are often made about the users of EC and highlight the need to acknowledge the different ways that women make sense of, and make decisions about, contraception.

Adolescent↗
PubMed2002

Provision of sexual health services to adolescent enrollees in Medicaid managed care.

OBJECTIVES: This Seattle project measured sexual health services provided to 1112 Medicaid managed care enrollees aged 14 to 18 years. METHODS: Three health maintenance organizations (HMOs) that provide Medicaid services for a capitated rate agreed to participate. These included a non-profit staff-model HMO, a for-profit independent practice association (IPA), and a non-profit alliance of community clinics. Analyses used health maintenance organizations' administrative data, chart reviews, and Medicaid encounter data. RESULTS: Health maintenance organizations provided primary care to 54% and well care to 20% of Medicaid enrollees. Girls were more likely than boys to have their sexual history taken or to be given condom counseling. Only 27% of sexually active girls were tested for chlamydia, with significantly lower rates of testing among those who spoke English as a second language. The nonprofit staff-model plan outperformed the for-profit independent practice association on most measures. CONCLUSIONS: Substantial room for improvement exists in sexual health services delivery to adolescent Medicaid managed care enrollees.

Adolescent↗
PubMed2001

Adolescents' use of emergency contraception provided by Washington State pharmacists.

STUDY OBJECTIVE: To increase knowledge about adolescents who obtained emergency contraceptive pills (ECP) directly from a pharmacist without first contacting a physician. DESIGN: Cross-sectional self-administered survey. SETTING: Fifteen randomly selected pharmacies providing ECP in western Washington State. PARTICIPANTS: Adolescents 15-21 years old (n = 126) who obtained ECP directly from a pharmacist. OUTCOME MEASURES: Responses to a 20-item questionnaire examining adolescents' reasons for seeking care from a pharmacist, need for additional medical evaluation, risk for not receiving additional medical care, and satisfaction with care provided by the pharmacist. RESULTS: The most common reasons for using the pharmacy were convenience (44%), lack of knowledge about alternatives (38%), and privacy (31%). If the pharmacy service were not available, 58% said they would see a doctor, 22% said they would wait to see if they got pregnant, and 20% did not know. Based on self-report, 81% of adolescents needed a new method of ongoing contraception, an evaluation for sexually transmitted disease, or both. Among these adolescents, 36% had risk factors for not receiving this care. Adolescents were satisfied with the pharmacy service; 94% said they would recommend the service to a friend. CONCLUSIONS: ECP provision by pharmacists is a useful way to increase access to emergency contraception. However, many adolescents using ECP need additional medical care. Programs designed to increase ECP access should use these opportunities to link adolescents with more comprehensive reproductive health care services.

Adolescent↗
PubMed1989

Corporate response to reproductive hazards in the workplace: results of the Family, Work, and Health Survey.

As a part of a Family, Work, and Health Survey, we analyzed corporate practices regarding reproductive hazards in the chemical and electronics manufacturing industries in Massachusetts. Over half of the 198 firms surveyed had at least one of four designated reproductive hazards in use. Among these firms, 57% provided information on reproductive risks to employees. Nearly 20% of companies excluded certain classes of workers from substances, work areas, or occupations on the basis of reproductive health concerns. Another 13% offered voluntary transfers to workers concerned about reproductive risks. With one exception, all restrictions and transfers applied to women only--even when scientific evidence supports potential reproductive risk to both sexes. Analysis of corporate practices by industry type, and size, gender stratification, and unionization of the workforce was carried out. Results of the survey raise important public health concerns about corporate practices that may restrict women's job opportunities on the basis of reproductive status while underprotecting the health of male workers.

Adolescent↗
PubMed2003

Evidence-based fertility treatment: what do we mean?

This article explores the meaning of 'evidence-based fertility treatment' and reviews the relevance of evidence-based health care to the proposed National Service Framework (NSF) for Infertility Services. It summarizes the principles of systematic literature reviewing and proposes an agenda for those developing the NSF. This agenda is illustrated by data from a preliminary review by the authors. The main strength of the proposed NSF lies in the National Evidence-Based Clinical Guidelines but the main weakness lies in the lack of rigorous positive evidence underpinning these guidelines. The NSF team will have to appraise, enhance, extend and synthesize these reviews. The lack of an NSF would threaten the future effectiveness and cost-effectiveness of infertility services in the UK.

