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PubMedDate not supplied

Body/self awareness and interpersonal communications: fundamental components of reproductive health awareness.

To protect and advocate for their own reproductive health, people of all ages can greatly benefit from enhanced body/self awareness and strong interpersonal communication skills. Body/self awareness and interpersonal communications, along with gender awareness and the integration of sexuality, are the fundamental components of a new approach to obtaining high quality health called reproductive health awareness.

Awareness↗
PubMed2003

HIV/AIDS in the shadows of reproductive health interventions.

In December 1999, the Tanzanian president declared HIV/AIDS a national disaster. By the time the National Policy on HIV/AIDS was released in 2001, an estimated 750,000 women of reproductive age were infected. Yet in spite of the impact of HIV on reproductive health, AIDS and reproductive health programmes are still thought of and implemented through separate channels, to the detriment of both. However, although AIDS remains in the shadows of reproductive health interventions, the lack of AIDS talk does not lessen the impact of the disease on people's lives. During the course of my participant observations in maternal and child health/family planning (MCH/FP) clinics collected during 25 months of fieldwork in 10 clinics in Morogoro, Ruvuma and Kilimanjaro Regions, I rarely heard about AIDS. This article attempts to analyse why. Historically competing bureaucracies in MCH/FP and gender and development are not easily unified with a vertical HIV/AIDS control programme under the umbrella of "reproductive health". HIV/AIDS cannot merely be inserted into existing family planning programmes, re-named "reproductive health" programmes. As the AIDS epidemic is transformed through new technologies, reproductive health policy and priorities will be called into question and force us to look at the state of the African health care system, networks of care-giving, and how individuals and communities fail when there is no socio-economic safety net.

Communicable Disease Control↗
PubMed1987

Young women's reproductive health survey.

A survey of reproductive health issues was conducted on 15 year old Hutt Valley secondary school girls by means of a self-administered anonymous questionnaire. The prevalence of sexual intercourse in the sample was 29%. Sixteen percent of the sexually active respondents used no method of contraception. Knowledge of reproductive health facts and contraception was poor both amongst sexually experienced and inexperienced respondents. Twenty-six percent relied on peers for this information, with mothers, teachers and books being other important sources cited. Respondents requested more information on sexually transmitted diseases, contraception and sexual relationships. Most would like this information more readily accessible. Preferred sources of information mentioned were: parents, books, films/videos, family planning clinics and friends.

Adolescent↗
PubMed1996

Male reproductive health and environmental xenoestrogens.

Male reproductive health has deteriorated in many countries during the last few decades. In the 1990s, declining semen quality has been reported from Belgium, Denmark, France, and Great Britain. The incidence of testicular cancer has increased during the same time incidences of hypospadias and cryptorchidism also appear to be increasing. Similar reproductive problems occur in many wildlife species. There are marked geographic differences in the prevalence of male reproductive disorders. While the reasons for these differences are currently unknown, both clinical and laboratory research suggest that the adverse changes may be inter-related and have a common origin in fetal life or childhood. Exposure of the male fetus to supranormal levels of estrogens, such as diethlylstilbestrol, can result in the above-mentioned reproductive defects. The growing number of reports demonstrating that common environmental contaminants and natural factors possess estrogenic activity presents the working hypothesis that the adverse trends in male reproductive health may be, at least in part, associated with exposure to estrogenic or other hormonally active (e.g., antiandrogenic) environmental chemicals during fetal and childhood development. An extensive research program is needed to understand the extent of the problem, its underlying etiology, and the development of a strategy for prevention and intervention.

Animals↗
PubMed2004

HIV/AIDS, sexual and reproductive health: intersections and implications for national programmes.