Adult↗
PubMedDate not supplied

The sexual health needs of people with learning disabilities.

The sexual health of people with learning disabilities raises important management and practice issues for health services, and should be examined in the context of the current policy emphasis on advocacy, person-centred services and social inclusion (Department of Health, 2001). People with learning disabilities may have limited access to mainstream health services, and sexual health and genitourinary medicine (GUM) services are no exception (DoH, 2001; 1998). They are often excluded from society, either because they are 'segregated' within specialist support services in the community or because they live in isolation with carers, and health and social care models do not always join up locally to meet their needs.

Persons with Disabilities↗
PubMed2002

Problems experienced by pregnant student nurses in the Republic of South Africa.

The purpose of this quantitative exploratory descriptive survey was to determine which problems pregnant student nurses experienced in the Northern Province (NP) of the Republic of South Africa (RSA). Questionnaires were completed by 93 pregnant student nurses in this province, indicating that the majority of them became pregnant because they lacked knowledge about contraceptives, emergency contraceptives, and termination of pregnancy (TOP) services (legalized in the RSA since 1996). They delayed seeking prenatal care and experienced tiredness, dizziness, and vaginal bleeding during the first trimester. Most pregnant student nurses encountered academic problems as a result of their pregnancies. These and other results indicate a dire need to educate the student nurses about contraceptives and about accessing reproductive health care services. If the students do not utilize the available services themselves, it is unlikely that they will advise their clients to utilize such services.

Adolescent↗
PubMed1978

A health program for commercial dairy herds. 3. Changes in reproductive performance.

A health program service was implemented on 9 farms, for periods ranging up to 7 years. Reproductive performance was substantially improved, when performance indicators were compared with values for the herds prior to commencement of the service. On average, the mean calving to conception intervals for the herds were reduced by 24 days over their periods of participation in the program, from an initial value of 119 days. The intercalving interval was reduced by an average of 27 days. This improvement was associated with a reduction in the mean dry period length of 20 days, from an initial value of 117 days. There was a tendency for the lactation lengths to be reduced to an undesirable extent due to slow adaptation by management to the improvement in reproductive performance, but the problem was corrected late in the study. The improvement in performance was attributed to improved oestrus detection, correction of temporary nutritional deficiencies, and prompt treatment of genital tract disorders in individual animals. Results for a range of performance indicators related to reproductive function are reported in detail.

Abortion, Veterinary↗
PubMed2004

Ten years of democracy in South Africa: documenting transformation in reproductive health policy and status.

The advent of democracy in South Africa in 1994 created a unique opportunity for new lows and policies to be passed. Today, a decade later, South African reproductive health policies and the laws that underwrite them are among the most progressive and comprehensive in the world in terms of the recognition that they give to human rights, including sexual and reproductive rights. This paper documents the changes in health policy and services that have occurred, focusing particularly on key areas of sexual and reproductive health: contraception, maternal health, termination of pregnancy, cervical and breast cancer, gender-based and sexual violence, HIV/AIDS and sexually transmitted infections and infertility. Despite important advances, significant changes in women's reproductive health status are difficult to discern, given the relatively short period of time and the multitude of complex factors that influence health, especially inequalities in socio-economic and gender status. Gaps remain in the implementation of reproductive health policies and in service delivery that need to be addressed in order for meaningful improvements in women's reproductive health status to be achieved. Civil society has played a major role in securing these legislative and policy changes, and health activist groups continue to pressure the government to introduce further changes in policy and service delivery, especially in the area of HIV/AIDS.

Democracy↗
PubMedDate not supplied

The nurse role in implementing the national sexual health strategy.

The rising incidence of sexually transmitted infections (STIs) in England and a recognition that looking after our sexual health is essential for long-term well-being, prompted the government to unveil its first sexual health and HIV strategy (Department of Health, 2001). The government's aim is to modernize sexual health and HIV services and help primary care trusts (PCTs) to address the rise in STIs and HIV, and to reduce unintended pregnancies.

Adolescent↗