HIV and AIDS have a myriad of effects on sexual and reproductive health and rights, and sexual and reproductive health services are critical for women and men with HIV and AIDS. Yet there has been a dearth of visible, in-depth mainstream attention to the links between sexual and reproductive health and prevention and treatment of HIV/AIDS since the early 1990s among major stakeholders internationally. This paper argues that access to essential sexual and reproductive health care should be provided in HIV/AIDS prevention, care and treatment programmes, and appropriate forms of prevention and treatment of HIV/AIDS should be included in all sexual and reproductive health services as a public health priority, particularly in sex education, family planning and abortion services, pregnancy-related care, sexually transmitted infection (STI) services and services addressing sexual violence. The paper analyzes existing barriers to linking and integrating these services, e.g. at country level due to the traditional training of health workers to implement vertical programmes, separate sources of funding for National AIDS Control Programmes and sexual and reproductive health services, and in international donor programme and UN agency structures. This paper calls for leadership to be exercised by donors, all the UN agencies working together, governments, health service managers and providers, NGOs and advocates in both fields to develop and implement these linkages at country level. Finally, it is crucial that UNAIDS, WHO, UNFPA, UNICEF, the Global Fund to Fight AIDS, TB and Malaria and those working to reach the targets set by the Millennium Development Goals come on board in these efforts.

Cooperative Behavior↗
PubMed2000

Use of reproductive health services among young men, 1995.

PURPOSE: To analyze the extent to which teenage males receive preventive reproductive health services and identify demographic and health factors associated with their receipt. METHODS: Bivariate and multivariate analyses of nationally representative data from the 1995 National Survey of Adolescent Males were conducted using logistic regression to determine which factors predicted whether teenagers had a physical examination and whether they discussed reproductive health topics with a medical professional, had a human immunodeficiency virus (HIV) test, or had a sexually transmitted disease (STD) test. RESULTS: Although 71% of males aged 15-19 years received a physical examination in the past year, only 39% of them received any of the three reproductive health services. Less than one-third of all young men discussed reproductive health with their doctor or nurse. Among sexually experienced males, one-sixth had an STD test and one-quarter an HIV test. In multivariate analysis, males who had a physical examination were more likely to have an STD or HIV test, but were no more likely to discuss reproductive health topics. Minority and low-income youth were more likely to receive these reproductive health services, as were young men with multiple sex partners and those with health problems. CONCLUSIONS: In general, the proportion of teenage men receiving reproductive health services is low, although levels are higher among minority youth and certain groups at risk. To reduce rates of teen pregnancy and STDs, physicians and nurses need to incorporate reproductive health care into routine health services for teenage males, as well as females.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Occupational reproductive health risks.

The potentially harmful effects on women of certain workplace exposures are widely appreciated, and steps to control these have included legislative efforts such as right-to-know laws of well as corporate policies mandating selective restriction of fertile women, which are illegal under federal civil rights laws. This chapter reviews the various occupational health risks reproductive women face in the workplace but also considers the effects of other genetic, medical, social, infectious, and environmental factors which may be of even greater concern than most occupational factors.

Female↗
PubMed2005

Norway at ICPD+10: international assistance for reproductive health does not reflect domestic policies.

Norway has a long history of good reproductive health care, with some of the world's best reproductive health indicators. Early reduction of maternal mortality, good services for abortion, contraception and sexually transmitted diseases, a low rate of adolescent pregnancies and a low number people with HIV are examples, achieved through an integrated, publicly provided and funded health care package. Official Norwegian development assistance started in 1952. Emphasis on family planning assistance dates back to 1966, making Norway one of the most consistent donors to family planning and reproductive health programmes. Norway also had a high profile at the International Conference on Population and Development and strongly supported the Programme of Action. Since then, while multilateral support in these areas has stayed high, bilateral support has been downscaled. Overall, international assistance does not reflect the domestic approach to reproductive health services. Norway has given little development support to improvement of maternity services, avoided the issues of abortion and post-coital contraception, and passed up opportunities to support adolescent services. Prevention and treatment of infertility has hardly been an issue. Revitalisation of the reproductive rights discourse in Norway could provide a basis for the protection of reproductive health care domestically, and for policy discussions and decisions in relation to Norway's development assistance.

Congresses as Topic↗
PubMed2002

Short-changing reproductive health.

Health sector reformers, particularly the economists among them, are prone to reject calls for more financial support for reproductive health as "special pleading" even when the argument is made that reproductive health is a basic human right. Reproductive health is not alone in this. Up to now, however, the idea that the right to reproductive health care should take precedence over other health rights has not been put on the table. Economists ask how much interventions cost and whether there is enough money to cover all of the interventions being proposed; if not, they ask which interventions will be funded. Basing decisions about spending for health on evidence about the burden of disease is a way of using the principles of economics to improve health systems performance. However, this methodology poses some special problems for reproductive health as pregnancy is not a disease. Further, economic principles are not the only valid criteria for decisions about health care funding. Those who are concerned about reproductive health need to remain vigilant about the impact of these changes and counter with their own evidence on how they may or may not be contributing to improved health system performance and to reproductive health and rights.

Decision Making, Organizational↗
PubMed2002

Analysis of women's reproductive health situation in Bida Emirate of Niger State, Nigeria.

This study examined the reproductive health situation in Bida Emirate of Nigeria, with a view to advancing frontiers in communication support for reproductive health education. Multi-stage sampling technique was used to randomly select 1,200 women respondents that participated in the study. Data was obtained on reproductive health and rights, reproductive health history, and personal and social characteristics of respondents. Data analyses showed that majority (68.1%) of respondents were aware of existing methods of birth control, while 31.9% were not. On the use of methods, abstinence, breastfeeding and use of condoms recorded 42.8%, 22% and 40.3% respectively. Respondents rarely used traditional methods of birth control. Forty five per cent blamed their husbands for not using family planning methods. Surprisingly, 84.8% of respondents had no idea of what HIV/AIDS is all about; only 13% and 3.1% could describe gonorrhoea and AIDS respectively. Results further revealed that there is no significant relationship between personal and social characteristics of respondents (religion, marital status and position, etc) and their attitude towards family planning. However, rural and urban women significantly differed in their health status (t = 0.2729; p < 0.001). Similar trend was observed for attitude towards family decision-making (t = 40; p < 0.001), sexuality and STD prevention (t = 90; p < 0.001), and maternity/childcare (t = 0.001; p < 0.001). In conclusion, the study reveals that there is a wide gap between social expectations of women's reproductive health and cultural realities in Nupeland of Nigeria. The study thus recommends, among others, the need for sustainable safe motherhood campaign in culture bound societies.

Adolescent↗
PubMed2003

Incorporating sexual and reproductive health care in the medical curriculum in developing countries.

Medical educators have a responsibility to train physicians and other health professionals in the core competencies needed to improve the sexual and reproductive health of their communities. Yet sexual and reproductive health care is significantly under-represented in the basic educational curriculum for medical and other health professionals, as well as in continuing medical education and professional development programmes for practising physicians and other health professionals. The Commonwealth Medical Association Trust is developing a model curriculum on sexual and reproductive health that can be integrated into undergraduate medical education and used with appropriate amendments for continuing medical education. This paper outlines topics for inclusion in the curriculum and three strategies for incorporating core components of sexual and reproductive health in the curriculum--by developing themes that can be integrated into the general curriculum in a multi-disciplinary fashion, adding free-standing modules as electives, and delegating cross-cutting issues such as gender issues and adolescent reproductive health to courses run by other departments. It argues for the use of problem-solving and case-based learning methodologies, as well as lectures, as the best way to teach health professionals how to provide information, counselling and support for sexual and reproductive health, as well as to cover the range of prevention and treatment needs of women and men seeking these services.

Curriculum↗
PubMed1999

What does society expect from health policy makers in reproductive health?

Family planning, and preventive measures generally, are very important for the health of a society. Despite this, official policy in Hungary has not given them enough support and recognition in recent years. The latest "act for the protection of the fetus," issued some years ago, dealt mainly with abortion; shortly thereafter, the health insurance stopped subsidizing the cost of contraceptives. Nowadays, patients must pay full price not only for condoms, but for pills, IUDs and even sterilization. The cost of preventing unwanted pregnancies became high; for many today, the reliable, modern methods are almost unaffordable. This situation is more than strange in a country with such high numbers and rates of induced abortion. Another problem is that service providers have too few resources. In the wake of the political and fiscal changes that have taken place since the early 1990s, the state does not have enough money to meet the need for this type of preventive work. There are still few non-governmental organizations (NGOs) operating in Hungary: those that there are do not yet have the financial strength to sponsor these initiatives. In light of these circumstances, decision makers concerned to reverse the disturbing demographic trends should concentrate on changing the health policy.

Family Planning Services↗
PubMed1998

[Reproductive health: integral part of human development].

The concept of reproductive health has changed throughout the years until it has come to be understood as a constant that goes beyond biological concerns and is related to the values, culture, and personal fulfillment of each human being. It encompasses, therefore, a wide range of action in individual and family life as well as in the collective development of populations. Promoting and maintaining reproductive health requires quality services with equitable access. PAHO has cooperated in this field with Member States for over 30 years, during which maternal and child mortality has diminished, the notion of integral adolescent health has been disseminated, the subject has been added to professional health curriculums, pertinent activities have been integrated into the health services, and new data have been gathered to inform policies and activities on reproductive health. The present situation of national health sector reforms presents a unique opportunity for approaching anew old problems related to reproductive health, to examine policies and strategies, and to implement changes that reaffirm the commitments made in international forums.

Female↗
PubMedDate not supplied

Managed care and reproductive health.

Managed care poses special challenges to midwives providing reproductive health care. This is owing to the sensitive nature of issues surrounding reproductive health and aspects of managed care that may impede a woman's ability to obtain continuous, confidential, and comprehensive care from the provider of her choice. Variations across payers (ie, Medicare, Medicaid, and commercial insurers) regarding covered benefits and reimbursement of midwifery services also may create obstacles. Furthermore, some physicians and managed care organizations are embracing policies that threaten the ability of midwives to function as primary health care providers for women. Despite these hurdles, midwives have the potential to remain competitive in the new marketplace. This article underscores the importance of being knowledgeable about legislation and policy issues surrounding the financing of midwifery services, quality performance measurement for HMOs as they pertain to reproductive health, and discussions regarding which clinicians should be defined as primary care providers.

Adolescent↗
PubMedDate not supplied

Reproductive health awareness: an integrated approach to obtaining a high quality of health.

The Georgetown University Institute for Reproductive Health has evolved a multi-dimensional approach to reproductive health education which has grown from their work in natural family planning and fertility awareness. This cohesive approach offers help to community, educational, and health organizations in providing knowledge and skills development in body/self-care, gender awareness, sexuality, and interpersonal communications.

Aging↗
PubMed2003

Integrating reproductive health services in a reforming health sector: the case of Tanzania.

Universal access to comprehensive reproductive health services, integrated into a well-functioning health system, remains an unfulfilled objective in many countries. In 2000-2001, in Tanzania, in-depth interviews were conducted with central level stakeholders and focus group discussions held with health management staff in three regional and nine district health offices, to assess progress in the integration of reproductive health services. Respondents at all levels reported stalled integration and lack of synchronisation in the planning and management of key services. This was attributed to fear of loss of power and resources among national level managers, uncertainty as to continuation of donor support and lack of linkages with the Health Sector Reform Secretariat. Among reproductive health programmes, sexually transmitted infection (STI) control alone retained its vertical planning, management and implementation structures. District-level respondents expressed frustration in their efforts to coordinate STI service delivery with other, more integrated programmes. They reported contradictory directives and poor communication channels with higher levels of the Ministry of Health; lack of technical skills at district level to undertake supervision of integrated services; low morale due to low salaries; and lack of district autonomy in decision-making. Integration requires a coherent policy environment. The uncoordinated and conflicting agendas of donors, on whom Tanzania is too heavily reliant, is a major obstacle.

Attitude of Health Personnel↗
PubMed2004

Reproductive health needs of adolescent males in rural Pakistan: an exploratory study.

This is the first study done to explore reproductive health needs of adolescent males in Pakistan. The purpose of this exploratory study was to obtain qualitative information on existing knowledge and perceptions on puberty and reproductive health needs and to identify effective communication channels for imparting reproductive health education to adolescent males. Seventy-eight unmarried adolescent males participated in the survey, conducted through in-depth interviews by a semi-structured questionnaire using purposive sampling, in eight rural districts in Pakistan. The study pointed out that there existed misconceptions and gaps in knowledge regarding puberty and reproductive health. These young men also have poor knowledge about sexually transmitted diseases dynamics. The communication between parents or siblings on the said issues was found to be poor and they mainly get information from friends followed by the media. The majority showed interest in getting quality information. Multiple entry points and settings can be used to enhance access to information and services. In-school adolescents could be effectively approached through teachers and peer group. Out-of-school adolescents could be reached via media and local health care providers. The results imply that there is a dire need for reproductive health education for adolescent males and suggestions from this study might be utilized when initiating any reproductive health educational service for male adolescents in rural areas in Pakistan. Future efforts should thus focus on assuring access to timely, comprehensive and high-quality reproductive health education for all teenagers and reducing gaps in access related to gender and school attendance.

Adolescent↗